Detection of dengue-4 virus in pune, western india after an absence of 30 years - its association with two severe cases.docVIP

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Detection of dengue-4 virus in pune, western india after an absence of 30 years - its association with two severe cases.doc

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Detection of dengue-4 virus in pune, western india after an absence of 30 years - its association with two severe cases

Ceciliaetal.VirologyJournal2011,8:46 /content/8/1/46 SHORT REPORT OpenAccess Detectionofdengue-4virusinpune,western indiaafteranabsenceof30years-its associationwithtwoseverecases DayarajCecilia ,MahadeoBKakade ,AshaBBhagat ,JoyprashantVallentyne ,AnandSingh,JayashriAPatil1, 1* 1 1 1 1 ShankarMTodkar ,SunithaBVarghese,PareshSShah1 2 3 Abstract Background:Differenceinseverityofdengueoutbreakshasbeenrelatedtovirusserotype,genotypeandclades withingenotypes.Tillthe1980s,IndiaandSriLankareportedlownumberofdenguehemorrhagicfever(DHF) casesdespitecirculationofallfourserotypesofdenguevirus(DENV).Sincethe1990stheoccurrenceofDHFhas increased.TheincreasehasbeenattributedtochangesinviruslineageespeciallywithregardtoDENV-2and DENV-3.DENV-1hasbeenassociatedwithdenguefever(DF)outbreaksandDENV-4reportshavebeenrare.The emergenceofDENV-4wasreportedrecentlyin2003inDelhiandin2007inHyderabad.ThelastreportofDENV-4 fromMaharashtrawasin1975fromAmalner. Results:WereportonthedetectionofDENV-4inPune,Maharashtraafteranabsenceofalmost30years.Two casesweredetectedin2009-10,serotypedbymultiplexreversetranscriptasepolymerasechainreaction(RT-PCR). Boththecaseswererecordedasseveredengue(Category3)requiringintensivecareunit(ICU)leveloftreatment. Dependingonthehemagglutinationinhibiting(HI)antibodytitresthe2009casewascharacterizedasaprimary infectionandthe2010caseasasecondaryinfection.Boththecasespresentedplasmaleakageandneither showedanykindofhaemorrhage.The2009casesurvivedwhilethe2010casewasfatal.Anisolatewasobtained fromthe2009case.Basedonenvelope(E)genesequenceanalysis,thevirusbelongedtogenotypeIofDENV-4, andclusteredwithisolatesfromIndiaandSriLankaandwasdistantfromtheisolatesfromThailand.The nucleotideandaminoaciddiversityoftheEgeneoftheIndianisolatesincreasedfrom1996to2007to2009in contextoftheEgenesequencesofotherisolatesbelongingtogenotypeI. Conclusion:TheincreasingdiversityinthecirculatingDENV-4callsforclosemonitoringoftheDENV-4serotype. Approach sera.Theinfectedcellsareexaminedforthepre