title: A secondary dengue 4 infection in a traveler returning from Haiti confirmed by virus isolation, complete genome sequencing and neutralisation assay: a brief report.
abstract: Here we report the clinical and laboratory findings of a dengue 4 virus (DENV) secondary infection in a patient returning from Haiti to France. The diagnostic of acute DEN-4 virus infection was demonstrated by (i) the presence of DEN-4 RNA in two successive serum samples, (ii) the isolation of a DEN-4 virus in Vero cells and subsequent identification of subtype IIb through complete genome sequencing, (iii) the presence of dengue NS1 antigen, (iv) the seroconversion with detection of dengue IgM in the second serum while negative in the first serum. The diagnosis of secondary dengue episode was demonstrated by (i) the presence of dengue IgG in the early serum, and (ii) the demonstration that neutralising antibodies against DEN-3 were present at the acute stage of the disease. Next-generation sequencing has a primary role to play in phylogeographic studies including database sequences, sequences from imported cases, and sequences from autochthonous cases.
authors.affiliation: APHM CHU Conception, Marseille, France; IHU Méditerranée Infection, APHM Public Hospitals of Marseille, 13385 Marseille, France.
authors.forename: Amelie
authors.initials: A
authors.lastname: Menard
authors.affiliation: IHU Méditerranée Infection, APHM Public Hospitals of Marseille, 13385 Marseille, France; Aix Marseille Université, IRD French Institute of Research for Development, EHESP French School of Public Health, EPV UMR_D 190 "Emergence des Pathologies Virales", 13385 Marseille, France.
authors.forename: Laetitia
authors.initials: L
authors.lastname: Ninove
authors.affiliation: IHU Méditerranée Infection, APHM Public Hospitals of Marseille, 13385 Marseille, France; Aix Marseille Université, IRD French Institute of Research for Development, EHESP French School of Public Health, EPV UMR_D 190 "Emergence des Pathologies Virales", 13385 Marseille, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Zandotti
authors.affiliation: IHU Méditerranée Infection, APHM Public Hospitals of Marseille, 13385 Marseille, France; Aix Marseille Université, IRD French Institute of Research for Development, EHESP French School of Public Health, EPV UMR_D 190 "Emergence des Pathologies Virales", 13385 Marseille, France; Institut de Recherche Biomédicale des Armées, National Reference Laboratory for Arboviruses, Marseille, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Leparc-Goffart
authors.affiliation: IHU Méditerranée Infection, APHM Public Hospitals of Marseille, 13385 Marseille, France; Aix Marseille Université, IRD French Institute of Research for Development, EHESP French School of Public Health, EPV UMR_D 190 "Emergence des Pathologies Virales", 13385 Marseille, France.
authors.forename: Raphaelle
authors.initials: R
authors.lastname: Klitting
authors.affiliation: IHU Méditerranée Infection, APHM Public Hospitals of Marseille, 13385 Marseille, France; Aix Marseille Université, IRD French Institute of Research for Development, EHESP French School of Public Health, EPV UMR_D 190 "Emergence des Pathologies Virales", 13385 Marseille, France.
authors.forename: Cecile
authors.initials: C
authors.lastname: Baronti
authors.affiliation: APHM CHU Conception, Marseille, France; IHU Méditerranée Infection, APHM Public Hospitals of Marseille, 13385 Marseille, France.
authors.forename: Andreas
authors.initials: A
authors.lastname: Stein
authors.affiliation: IHU Méditerranée Infection, APHM Public Hospitals of Marseille, 13385 Marseille, France; Aix Marseille Université, IRD French Institute of Research for Development, EHESP French School of Public Health, EPV UMR_D 190 "Emergence des Pathologies Virales", 13385 Marseille, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: de Lamballerie
authors.affiliation: IHU Méditerranée Infection, APHM Public Hospitals of Marseille, 13385 Marseille, France; Aix Marseille Université, IRD French Institute of Research for Development, EHESP French School of Public Health, EPV UMR_D 190 "Emergence des Pathologies Virales", 13385 Marseille, France. Electronic address: remi.charrel@univ-amu.fr.
authors.forename: Rémi N
authors.initials: RN
authors.lastname: Charrel
mesh_terms: D000208:Acute Disease; D057134:Antibodies, Neutralizing / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood; D060085:Coinfection / Q000821:virology*; D003715:Dengue / Q000175:diagnosis* / Q000821:virology*; D003716:Dengue Virus / Q000145:classification* / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D005260:Female; D005602:France; D016679:Genome, Viral; D006205:Haiti; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D008875:Middle Aged; D010802:Phylogeny; D017422:Sequence Analysis, DNA; D014195:Travel
chemical_list: D057134:Antibodies, Neutralizing; D000914:Antibodies, Viral; D007075:Immunoglobulin M
keywords: Autochthonous; Fever; Flavivirus; Imported; Traveler