title: First report of sylvatic DENV-2-associated dengue hemorrhagic fever in West Africa.
abstract: Dengue virus (DENV) circulates in human and sylvatic cycles. Sylvatic strains are both ecologically and evolutionarily distinct from endemic viruses. Although sylvatic dengue cycles occur in West African countries and Malaysia, only a few cases of mild human disease caused by sylvatic strains and one single case of dengue hemorrhagic fever in Malaysia have been reported. Here we report a case of dengue hemorrhagic fever (DHF) with thrombocytopenia (13000/µl), a raised hematocrit (32% above baseline) and mucosal bleeding in a 27-year-old male returning to Spain in November 2009 after visiting his home country Guinea Bissau. Sylvatic DENV-2 West African lineage was isolated from blood and sera. This is the first case of DHF associated with sylvatic DENV-2 in Africa and the second case worldwide of DHF caused by a sylvatic strain.
authors.affiliation: National Center for Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain. francolet@isciii.es
authors.forename: Leticia
authors.initials: L
authors.lastname: Franco
authors.forename: Gustavo
authors.initials: G
authors.lastname: Palacios
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Martinez
authors.forename: Ana
authors.initials: A
authors.lastname: Vázquez
authors.forename: Nazir
authors.initials: N
authors.lastname: Savji
authors.forename: Fernando
authors.initials: F
authors.lastname: De Ory
authors.forename: María Paz
authors.initials: MP
authors.lastname: Sanchez-Seco
authors.forename: Dolores
authors.initials: D
authors.lastname: Martín
authors.forename: W Ian
authors.initials: WI
authors.lastname: Lipkin
authors.forename: Antonio
authors.initials: A
authors.lastname: Tenorio
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D003716:Dengue Virus / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D054242:Emigrants and Immigrants; D004777:Environment; D004797:Enzyme-Linked Immunosorbent Assay; D006169:Guinea-Bissau / Q000208:ethnology; D006801:Humans; D008297:Male; D010802:Phylogeny; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000097:blood; D019595:Severe Dengue / Q000097:blood / Q000175:diagnosis / Q000821:virology*; D013030:Spain; D013921:Thrombocytopenia / Q000821:virology
chemical_list: D000914:Antibodies, Viral; D012367:RNA, Viral