Abstract
BackgroundDengue is endemic in the Western Pacific and Oceania and the region reports more than 200,000 cases annually. Outbreaks of dengue and severe dengue occur regularly and movement of virus throughout the region has been reported. Disease surveillance systems, however, in many areas are not fully established and dengue incidence is underreported. Dengue epidemiology is likely least understood in Papua New Guinea (PNG), where the prototype DENV-2 strain New Guinea C was first isolated by Sabin in 1944 but where routine surveillance is not undertaken and little incidence and prevalence data is available.Methodology/Principal findingsSerum samples from individuals with recent acute febrile illness or with non-febrile conditions collected between 2007–2010 were tested for anti-DENV neutralizing antibody. Responses were predominantly multitypic and seroprevalence increased with age, a pattern indicative of endemic dengue. DENV-1, DENV-2 and DENV-3 genomes were detected by RT-PCR within a nine-month period and in several instances, two serotypes were identified in individuals sampled within a period of 10 days. Phylogenetic analysis of whole genome sequences identified a DENV-3 Genotype 1 lineage which had evolved on the northern coast of PNG which was likely exported to the western Pacific five years later, in addition to a DENV-2 Cosmopolitan Genotype lineage which had previously circulated in the region.Conclusions/SignificanceWe show that dengue is hyperendemic in PNG and identify an endemic, locally evolved lineage of DENV-3 that was associated with an outbreak of severe dengue in Pacific countries in subsequent years, although severe disease was not identified in PNG. Additional studies need to be undertaken to understand dengue epidemiology and burden of disease in PNG.
Highlights
The dengue viruses (DENV) are the most important arboviral pathogens of humans causing an estimated 390 million infections annually, of which approximately one quarter are symptomatic [1]
DENV infection is identified in travellers from Papua New Guinea (PNG) there are no data on locally circulating strains and how they may compare to viruses associated with severe dengue epidemics in other countries in the Asia Pacific region
We identified evidence for previous infection with all four DENV serotypes among people living on the northern coast of PNG, in Madang, and on Lihir Island in the Bismarck Archipelago off the northeastern coast
Summary
The dengue viruses (DENV) are the most important arboviral pathogens of humans causing an estimated 390 million infections annually, of which approximately one quarter are symptomatic [1]. Like other RNA viruses, DENV displays considerable genetic diversity and is grouped into four antigenically distinct serotypes (DENV-1-DENV-4) which may be distinguished on the basis of serum neutralization tests. DENV genetic diversity appears to impact host mechanisms shown to mediate pathogenesis [11] and disease severity. Dengue is endemic in the Western Pacific and Oceania and the region reports more than 200,000 cases annually. Outbreaks of dengue and severe dengue occur regularly and movement of virus throughout the region has been reported. Dengue epidemiology is likely least understood in Papua New Guinea (PNG), where the prototype DENV-2 strain New Guinea C was first isolated by Sabin in 1944 but where routine surveillance is not undertaken and little incidence and prevalence data is available
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