title: Molecular surveillance of circulating dengue genotypes through European travelers.
abstract: BACKGROUND
  Dengue viruses (DENV) are the most widespread arthropod-borne viruses, which have shown an unexpected geographic expansion, as well as an increase in number and severity of outbreaks in the last decades. Although the emergence of dengue is considered to be due to a number of complex factors, epidemiological studies have shown that some strains of dengue might be associated with increased severity and higher transmission rates than others. In this context, surveillance and identification of the appearance or introduction of more virulent strains, along with fluctuation of DENV among endemic areas are now considered essential public health activities.
  
  
  METHODS
  Samples from travelers returning from the tropics with acute dengue infections were analyzed to obtain up-dated information on circulating dengue strains. A short nucleotide fragment located in the carboxyl terminus of the dengue E gene was used for the characterization of DENV strains and the identification of their sero- and genotype.
  
  
  RESULTS
  One hundred eighty-six new dengue strains have been classified into 12 distinct genotype groups within the four dengue serotypes. The identification of the emergence of different sero- and genotypes, the appearance of new clades correlating with outbreaks, and the identification of a dengue-4 genotype not previously reported have been achieved. Interestingly, African strains characterized in this study have provided valuable data on dengue circulation on the continent.
  
  
  CONCLUSIONS
  This work demonstrates the convenience of routine application of molecular epidemiology analyses in dengue diagnosis laboratories. The use of molecular epidemiology tools on the analysis of imported dengue infections strengthens data acquisition on dengue strain movements correlating with epidemiological changes. The importance of surveillance of imported diseases contributing data for the epidemiological knowledge of infectious diseases in endemic areas has been once more demonstrated.
authors.affiliation: Diagnostic Microbiology, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain. Domingo-CarrascoC@rki.de
authors.forename: Cristina
authors.initials: C
authors.lastname: Domingo
authors.forename: Matthias
authors.initials: M
authors.lastname: Niedrig
authors.forename: Joaquim
authors.initials: J
authors.lastname: Gascón
authors.forename: Gustavo
authors.initials: G
authors.lastname: Palacios
authors.forename: Noelia
authors.initials: N
authors.lastname: Reyes
authors.forename: María José
authors.initials: MJ
authors.lastname: Malo
authors.forename: Ole
authors.initials: O
authors.lastname: Wichmann
authors.forename: Joaquim
authors.initials: J
authors.lastname: Ruiz
authors.forename: Detlev
authors.initials: D
authors.lastname: Schultze
authors.forename: Mirjam
authors.initials: M
authors.lastname: Schunk
authors.forename: Sabino
authors.initials: S
authors.lastname: Puente
authors.forename: Lasse
authors.initials: L
authors.lastname: Vinner
authors.forename: Marjan
authors.initials: M
authors.lastname: Van Esbroeck
authors.forename: Isabelle
authors.initials: I
authors.lastname: Schuffenecker
authors.forename: Marc
authors.initials: M
authors.lastname: Grandadam
authors.forename: Rogelio
authors.initials: R
authors.lastname: López-Vélez
authors.forename: Antonio
authors.initials: A
authors.lastname: Tenorio
mesh_terms: D000349:Africa; D001483:Base Sequence; D003715:Dengue / Q000097:blood / Q000453:epidemiology* / Q000821:virology*; D003716:Dengue Virus / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D005060:Europe / Q000453:epidemiology; D005838:Genotype; D006801:Humans; D012367:RNA, Viral; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014195:Travel
chemical_list: D012367:RNA, Viral