title: First dengue co-infection in a Belgian traveler returning from Thailand, July 2013.
abstract: We report a dengue virus (DENV) co-infection in a Belgian traveler after a three-weeks holiday to Thailand. The patient recovered well without any complication. The infection was diagnosed by NS1 antigen testing and the concurrent presence of serotype DENV1 and DENV2 was demonstrated by reverse transcriptase polymerase chain reaction (RT-PCR) in acute phase serum sampled three days after symptoms onset. The predominant DENV1 serotype was identified as genotype I, lineage Asia-3 by sequencing. To our knowledge, this is the first time that a dengue co-infection is reported in a European traveler. The co-infection accounts for 1.0% of the total number of RT-PCR-positive samples (n=105) diagnosed in the reference laboratory of Belgium between 2008 and 2013. We expect that the number of reports on acute co-infections will increase in the coming years considering the increasing number of regions that are progressively becoming hyperendemic, especially in Southeast Asia.
authors.affiliation: Institute of Tropical Medicine (ITM), Department of Clinical Sciences, Central Laboratory for Clinical Biology (CLKB), Kronenburgstraat 43/3, B-2000 Antwerp, Belgium. Electronic address: lcnops@itg.be.
authors.forename: Lieselotte
authors.initials: L
authors.lastname: Cnops
authors.affiliation: Robert Koch Institute (RKI), Center for Biological Threats and Special Pathogens (ZBS-1), Nordufer 20, 13353 Berlin, Germany. Electronic address: Domingo-CarrascoC@rki.de.
authors.forename: Cristina
authors.initials: C
authors.lastname: Domingo
authors.affiliation: Institute of Tropical Medicine (ITM), Department of Clinical Sciences, Central Laboratory for Clinical Biology (CLKB), Kronenburgstraat 43/3, B-2000 Antwerp, Belgium. Electronic address: dorienvdb@hotmail.com.
authors.forename: Dorien
authors.initials: D
authors.lastname: Van den Bossche
authors.affiliation: Medisch Labo Medina, Hoogveld 10, B-9200 Dendermonde, Belgium. Electronic address: Evilien.vekens@medina.be.
authors.forename: Evilien
authors.initials: E
authors.lastname: Vekens
authors.affiliation: Huisartsenpraktijk De Mier, Luiaardweg 16, 1850 Grimbergen, Belgium. Electronic address: evelienbrigou@gmail.com.
authors.forename: Evelien
authors.initials: E
authors.lastname: Brigou
authors.affiliation: Institute of Tropical Medicine (ITM), Department of Clinical Sciences, Central Laboratory for Clinical Biology (CLKB), Kronenburgstraat 43/3, B-2000 Antwerp, Belgium. Electronic address: mvesbroeck@itg.be.
authors.forename: Marjan
authors.initials: M
authors.lastname: Van Esbroeck
mesh_terms: D000328:Adult; D000956:Antigens, Viral / Q000097:blood; D001530:Belgium; D060085:Coinfection / Q000175:diagnosis* / Q000821:virology; D003715:Dengue / Q000175:diagnosis* / Q000821:virology; D003716:Dengue Virus / Q000145:classification* / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D007159:Immunologic Tests; D025202:Molecular Diagnostic Techniques; D012367:RNA, Viral / Q000097:blood; D020133:Reverse Transcriptase Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D013785:Thailand; D014195:Travel
chemical_list: D000956:Antigens, Viral; D012367:RNA, Viral
keywords: Dengue virus; Imported case; Mixed infection; RT-PCR; Thailand; Travel