Epidemiological and clinical characteristics of Dengue virus outbreaks in two regions of China, 2014 - 2015

PLoS One. 2019 Mar 5;14(3):e0213353. doi: 10.1371/journal.pone.0213353. eCollection 2019.

Abstract

Dengue virus (DENV), a single-stranded RNA virus and Flaviviridae family member, is transmitted by Aedes aegypti and Aedes albopictus mosquitoes. DENV causes dengue fever, which may progress to severe dengue. Hospital-based surveillance was performed in two Chinese regions, Guangzhou and Xishuangbanna, during the dengue epidemics in 2014 and 2015, respectively. Acute-phase serum was obtained from 133 patients with suspected dengue infections during the peak season for dengue cases. Viremia levels, virus sero-positivity, serotype distribution, infection type, clinical manifestations and virus phylogenetics were investigated. Of the 112 DENV-confirmed cases, 92(82.14%) were IgM antibody-positive for DENV, and 69(51.88%) were positive for DENV RNA. From these cases, 47(41.96%) were classified as primary infections, 39(34.82%) as secondary infections and 26 (23.21%) as undetermined infections. The viremia levels were negatively correlated with IgM presence, but had no relationship with the infection type. DENV-1 genotype V dominated in Guangzhou, whereas the DENV-2 Cosmopolitan genotype dominated in Xishuangbanna, where fewer DENV-1 genotype I cases occurred. DENV-2 is associated with severe dengue illness with more serious clinical issues. The strains isolated during 2014-2015 are closely related to the isolates obtained from other Chinese regions and to those isolated recently in Southeast Asian countries. Our results indicate that DENV is no longer an imported virus and is now endemic in China. An extensive seroepidemiological study of DENV and the implementation of vector control measures against it are now warranted in China.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aedes / virology
  • Aged
  • Aged, 80 and over
  • Animals
  • Antibodies, Viral / blood
  • Child
  • China / epidemiology
  • Dengue / epidemiology*
  • Dengue / prevention & control
  • Dengue / virology
  • Dengue Virus / classification
  • Dengue Virus / genetics
  • Dengue Virus / immunology
  • Disease Outbreaks*
  • Endemic Diseases / prevention & control
  • Female
  • Genes, Viral
  • Genotype
  • Humans
  • Male
  • Middle Aged
  • Mosquito Vectors / virology
  • Phylogeny
  • Serogroup
  • Young Adult

Substances

  • Antibodies, Viral

Grants and funding

This work was supported by CAMS Innovation Fund for Medical Sciences (CIFMS) (2017-12M-3-017), National major instrument and equipment research and development program (2016YFF0103103), Chinese Postdoctoral Science Foundation (2018M630193), Priority Project on Infectious Disease Control and Prevention (2018ZX10711001-004-001, 2018ZX10713002-001-008). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.