Abstract
Dengue virus (DENV), a globally emerging cause of undifferentiated fever, has been documented in the heavily urbanized western coast of Sri Lanka since the 1960s. New areas of Sri Lanka are now being affected, and the reported number and severity of cases have increased. To study emerging DENV in southern Sri Lanka, we obtained epidemiologic and clinical data and acute- and convalescent-phase serum samples from patients >2 years old with febrile illness. We tested paired serum samples for DENV IgG and IgM and serotyped virus by using isolation and reverse transcription PCR. We identified acute DENV infection (serotypes 2, 3, and 4) in 54 (6.3%) of 859 patients. Only 14% of patients had clinically suspected dengue; however, 54% had serologically confirmed acute or past DENV infection. DENV is a major and largely unrecognized cause of fever in southern Sri Lanka, especially in young adults.
Highlights
Dengue virus (DENV), a globally emerging cause of undifferentiated fever, has been documented in the heavily urbanized western coast of Sri Lanka since the 1960s
Blood and serum samples were stored promptly at −80°C and shipped on dry ice to the University of North Carolina School of Medicine, where paired serum samples were tested by ELISA and acute-phase serum samples were cultured and tested by PCR
Among the 859 patients with paired serum samples, 61.2% were male, and the median age was 30.7 years, which did not differ by sex (p = 0.97)
Summary
Dengue virus (DENV), a globally emerging cause of undifferentiated fever, has been documented in the heavily urbanized western coast of Sri Lanka since the 1960s. To study emerging DENV in southern Sri Lanka, we obtained epidemiologic and clinical data and acute- and convalescent-phase serum samples from patients >2 years old with febrile illness. Outpatient, clinic-based surveillance at Colombo’s Lady Ridgeway Children’s Hospital during 1980–1984 found dengue accounted for 16% of acute febrile illness, among which 66% were secondary (recurrent) dengue cases. A 1980–1985 school-based study found a baseline DENV seroprevalence of 50% in Colombo and a 6-month dengue incidence of 15.6%, of which 37% were secondary cases [4]. Since 1989, many cases of DHF have been reported from the heavily urbanized western coastal belt of Sri Lanka, which includes Colombo [5], and cases have recently been reported elsewhere in the country. The temperature ranged from highs of 27.5°C to 32°C and lows of 24°C to 26°C, and rainfall was variable (mean 301 mm, range 36–657 mm)
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