DENGUE HEMORRHAGIC FEVER CAUSED BY SEQUENTIAL DENGUE 1–3 VIRUS INFECTIONS OVER A LONG TIME INTERVAL: HAVANA EPIDEMIC, 2001–2002
Mayling Álvareza b, R. Rodrígueza b, Lídice Bernardoa b, Susana Vázqueza b, Luís Moriera b, Daniel C. Gonzaleza b, Osvaldo Castroa b, Gustavo Kouría b, Scott B. Halsteada b, María G. Guzmána b✉
- aDepartment of Virology, Pan American Health Organization/World Health Organization Collaborating Center for the Study of Dengue and its Vector, Department of Virology, Pedro Kourí Tropical Medicine Institute, Havana, Cuba
- bPediatric Dengue Vaccine Initiative, Bethesda, Maryland
- ✉Corresponding author
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Abstract
A dengue epidemic caused by dengue virus 3 (DENV-3) occurred in Cuba in 2001-2002. It included cases of dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS). We report neutralizing antibody studies on sera from 54 of 78 DHF/DSS patients that provide evidence of infections occurring in the sequence DENV-1 followed by DENV-3. No sera showed infection in the sequence DENV-2 followed by DENV-3. Some sera showed a pattern of infection in the sequence DENV-1 followed by DENV-2 and then DENV-3. However definitive categorization of a tertiary infection was not possible because of broadly reactive antibodies, which could have been raised by infections in the sequence DENV-1 then DENV-3.