Unusual, neurological and severe dengue manifestations during the outbreak in Sri Lanka, 2017.

Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology
Mya Myat Ngwe TunKouichi Morita

Abstract

Sri Lanka experienced its largest dengue outbreak in 2017 with more than 185,000 dengue cases including at least 250 fatalities. Our study aimed to characterize the clinical, immunological and virological features of confirmed dengue patients in Sri Lanka during the outbreak in 2017 when unusual manifestations of severe dengue were observed. Sera from 295 patients who were admitted to Teaching Hospital Kandy, Kandy, Sri Lanka between March 2017- January 2018 were subjected to NS1 antigen, IgM and IgG ELISAs, virus isolation, conventional and real time RT-PCR and next generation sequencing. Primary and secondary infections were detected in 48.5 % and 51.5 % of the study population, respectively. Two hundred twenty five DENV strains were isolated (219 DENV-2, one DENV-3, two DENV-4, two mixed infections of DENV-2 and -3 and one mixed infection of DENV-2 and -4). Unusual and severe manifestations such as encephalitis, encephalopathy, liver failure, kidney failure, myocarditis, Guillain-Barré syndrome and multi-organ failure were noted in 44 dengue patients with 11 deaths. The viraemia levels in patients with primary infection and unusual manifestations were significantly higher compared to those in patients with secondary infectio...Continue Reading

Citations

Jun 20, 2020·Journal of Medical Virology·Ravindra Kumar GargAnkit Gupta
Jan 8, 2021·Transactions of the Royal Society of Tropical Medicine and Hygiene·Tsheten TshetenKinley Wangdi
Mar 2, 2021·Japanese Journal of Infectious Diseases·Mya Myat Ngwe TunKouichi Morita
Aug 24, 2021·Vector Borne and Zoonotic Diseases·Jonas NäslundOlivia Wesula Lwande
Aug 29, 2021·Viruses·Mya Myat Ngwe TunKouichi Morita

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