Outbreak of severe dengue associated with DENV-3 in the city of Manado, North Sulawesi, Indonesia
Suryadi N. N. Taturaa, Dionisius Denisb, Marsha Sinditia Santosob, Rahma Hayatib, Billy J. Kepelc, Benediktus Yohanb, R. Tedjo Sasmonob d✉
- aDivision of Paediatric Infection and Tropical Medicine, Department of Paediatrics, Faculty of Medicine, Sam Ratulangi University, and Prof. R.D. Kandou General Hospital, Manado, North Sulawesi, Indonesia
- bEijkman Institute for Molecular Biology, Jakarta, Indonesia
- cFaculty of Medicine, Sam Ratulangi University, Manado, North Sulawesi, Indonesia
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Abstract
BACKGROUND: In early 2019, an outbreak of severe dengue was reported in Manado, North Sulawesi Province, Indonesia. This epidemic raised public concern and recorded the highest number of cases in the last 10 years. This study aimed to determine the clinical spectrum, disease aetiology and virological characteristics associated with this outbreak of severe dengue. METHODS: Dengue was diagnosed using non-structural protein 1 detection, reverse transcription polymerase chain reaction and immunoglobulin (Ig)G/IgM serology. Envelope gene sequencing was conducted to determine the phylogeny of the dengue virus (DENV). RESULTS: In total, 146 patients with a median age of 8 years (interquartile range IQR 5-11 years) were recruited. Most patients experienced expanded dengue syndrome, characterized by severe organ involvement including liver enlargement, stomach ache and coagulation problems. During the outbreak, DENV-3 was the dominant serotype (75.9%). Smaller numbers of DENV-1, -2 and -4 were also detected. Phylogenetically, the dominant DENV-3 strains were grouped in multiple clusters and were related to other Indonesian strains, suggesting the emergence of heterogenous local viruses. CONCLUSION: The occurrence of an outbreak of severe dengue in Manado was confirmed, and DENV-3 was found to be the dominant serotype during the outbreak. This study shows the benefits of virological surveillance in understanding the aetiological agents responsible for outbreaks of severe dengue.
TL;DRThe occurrence of a severe dengue outbreak in Manado was confirmed and detected DENV-3 as the dominant serotype during the outbreak and demonstrates the benefits of virological surveillance in understanding the etiological agents responsible for outbreak of severe d Dengue. (Semantic Scholar)