Short communicationImported dengue from 2013 Angola outbreak: Not just serotype 1 was detected
Section snippets
Background
Serosurveys in Africa document the presence of dengue since 1926 [1]. In Africa the surveillance data are poor and its knowledge is not accurate [2]. Despite this, there are reports from serotypes 1, 2, 3 and, more rarely, serotype 4 in several African countries [3], [4], [5], [6].
Angola’s dengue cases have been described in 1986 and 1999–2002 [7], but no dengue outbreak was reported until 2013. All isolates from this outbreak have been consistently reported as serotype 1 [8], [9], [10].
Objectives
To report clinical and laboratory data concerning imported dengue in 2013 in patients returning from Angola.
Methods
We made a hospital-based, retrospective and cross-sectional study, analysing all the clinical and laboratory records of adults returning from Angola and diagnosed with dengue. We used an in-vitro rapid immunochromatographic assay, SD BIOLINE Dengue Duo® (Dengue NS1 Ag + IgG/IgM) kit following the manufacture protocol. From some randomly selected patients the plasma was frozen (−20 °C). Later we tested for Dengue virus RNA and serotyped. We used an in-house one step Reverse Transcription Real Time
Results
From the 47 patients with dengue, 45 were non-Angolan and 20 were expatriate in Angola. No patient had previously reported clinical dengue fever. They all lived or stayed for some days in Luanda, before travelling to Portugal. At diagnosis fever was reported in all patients, myalgia in 40, headache in 37, asthenia in 31, retro-orbital pain in 17 and arthralgia in 15. Gum bleeding and metrorrhagia was elicited in 2 patients.
Discussion
This study addresses for the first time the circulation of the four dengue serotypes in the 2013 Angola’s outbreak. The outbreak was linked to serotype 1 [8]. In Africa very few studies explore the serotypes identification, evolutionary history and dynamic of the disease and there is not any report of these serotypes co-circulating [13]. The detection of the four serotypes in this outbreak may translate a large dissemination of dengue virus.
We screened all the samples with the SD BIOLINE Dengue
Acknowledgements
The authors would like to thank Professor Henrique Lecour for his valuable comments and review of the draft manuscript.
References (17)
- et al.
Global spread of dengue virus types: mapping the 70 year history
Trends Microbiol.
(2014) Infection disease surveillance update
Lancet Infect. Dis.
(2016)- et al.
Neutralizing antibodies to arthropod-borne viruses in human beings and animals in the Union of South Africa
J. Immunol.
(1956) Dengue Guidelines for Diagnosis, Treatment, Prevention and Control
(2009)- et al.
Recent introduction and rapid dissemination of Chikungunya virus and Dengue virus serotype 2 associated with human and mosquito coinfections in Gabon, central Africa
Clin. Infect. Dis.
(2012) - et al.
First report of sylvatic DENV-2-associated dengue hemorrhagic fever in West Africa
PLoS Negl. Trop. Dis.
(2011) - et al.
Dengue type 3 virus infections in European travellers returning from the Comoros and Zanzibar, February-April 2010
Euro Surveill.
(2010) - et al.
Dengue virus infection in travellers returning from Benin to France, July–August, 2010
Euro Surveill.
(2010)
Cited by (10)
Understanding dengue virus evolution to support epidemic surveillance and counter-measure development
2018, Infection, Genetics and EvolutionCitation Excerpt :While DENV surveillance in Africa has been historically limited compared to other DENV endemic regions, recent DENV global cartography efforts have shown evidence of DENV circulation in Angola, Burkina Faso, Gabon, Kenya, Mali and Nigeria (Messina et al., 2014), and severe human dengue infections have been documented in Senegal (Weaver and Vasilakis, 2009; Faye et al., 2014). All four serotypes have been detected in Africa to date (Abreu et al., 2016; Caron et al., 2013; Faye et al., 2014; Ridde et al., 2016; Sutherland et al., 2011), with some evidence that there is an increasing circulation of these serotypes (Weaver and Vasilakis, 2009). Africa was the destination of the majority of travelers seen at a European travel clinic with laboratory confirmed DENV illness (Toro et al., 2017), indicating that this region also plays an important role in travel-related dengue case burdens.
A historical perspective on arboviruses of public health interest in Southern Africa
2023, Pathogens and Global HealthContribution of phylogenetics to understanding the evolution and epidemiology of dengue virus
2022, Animal Models and Experimental MedicineMolecular and genomic investigation of an urban outbreak of dengue virus serotype 2 in Angola, 2017–2019
2022, PLoS Neglected Tropical Diseases
- 1
These two authors contributed equally in the design, conception, analysis, and paper writing.