title: The clinical, serological and molecular diagnosis of emerging dengue infection at a tertiary care institute in southern, India.
abstract: BACKGROUND
  Dengue is an acute viral infection which presents as uneventful pyrexia to a fatal complication. This infection is increasingly being recognized as the world's major emerging tropical disease and an important public health problem. This article highlights the clinical manifestations of Dengue virus infection and the various molecular tests that were used for its laboratory diagnosis.
  
  
  METHODS
  Serum samples from 713 suspected cases of Dengue were collected between August and December 2007. The clinical profiles of 123 hospitalized patients were analyzed. Serology, RT- PCR, virus isolation and sequencing were done.
  
  
  RESULTS
  The most common clinical symptoms were fever, thrombocytopenia, rash and elevated liver enzymes. The demonstration of the Dengue RNA in 5.16% samples, the detection of Dengue specific IgM antibodies in 18% samples and the isolation of the DENV-4 and the DENV-3 viruses from the clinical samples confirmed this Dengue outbreak. A co -infection with Chikungunya was observed in 2.06% of the cases. The phylogenetic analysis revealed that the Indian Dengue-4 isolates from this outbreak belonged to the genotype I. This study clearly indicated the sudden dominance of DENV-4 in an Indian Dengue outbreak.
  
  
  CONCLUSIONS
  The surveillance of the Dengue viruses needs to be closely monitored for the emergence of newer serotype(s) in hitherto unknown areas.
authors: Department of Microbiology, Nizam's Institute of Medical Sciences , Punjagutta Hyderabad - 500082, A.P., India .
authors: Mamidi
authors: M
authors: Neeraja
authors: Vemu
authors: V
authors: Lakshmi
authors: P K
authors: PK
authors: Dash
authors: M M
authors: MM
authors: Parida
authors: P V L
authors: PV
authors: Rao
keywords: Chikungunya; Dengue fever; Dengue-3; Dengue-4; Phylogenetic analysis
references: J Clin Microbiol. 1992 Mar;30(3):545-51
references: 1372617
references: Science. 1964 Jan 10;143(3602):131-2
references: 14075719
references: Emerg Infect Dis. 1999 Jul-Aug;5(4):589-90
references: 10458971
references: J Gen Virol. 1997 Sep;78 ( Pt 9):2279-84
references: 9292015
references: Brief Bioinform. 2004 Jun;5(2):150-63
references: 15260895
references: Clin Diagn Lab Immunol. 1999 Sep;6(5):705-12
references: 10473522
references: Clin Microbiol Rev. 1998 Jul;11(3):480-96
references: 9665979
references: J Med Virol. 2004 Oct;74(2):314-22
references: 15332281
references: Emerg Infect Dis. 2009 Jul;15(7):1077-80
references: 19624923
references: Bioinformatics. 2003 Aug 12;19(12):1572-4
references: 12912839
references: Emerg Infect Dis. 2006 Oct;12(10):1580-3
references: 17176577
references: Emerg Infect Dis. 2006 Feb;12(2):352-3
references: 17080580
references: Indian J Pathol Microbiol. 2011 Oct-Dec;54(4):844-6
references: 22234131
references: Virol J. 2011 Feb 01;8:46
references: 21284832
references: Indian J Med Microbiol. 2006 Oct;24(4):280-2
references: 17185847
references: Virol J. 2009 Jan 06;6:1
references: 19126194
references: Southeast Asian J Trop Med Public Health. 2005 Mar;36(2):370-7
references: 15916043
references: Indian J Med Microbiol. 2011 Oct-Dec;29(4):359-62
references: 22120794
references: Clin Diagn Lab Immunol. 2004 Jul;11(4):642-50
references: 15242935
references: Diagn Microbiol Infect Dis. 2008 Sep;62(1):52-7
references: 18583086