Unusual dengue virus 3 epidemic in Nicaragua, 2009.
The four dengue virus serotypes (DENV1-4) cause the most prevalent mosquito-borne viral disease affecting humans worldwide. In 2009, Nicaragua experienced the largest dengue epidemic in over a decade, marked by unusual clinical presentation, as observed in two prospective studies of pediatric dengue...
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ftdoajarticles:oai:doaj.org/article:147e88be498a496ea56b95705aadc5e7 2023-05-15T15:14:05+02:00 Unusual dengue virus 3 epidemic in Nicaragua, 2009. Gamaliel Gutierrez Katherine Standish Federico Narvaez Maria Angeles Perez Saira Saborio Douglas Elizondo Oscar Ortega Andrea Nuñez Guillermina Kuan Angel Balmaseda Eva Harris 2011-11-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0001394 https://doaj.org/article/147e88be498a496ea56b95705aadc5e7 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC3210753?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0001394 https://doaj.org/article/147e88be498a496ea56b95705aadc5e7 PLoS Neglected Tropical Diseases, Vol 5, Iss 11, p e1394 (2011) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2011 ftdoajarticles https://doi.org/10.1371/journal.pntd.0001394 2022-12-31T03:49:40Z The four dengue virus serotypes (DENV1-4) cause the most prevalent mosquito-borne viral disease affecting humans worldwide. In 2009, Nicaragua experienced the largest dengue epidemic in over a decade, marked by unusual clinical presentation, as observed in two prospective studies of pediatric dengue in Managua. From August 2009-January 2010, 212 dengue cases were confirmed among 396 study participants at the National Pediatric Reference Hospital. In our parallel community-based cohort study, 170 dengue cases were recorded in 2009-10, compared to 13-65 cases in 2004-9. In both studies, significantly more patients experienced "compensated shock" (poor capillary refill plus cold extremities, tachycardia, tachypnea, and/or weak pulse) in 2009-10 than in previous years (42.5% [90/212] vs. 24.7% [82/332] in the hospital study (p<0.001) and 17% [29/170] vs. 2.2% [4/181] in the cohort study (p<0.001). Signs of poor peripheral perfusion presented significantly earlier (1-2 days) in 2009-10 than in previous years according to Kaplan-Meier survival analysis. In the hospital study, 19.8% of subjects were transferred to intensive care, compared to 7.1% in previous years - similar to the cohort study. DENV-3 predominated in 2008-9, 2009-10, and 2010-11, and full-length sequencing revealed no major genetic changes from 2008-9 to 2010-11. In 2008-9 and 2010-11, typical dengue was observed; only in 2009-10 was unusual presentation noted. Multivariate analysis revealed only "2009-10" as a significant risk factor for Dengue Fever with Compensated Shock. Interestingly, circulation of pandemic influenza A-H1N1 2009 in Managua was shifted such that it overlapped with the dengue epidemic. We hypothesize that prior influenza A H1N1 2009 infection may have modulated subsequent DENV infection, and initial results of an ongoing study suggest increased risk of shock among children with anti-H1N1-2009 antibodies. This study demonstrates that parameters other than serotype, viral genomic sequence, immune status, and sequence of ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Meier ENVELOPE(-45.900,-45.900,-60.633,-60.633) PLoS Neglected Tropical Diseases 5 11 e1394 |
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Directory of Open Access Journals: DOAJ Articles |
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English |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Gamaliel Gutierrez Katherine Standish Federico Narvaez Maria Angeles Perez Saira Saborio Douglas Elizondo Oscar Ortega Andrea Nuñez Guillermina Kuan Angel Balmaseda Eva Harris Unusual dengue virus 3 epidemic in Nicaragua, 2009. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
The four dengue virus serotypes (DENV1-4) cause the most prevalent mosquito-borne viral disease affecting humans worldwide. In 2009, Nicaragua experienced the largest dengue epidemic in over a decade, marked by unusual clinical presentation, as observed in two prospective studies of pediatric dengue in Managua. From August 2009-January 2010, 212 dengue cases were confirmed among 396 study participants at the National Pediatric Reference Hospital. In our parallel community-based cohort study, 170 dengue cases were recorded in 2009-10, compared to 13-65 cases in 2004-9. In both studies, significantly more patients experienced "compensated shock" (poor capillary refill plus cold extremities, tachycardia, tachypnea, and/or weak pulse) in 2009-10 than in previous years (42.5% [90/212] vs. 24.7% [82/332] in the hospital study (p<0.001) and 17% [29/170] vs. 2.2% [4/181] in the cohort study (p<0.001). Signs of poor peripheral perfusion presented significantly earlier (1-2 days) in 2009-10 than in previous years according to Kaplan-Meier survival analysis. In the hospital study, 19.8% of subjects were transferred to intensive care, compared to 7.1% in previous years - similar to the cohort study. DENV-3 predominated in 2008-9, 2009-10, and 2010-11, and full-length sequencing revealed no major genetic changes from 2008-9 to 2010-11. In 2008-9 and 2010-11, typical dengue was observed; only in 2009-10 was unusual presentation noted. Multivariate analysis revealed only "2009-10" as a significant risk factor for Dengue Fever with Compensated Shock. Interestingly, circulation of pandemic influenza A-H1N1 2009 in Managua was shifted such that it overlapped with the dengue epidemic. We hypothesize that prior influenza A H1N1 2009 infection may have modulated subsequent DENV infection, and initial results of an ongoing study suggest increased risk of shock among children with anti-H1N1-2009 antibodies. This study demonstrates that parameters other than serotype, viral genomic sequence, immune status, and sequence of ... |
format |
Article in Journal/Newspaper |
author |
Gamaliel Gutierrez Katherine Standish Federico Narvaez Maria Angeles Perez Saira Saborio Douglas Elizondo Oscar Ortega Andrea Nuñez Guillermina Kuan Angel Balmaseda Eva Harris |
author_facet |
Gamaliel Gutierrez Katherine Standish Federico Narvaez Maria Angeles Perez Saira Saborio Douglas Elizondo Oscar Ortega Andrea Nuñez Guillermina Kuan Angel Balmaseda Eva Harris |
author_sort |
Gamaliel Gutierrez |
title |
Unusual dengue virus 3 epidemic in Nicaragua, 2009. |
title_short |
Unusual dengue virus 3 epidemic in Nicaragua, 2009. |
title_full |
Unusual dengue virus 3 epidemic in Nicaragua, 2009. |
title_fullStr |
Unusual dengue virus 3 epidemic in Nicaragua, 2009. |
title_full_unstemmed |
Unusual dengue virus 3 epidemic in Nicaragua, 2009. |
title_sort |
unusual dengue virus 3 epidemic in nicaragua, 2009. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2011 |
url |
https://doi.org/10.1371/journal.pntd.0001394 https://doaj.org/article/147e88be498a496ea56b95705aadc5e7 |
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ENVELOPE(-45.900,-45.900,-60.633,-60.633) |
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Arctic Meier |
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Arctic Meier |
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Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 5, Iss 11, p e1394 (2011) |
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http://europepmc.org/articles/PMC3210753?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0001394 https://doaj.org/article/147e88be498a496ea56b95705aadc5e7 |
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https://doi.org/10.1371/journal.pntd.0001394 |
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PLoS Neglected Tropical Diseases |
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e1394 |
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