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Isolation of dengue viruses from hospitalized patients in the Philippines, 1983-1986
1US Naval Medical Research Unit, Manila, Philippines.
Abstract:
Between 1983-1986, 336 strains of dengue virus were isolated from 1,911 patients who had been hospitalized with clinically suspected DF/DHF in Manila and nearby areas. Multiple serotypes were present every year. Although DEN 3 was the most common serotype isolated (40%) over the entire study period, DEN 2 and DEN 1 were more frequently isolated in 1983 and 1984, respectively. DEN 4 was consistently the least common serotype recovered. During 1984, geographic differences in the pattern of serotypes isolated were found for two heavily populated areas located only 70 km apart. A higher proportion of DEN 2 isolates were recovered from patients with gastrointestinal bleeding compared to DEN 1 and DEN 3. A higher proportion of DEN 1 and DEN 3 isolates came from patients experiencing a 1 degree infection compared to DEN 2, and the mean homologous HI antibody titer of the sera that DEN 2 was isolated from was significantly higher than the homologous titers of sera from which DEN 1 and DEN 3 were isolated.
Insights
Dengue virus serotypes circulated in Manila between 1983-1986, with DEN 3 most common overall. Serotype distribution varied geographically and by clinical presentation, impacting dengue fever and dengue hemorrhagic fever patient outcomes.
Area of Science:
- Medical Virology
- Epidemiology
- Infectious Diseases
Background:
- Dengue virus (DENV) poses a significant public health threat, with multiple serotypes co-circulating and causing disease.
- Understanding the dynamics of DENV serotype distribution and their clinical associations is crucial for effective disease control.
Purpose of the Study:
- To analyze the serotype distribution of dengue virus isolates in Manila from 1983-1986.
- To investigate geographic variations and clinical correlations of different dengue virus serotypes.
Main Methods:
- Isolation and identification of 336 dengue virus strains from 1,911 hospitalized patients with suspected dengue fever (DF) or dengue hemorrhagic fever (DHF).
- Analysis of serotype prevalence, geographic distribution, and association with clinical manifestations like gastrointestinal bleeding and primary infection.
- Comparison of homologous hemagglutination inhibition (HI) antibody titers across different serotypes.
Main Results:
- Dengue virus serotype 3 (DEN 3) was the most frequently isolated (40%), followed by DEN 2 and DEN 1, with DEN 4 being the least common.
- Geographic variations in serotype prevalence were observed between two populated areas.
- DEN 2 isolates were more common in patients with gastrointestinal bleeding, while DEN 1 and DEN 3 were associated with primary infections and lower homologous HI antibody titers compared to DEN 2.
Conclusions:
- Dengue virus serotype distribution in Manila exhibited temporal and geographic variability during 1983-1986.
- Specific dengue virus serotypes showed distinct associations with clinical presentations and immune responses, highlighting the importance of serotype surveillance in disease management.