Correlation of disease spectrum among four Dengue serotypes: a five years hospital based study from India

Abstract

The recognition of DF (DHF Dengue Hemorrhagic Fever) is very complicateddue to occurrence of a wide spectrum of clinical signs and symptomsduring acute phase of illness. Moreover, presence of four serotypesfurther complicates the prognosis. To investigate the predictors ofdisease severity and elucidate the prognostic markers among four dengueserotypes, this study was conducted on 320 inpatients having acutefebrile illness clinically suspected as DI, over a period of five years.Dengue serotypes were confirmed by multiplex reverse transcriptase(RT)-PCR. Eighty patients were positive for DI with presence of Den-1,Den-2, Den-3, and Den-4 in 8, 35, 27 and 10 patients, respectively. Thesevere clinical manifestations, abdominal pain and hepatomegaly, werecomparatively higher in Den-2 patients. Liver aminotransferases levelswere also higher in Den-2 patients (app. 5 fold). This study clearlyindicates the hyperendemicity of all dengue serotypes. Nucleotidesequencing of Envelope region revealed that the presently emerged Den-3belongs to type III, having high homology with genotype responsible fornumber of outbreaks in 1980s. The re-emergence of this deadly type canbe suspected to cause more outbreaks in future and is a matter of greatconcern.