Epidemiological and Virological Characterizations of the 2014 Dengue Outbreak in Guangzhou, China

PLoS One. 2016 Jun 3;11(6):e0156548. doi: 10.1371/journal.pone.0156548. eCollection 2016.

Abstract

Dengue used to be recognized as an imported and sporadic disease in China. Since June 2014, an unexpected large dengue outbreak has attacked Guangzhou, China, resulting in more than 40,000 cases. Among the 1,942 laboratory-confirmed hospitalized dengue cases, 121 were diagnosed as severe dengue according to the 2009 WHO guideline, and 2 patients finally died. Laboratory diagnosis and virus isolation demonstrated that the majority (96%) cases were caused by dengue virus serotype 1 (DENV-1), and the others by serotype 2 (DENV-2). 14 DENV strains were isolated from the sera of acute-phase dengue patients during this outbreak, and the complete envelope (E) gene of 12 DENV-1 strains and two DENV-2 strains were determined using RT-PCR assay. Phylogenetic analysis based on the E gene revealed the DENV-1 strains isolated during the outbreak belonged to genotype I and V, respectively. These isolates formed three clades. DENV-2 isolates were assigned to the same clade belonging to genotype cosmopolitan. These strains isolated in 2014 were closely related to the isolates obtained from the same province, Guangdong, in 2013. No amino acid mutations known to increase virulence were identified throughout the E protein of isolates in 2014. These results indicate that dengue is turning into endemic in Guangdong, China, and extensive seroepidemiological investigation and mosquito control measures are critically needed in the future.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • China / epidemiology
  • Dengue / epidemiology*
  • Dengue Virus / classification
  • Dengue Virus / genetics
  • Dengue Virus / pathogenicity
  • Disease Outbreaks / statistics & numerical data
  • Female
  • Genome, Viral / genetics
  • Genotype
  • Humans
  • Male
  • Middle Aged
  • Molecular Epidemiology
  • Phylogeny
  • Sequence Analysis, DNA
  • Serogroup

Grants and funding

This study was supported by Guangzhou Science and Technology Program for Public Wellbeing (No.2014Y2-00185 and No.201508020263), the Special Program of Guangdong Provincial Department of Science and Technology (2013A020229001 and 2013A020229002), the Special Program of National Science and Technology of China (No.2013ZX10004-805), and the National Natural Science Foundation of China (No.81301491 and No.31270974). CF Qin was supported by the Excellent Young Scientist Program of the National Natural Science Foundation of China (No. 81522025) and the Newton Advanced Fellowship from the Academy of Medical Sciences, UK and the NSFC of China (No. 81661130162). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.