title: Laboratory surveillance of dengue virus in Central Brazil, 1994-2003.
abstract: BACKGROUND
  In Brazil, dengue endemic and epidemic patterns indicate an upward trend in incidence and hospitalization in the past decade.
  
  
  OBJECTIVE
  To report dengue circulating serotypes from 1994 to 2003 and the role of distinct serotypes on dengue clinical outcomes in Central Brazil.
  
  
  METHODS
  Virological surveillance for dengue cases was conducted in the city of Goiania ( approximately 1,200,000 population) from 1994 to 2003. Samples were tested using dengue IgM antibody (MAC-ELISA) and/or virus isolation. Circulating subtypes and genotypes were identified by reverse transcriptase PCR (RT-PCR) and by restricted site-specific PCR (RSS-PCR) patterns in selected samples.
  
  
  RESULTS
  Adults (87.4%) were the most affected group and dengue fever accounted for the majority of the cases. Laboratory surveillance identified mainly DEN 1 serotype from 1994 to 2002 shifting to a high circulation of DEN 3 in 2003. The ratio of dengue fever to dengue with complications/DHF remained constant following the introduction of DEN 3. Diagnosis of dengue was confirmed in approximately 50% of the suspected cases enhanced by RT-PCR. RSS-PCR patterns for DEN 1 and DEN 3 corresponded to the circulating subtypes in the country.
  
  
  CONCLUSIONS
  The result of virological surveillance did not suggest a major role of infecting DEN 3 serotype in increasing disease severity during its first-year spread in Central Brazil.
authors.affiliation: Public Health Laboratory-LACEN-Go, Secretariat of State of Goias, Goiania-Goias, Brazil.
authors.forename: Valéria Christina Rezende
authors.initials: VC
authors.lastname: Feres
authors.forename: Celina Maria Turchi
authors.initials: CM
authors.lastname: Martelli
authors.forename: Marilia Dalva
authors.initials: MD
authors.lastname: Turchi
authors.forename: João Bosco Siqueira
authors.initials: JB
authors.lastname: Junior
authors.forename: Rita Maria Ribeiro
authors.initials: RM
authors.lastname: Nogueira
authors.forename: Benigno Alberto Moraes
authors.initials: BA
authors.lastname: Rocha
authors.forename: Lucileis F F
authors.initials: LF
authors.lastname: Silva
authors.forename: Maysa Madalena
authors.initials: MM
authors.lastname: de Jesus Silva
authors.forename: Divina da Dores
authors.initials: Dda D
authors.lastname: de Paula Cardoso
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003715:Dengue / Q000097:blood / Q000145:classification* / Q000453:epidemiology*; D003716:Dengue Virus / Q000145:classification* / Q000302:isolation & purification; D004196:Disease Outbreaks; D006801:Humans; D007223:Infant; D008875:Middle Aged; D011159:Population Surveillance; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods; D012703:Serotyping