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Australia ex SE Asia: Woman contracts potentially novel strain of dengue

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Senior Moderator
Published Date: 2014-09-10 12:59:44
Subject: PRO> Dengue - Australia: (QL) ex SE Asia, atypical strain susp
Archive Number: 20140910.2762015

DENGUE - AUSTRALIA: (QUEENSLAND) ex SOUTHEAST ASIA, ATYPICAL STRAIN SUSPECTED
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Date: Tue 9 Sep 2014
From: Alyssa Pyke <Alyssa.Pyke@health.qld.gov.au> [edited]


Dengue infection with a potentially atypical dengue virus strain -- Brisbane, Queensland, Australia, August 2014
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A female patient in her 50's who recently returned from Southeast Asia to Brisbane, Queensland, Australia, has been diagnosed with dengue disease attributed to infection with a potentially atypical dengue virus strain. The patient was a researcher who had spent considerable time in the jungle both day and night before returning to Australia in early July 2014. Whilst working in the jungle, the patient was repeatedly exposed to mosquitoes and developed dengue-like symptoms including fever, myalgia, and arthralgia. Although subsequent laboratory diagnosis confirmed dengue virus infection, further nucleotide sequencing analysis indicated that the dengue virus strain responsible for the illness was only distantly related to available dengue virus 1-4 serotype sequences, the closest being dengue virus serotype 1.

Interestingly, a 5th serotype of dengue virus from Malaysia of sylvatic origin has recently been reported (1), which is distinctly different to the dengue serotype 1-4 viruses usually involved in endemic and epidemic transmission in humans. It is possible that a sylvatic dengue virus may also be responsible for the illness in the Brisbane patient due to a potential spillover event.

Reference
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1. Vasilakis N: The Daemon in the Forest -- Emergence of a New Dengue Serotype in Southeast Asia. Conference Abstract 0025R01, The Third International Conference on Dengue and Dengue Haemorrhagic Fever, 21-23 Oct 2013, Bangkok, Thailand.

--
Communicated by:
Dr Alyssa Pyke,
Public and Environmental Health - Virology
Forensic & Scientific Services, Health Support Queensland
Department of Health, Queensland Government
Australia
<Alyssa.Pyke@health.qld.gov.au>

[This is a very interesting observation. Combined with the previous report that Dr Pike cites, it raises the question about unusual dengue types circulating in nature, perhaps in the absence of serial human transmission. It would be of interest to know if full sequences of these unusual types have been done. It would also be of interest to know exactly where in Southeast Asia these viruses were acquired.

Very early reports from the forests of the Malay Peninsula in the 1960s indicated that dengue virus was circulating among primates there based on serological studies, suggesting virus maintenance in the absence of human-to-human transmission. These primates were captured in forested areas far from human settlements. A sylvan maintenance cycle could provide geographic isolation and maintenance in non-human primates with persistence of, or emergence of, genetic differences from the human epidemic dengue viruses. It would be of interest to know if those Malay viruses are similar to these recent unusual isolates, but unfortunately no Malay virus isolates were made in that era of mouse inoculation.

References
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1. Rudnick A: Studies of the ecology of dengue in Malaysia. Bull World Health Organ. 1966; 35(1): 78-9; http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2476186/.
2. Rudnick A, Marchette NJ, Garcia R: Possible jungle dengue -- recent studies and hypotheses. Jpn J Med Sci Biol. 1967; 20 Suppl: 69-74.

Maps of Australia can be seen at http://www.ga.gov.au/image_cache/GA4073.jpg - Sr.Tech.Ed.MJ]

.................................................m pp/ty/mj/mpp
 
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