title: Epidemiology of dengue in Sri Lanka before and after the emergence of epidemic dengue hemorrhagic fever.
abstract: Before 1989, dengue epidemiology in Sri Lanka was characterized by frequent transmission of all four dengue serotypes but a low incidence of dengue hemorrhagic fever (DHF). After 1989, cases of DHF dramatically increased. Here we present the results of epidemiologic studies conducted in Colombo, Sri Lanka before and after epidemic emergence of DHF in 1989. We compared the proportion of dengue cases among people with fever attending clinics from 1980 to 1984 and in 1997 and 1998 to determine if an increase in dengue transmission was associated with more DHF cases being reported. We also compared the relative distribution of dengue virus serotypes circulating in Colombo before and after the emergence of DHF. We detected no significant differences in dengue as a proportion of fever cases or in serotype distribution between the pre and post-DHF periods. We conclude that an increase in virus transmission or a change in circulating serotypes does not explain the epidemic emergence of DHF in Sri Lanka.
authors.affiliation: Department of Microbiology and Immunology, University of North Carolina, Chapel Hill 27599, USA.
authors.forename: William B
authors.initials: WB
authors.lastname: Messer
authors.forename: U Tissa
authors.initials: UT
authors.lastname: Vitarana
authors.forename: Kamalanayani
authors.initials: K
authors.lastname: Sivananthan
authors.forename: Jayanthi
authors.initials: J
authors.lastname: Elvtigala
authors.forename: L D
authors.initials: LD
authors.lastname: Preethimala
authors.forename: R
authors.initials: R
authors.lastname: Ramesh
authors.forename: Nalini
authors.initials: N
authors.lastname: Withana
authors.forename: Duane J
authors.initials: DJ
authors.lastname: Gubler
authors.forename: Aravinda M
authors.initials: AM
authors.lastname: De Silva
mesh_terms: D000914:Antibodies, Viral / Q000097:blood; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003715:Dengue / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D003716:Dengue Virus / Q000235:genetics / Q000302:isolation & purification*; D006385:Hemagglutination Inhibition Tests; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D015994:Incidence; D015203:Reproducibility of Results; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012703:Serotyping / Q000379:methods; D019595:Severe Dengue / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology*; D013188:Sri Lanka / Q000453:epidemiology; D013997:Time Factors
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M