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Abstract Background Dengue virus serotype 2 (DENV-2) was the major serotype in the 2015 dengue outbreak in Taiwan, while DENV-1 and DENV-3 were dominant between 2005 and 2014. We aimed to investigate whether DENV-2 contributed to disease severity and mortality in the outbreak in Kaohsiung city, Taiwan. Methods We collected serum samples from dengue patients to detect the presence of DENV and determine the serotypes by using quantitative reverse transcription-polymerase chain reaction. Our cohorts comprised 105 DENV-1-infected cases and 1,550 DENV-2-infected cases. Demographic data, DENV serotype, and comorbidities were covariates for univariate and multivariate analyses to explore the association with severity and mortality. Results The results suggested that DENV-1 persisted and circulated, while DENV-2 was dominant during the dengue outbreak that occurred between September and December 2015. However, DENV-2 did not directly contribute to either severity or mortality. Aged patients and patients with diabetes mellitus (DM) or moderate to severe chronic kidney disease (CKD) had a higher risk of developing severe dengue. The mortality of dengue patients was related to a higher Charlson comorbidity index score and severe dengue. Among DENV-2-infected patients and older patients, preexisting anti-dengue IgG, DM, and moderate to severe CKD were associated with severe dengue. Moreover, female sex and severe dengue were associated with a significantly higher risk of death. Conclusions Our findings highlight the importance of timely serological testing in elderly patients to identify potential secondary infections and focus on the meticulous management of elderly patients with DM or moderate to severe CKD to reduce dengue-related death.

Background: Dengue virus serotype 2 (DENV-2) was the major serotype in the 2015 dengue outbreak in Taiwan, while DENV-1 and DENV-3 were dominant between 2005 and 2014. We aimed to investigate whether DENV-2 contributed to disease severity and mortality in the outbreak in Kaohsiung city, Taiwan. Methods: We collected serum samples from dengue patients to detect the presence of DENV and determine the serotypes by using quantitative reverse transcription-polymerase chain reaction. Our cohorts comprised 105 DENV-1-infected cases and 1,550 DENV-2-infected cases. Demographic data, DENV serotype, and comorbidities were covariates for univariate and multivariate analyses to explore the association with severity and mortality. Results: The results suggested that DENV-1 persisted and circulated, while DENV-2 was dominant during the dengue outbreak that occurred between September and December 2015. However, DENV-2 did not directly contribute to either severity or mortality. Aged patients and patients with diabetes mellitus (DM) or moderate to severe chronic kidney disease (CKD) had a higher risk of developing severe dengue. The mortality of dengue patients was related to a higher Charlson comorbidity index score and severe dengue. Among DENV-2-infected patients and older patients, preexisting anti-dengue IgG, DM, and moderate to severe CKD were associated with severe dengue. Moreover, female sex and severe dengue were associated with a significantly higher risk of death. Conclusions: Our findings highlight the importance of timely serological testing in elderly patients to identify potential secondary infections and focus on the meticulous management of elderly patients with DM or moderate to severe CKD to reduce dengue-related death. [ABSTRACT FROM AUTHOR]

Introduction: The risk of transfusion transmitted dengue has been increasingly recognized. Blood donors in an endemic area like Delhi may serve as a potential vehicle for transmission of the infection. Moreover, prevalence of infection in them would be representative of the true picture of dengue in a population. Aim: To determine the prevalence of dengue virus infection in blood donors in a tertiary care centre. Materials and Methods: A total of 200 blood donors were recruited in the study after obtaining informed consent in the Institute of Liver and Biliary Sciences, New Delhi in July and August 2012. Data regarding clinical and demographic characteristics was collected using a preformed questionnaire. Blood samples obtained were subjected to anti-dengue IgM and IgG ELISA as well as semi-nested Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) for dengue RNA. Results: Of the study subjects, most were men (97%) with a median age of 28 years (range 19–51 years). Anti-dengue IgG was positive in 116 cases (58%) while IgM was seen in 27cases (13.5%). Of them, in 25 (12.5%) cases both IgG and IgM were positive, while only two (1%) cases tested positive for IgM alone. None of the blood donors were found to be viremic on screening using Nested RT-PCR. A clear increase of IgG seroprevalence with age was evident. No difference in the seroprevalence rates in urban vs. rural areas was seen. Conclusion: High seroprevalence of dengue infection was seen in healthy asymptomatic blood donors. Though evidence of acute infection was found in some, none were found to be viremic. Larger studies are required to quantify the risk and provide strong evidence for policies to be made.

Introduction: The risk of transfusion transmitted dengue has been increasingly recognized. Blood donors in an endemic area like Delhi may serve as a potential vehicle for transmission of the infection. Moreover, prevalence of infection in them would be representative of the true picture of dengue in a population. Aim: To determine the prevalence of dengue virus infection in blood donors in a tertiary care centre. Materials and Methods: A total of 200 blood donors were recruited in the study after obtaining informed consent in the Institute of Liver and Biliary Sciences, New Delhi in July and August 2012. Data regarding clinical and demographic characteristics was collected using a preformed questionnaire. Blood samples obtained were subjected to anti-dengue IgM and IgG ELISA as well as semi-nested Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) for dengue RNA. Results: Of the study subjects, most were men (97%) with a median age of 28 years (range 19-51 years). Anti-dengue IgG was positive in 116 cases (58%) while IgM was seen in 27cases (13.5%). Of them, in 25 (12.5%) cases both IgG and IgM were positive, while only two (1%) cases tested positive for IgM alone. None of the blood donors were found to be viremic on screening using Nested RT-PCR. A clear increase of IgG seroprevalence with age was evident. No difference in the seroprevalence rates in urban vs. rural areas was seen. Conclusion: High seroprevalence of dengue infection was seen in healthy asymptomatic blood donors. Though evidence of acute infection was found in some, none were found to be viremic. Larger studies are required to quantify the risk and provide strong evidence for policies to be made. [ABSTRACT FROM AUTHOR]