title: Severe dengue epidemics in Sri Lanka, 2003-2006.
abstract: Recent emergence of dengue hemorrhagic fever in the Indian subcontinent has been well documented in Sri Lanka. We compare recent (2003-2006) and past (1980-1997) dengue surveillance data for Sri Lanka. The 4 dengue virus (DENV) serotypes have been cocirculating in Sri Lanka for >30 years. Over this period, a new genotype of DENV-1 has replaced an old genotype. Moreover, new clades of DENV-3 genotype III viruses have replaced older clades. Emergence of new clades of DENV-3 in 1989 and 2000 coincided with abrupt increases in the number of reported dengue cases, implicating this serotype in severe epidemics. In 1980-1997, most reported dengue cases were in children. Recent epidemics have been characterized by many cases in children and adults. Changes in local transmission dynamics and genetic changes in DENV-3 are likely increasing emergence of severe dengue epidemics in Sri Lanka.
authors.affiliation: Genetech Research Institute, Colombo, Sri Lanka. genetech@slt.lk
authors.forename: Nalaka
authors.initials: N
authors.lastname: Kanakaratne
authors.forename: Wahala M P B
authors.initials: WM
authors.lastname: Wahala
authors.forename: William B
authors.initials: WB
authors.lastname: Messer
authors.forename: Hasitha A
authors.initials: HA
authors.lastname: Tissera
authors.forename: Aruna
authors.initials: A
authors.lastname: Shahani
authors.forename: Nihal
authors.initials: N
authors.lastname: Abeysinghe
authors.forename: Aravinda M
authors.initials: AM
authors.lastname: de-Silva
authors.forename: Maya
authors.initials: M
authors.lastname: Gunasekera
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000818:Animals; D002648:Child; D002675:Child, Preschool; D021821:Communicable Diseases, Emerging / Q000453:epidemiology* / Q000503:physiopathology / Q000821:virology; D003716:Dengue Virus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D004196:Disease Outbreaks; D005838:Genotype; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D010802:Phylogeny; D017422:Sequence Analysis, DNA; D012703:Serotyping; D019595:Severe Dengue / Q000453:epidemiology* / Q000503:physiopathology / Q000821:virology; D012720:Severity of Illness Index; D013188:Sri Lanka / Q000453:epidemiology; D055815:Young Adult