Abstract
Investigation of a dengue case in a laboratory worker in North Carolina, USA, revealed that the case-patient prepared high-titer dengue virus stocks soon before illness onset. Improper doffing of gloves with an open finger wound likely resulted in cutaneous exposure. This case reinforces recommendations for enhanced precautions when working with high-titer dengue virus.
Highlights
The Study We interviewed the case-patient and reviewed medical records to collect travel history, potential exposures, clinical course, and diagnostic test results
Four serum specimens were forwarded to CDC for diagnostic testing: a baseline specimen collected ≈1.5 years before illness onset; an acute specimen collected 7 days after illness onset; an early-convalescent specimen collected ≈1 month after illness onset; and a late-convalescent specimen collected ≈6 months after illness onset (Table)
The acute specimen tested positive at a commercial laboratory for detection of nonstructural protein 1 (NS1) antigen and DENV IgM and negative for Ehrlichia IgG
Summary
The Study We interviewed the case-patient and reviewed medical records to collect travel history, potential exposures, clinical course, and diagnostic test results. After reporting the illness to the institutional occupational health clinic, the case-patient was referred to an infectious disease physician. The acute specimen tested positive at a commercial laboratory for detection of nonstructural protein 1 (NS1) antigen and DENV IgM and negative for Ehrlichia IgG. In the 2 weeks before illness onset, the casepatient reported working with a protocol to grow, purify, and concentrate DENV-4.
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