Molecular epidemiology of large dengue serotypes outbreak from Peru, 2023FIRST REVIEW ROUND - REVIEWERS...

Dengue has long been considered a neglected disease since its emergence. However, in recent years, the number of cases has increased significantly, particularly in tropical countries across Latin America.

This study aims to describe the evolution of dengue during the 2023 outbreak in Peru.

Here, we describe the analysis of 245 positive samples for dengue carried out by the National Institute of Health (INS) of Peru through genomic surveillance protocols, and analyse the evolution of serotypes and genotypes during the outbreak.

We analysed 245 dengue-positive samples sequenced by the INS of Peru during the 2023 outbreak to describe the evolutionary dynamics of circulating serotypes. We identified dengue virus (DENV)-1 genotype V (lineages D.1 and D.2), DENV-2 genotype II (Cosmopolitan, lineage F.1.2), and DENV-3 genotype III (lineage B.3). Phylogenetic and population-structure analyses revealed multiple introductions, rapid diversification, and wide dispersal of DENV-1 and DENV-2 across Peru, while DENV-3III showed a localised introduction in Lima with phylogenetic links to the Caribbean. Our findings provide the most comprehensive genomic characterisation to date of dengue circulation in Peru in 2023 year, and highlight the need for sustained genomic surveillance.

To summarise, the three serotypes of dengue in Peru show a dynamic diversity that becomes necessary to understand, to improve public health decisions by authorities.