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Virus-Specific Differences in Rates of Disease during the 2010 Dengue Epidemic in Puerto Rico

BACKGROUND: Dengue is a potentially fatal acute febrile illness (AFI) caused by four mosquito-transmitted dengue viruses (DENV-1–4) that are endemic in Puerto Rico. In January 2010, the number of suspected dengue cases reported to the passive dengue surveillance system exceeded the epidemic threshol...

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Autores principales: Sharp, Tyler M., Hunsperger, Elizabeth, Santiago, Gilberto A., Muñoz-Jordan, Jorge L., Santiago, Luis M., Rivera, Aidsa, Rodríguez-Acosta, Rosa L., Gonzalez Feliciano, Lorenzo, Margolis, Harold S., Tomashek, Kay M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3617145/
https://www.ncbi.nlm.nih.gov/pubmed/23593526
http://dx.doi.org/10.1371/journal.pntd.0002159
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author Sharp, Tyler M.
Hunsperger, Elizabeth
Santiago, Gilberto A.
Muñoz-Jordan, Jorge L.
Santiago, Luis M.
Rivera, Aidsa
Rodríguez-Acosta, Rosa L.
Gonzalez Feliciano, Lorenzo
Margolis, Harold S.
Tomashek, Kay M.
author_facet Sharp, Tyler M.
Hunsperger, Elizabeth
Santiago, Gilberto A.
Muñoz-Jordan, Jorge L.
Santiago, Luis M.
Rivera, Aidsa
Rodríguez-Acosta, Rosa L.
Gonzalez Feliciano, Lorenzo
Margolis, Harold S.
Tomashek, Kay M.
author_sort Sharp, Tyler M.
collection PubMed
description BACKGROUND: Dengue is a potentially fatal acute febrile illness (AFI) caused by four mosquito-transmitted dengue viruses (DENV-1–4) that are endemic in Puerto Rico. In January 2010, the number of suspected dengue cases reported to the passive dengue surveillance system exceeded the epidemic threshold and an epidemic was declared soon after. METHODOLOGY/PRINCIPAL FINDINGS: To characterize the epidemic, surveillance and laboratory diagnostic data were compiled. A suspected case was a dengue-like AFI in a person reported by a health care provider with or without a specimen submitted for diagnostic testing. Laboratory-positive cases had: (i) DENV nucleic acid detected by reverse transcriptase-polymerase chain reaction (RT-PCR) in an acute serum specimen; (ii) anti-DENV IgM antibody detected by ELISA in any serum specimen; or (iii) DENV antigen or nucleic acid detected in an autopsy-tissue specimen. In 2010, a total of 26,766 suspected dengue cases (7.2 per 1,000 residents) were identified, of which 46.6% were laboratory-positive. Of 7,426 RT-PCR-positive specimens, DENV-1 (69.0%) and DENV-4 (23.6%) were detected more frequently than DENV-2 (7.3%) and DENV-3 (<0.1%). Nearly half (47.1%) of all laboratory-positive cases were adults, 49.7% had dengue with warning signs, 11.1% had severe dengue, and 40 died. Approximately 21% of cases were primary DENV infections, and 1–4 year olds were the only age group for which primary infection was more common than secondary. Individuals infected with DENV-1 were 4.2 (95% confidence interval [CI]: 1.7–9.8) and 4.0 (95% CI: 2.4–6.5) times more likely to have primary infection than those infected with DENV-2 or -4, respectively. CONCLUSIONS/SIGNIFICANCE: This epidemic was long in duration and yielded the highest incidence of reported dengue cases and deaths since surveillance began in Puerto Rico in the late 1960's. This epidemic re-emphasizes the need for more effective primary prevention interventions to reduce the morbidity and mortality of dengue.
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spelling pubmed-36171452013-04-16 Virus-Specific Differences in Rates of Disease during the 2010 Dengue Epidemic in Puerto Rico Sharp, Tyler M. Hunsperger, Elizabeth Santiago, Gilberto A. Muñoz-Jordan, Jorge L. Santiago, Luis M. Rivera, Aidsa Rodríguez-Acosta, Rosa L. Gonzalez Feliciano, Lorenzo Margolis, Harold S. Tomashek, Kay M. PLoS Negl Trop Dis Research Article BACKGROUND: Dengue is a potentially fatal acute febrile illness (AFI) caused by four mosquito-transmitted dengue viruses (DENV-1–4) that are endemic in Puerto Rico. In January 2010, the number of suspected dengue cases reported to the passive dengue surveillance system exceeded the epidemic threshold and an epidemic was declared soon after. METHODOLOGY/PRINCIPAL FINDINGS: To characterize the epidemic, surveillance and laboratory diagnostic data were compiled. A suspected case was a dengue-like AFI in a person reported by a health care provider with or without a specimen submitted for diagnostic testing. Laboratory-positive cases had: (i) DENV nucleic acid detected by reverse transcriptase-polymerase chain reaction (RT-PCR) in an acute serum specimen; (ii) anti-DENV IgM antibody detected by ELISA in any serum specimen; or (iii) DENV antigen or nucleic acid detected in an autopsy-tissue specimen. In 2010, a total of 26,766 suspected dengue cases (7.2 per 1,000 residents) were identified, of which 46.6% were laboratory-positive. Of 7,426 RT-PCR-positive specimens, DENV-1 (69.0%) and DENV-4 (23.6%) were detected more frequently than DENV-2 (7.3%) and DENV-3 (<0.1%). Nearly half (47.1%) of all laboratory-positive cases were adults, 49.7% had dengue with warning signs, 11.1% had severe dengue, and 40 died. Approximately 21% of cases were primary DENV infections, and 1–4 year olds were the only age group for which primary infection was more common than secondary. Individuals infected with DENV-1 were 4.2 (95% confidence interval [CI]: 1.7–9.8) and 4.0 (95% CI: 2.4–6.5) times more likely to have primary infection than those infected with DENV-2 or -4, respectively. CONCLUSIONS/SIGNIFICANCE: This epidemic was long in duration and yielded the highest incidence of reported dengue cases and deaths since surveillance began in Puerto Rico in the late 1960's. This epidemic re-emphasizes the need for more effective primary prevention interventions to reduce the morbidity and mortality of dengue. Public Library of Science 2013-04-04 /pmc/articles/PMC3617145/ /pubmed/23593526 http://dx.doi.org/10.1371/journal.pntd.0002159 Text en https://creativecommons.org/publicdomain/zero/1.0/ This is an open-access article distributed under the terms of the Creative Commons Public Domain declaration, which stipulates that, once placed in the public domain, this work may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose.
spellingShingle Research Article
Sharp, Tyler M.
Hunsperger, Elizabeth
Santiago, Gilberto A.
Muñoz-Jordan, Jorge L.
Santiago, Luis M.
Rivera, Aidsa
Rodríguez-Acosta, Rosa L.
Gonzalez Feliciano, Lorenzo
Margolis, Harold S.
Tomashek, Kay M.
Virus-Specific Differences in Rates of Disease during the 2010 Dengue Epidemic in Puerto Rico
title Virus-Specific Differences in Rates of Disease during the 2010 Dengue Epidemic in Puerto Rico
title_full Virus-Specific Differences in Rates of Disease during the 2010 Dengue Epidemic in Puerto Rico
title_fullStr Virus-Specific Differences in Rates of Disease during the 2010 Dengue Epidemic in Puerto Rico
title_full_unstemmed Virus-Specific Differences in Rates of Disease during the 2010 Dengue Epidemic in Puerto Rico
title_short Virus-Specific Differences in Rates of Disease during the 2010 Dengue Epidemic in Puerto Rico
title_sort virus-specific differences in rates of disease during the 2010 dengue epidemic in puerto rico
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3617145/
https://www.ncbi.nlm.nih.gov/pubmed/23593526
http://dx.doi.org/10.1371/journal.pntd.0002159
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