title: Angola's 2013 dengue outbreak: clinical, laboratory and molecular analyses of cases from four Portuguese institutions.
abstract: BACKGROUND
  Dengue virus (DENV) is the arbovirus with the widest impact on human health. In Africa in general, and in Angola in particular, the epidemiology and public health impact of DENV is far from clear. However, rapid population growth, unplanned urbanization, increased international travel, and the presence of virus major vector (Aedes aegypti) in the country suggest that DENV transmission may occur.
  
  
  METHODS
  In parallel to the occurrence of a dengue outbreak affecting the capital of Angola, between March and July 2013 four Portuguese institutions diagnosed dengue infection in 146 individuals returning to Portugal. Clinical presentation, laboratory findings, and molecular analyses of partial viral genomic segments were performed.
  
  
  RESULTS
  The mean age of the individuals included in this study was 42 years old, the majority being men of Portuguese nationality, reporting various lengths of stay in Angola. Fever was the most reported clinical sign, being frequently associated (61.0%) with myalgia and headache. Hematological values, including hematocrit, white-blood cell and platelets counts, correlated with the absence of severe or complicated cases, or coagulation disorders. No deaths were observed. Viral NS1 was detected in 56.2% of the samples, and all NS1 negative cases had anti-dengue IgM antibodies. RT-PCR indicated the presence of DENV1, which was confirmed by phylogenetic analysis of 25 partial NS5 viral sequences.
  
  
  CONCLUSIONS
  The DENV cases analyzed conformed to classical and uncomplicated dengue, caused by the suggested exclusive circulation of a genetically homogeneous DENV1 of genotype III, apparently with a single origin.
authors.affiliation: Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisboa, Portugal. Ricardo@ihmt.unl.pt.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Parreira
authors.forename: Cláudia
authors.initials: C
authors.lastname: Conceição
authors.forename: Sónia
authors.initials: S
authors.lastname: Centeno-Lima
authors.forename: Nuno
authors.initials: N
authors.lastname: Marques
authors.forename: José
authors.initials: J
authors.lastname: Saraiva da Cunha
authors.forename: Cândida
authors.initials: C
authors.lastname: Abreu
authors.forename: Laura
authors.initials: L
authors.lastname: Sá
authors.forename: António
authors.initials: A
authors.lastname: Sarmento
authors.forename: Jorge
authors.initials: J
authors.lastname: Atouguia
authors.forename: Virgínia
authors.initials: V
authors.lastname: Moneti
authors.forename: Telma
authors.initials: T
authors.lastname: Azevedo
authors.forename: Jaime
authors.initials: J
authors.lastname: Nina
authors.forename: Kamal
authors.initials: K
authors.lastname: Mansinho
authors.forename: Abílio
authors.initials: A
authors.lastname: Antunes
authors.forename: Rosa
authors.initials: R
authors.lastname: Teodósio
authors.forename: Teresa
authors.initials: T
authors.lastname: Nazareth
authors.forename: Jorge
authors.initials: J
authors.lastname: Seixas
mesh_terms: D000328:Adult; D000368:Aged; D000810:Angola / Q000453:epidemiology; D000818:Animals; D001773:Blood Cells / Q000473:pathology; D003715:Dengue / Q000453:epidemiology* / Q000473:pathology* / Q000821:virology; D003716:Dengue Virus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D004196:Disease Outbreaks; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D012367:RNA, Viral / Q000097:blood / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D017361:Viral Nonstructural Proteins / Q000097:blood; D055815:Young Adult
chemical_list: D012367:RNA, Viral; D017361:Viral Nonstructural Proteins