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Harsha G, Anish TS, Rajaneesh A, Prasad MK, Mathew R, Mammen PC, Ajin RS, Kuriakose SL. Dengue risk zone mapping of Thiruvananthapuram district, India: a comparison of the AHP and F-AHP methods. GEOJOURNAL 2022; 88:2449-2470. [PMID: 36157197 PMCID: PMC9483355 DOI: 10.1007/s10708-022-10757-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/06/2022] [Indexed: 05/12/2023]
Abstract
Dengue fever, which is spread by Aedes mosquitoes, has claimed many lives in Kerala, with the Thiruvananthapuram district bearing the brunt of the toll. This study aims to demarcate the dengue risk zones in Thiruvananthapuram district using the analytical hierarchy process (AHP) and the fuzzy-AHP (F-AHP) methods. For the risk modelling, geo-environmental factors (normalized difference vegetation index, land surface temperature, topographic wetness index, land use/land cover types, elevation, normalized difference built-up index) and demographic factors (household density, population density) have been utilized. The ArcGIS 10.8 and ERDAS Imagine 8.4 software tools have been used to derive the risk zone maps. The area of the risk maps is classified into five zones. The dengue risk zone maps were validated using dengue case data collected from the Integrated Disease Surveillance Programme portal. From the receiver operating characteristic (ROC) curve analysis and the area under the ROC curve (AUC) values, it is proved that the F-AHP method (AUC value of 0.971) has comparatively more prediction capability than the AHP method (AUC value of 0.954) in demarcating the dengue risk zones. Also, based on the comparison of the risk zone map with actual case data, it was confirmed that around 82.87% of the dengue cases occurred in the very high and high-risk zones, thus proving the efficacy of the model. According to the dengue risk map prepared using the F-AHP model, 9.09% of the area of Thiruvananthapuram district is categorized as very high risk. The prepared dengue risk maps will be helpful for decision-makers, staff with the health, and disaster management departments in adopting effective measures to prevent the risks of dengue spread and thereby minimize loss of life.
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Affiliation(s)
- G. Harsha
- School of Fishery Environment, Kerala University of Fisheries and Ocean Studies, Kochi, Kerala India
| | - T. S. Anish
- Department of Community Medicine, Government Medical College, Thiruvananthapuram, Kerala India
| | - A. Rajaneesh
- Department of Geology, University of Kerala, Thiruvananthapuram, India
| | - Megha K. Prasad
- Department of Remote Sensing, Bharathidasan University, Tiruchirappalli, Tamil Nadu India
| | - Ronu Mathew
- Department of Remote Sensing, Bharathidasan University, Tiruchirappalli, Tamil Nadu India
- Kerala State Emergency Operations Centre, Kerala State Disaster Management Authority, Thiruvananthapuram, India
| | - Pratheesh C. Mammen
- Kerala State Emergency Operations Centre, Kerala State Disaster Management Authority, Thiruvananthapuram, India
| | - R. S. Ajin
- Kerala State Emergency Operations Centre, Kerala State Disaster Management Authority, Thiruvananthapuram, India
- Resilience Development Initiative (RDI), Bandung, Indonesia
| | - Sekhar L. Kuriakose
- Kerala State Emergency Operations Centre, Kerala State Disaster Management Authority, Thiruvananthapuram, India
- Faculty for Geo-Information Science and Earth Observation (ITC), Centre for Disaster Resilience (CDR), University of Twente, Enschede, Netherlands
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Raj ARR, Shashindran N, Shenoy V, Kumar A. Dengue seropositivity among blood donors in a tertiary hospital in Kerala, Southern India. Ann Afr Med 2022; 21:39-42. [PMID: 35313403 PMCID: PMC9020633 DOI: 10.4103/aam.aam_72_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: The aim of this study was to screen blood donors in a tertiary hospital in Kerala for dengue during the period of peak dengue transmission. Materials and Methods: One hundred and seventy-eight continuous serum samples obtained from asymptomatic blood donors during the monsoon season were subjected to ELISA for Dengue NS1 antigen and dengue immunoglobulin M (IgM) antibodies. Results: Dengue IgM antibodies were positive in 20 (11.23%) donors and NS1 antigen was positive in 1 (0.56%) donor. The presence of these markers in asymptomatic blood donors showed that they may have had active or subclinical dengue infection at the time of donation or in the recent past. The presence of NS1 in particular raises the possibility that the donor may have been viremic at the time of donation. Conclusion: The findings of this study suggest the risk of transfusion transmission of dengue during the monsoon in Kerala and strengthen the case for dengue screening among blood donors during this period of high incidence.
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Affiliation(s)
- A R Rahul Raj
- Department of Microbiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Nandita Shashindran
- Department of Microbiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Veena Shenoy
- Department of Transfusion Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Anil Kumar
- Department of Microbiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
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3
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OUP accepted manuscript. Trans R Soc Trop Med Hyg 2022; 116:900-909. [DOI: 10.1093/trstmh/trac001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 12/11/2021] [Accepted: 01/09/2022] [Indexed: 11/13/2022] Open
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Basawarajappa SG, Rangaiah A, Venugopal SJ, Varun CN, Nagaraj V, Padukone S, Shankar SM. Clinical and Molecular facets of Dengue Virus infection from Bengaluru, South India. Nepal J Epidemiol 2021; 11:1053-1062. [PMID: 34733567 PMCID: PMC8560139 DOI: 10.3126/nje.v11i3.37712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 09/01/2021] [Accepted: 09/20/2021] [Indexed: 11/30/2022] Open
Abstract
Background Dengue virus (DENV) continues to be an epidemic with high mortality rates. The clinical features, especially in the early phase of infection, are nonspecific and there is no single marker that can be reliably deployed for diagnostics. Further, serotype and genotype diversity is not clearly understood. This study was conceived to understand the performance characteristics of various diagnostic markers; serotype and genotype distribution is thus a vital requirement. Methods A subset of blood samples was obtained for all the clinically suspected Dengue cases during the period January to December 2017. The samples were tested for IgM and IgG antibodies and NS1 antigen by both ELISA and rapid tests. Real-time PCR, Conventional PCR and sequencing was performed based on the serology results. Correlation of the data with demographic and clinical details was used to analyze the performance characteristics of various tests. Results Clinical signs and symptoms could not predict dengue positivity due to lack of specific symptoms. The performance of IgM rapid test was found to be lower than the ELISA method (53.5% agreement). The NS1 rapid and NS1 ELISA tests were comparable (89.2% agreement). Majority of the infections were caused due to DEN-2 serotype and phylogenetic analysis revealed all the sequenced DEN-2 serotypes belong to Genotype IV. Three sequences were deposited into NCBI GenBank (GenBank accession number MW583116, MW579054 and MW579053). Conclusion Our comprehensive data suggests that NS1 ELISA and PCR are best used in the early phase of dengue infection (< 5 days post-onset of fever), whereas IgM antibody detection is reliable only in the late phase. We also highlight the unreliable performance of rapid tests.
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Affiliation(s)
- Shantala Gowdara Basawarajappa
- Department of Microbiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India.,State Level VRDL, Department of Microbiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Ambica Rangaiah
- Department of Microbiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India.,State Level VRDL, Department of Microbiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Shwetha Jinnahalli Venugopal
- Department of Microbiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India.,State Level VRDL, Department of Microbiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Chakrakodi N Varun
- State Level VRDL, Department of Microbiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Vijay Nagaraj
- Institute of Animal Health and Veterinary Biologicals, Hebbal, Bengaluru-560024
| | - Shashiraja Padukone
- State Level VRDL, Department of Microbiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Sathyanarayan Muthur Shankar
- Department of Microbiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India.,State Level VRDL, Department of Microbiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
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Gowri Sankar S, Mowna Sundari T, Alwin Prem Anand A. Emergence of Dengue 4 as Dominant Serotype During 2017 Outbreak in South India and Associated Cytokine Expression Profile. Front Cell Infect Microbiol 2021; 11:681937. [PMID: 34447698 PMCID: PMC8382982 DOI: 10.3389/fcimb.2021.681937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/12/2021] [Indexed: 12/23/2022] Open
Abstract
Dengue virus (DENV) infection is prevalent in tropical and subtropical regions of the world, which is fatal if untreated symptomatically. Emergence of new genotype within serotypes led to enhanced severity. The objective of the study is to identify the molecular characteristics of the DENV circulated during 2017 outbreak in Tamil Nadu, India, and to investigate the role of inflammatory cytokines in different “serotypes” and in “dengue severity”. A total of 135 suspected samples were tested for DENV infection using IgM, IgG, and qPCR assay; where 76 samples were positive for DENV and analyzed for 12 inflammatory cytokines using ELISA. Serotyping shows 14 DENV-1, 22 DENV-2, 7 DENV-3, and 33 DENV-4, where DENV-4 was predominant. Among 76, 42 isolates were successfully sequenced for C-prM region and grouped. A lineage shift was observed in DENV-4 genotype. Irrespective of serotypes, IFNγ was significantly elevated in all serotypes than control as well as in primary infection than secondary, indicating its role in immune response. GM-CSF and IP-10 were significantly elevated in secondary infection and could be used as prognostic biomarkers for secondary infection. Our observation shows differential cytokine expression profile varied with each serotype, indicating serotype/genotype-specific viral proteins might play a major role in dengue severity. DENV-4 as dominant serotype was reported in Tamil Nadu for the first time during an outbreak with a mixed Th1/Th17 cytokine expression profile that correlated with disease severity. We conclude it is essential to identify circulating viral genotype and their fitness by mutational analysis to correlate with disease severity and immune status, as this correlation will be helpful in diagnostics and therapeutics applications.
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Affiliation(s)
- S Gowri Sankar
- Department of Molecular Biology, Indian Council of Medical Research (ICMR)-Vector Control Research Center - Field Station, Madurai, India
| | - T Mowna Sundari
- Department of Biotechnology - Bioinformatics Infrastructure Facilities (DBT-BIF) Centre (Under DBT Biotechnology Information System Network (BTISNet) Scheme), Lady Doak College, Madurai, India.,Department of Biotechnology, Lady Doak College, Madurai, India
| | - A Alwin Prem Anand
- Institute of Clinical Anatomy and Cell Analysis, University of Tuebingen, Tuebingen, Germany
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Deval H, Behera SP, Agrawal A, Singh R, Misra B, Janardhan V, Patil G, Sah K, Kumar N, Singh R, Bondre VP. Genetic characterization of dengue virus serotype 2 isolated from dengue fever outbreaks in eastern Uttar Pradesh and western Bihar, India. J Med Virol 2021; 93:3322-3329. [PMID: 32633814 DOI: 10.1002/jmv.26239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 06/20/2020] [Accepted: 06/22/2020] [Indexed: 01/23/2023]
Abstract
Dengue (DEN) is the most common cause of mosquito-borne endemic viral diseases in the tropical and subtropical countries. DEN outbreaks associated with multiple dengue virus (DV) serotypes have been regularly reported in different parts of India. This study was done during DEN outbreaks in 2015 to 2016 in UP and Bihar where DEN-2 was found as the only prevalent serotype. DV-2 was the only serotype amplified in serotype-specific reverse-transcription polymerase chain reaction from sera of 210 (65.21%) out of 322 DV NS1 antigen-positive patients. Further genetic analysis based on full-length envelope (E) protein sequence derived from patient's sera as well as DV isolate showed the circulation of lineages I and III of DV-2 cosmopolitan genotype during 2015 and lineage II during 2016. Finally, the phylogenetic analysis using the E gene sequence revealed that these DV-2 strains have a close genetic relationship with the recently reported DV-2 genotypes from DEN outbreaks reported from different parts of north India. These results showed the circulation of cosmopolitan genotype of DV-2 in eastern Uttar Pradesh and western Bihar, India. The genetic database generated on circulating DV strains in this study will be useful as reference for disease surveillance and strengthening laboratory diagnosis protocols.
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Affiliation(s)
- Hirawati Deval
- Molecular Virology, National Institute of Virology (Gorakhpur Unit), Gorakhpur, Uttar Pradesh, India
| | - Sthita P Behera
- Molecular Virology, National Institute of Virology (Gorakhpur Unit), Gorakhpur, Uttar Pradesh, India
| | - Awdhesh Agrawal
- Division of Pathology, Gorakhnath Hospital, Gorakhpur, Uttar Pradesh, India
| | - Rajeev Singh
- Molecular Virology, National Institute of Virology (Gorakhpur Unit), Gorakhpur, Uttar Pradesh, India
| | - Brijranjan Misra
- Molecular Virology, National Institute of Virology (Gorakhpur Unit), Gorakhpur, Uttar Pradesh, India
| | - Vanka Janardhan
- Molecular Virology, National Institute of Virology (Gorakhpur Unit), Gorakhpur, Uttar Pradesh, India
| | - Gajanan Patil
- Molecular Virology, National Institute of Virology (Gorakhpur Unit), Gorakhpur, Uttar Pradesh, India
| | - Kamlesh Sah
- Molecular Virology, National Institute of Virology (Gorakhpur Unit), Gorakhpur, Uttar Pradesh, India
| | - Niraj Kumar
- Molecular Virology, National Institute of Virology (Gorakhpur Unit), Gorakhpur, Uttar Pradesh, India
| | - Ravishankar Singh
- Molecular Virology, National Institute of Virology (Gorakhpur Unit), Gorakhpur, Uttar Pradesh, India
| | - Vijay P Bondre
- Encephalitis Group, ICMR-National Institute of Virology, Microbial Containment Complex, Pune, Maharashtra, India
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7
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Tiraki D, Singh K, Shrivastava S, Mishra AC, Arankalle V. Complete genome characterization and evolutionary analysis of dengue viruses isolated during 2016-2017 in Pune, India. INFECTION GENETICS AND EVOLUTION 2021; 93:104909. [PMID: 34082088 DOI: 10.1016/j.meegid.2021.104909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 04/14/2021] [Accepted: 05/06/2021] [Indexed: 11/15/2022]
Abstract
Dengue is the most common mosquito-borne viral infection in tropical and sub-tropical countries. In the recent years, frequent dengue outbreaks are being reported in many parts of India. DENV circulates as four independent serotypes posing a major public health threat around the globe. Phylogenetic and full genome sequence analyses of 19 complete DENV genome sequences presenting all the four serotypes in Pune, India (2016-2017) revealed no change in the circulating genotypes i.e., genotype V clade C (D1), genotype IVB (D2), genotype III lineage III (D3) and genotype I clade D (D4). Additionally, unique amino acid substitutions that may potentially influence viral fitness and virulence in host cells were identified. Mapping of the unique amino acid substitutions onto the T cell epitopes of the reference strains revealed that 8/10 (D1), 14/15 (D2), 3/4 (D3) and 21/74 (D4), amino acids were involved in T-cell epitope presentation for a maximum number of HLA alleles associated with disease outcome. Selection pressure analysis documented a positive selection pressure to be acting on few amino acid sites indicating continuous evolutionary changes in the viral RNA. Overall, the evolutionary and selection pressure data generated during this study may help in better understanding of DENV evolution and epidemiology.
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Affiliation(s)
- Divya Tiraki
- Department of Communicable Diseases, Interactive Research School for Health Affairs, Bharati Vidyapeeth Deemed University, Pune, Maharashtra, India
| | - Karuna Singh
- Department of Communicable Diseases, Interactive Research School for Health Affairs, Bharati Vidyapeeth Deemed University, Pune, Maharashtra, India
| | - Shubham Shrivastava
- Department of Communicable Diseases, Interactive Research School for Health Affairs, Bharati Vidyapeeth Deemed University, Pune, Maharashtra, India
| | - A C Mishra
- Department of Communicable Diseases, Interactive Research School for Health Affairs, Bharati Vidyapeeth Deemed University, Pune, Maharashtra, India
| | - Vidya Arankalle
- Department of Communicable Diseases, Interactive Research School for Health Affairs, Bharati Vidyapeeth Deemed University, Pune, Maharashtra, India.
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8
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Murugesan A, Aridoss D, Senthilkumar S, Sivathanu L, Sekar R, Shankar EM, Manickan E. Molecular diversity of dengue virus serotypes 1-4 during an outbreak of acute dengue virus infection in Theni, India. Indian J Med Microbiol 2020; 38:401-408. [PMID: 33154254 DOI: 10.4103/ijmm.ijmm_20_89] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Dengue fever (DF) is caused by an arthropod-borne dengue virus (DENV), has four serotypes and several genotypes. Although having clinical and epidemiological significance, the information on the circulating serotypes/genotypes is scarce in India. Materials and Methods Blood specimens were collected from the patients suspected of DF and they are tested for DENV NS1 antigen and DENV IgM by ELISA. Antigen-positive samples were further serotyped by reverse transcriptase polymerase chain reaction. Representative samples from each serotype were sequenced to identify the genotypes. Results All the four DENV serotypes were detected with the pre-dominance of DENV-1 (n = 49; 41.9%). Cases with multiple DENV serotype infections were also identified. Genotyping showed that DENV-1 belonging to genotype I, DENV-2 cosmopolitan (IV), DENV-3 genotype III and DENV-4 genotype I were active in the circulation during the outbreak in 2017. Conclusion Our study documents the molecular characteristics of DENV circulating in our geographical locality. The detection of heterologous DENV serotypes highlights the importance of regular molecular monitoring for the early recognition of any switch in pre-dominant serotype.
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Affiliation(s)
- Amudhan Murugesan
- Department of Microbiology, Government Theni Medical College, Theni; Department of Microbiology, Dr ALM PG IBMS, University of Madras, Chennai; Department of Microbiology, Virus Research and Diagnostic Laboratory, Government Theni Medical College, Theni, Tamil Nadu, India
| | - Dhanasezhian Aridoss
- Department of Microbiology, Government Theni Medical College, Theni; Department of Microbiology, Dr ALM PG IBMS, University of Madras, Chennai; Department of Microbiology, Virus Research and Diagnostic Laboratory, Government Theni Medical College, Theni, Tamil Nadu, India
| | - Swarna Senthilkumar
- Department of Microbiology; Department of Microbiology, Virus Research and Diagnostic Laboratory, Government Theni Medical College, Theni, Tamil Nadu, India
| | - Lallitha Sivathanu
- Department of Microbiology; Department of Microbiology, Virus Research and Diagnostic Laboratory, Government Theni Medical College, Theni, Tamil Nadu, India
| | - Ramalingam Sekar
- Department of Microbiology; Department of Microbiology, Virus Research and Diagnostic Laboratory, Government Theni Medical College, Theni, Tamil Nadu, India
| | - Esaki M Shankar
- Infection Biology, Department of Life Sciences, School of Life Sciences, Central University of Tamil Nadu, Thiruvarur, Tamil Nadu, India
| | - Elanchezhiyan Manickan
- Department of Microbiology, Dr ALM PG IBMS, University of Madras, Chennai, Tamil Nadu, India
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Sharmila PF, Vanathy K, Rajamani B, Kaliaperumal V, Dhodapkar R. Emergence of dengue virus 4 as the predominant serotype during the outbreak of 2017 in South India. Indian J Med Microbiol 2019; 37:393-400. [PMID: 32003339 DOI: 10.4103/ijmm.ijmm_19_338] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Context Dengue virus (DENV) causes acute febrile illness in tropical and subtropical countries. In India there is a steady increase in incidence since 1950s which could be attributed to emergence of new serotype or lineage\clade shifts in circulating DENV. Aims We aimed to perform molecular characterisation and phylogenetic analysis on samples from the recent outbreak (August-October 2017). Settings and Design Retrospective epidemiological analysis of dengue outbreak. Subjects and Methods Samples positive for non-steroidal 1 antigen by enzyme-linked immunosorbent assay (n = 147) were included. The study was approved by our institute ethics committee (JIP/IEC/2018/496). Five hundred and eleven base pair of capsid and pre-membrane encoding genes (CprM) region was amplified using Lanciotti primers, followed by second round of polymerase chain reaction using serotype specific primers. Samples which were positive by second round (n = 68) were sequenced and genotyped using Basic Local Alignment Search Tool analysis and phylogenetic tree was constructed by MEGA7 software. Results Phylogenetic analysis of CprM sequences identified all 4 serotypes in circulation during this outbreak. We observed both single (n = 50) and concurrent infections (n = 18), with DENV4 as the major contributor (64%). Within Genotype I of DENV4 we observed a distinct new clade (Clade E) which was 2.6% ± 0.9%-5.5% ± 1.1% divergent from the other clades. Among the concurrent infection, DENV 4 and DENV 2 combination was observed to form the majority (77.8%). Conclusions Overall this study documents the emergence of DENV4 as the major serotype in circulation, replacing DENV1, 2 and 3 which had been previously reported from Tamil Nadu and Puducherry. This substantiates the need for continuous monitoring in endemic countries like India, where such data may impact the formulation of vaccine policy for dengue.
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Affiliation(s)
- P Ferdinamarie Sharmila
- Department of Microbiology, Regional Viral Research and Diagnostic Laboratory, JIPMER, Puducherry, India
| | - K Vanathy
- Department of Microbiology, MGMCRI, Sri Balaji Vidyapeeth, Puducherry, India
| | - Barathidasan Rajamani
- Department of Microbiology, Regional Viral Research and Diagnostic Laboratory, JIPMER, Puducherry, India
| | - Venkatesh Kaliaperumal
- Department of Microbiology, Regional Viral Research and Diagnostic Laboratory, JIPMER, Puducherry, India
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Shaji Mathew J, Menon VP, Menon VP, Mallick S, Sivasankara Pillai Thankamony Amma B, Balakrishnan D, Gopalakrishnan U, Narayana Menon R, Athira PP, Jagan OA, Surendran S. Dengue virus transmission from live donor liver graft. Am J Transplant 2019; 19:1838-1846. [PMID: 30672135 DOI: 10.1111/ajt.15270] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 01/17/2019] [Accepted: 01/18/2019] [Indexed: 01/25/2023]
Abstract
Arboviral transmission through transplanted organs is rare. We report a highly probable case of dengue viral transmission during live donor liver transplantation. Fever with severe thrombocytopenia was observed in the donor and recipient within 6 and 9 days after transplantation, respectively. Dengue diagnosis was confirmed by testing blood and explant tissue from the donor and recipient using dengue-specific NAT (nucleic acid testing) and serology. Serology indicated the donor had secondary dengue infection that ran a mild course. However, the dengue illness in the recipient was severe and deteriorated rapidly, eventually proving fatal. The recipient's explant liver tissue tested negative for viral RNA indicative of a pretransplant naïve status. The prM-Envelope gene sequence analysis of the donor and recipient viral RNA identified a similar serotype (DENV1) with almost 100% sequence identity in the envelope region. Molecular phylogenetic analysis of donor and recipient viral envelope sequences with regional and local dengue strains further confirmed their molecular similarity, suggesting a probable donor-to-recipient transmission via organ transplantation. Screening of living donors for dengue virus may be considered in endemic regions.
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Affiliation(s)
- Johns Shaji Mathew
- Department of Solid Organ Transplant, Amrita Institute of Medical Sciences & Research Centre, Amrita University, Kochi, India
| | - Vidya P Menon
- Department of Clinical Infectious Diseases, Amrita Institute of Medical Sciences & Research Centre, Amrita University, Kochi, India
| | - Veena P Menon
- Department of Virology, Amrita Institute of Medical Sciences & Research Centre, Amrita University, Kochi, India
| | - Shweta Mallick
- Department of Solid Organ Transplant, Amrita Institute of Medical Sciences & Research Centre, Amrita University, Kochi, India
| | | | - Dinesh Balakrishnan
- Department of Solid Organ Transplant, Amrita Institute of Medical Sciences & Research Centre, Amrita University, Kochi, India
| | - Unnikrishnan Gopalakrishnan
- Department of Solid Organ Transplant, Amrita Institute of Medical Sciences & Research Centre, Amrita University, Kochi, India
| | - Ramachandran Narayana Menon
- Department of Solid Organ Transplant, Amrita Institute of Medical Sciences & Research Centre, Amrita University, Kochi, India
| | - Padmanabhan P Athira
- Department of Virology, Amrita Institute of Medical Sciences & Research Centre, Amrita University, Kochi, India
| | - Ozhiparambil A Jagan
- Department of Virology, Amrita Institute of Medical Sciences & Research Centre, Amrita University, Kochi, India
| | - Sudhindran Surendran
- Department of Solid Organ Transplant, Amrita Institute of Medical Sciences & Research Centre, Amrita University, Kochi, India
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Ahamed SF, Rosario V, Britto C, Dias M, Nayak K, Chandele A, Kaja MK, Shet A. Emergence of new genotypes and lineages of dengue viruses during the 2012-15 epidemics in southern India. Int J Infect Dis 2019; 84S:S34-S43. [PMID: 30639622 DOI: 10.1016/j.ijid.2019.01.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 01/06/2019] [Accepted: 01/07/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To genotypically characterize dengue virus (DENV) isolates among dengue-infected children from 2012-13/2014-15 outbreaks in southern India. METHODS Children hospitalized with suspected dengue were tested for dengue RT-PCR targeting Capsid-preMembrane (C-prM) and Envelope (Env) regions. Following virologic confirmation (n=612), a representative selection of DENV isolates (n=99) were sequenced for C-prM, aligned using ClustalW and subjected to phylogenetic analysis by maximum-likelihood method in MEGA6. RESULTS In 2012-13 (n=113), DENV-3 (44, 38.9%) and DENV-2 (43, 38.1%) predominated; DENV-1 (22, 19.5%) and DENV-4 (1, 0.9%) were less common. The pattern changed in 2014-15 (n=499), when DENV-1 (329, 65.7%) predominated, followed by DENV-2 (97, 21.2%), DENV-3 (36, 6.7%) and DENV-4 (10, 2.0%). Multiple-serotype co-infections occurred in 2.7% and 5.4% in 2012-13 and 2014-15, respectively. Genotype III (GIII) of DENV-1 predominated (85.7%) in 2012-13, ceding to GI predominance (80.8%) in 2014-15. Among DENV-2, 71.9% (23/32) showed distinct clustering suggesting a new lineage, 'GIVc'. All tested DENV-4 were GIC, whose clustering pattern showed the emergence of two distinct clades. CONCLUSIONS New genotypic/lineage variations in DENV-1 and DENV-2 may have influenced the magnitude and severity of dengue epidemics in southern India during this period. These findings emphasize the role of active surveillance of DENV serotypes/genotypes in aiding outbreak control and vaccine studies.
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Affiliation(s)
- Syed Fazil Ahamed
- Division of Infectious Diseases, St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, 560034, Karnataka, India; The University of Trans-Disciplinary Health Sciences & Technology (TDU), Bangalore, 560064, Karnataka, India.
| | - Vivek Rosario
- Division of Infectious Diseases, St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, 560034, Karnataka, India.
| | - Carl Britto
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, UK.
| | - Mary Dias
- Division of Infectious Diseases, St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, 560034, Karnataka, India; Department of Microbiology, St. John's Medical College Hospital, St. John's National Academy of Health Sciences, Bangalore, 560034, Karnataka, India.
| | - Kaustuv Nayak
- ICGEB-Emory Vaccine Centre, International Centre for Genetic Engineering and Biotechnology, Aruna Asaf Ali Marg, New Delhi, 110067, India.
| | - Anmol Chandele
- ICGEB-Emory Vaccine Centre, International Centre for Genetic Engineering and Biotechnology, Aruna Asaf Ali Marg, New Delhi, 110067, India.
| | - Murali-Krishna Kaja
- ICGEB-Emory Vaccine Centre, International Centre for Genetic Engineering and Biotechnology, Aruna Asaf Ali Marg, New Delhi, 110067, India; Department of Pediatrics, Emory University, 1760 Haygood Drive, Atlanta, GA, 30322, USA.
| | - Anita Shet
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, 415 N Washington St, Baltimore 21231, USA.
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12
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Ganeshkumar P, Murhekar MV, Poornima V, Saravanakumar V, Sukumaran K, Anandaselvasankar A, John D, Mehendale SM. Dengue infection in India: A systematic review and meta-analysis. PLoS Negl Trop Dis 2018; 12:e0006618. [PMID: 30011275 PMCID: PMC6078327 DOI: 10.1371/journal.pntd.0006618] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 08/06/2018] [Accepted: 06/19/2018] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Dengue is the most extensively spread mosquito-borne disease; endemic in more than 100 countries. Information about dengue disease burden, its prevalence, incidence and geographic distribution is critical in planning appropriate control measures against dengue fever. We conducted a systematic review and meta-analysis of dengue fever in India. METHODS We searched for studies published until 2017 reporting the incidence, the prevalence or case fatality of dengue in India. Our primary outcomes were (a) prevalence of laboratory confirmed dengue infection among clinically suspected patients, (b) seroprevalence in the general population and (c) case fatality ratio among laboratory confirmed dengue patients. We used binomial-normal mixed effects regression model to estimate the pooled proportion of dengue infections. Forest plots were used to display pooled estimates. The metafor package of R software was used to conduct meta-analysis. RESULTS Of the 2285 identified articles on dengue, we included 233 in the analysis wherein 180 reported prevalence of laboratory confirmed dengue infection, seven reported seroprevalence as evidenced by IgG or neutralizing antibodies against dengue and 77 reported case fatality. The overall estimate of the prevalence of laboratory confirmed dengue infection among clinically suspected patients was 38.3% (95% CI: 34.8%-41.8%). The pooled estimate of dengue seroprevalence in the general population and CFR among laboratory confirmed patients was 56.9% (95% CI: 37.5-74.4) and 2.6% (95% CI: 2-3.4) respectively. There was significant heterogeneity in reported outcomes (p-values<0.001). CONCLUSIONS Identified gaps in the understanding of dengue epidemiology in India emphasize the need to initiate community-based cohort studies representing different geographic regions to generate reliable estimates of age-specific incidence of dengue and studies to generate dengue seroprevalence data in the country.
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Affiliation(s)
| | - Manoj V. Murhekar
- Department of Epidemiology, National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - Veeraraghavadoss Poornima
- School of Public Health, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Velusamy Saravanakumar
- Department of Epidemiology, National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - Krishnendu Sukumaran
- School of Public Health, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Anandan Anandaselvasankar
- School of Public Health, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Denny John
- Campbell Collaboration, New Delhi, India
| | - Sanjay M. Mehendale
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
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Shrivastava S, Tiraki D, Diwan A, Lalwani SK, Modak M, Mishra AC, Arankalle VA. Co-circulation of all the four dengue virus serotypes and detection of a novel clade of DENV-4 (genotype I) virus in Pune, India during 2016 season. PLoS One 2018; 13:e0192672. [PMID: 29470509 PMCID: PMC5823370 DOI: 10.1371/journal.pone.0192672] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Accepted: 01/22/2018] [Indexed: 11/19/2022] Open
Abstract
Dengue is the most common mosquito-borne viral infection in tropical and sub-tropical countries. In recent years, India has reported increased incidences of concurrent infection with multiple serotypes of dengue viruses (DENV). In the present study, we have characterized DENV circulating during a single season of 2016 in Pune, India. A total of 64 serum samples from NS1 ELISA positive dengue patients were used for PCR amplification of CprM region of the viral genome and sequencing. Phylogenetic analysis documented circulation of all the four DENV serotypes with predominance of DENV-2 (40.6%). DENV genotyping classified DENV-1 to Genotype V, DENV-2 to Genotype IV, DENV-3 to Genotype III and DENV-4 to Genotype I. Further analysis revealed emergence of a novel clade (D) of genotype I of DENV-4. Subsequent isolation of three DENV-4 viruses in cell culture followed by complete genome sequence analysis confirmed this observation. Additionally, a new genotype within serotype-4 with >6.7% sequence variation from other genotypes was identified. This first report of significant co-circulation of all the four serotypes in a single outbreak in Pune reconfirms need for molecular monitoring of DENV.
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Affiliation(s)
- Shubham Shrivastava
- Department of Communicable Diseases, Interactive Research School for Health Affairs, Bharati Vidyapeeth Deemed University, Pune, Maharashtra, India
| | - Divya Tiraki
- Department of Communicable Diseases, Interactive Research School for Health Affairs, Bharati Vidyapeeth Deemed University, Pune, Maharashtra, India
| | - Arundhati Diwan
- Department of Medicine, Bharati Vidyapeeth Deemed University Medical College, Pune, Maharashtra, India
| | - Sanjay K. Lalwani
- Department of Pediatrics, Bharati Vidyapeeth Deemed University Medical College, Pune, Maharashtra, India
| | - Meera Modak
- Department of Microbiology, Bharati Vidyapeeth Deemed University Medical College, Pune, Maharashtra, India
| | - Akhilesh Chandra Mishra
- Department of Communicable Diseases, Interactive Research School for Health Affairs, Bharati Vidyapeeth Deemed University, Pune, Maharashtra, India
| | - Vidya A. Arankalle
- Department of Communicable Diseases, Interactive Research School for Health Affairs, Bharati Vidyapeeth Deemed University, Pune, Maharashtra, India
- * E-mail:
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Cecilia D, Patil J, Kakade M, Walimbe A, Alagarasu K, Anukumar B, Abraham A. Emergence of the Asian genotype of DENV-1 in South India. Virology 2017; 510:40-45. [DOI: 10.1016/j.virol.2017.07.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 06/29/2017] [Accepted: 07/03/2017] [Indexed: 10/19/2022]
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15
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Mishra B, Turuk J, Sahu SJ, Khajuria A, Kumar S, Dey A, Praharaj AK. Co-circulation of All Four Dengue Virus Serotypes: First Report from Odisha. Indian J Med Microbiol 2017; 35:293-295. [DOI: 10.4103/ijmm.ijmm_15_536] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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16
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Enhancing the sensitivity of Dengue virus serotype detection by RT-PCR among infected children in India. J Virol Methods 2017; 244:46-54. [PMID: 28254680 DOI: 10.1016/j.jviromet.2017.02.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 02/23/2017] [Accepted: 02/27/2017] [Indexed: 12/19/2022]
Abstract
Dengue surveillance relies on reverse transcription-polymerase chain reaction (RT-PCR), for confirmation of dengue virus (DENV) serotypes. We compared efficacies of published and modified primer sets targeting envelope (Env) and capsid-premembrane (C-prM) genes for detection of circulating DENV serotypes in southern India. Acute samples from children with clinically-diagnosed dengue were used for RT-PCR testing. All samples were also subjected to dengue serology (NS1 antigen and anti-dengue-IgM/IgG rapid immunochromatographic assay). Nested RT-PCR was performed on viral RNA using three methods targeting 654bp C-prM, 511bp C-prM and 641bp Env regions, respectively. RT-PCR-positive samples were validated by population sequencing. Among 171 children with suspected dengue, 121 were dengue serology-positive and 50 were dengue serology-negative. Among 121 serology-positives, RT-PCR detected 91 (75.2%) by CprM654, 72 (59.5%) by CprM511, and 74 (61.1%) by Env641. Among 50 serology-negatives, 10 (20.0%) were detected by CprM654, 12 (24.0%) by CprM511, and 11 (22.0%) by Env641. Overall detection rate using three methods sequentially was 82.6% (100/121) among serology-positive and 40.0% (20/50) among serology-negative samples; 6.6% (8/120) had co-infection with multiple DENV serotypes. We conclude that detection of acute dengue was enhanced by a modified RT-PCR method targeting the 654bp C-prM region, and further improved by using all three methods sequentially.
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17
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Complete genome characterization and evolutionary analysis of serotype-4 associated with severe dengue. Epidemiol Infect 2017; 145:1443-1450. [PMID: 28215186 DOI: 10.1017/s0950268817000243] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Dengue virus circulates as four independent serotypes posing a major public health threat around the globe. In the recent years, frequent dengue outbreaks are being reported in many parts of the world including India. Among four serotypes, Den-4 is the least sampled and studied serotype until recent times, but the reported cases with Den-4 infections were mostly known to associate with severe dengue. In the past three decades, only one complete genome sequence of Den-4 has been published from India. Hence there is a deficit in information with reference to this serotype which would be required in deciphering its association with severe dengue. In this study, we have carried out the complete genome characterization of Den-4 virus, isolated from a dengue shock syndrome patient during the 2015 outbreak from Hyderabad, South India. Phylogenetic analysis revealed the circulation of genotype I (lineage C) which showed close relatedness to the reported virulent strains. The data also indicated few unique amino acid substitutions which are known to be important in virus replication and epitope presentation. This is the first report of complete genome characterization of Den-4 from South India, which may assist in shaping the genetic diversity of circulating strains in India.
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