title: Molecular epidemiology of dengue fever cases imported into Romania between 2008 and 2013.
abstract: BACKGROUND
  Dengue fever is the commonest arthropod-borne infection worldwide. In recent years, rapid growth in global air travel has resulted in a considerable increase in the incidence of imported cases. In Romania it is now the second most frequent cause for hospitalization (after malaria) in patients arriving from tropical regions.
  
  
  METHODS
  Serological and molecular diagnostics were applied to samples obtained between 2008 and 2013 from travelers with suspected dengue. Molecular typing was performed by RT-PCR followed by sequencing of the E-NS1 junction.
  
  
  RESULTS
  Twelve of 37 suspected cases were confirmed and three remained probable. The infections were acquired in endemic regions in Asia, Africa and in Europe (Madeira Island). Dengue virus nucleic acid was detected and sequenced in nine cases. Phylogenetic analysis indicated that the viruses were of genotypes I and V of serotype 1, cosmopolitan genotype of serotype 2 and genotypes I and III of serotype 3.
  
  
  CONCLUSIONS
  Romanian tourists traveling to dengue-endemic countries are at risk of acquiring dengue infection. Appropriate prevention measures prior to travel and upon return should be taken, particularly as the dengue secondary vector Aedes albopictus is now established in Bucharest.
authors.affiliation: Molecular Epidemiology Laboratory, "Cantacuzino" National Institute of Research-Development for Microbiology and Immunology, 103 Splaiul Independenţei, 050096 Bucharest, Romania; Genetics Department, Faculty of Biology, University of Bucharest, 1-3 Aleea Portocalelor, 060101 Bucharest, Romania.
authors.forename: Sorin
authors.initials: S
authors.lastname: Dinu
authors.affiliation: Vector-Borne Infections and Medical Entomology Laboratory, "Cantacuzino" National Institute of Research-Development for Microbiology and Immunology, 103 Splaiul Independenţei, 050096 Bucharest, Romania.
authors.forename: Ioana R
authors.initials: IR
authors.lastname: Pănculescu-Gătej
authors.affiliation: Clinical Hospital of Infectious and Tropical Diseases "Dr. Victor Babeş", 281 Şos. Mihai Bravu, 030303 Bucharest, Romania; University of Medicine "Carol Davila", 37 Dionisie Lupu, 020021 Bucharest, Romania.
authors.forename: Simin A
authors.initials: SA
authors.lastname: Florescu
authors.affiliation: Clinical Hospital of Infectious and Tropical Diseases "Dr. Victor Babeş", 281 Şos. Mihai Bravu, 030303 Bucharest, Romania; University of Medicine "Carol Davila", 37 Dionisie Lupu, 020021 Bucharest, Romania.
authors.forename: Corneliu P
authors.initials: CP
authors.lastname: Popescu
authors.affiliation: National Institute of Public Health-National Centre for Surveillance and Control of Communicable Diseases, 1-3 Dr. Leonte Anastasievici, 050463, Bucharest, Romania.
authors.forename: Anca
authors.initials: A
authors.lastname: Sîrbu
authors.affiliation: Molecular Epidemiology Laboratory, "Cantacuzino" National Institute of Research-Development for Microbiology and Immunology, 103 Splaiul Independenţei, 050096 Bucharest, Romania.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Oprişan
authors.affiliation: Vector-Borne Infections and Medical Entomology Laboratory, "Cantacuzino" National Institute of Research-Development for Microbiology and Immunology, 103 Splaiul Independenţei, 050096 Bucharest, Romania.
authors.forename: Daniela
authors.initials: D
authors.lastname: Bădescu
authors.affiliation: Arbovirus and Imported Viral Diseases, National Centre of Microbiology, Instituto de Salud Carlos III, Ctra. de Majadahonda-Pozuelo, km. 2,200, 28220 Majadahonda, Madrid, Spain.
authors.forename: Leticia
authors.initials: L
authors.lastname: Franco
authors.affiliation: Vector-Borne Infections and Medical Entomology Laboratory, "Cantacuzino" National Institute of Research-Development for Microbiology and Immunology, 103 Splaiul Independenţei, 050096 Bucharest, Romania. Electronic address: ceianu@cantacuzino.ro.
authors.forename: Cornelia S
authors.initials: CS
authors.lastname: Ceianu
mesh_terms: D000330:Aedes / Q000821:virology; D000349:Africa; D000818:Animals; D001208:Asia; D003715:Dengue / Q000453:epidemiology* / Q000821:virology*; D003716:Dengue Virus / Q000235:genetics*; D005060:Europe; D006801:Humans; D015994:Incidence; D017720:Molecular Epidemiology; D058889:Molecular Typing; D010802:Phylogeny; D060888:Real-Time Polymerase Chain Reaction; D012383:Romania / Q000453:epidemiology; D017422:Sequence Analysis, DNA; D014195:Travel
keywords: DNA sequencing; Dengue viruses; Mosquito-borne infection; Phylogenetic analysis; RT-PCR