Virus-specific differences in rates of disease during the 2010 Dengue epidemic in Puerto Rico
Dengue is a potentially fatal acute febrile illness (AFI) caused by four mosquito-transmitted dengue viruses (DENV-1-4) that are endemic in Puerto Rico. In January 2010, the number of suspected dengue cases reported to the passive dengue surveillance system exceeded the epidemic threshold and an epi...
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| creator | Sharp, Tyler M Hunsperger, Elizabeth Santiago, Gilberto A Muñoz-Jordan, Jorge L Santiago, Luis M Rivera, Aidsa Rodríguez-Acosta, Rosa L Gonzalez Feliciano, Lorenzo Margolis, Harold S Tomashek, Kay M |
| description | Dengue is a potentially fatal acute febrile illness (AFI) caused by four mosquito-transmitted dengue viruses (DENV-1-4) that are endemic in Puerto Rico. In January 2010, the number of suspected dengue cases reported to the passive dengue surveillance system exceeded the epidemic threshold and an epidemic was declared soon after.
To characterize the epidemic, surveillance and laboratory diagnostic data were compiled. A suspected case was a dengue-like AFI in a person reported by a health care provider with or without a specimen submitted for diagnostic testing. Laboratory-positive cases had: (i) DENV nucleic acid detected by reverse transcriptase-polymerase chain reaction (RT-PCR) in an acute serum specimen; (ii) anti-DENV IgM antibody detected by ELISA in any serum specimen; or (iii) DENV antigen or nucleic acid detected in an autopsy-tissue specimen. In 2010, a total of 26,766 suspected dengue cases (7.2 per 1,000 residents) were identified, of which 46.6% were laboratory-positive. Of 7,426 RT-PCR-positive specimens, DENV-1 (69.0%) and DENV-4 (23.6%) were detected more frequently than DENV-2 (7.3%) and DENV-3 ( |
| doi_str_mv | 10.1371/journal.pntd.0002159 |
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To characterize the epidemic, surveillance and laboratory diagnostic data were compiled. A suspected case was a dengue-like AFI in a person reported by a health care provider with or without a specimen submitted for diagnostic testing. Laboratory-positive cases had: (i) DENV nucleic acid detected by reverse transcriptase-polymerase chain reaction (RT-PCR) in an acute serum specimen; (ii) anti-DENV IgM antibody detected by ELISA in any serum specimen; or (iii) DENV antigen or nucleic acid detected in an autopsy-tissue specimen. In 2010, a total of 26,766 suspected dengue cases (7.2 per 1,000 residents) were identified, of which 46.6% were laboratory-positive. Of 7,426 RT-PCR-positive specimens, DENV-1 (69.0%) and DENV-4 (23.6%) were detected more frequently than DENV-2 (7.3%) and DENV-3 (<0.1%). Nearly half (47.1%) of all laboratory-positive cases were adults, 49.7% had dengue with warning signs, 11.1% had severe dengue, and 40 died. Approximately 21% of cases were primary DENV infections, and 1-4 year olds were the only age group for which primary infection was more common than secondary. Individuals infected with DENV-1 were 4.2 (95% confidence interval [CI]: 1.7-9.8) and 4.0 (95% CI: 2.4-6.5) times more likely to have primary infection than those infected with DENV-2 or -4, respectively.
This epidemic was long in duration and yielded the highest incidence of reported dengue cases and deaths since surveillance began in Puerto Rico in the late 1960's. This epidemic re-emphasizes the need for more effective primary prevention interventions to reduce the morbidity and mortality of dengue.</description><identifier>ISSN: 1935-2735</identifier><identifier>ISSN: 1935-2727</identifier><identifier>EISSN: 1935-2735</identifier><identifier>DOI: 10.1371/journal.pntd.0002159</identifier><identifier>PMID: 23593526</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Age ; Biology ; Confidence intervals ; Dengue - epidemiology ; Dengue - virology ; Dengue fever ; Dengue Virus - classification ; Dengue Virus - genetics ; Dengue Virus - pathogenicity ; Dengue viruses ; Disease control ; Disease prevention ; Distribution ; Humans ; Illnesses ; Infections ; Laboratories ; Medicine ; Morbidity ; Mortality ; Phylogeny ; Polymerase chain reaction ; Puerto Rico - epidemiology ; Retrospective Studies</subject><ispartof>PLoS neglected tropical diseases, 2013-04, Vol.7 (4), p.e2159-e2159</ispartof><rights>COPYRIGHT 2013 Public Library of Science</rights><rights>2013</rights><rights>2013 Public Library of Science. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Citation: Sharp TM, Hunsperger E, Santiago GA, Muñoz-Jordan JL, Santiago LM, et al. (2013) Virus-Specific Differences in Rates of Disease during the 2010 Dengue Epidemic in Puerto Rico. PLoS Negl Trop Dis 7(4): e2159. doi:10.1371/journal.pntd.0002159</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c596t-9b8cf18e7ca0c0d4470681582b81eda82563a635e3eea6b065189819c309c2963</citedby><cites>FETCH-LOGICAL-c596t-9b8cf18e7ca0c0d4470681582b81eda82563a635e3eea6b065189819c309c2963</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3617145/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3617145/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23593526$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sharp, Tyler M</creatorcontrib><creatorcontrib>Hunsperger, Elizabeth</creatorcontrib><creatorcontrib>Santiago, Gilberto A</creatorcontrib><creatorcontrib>Muñoz-Jordan, Jorge L</creatorcontrib><creatorcontrib>Santiago, Luis M</creatorcontrib><creatorcontrib>Rivera, Aidsa</creatorcontrib><creatorcontrib>Rodríguez-Acosta, Rosa L</creatorcontrib><creatorcontrib>Gonzalez Feliciano, Lorenzo</creatorcontrib><creatorcontrib>Margolis, Harold S</creatorcontrib><creatorcontrib>Tomashek, Kay M</creatorcontrib><title>Virus-specific differences in rates of disease during the 2010 Dengue epidemic in Puerto Rico</title><title>PLoS neglected tropical diseases</title><addtitle>PLoS Negl Trop Dis</addtitle><description>Dengue is a potentially fatal acute febrile illness (AFI) caused by four mosquito-transmitted dengue viruses (DENV-1-4) that are endemic in Puerto Rico. In January 2010, the number of suspected dengue cases reported to the passive dengue surveillance system exceeded the epidemic threshold and an epidemic was declared soon after.
To characterize the epidemic, surveillance and laboratory diagnostic data were compiled. A suspected case was a dengue-like AFI in a person reported by a health care provider with or without a specimen submitted for diagnostic testing. Laboratory-positive cases had: (i) DENV nucleic acid detected by reverse transcriptase-polymerase chain reaction (RT-PCR) in an acute serum specimen; (ii) anti-DENV IgM antibody detected by ELISA in any serum specimen; or (iii) DENV antigen or nucleic acid detected in an autopsy-tissue specimen. In 2010, a total of 26,766 suspected dengue cases (7.2 per 1,000 residents) were identified, of which 46.6% were laboratory-positive. Of 7,426 RT-PCR-positive specimens, DENV-1 (69.0%) and DENV-4 (23.6%) were detected more frequently than DENV-2 (7.3%) and DENV-3 (<0.1%). Nearly half (47.1%) of all laboratory-positive cases were adults, 49.7% had dengue with warning signs, 11.1% had severe dengue, and 40 died. Approximately 21% of cases were primary DENV infections, and 1-4 year olds were the only age group for which primary infection was more common than secondary. Individuals infected with DENV-1 were 4.2 (95% confidence interval [CI]: 1.7-9.8) and 4.0 (95% CI: 2.4-6.5) times more likely to have primary infection than those infected with DENV-2 or -4, respectively.
This epidemic was long in duration and yielded the highest incidence of reported dengue cases and deaths since surveillance began in Puerto Rico in the late 1960's. This epidemic re-emphasizes the need for more effective primary prevention interventions to reduce the morbidity and mortality of dengue.</description><subject>Age</subject><subject>Biology</subject><subject>Confidence intervals</subject><subject>Dengue - epidemiology</subject><subject>Dengue - virology</subject><subject>Dengue fever</subject><subject>Dengue Virus - classification</subject><subject>Dengue Virus - genetics</subject><subject>Dengue Virus - pathogenicity</subject><subject>Dengue viruses</subject><subject>Disease control</subject><subject>Disease prevention</subject><subject>Distribution</subject><subject>Humans</subject><subject>Illnesses</subject><subject>Infections</subject><subject>Laboratories</subject><subject>Medicine</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Phylogeny</subject><subject>Polymerase chain reaction</subject><subject>Puerto Rico - epidemiology</subject><subject>Retrospective Studies</subject><issn>1935-2735</issn><issn>1935-2727</issn><issn>1935-2735</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>DOA</sourceid><recordid>eNptkl2L1DAUhoso7rr6D0QLgnjTMR9NmtwIy_q1sKCIeichTU87GTpJTVLBf2-6011mQHKRcM7zvjk5OUXxHKMNpg1-u_NzcHrcTC51G4QQwUw-KM6xpKwiDWUPj85nxZMYdwgxyQR-XJwRynKK8PPi108b5ljFCYztrSk72_cQwBmIpXVl0CkffJ_jEXSEspuDdUOZtlAShFH5HtwwQwmT7WCf9VnzdYaQfPnNGv-0eNTrMcKzdb8ofnz88P3qc3Xz5dP11eVNZZjkqZKtMD0W0BiNDOrqukFcYCZIKzB0WhDGqeaUAQXQvEWcYSEFloYiaYjk9KJ4efCdRh_V2pmoMM3gYrQQ1wei83qnpmD3OvxVXlt1G_BhUDoka0ZQjTCga0NI35qlFMm4EI1gmEpZtxqy17v1trndQ2fApaDHE9PTjLNbNfg_inLc4JplgzerQfC_Z4hJ7W00MI7agZ-XuolgNSc1zeirAzroXJp1vc-OZsHVJaWolkIQmanNf6i8bj_FO-htjp8IXh8JtqDHtI1-nJP1Lp6C9QE0wccYoL9_JkZqmcO7bqtlDtU6h1n24rhF96K7waP_AOjh2Fg</recordid><startdate>20130401</startdate><enddate>20130401</enddate><creator>Sharp, Tyler M</creator><creator>Hunsperger, Elizabeth</creator><creator>Santiago, Gilberto A</creator><creator>Muñoz-Jordan, Jorge L</creator><creator>Santiago, Luis M</creator><creator>Rivera, Aidsa</creator><creator>Rodríguez-Acosta, Rosa L</creator><creator>Gonzalez Feliciano, Lorenzo</creator><creator>Margolis, Harold S</creator><creator>Tomashek, Kay M</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20130401</creationdate><title>Virus-specific differences in rates of disease during the 2010 Dengue epidemic in Puerto Rico</title><author>Sharp, Tyler M ; Hunsperger, Elizabeth ; Santiago, Gilberto A ; Muñoz-Jordan, Jorge L ; Santiago, Luis M ; Rivera, Aidsa ; Rodríguez-Acosta, Rosa L ; Gonzalez Feliciano, Lorenzo ; Margolis, Harold S ; Tomashek, Kay M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c596t-9b8cf18e7ca0c0d4470681582b81eda82563a635e3eea6b065189819c309c2963</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Age</topic><topic>Biology</topic><topic>Confidence intervals</topic><topic>Dengue - epidemiology</topic><topic>Dengue - virology</topic><topic>Dengue fever</topic><topic>Dengue Virus - classification</topic><topic>Dengue Virus - genetics</topic><topic>Dengue Virus - pathogenicity</topic><topic>Dengue viruses</topic><topic>Disease control</topic><topic>Disease prevention</topic><topic>Distribution</topic><topic>Humans</topic><topic>Illnesses</topic><topic>Infections</topic><topic>Laboratories</topic><topic>Medicine</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Phylogeny</topic><topic>Polymerase chain reaction</topic><topic>Puerto Rico - epidemiology</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sharp, Tyler M</creatorcontrib><creatorcontrib>Hunsperger, Elizabeth</creatorcontrib><creatorcontrib>Santiago, Gilberto A</creatorcontrib><creatorcontrib>Muñoz-Jordan, Jorge L</creatorcontrib><creatorcontrib>Santiago, Luis M</creatorcontrib><creatorcontrib>Rivera, Aidsa</creatorcontrib><creatorcontrib>Rodríguez-Acosta, Rosa L</creatorcontrib><creatorcontrib>Gonzalez Feliciano, Lorenzo</creatorcontrib><creatorcontrib>Margolis, Harold S</creatorcontrib><creatorcontrib>Tomashek, Kay M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PLoS neglected tropical diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sharp, Tyler M</au><au>Hunsperger, Elizabeth</au><au>Santiago, Gilberto A</au><au>Muñoz-Jordan, Jorge L</au><au>Santiago, Luis M</au><au>Rivera, Aidsa</au><au>Rodríguez-Acosta, Rosa L</au><au>Gonzalez Feliciano, Lorenzo</au><au>Margolis, Harold S</au><au>Tomashek, Kay M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Virus-specific differences in rates of disease during the 2010 Dengue epidemic in Puerto Rico</atitle><jtitle>PLoS neglected tropical diseases</jtitle><addtitle>PLoS Negl Trop Dis</addtitle><date>2013-04-01</date><risdate>2013</risdate><volume>7</volume><issue>4</issue><spage>e2159</spage><epage>e2159</epage><pages>e2159-e2159</pages><issn>1935-2735</issn><issn>1935-2727</issn><eissn>1935-2735</eissn><abstract>Dengue is a potentially fatal acute febrile illness (AFI) caused by four mosquito-transmitted dengue viruses (DENV-1-4) that are endemic in Puerto Rico. In January 2010, the number of suspected dengue cases reported to the passive dengue surveillance system exceeded the epidemic threshold and an epidemic was declared soon after.
To characterize the epidemic, surveillance and laboratory diagnostic data were compiled. A suspected case was a dengue-like AFI in a person reported by a health care provider with or without a specimen submitted for diagnostic testing. Laboratory-positive cases had: (i) DENV nucleic acid detected by reverse transcriptase-polymerase chain reaction (RT-PCR) in an acute serum specimen; (ii) anti-DENV IgM antibody detected by ELISA in any serum specimen; or (iii) DENV antigen or nucleic acid detected in an autopsy-tissue specimen. In 2010, a total of 26,766 suspected dengue cases (7.2 per 1,000 residents) were identified, of which 46.6% were laboratory-positive. Of 7,426 RT-PCR-positive specimens, DENV-1 (69.0%) and DENV-4 (23.6%) were detected more frequently than DENV-2 (7.3%) and DENV-3 (<0.1%). Nearly half (47.1%) of all laboratory-positive cases were adults, 49.7% had dengue with warning signs, 11.1% had severe dengue, and 40 died. Approximately 21% of cases were primary DENV infections, and 1-4 year olds were the only age group for which primary infection was more common than secondary. Individuals infected with DENV-1 were 4.2 (95% confidence interval [CI]: 1.7-9.8) and 4.0 (95% CI: 2.4-6.5) times more likely to have primary infection than those infected with DENV-2 or -4, respectively.
This epidemic was long in duration and yielded the highest incidence of reported dengue cases and deaths since surveillance began in Puerto Rico in the late 1960's. This epidemic re-emphasizes the need for more effective primary prevention interventions to reduce the morbidity and mortality of dengue.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>23593526</pmid><doi>10.1371/journal.pntd.0002159</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Age Biology Confidence intervals Dengue - epidemiology Dengue - virology Dengue fever Dengue Virus - classification Dengue Virus - genetics Dengue Virus - pathogenicity Dengue viruses Disease control Disease prevention Distribution Humans Illnesses Infections Laboratories Medicine Morbidity Mortality Phylogeny Polymerase chain reaction Puerto Rico - epidemiology Retrospective Studies |
| title | Virus-specific differences in rates of disease during the 2010 Dengue epidemic in Puerto Rico |
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