title: A survey of the 2014 dengue fever epidemic in Guangzhou, China.
abstract: In 2014, a serious dengue outbreak in Guangzhou occurred, consisting of 37 354 laboratory confirmed cases of infection. In this study, the clinical picture of dengue fever due to dengue virus (DENV) type 1 in Guangzhou was described. Clinical and laboratory data collected by studying 726 sera of suspected clinical cases from hospitals and 328 sera of healthy persons from two residence communities were analyzed during the outbreak, and 484 patients were diagnosed with an acute dengue infection. Fever, headache, congestion of the throat, and myalgia were the most typical symptoms in DENV-infected patients. Thrombocytopenia, leukopenia, and an increase in liver enzymes were significantly more common in the infected patients than in the healthy controls. Fourteen cases of silent infection were discovered among the 328 healthy persons, suggesting a DENV inapparent infection rate of 4.27% among healthy individuals. The data obtained by analyzing 212 positive sera with three methods indicated different results with different detection methods. DENV RNA should be used for early diagnoses during days 1-6 after symptom onset, immunoglobulin M (IgM) can be easily recognized after four days have passed since symptom onset and DENV isolation has a peak positive rate during days 1-3 after the onset of symptoms. A phylogenetic analysis of viral NS1 gene sequences from this outbreak indicated that the predominant isolates could be categorized as DENV-1 genotype III and had the highest homology with the India genotypes from 2009 to 2011. However, this analysis also revealed a co-epidemic of the 2013 Zhongshan and 2003 Singapore genotypes, both belonging to DENV-1 genotype I, which suggested multiple geographic origins for the 2014 epidemic of dengue 1 strains in Guangzhou.
authors.affiliation: Center for Disease Control and Prevention of Guangzhou Military Command of the PLA, Guangzhou 510507, Guangdong Province, China.|Guangdong Arbovirus Diseases Emergency Technology Research Center, Guangzhou 510507, Guangdong Province, China.
authors.forename: Liu
authors.initials: L
authors.lastname: Yang
authors.affiliation: Center for Disease Control and Prevention of Guangzhou Military Command of the PLA, Guangzhou 510507, Guangdong Province, China.|Guangdong Arbovirus Diseases Emergency Technology Research Center, Guangzhou 510507, Guangdong Province, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Center for Disease Control and Prevention of Guangzhou Military Command of the PLA, Guangzhou 510507, Guangdong Province, China.|Guangdong Arbovirus Diseases Emergency Technology Research Center, Guangzhou 510507, Guangdong Province, China.
authors.forename: Huacheng
authors.initials: H
authors.lastname: Yan
authors.affiliation: Center for Disease Control and Prevention of Guangzhou Military Command of the PLA, Guangzhou 510507, Guangdong Province, China.|Guangdong Arbovirus Diseases Emergency Technology Research Center, Guangzhou 510507, Guangdong Province, China.
authors.forename: Pei
authors.initials: P
authors.lastname: Zhang
authors.affiliation: South China Agriculture University, Guangzhou 510642, Guangdong Province, China.
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Xu
authors.affiliation: Center for Disease Control and Prevention of Guangzhou Military Command of the PLA, Guangzhou 510507, Guangdong Province, China.|Guangdong Arbovirus Diseases Emergency Technology Research Center, Guangzhou 510507, Guangdong Province, China.
authors.forename: Boheng
authors.initials: B
authors.lastname: Tang
authors.affiliation: The Second Military Medical University, Shanghai 200433, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Zhao
authors.affiliation: Center for Disease Control and Prevention of Guangzhou Military Command of the PLA, Guangzhou 510507, Guangdong Province, China.|Guangdong Arbovirus Diseases Emergency Technology Research Center, Guangzhou 510507, Guangdong Province, China.
authors.forename: Ruiwen
authors.initials: R
authors.lastname: Ren
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D003715:Dengue / Q000453:epidemiology*; D003716:Dengue Virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D004196:Disease Outbreaks; D005260:Female; D005838:Genotype; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D017422:Sequence Analysis, DNA; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D007075:Immunoglobulin M