Fever Screening at Airports and Imported Dengue

Shu, Pei-Yun; Chien, Li Jung; Chang, Shui-Feng; Su, Chien Ling; Kuo, Yu Chung; Liao, Tsai Ling; Ho, Margaret S.; Lin, Ting Hsiang; Huang, Jyh Hsiung

doi:10.3201/eid1103.040420

Cited by 79 publications

(96 citation statements)

References 8 publications

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“…Dengue is a notifiable infectious disease in Taiwan, and suspected cases must be reported within 24 hours of clinical diagnosis. 17 Human serum samples of suspected dengue cases must be submitted to the Centers for Disease Control, Taiwan (Taiwan CDC) or a dengue laboratory in Kaohsiung Medicine University Hospital (approved by Taiwan CDC) to confirm DENV infection. The human serum samples used in this study were derived from confirmed dengue cases.…”

Section: Methodsmentioning

confidence: 99%

Laboratory-Based Surveillance and Molecular Characterization of Dengue Viruses in Taiwan, 2014

Chang

Yang

Hsu

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. We present the results of a laboratory-based surveillance of dengue in Taiwan in 2014. A total of 240 imported dengue cases were identified. The patients had arrived from 16 countries, and Malaysia, Indonesia, the Philippines, and China were the most frequent importing countries. Phylogenetic analyses showed that genotype I of dengue virus type 1 (DENV-1) and the cosmopolitan genotype of DENV-2 were the predominant DENV strains circulating in southeast Asia. The 2014 dengue epidemic was the largest ever to occur in Taiwan since World War II, and there were 15,492 laboratory-confirmed indigenous dengue cases. Phylogenetic analysis showed that the explosive dengue epidemic in southern Taiwan was caused by a DENV-1 strain of genotype I imported from Indonesia. There were several possible causes of this outbreak, including delayed notification of the outbreak, limited staff and resources for control measures, abnormal weather conditions, and a serious gas pipeline explosion in the dengue hot spot areas in Kaohsiung City. However, the results of this surveillance indicated that both active and passive surveillance systems should be strengthened so appropriate public health measures can be taken promptly to prevent large-scale dengue outbreaks.

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Section: Methodsmentioning

confidence: 99%

Laboratory-Based Surveillance and Molecular Characterization of Dengue Viruses in Taiwan, 2014

Chang

Yang

Hsu

et al. 2016

The American Society of Tropical Medicine and Hygiene

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“…With the increase in worldwide travel, the rapid expansion of DENV strains to different parts of the world has been well documented. [8][9][10][11][12][13][14] Studies on imported dengue cases can provided useful information for the geographic distribution and global movement of DENV strains.…”

Section: Introductionmentioning

confidence: 99%

Molecular Characterization and Phylogenetic Analysis of Dengue Viruses Imported into Taiwan during 2008–2010

Huang

Su²,

Yang³

et al. 2012

The American Society of Tropical Medicine and Hygiene

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Abstract. We present our surveillance results on imported dengue cases in Taiwan during [2008][2009][2010]. A total of 734 imported dengue patients were identified. The travelers were arriving from 18 countries, including Southeast Asia, the Indian subcontinent, South Pacific islands, and Latin America. Gene sequences from 358 dengue virus (DENV) isolates were used to perform phylogenetic analyses, thus, providing an updated view of the geographic distribution and dynamic transmission of DENV strains circulating in these countries. Our results suggest that the DENV-1 genotype I and DENV-2 Cosmopolitan genotype comprise the predominant DENV strains circulating in Southeast Asian countries. The DENV-3 Genotype III strain was found to be newly emerging in several Southeast Asian countries, however, the Asian genotype 2 and the Asian/American genotype of DENV-2 strains appeared to be less prevalent in Southeast Asia. Furthermore, imported dengue viruses are representative of the overall patterns of serotype/genotype frequencies of dengue outbreaks that occurred in Taiwan.

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“…He had symptoms of fever, headache, vomiting, arthralgia, rash, and skin itch. Molecular screening for flavivirus and alphavirus infections using multiplex one-step SYBR green I-based real-time reverse transcription-PCR (RT-PCR) (15,16) showed positive reactions to both alphavirus and DENV infections, suggesting the possibility of coinfection. Confirmation using specific primers showed positive reactions to CHIKV and DENV-2.…”

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confidence: 99%

Concurrent Isolation of Chikungunya Virus and Dengue Virus from a Patient with Coinfection Resulting from a Trip to Singapore

Chang

Shu

et al. 2010

J Clin Microbiol

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We report two cases of imported infection in patients who had returned to Taiwan from Singapore: one was coinfected with chikungunya virus and dengue virus type 2, and the other was infected with the same dengue virus. Both viruses were successfully isolated from the coinfected case by using antibody neutralization and a plaque purification technique.Dengue fever, caused by a flavivirus in the family Flaviviridae, is the most prevalent arboviral disease in tropical and subtropical regions of Asia, the Pacific and Caribbean islands, and Central and South America (9). Chikungunya, caused by an alphavirus in the family Togaviridae, is endemic to Africa and Asia (12). Both diseases are transmitted to humans by day-biting Aedes aegypti and Aedes albopictus mosquitoes, and both diseases have similar clinical symptoms, including fever, rash, and joint pains as well as headache, fatigue, nausea, vomiting, and muscle pain; a laboratory test is required to distinguish between the two diseases. Thus, many risk factors for chikungunya virus (CHIKV) and dengue virus (DENV) infections are the same or similar. The urban mosquito Aedes aegypti is the primary vector of both viruses throughout most of their geographic range, although Aedes albopictus was recently identified as the main vector of the recently emerged CHIKV E1-226V variant of the African genotype (17).The explosive epidemics of chikungunya in Indian Ocean islands and India since 2004 and the worldwide increase in travel have facilitated the expansion of different strains of CHIKV of the African genotype into overlap areas where DENV is endemic (13). As a result, cocirculation of CHIKV and DENV has been reported in various geographic areas, including India, Sri Lanka, Gabon, Cameroon, Madagascar, Malaysia, Indonesia, Singapore, and Thailand. Consequently, a few studies showing patients coinfected with CHIKV and DENV have been reported in India, Sri Lanka, Malaysia, and Gabon (1,5,8,11,14). Although molecular and serologic evidence demonstrated or suggested coinfections in the abovementioned reports, neither CHIKV nor DENV was isolated from these patients. Successful isolation of both viruses is needed to conduct basic and applied research on CHIKV and DENV biology, immunology, and pathogenesis, as well as the development of laboratory diagnosis, antiviral drugs, and vaccines.The first and only concurrent isolation of CHIKV and DENV-2, from a single blood specimen taken from a patient in the acute phase of a dengue-like illness in southern India in 1964, was reported by Myers and Carey (10). In their study, the dominance of CHIKV in the coinfected patient's serum, along with growth competition, prevented the initial isolation of DENV-2; isolation was finally accomplished through pretreatment of the acute-phase serum sample with a CHIKV-specific mouse antibody, followed by inoculation into infant mice for in vivo growth. Here we report only the second case confirmed by actual isolation of CHIKV and DENV-2, from a patient returned from Singapore, using an in vitro cell...

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Fever Screening at Airports and Imported Dengue

Cited by 79 publications

References 8 publications

Laboratory-Based Surveillance and Molecular Characterization of Dengue Viruses in Taiwan, 2014

Laboratory-Based Surveillance and Molecular Characterization of Dengue Viruses in Taiwan, 2014

Molecular Characterization and Phylogenetic Analysis of Dengue Viruses Imported into Taiwan during 2008–2010

Concurrent Isolation of Chikungunya Virus and Dengue Virus from a Patient with Coinfection Resulting from a Trip to Singapore

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