Correlation of Serotype-Specific Dengue Virus Infection with Clinical Manifestations

Abstract

BackgroundDisease caused by the dengue virus (DENV) is a significant cause of morbidity throughout the world. Although prior research has focused on the association of specific DENV serotypes (DENV-1, DENV-2, DENV-3, and DENV-4) with the development of severe outcomes such as dengue hemorrhagic fever and dengue shock syndrome, relatively little work has correlated other clinical manifestations with a particular DENV serotype. The goal of this study was to estimate and compare the prevalence of non-hemorrhagic clinical manifestations of DENV infection by serotype.Methodology and Principal FindingsBetween the years 2005–2010, individuals with febrile disease from Peru, Bolivia, Ecuador, and Paraguay were enrolled in an outpatient passive surveillance study. Detailed information regarding clinical signs and symptoms, as well as demographic information, was collected. DENV infection was confirmed in patient sera with polyclonal antibodies in a culture-based immunofluorescence assay, and the infecting serotype was determined by serotype-specific monoclonal antibodies. Differences in the prevalence of individual and organ-system manifestations were compared across DENV serotypes. One thousand seven hundred and sixteen individuals were identified as being infected with DENV-1 (39.8%), DENV-2 (4.3%), DENV-3 (41.5%), or DENV-4 (14.4%). When all four DENV serotypes were compared with each other, individuals infected with DENV-3 had a higher prevalence of musculoskeletal and gastrointestinal manifestations, and individuals infected with DENV-4 had a higher prevalence of respiratory and cutaneous manifestations.Conclusions/SignificanceSpecific clinical manifestations, as well as groups of clinical manifestations, are often overrepresented by an individual DENV serotype.

Occurrence and Correlates of Symptom Persistence Following Acute Dengue Fever in Peru

“…28,29 Compared with the other DENV serotypes, we noted that individuals with DENV-4 infection were significantly less likely to have persistence of at least one symptom, independent of demographic factors, temporal factors, and prior DENV infection status. Although no longitudinal study has evaluated the association of symptom persistence with specific DENV serotype, many cross-sectional studies of acute DENV infection have assessed clinical features among the different DENV serotypes, including variations in acute severity and specific manifestations 16,30,31 ; our findings provide more evidence of the distinct clinical differences among DENV serotypes.…”

“…Cutaneous manifestations have been welldescribed in dengue disease. 3,16,21 Typical descriptions include a macular or morbilliform rash, which may be pruritic, often appearing at the time of defervescence, and lasting from 2 to 5 days. Given that 76.7% of study subjects still had fever at their acute visit, a significant portion may not have developed cutaneous symptoms until immediately after their initial presentation.…”

“…The current study protocol has been used previously to characterize the epidemiology and clinical aspects of dengue and other arboviral diseases in febrile subjects in Peru 16,17 ; this prospective study occurred at 19 healthcare facilities located in six cities throughout Peru ( Figure 1): Iquitos, La Merced, Yurimaguas, Puerto Maldonado, Piura, and Tumbes. Participants were enrolled between January 1, 2005 and December 6, 2010.…”

Clinical Presentation of Dengue by Serotype and Year of Epidemic in Martinique

“…[9][10][11] This issue confounds the ability to compare our results with those that used different case classifications or that were conducted in a pediatric setting. [12][13][14][15][16] Our study in adolescents and adults showed that, in this series, specific clinical aspects existed for each serotype. The DENV-4 infections most often had a milder clinical profile, regardless of the immune status and the year of observation.…”

An Analysis of the Genomes of Dengue Virus Using Decision Tree and Apriori Algorithm

“…Those infected with DENV 1 had an increased prevalence of rhinorrhea. People infected with DENV 4 had a higher prevalence of cutaneous and respiratory symptoms, and an increased prevalence of pharyngeal congestion [5].…”