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An outbreak of dengue-type fever among royal marines in Sabah--1964

Wilson RG

J R Nav Med Serv, 1973;59(1):30-4.
PMID: 4147205
Matched MeSH terms: Dengue*
Fulltext Correlation analysis of air pollutant index levels and dengue cases across five different zones in Selangor, Malaysia

Thiruchelvam L, Dass SC, Zaki R, Yahya A, Asirvadam VS

Geospat Health, 2018 05 07;13(1):613.
PMID: 29772882 DOI: 10.4081/gh.2018.613

This study investigated the potential relationship between dengue cases and air quality - as measured by the Air Pollution Index (API) for five zones in the state of Selangor, Malaysia. Dengue case patterns can be learned using prediction models based on feedback (lagged terms). However, the question whether air quality affects dengue cases is still not thoroughly investigated based on such feedback models. This work developed dengue prediction models using the autoregressive integrated moving average (ARIMA) and ARIMA with an exogeneous variable (ARIMAX) time series methodologies with API as the exogeneous variable. The Box Jenkins approach based on maximum likelihood was used for analysis as it gives effective model estimates and prediction. Three stages of model comparison were carried out for each zone: first with ARIMA models without API, then ARIMAX models with API data from the API station for that zone and finally, ARIMAX models with API data from the zone and spatially neighbouring zones. Bayesian Information Criterion (BIC) gives goodness-of-fit versus parsimony comparisons between all elicited models. Our study found that ARIMA models, with the lowest BIC value, outperformed the rest in all five zones. The BIC values for the zone of Kuala Selangor were -800.66, -796.22, and -790.5229, respectively, for ARIMA only, ARIMAX with single API component and ARIMAX with API components from its zone and spatially neighbouring zones. Therefore, we concluded that API levels, either temporally for each zone or spatio- temporally based on neighbouring zones, do not have a significant effect on dengue cases.

Matched MeSH terms: Dengue/epidemiology*
Fulltext Operational utility of the reverse-transcription recombinase polymerase amplification for detection of dengue virus

Tan KK, Azizan NS, Yaacob CN, Che Mat Seri NAA, Samsudin NI, Teoh BT, et al.

BMC Infect Dis, 2018 04 11;18(1):169.
PMID: 29642856 DOI: 10.1186/s12879-018-3065-1

BACKGROUND: A method for rapid detection of dengue virus using the reverse-transcription recombinase polymerase amplification (RT-RPA) was recently developed, evaluated and made ready for deployment. However, reliance solely on the evaluation performed by experienced researchers in a well-structured and well-equipped reference laboratory may overlook the potential intrinsic problems that may arise during deployment of the assay into new application sites, especially for users unfamiliar with the test. Appropriate assessment of this newly developed assay by users who are unfamiliar with the assay is, therefore, vital.
METHODS: An operational utility test to elucidate the efficiency and effectiveness of the dengue RT-RPA assay was conducted among a group of researchers new to the assay. Nineteen volunteer researchers with different research experience were recruited. The participants performed the RT-RPA assay and interpreted the test results according to the protocol provided. Deviation from the protocol was identified and tabulated by trained facilitators. Post-test questionnaires were conducted to determine the user satisfaction and acceptability of the dengue RT-RPA assay.
RESULTS: All the participants completed the test and successfully interpreted the results according to the provided instructions, regardless of their research experience. Of the 19 participants, three (15.8%) performed the assay with no deviations and 16 (84.2%) performed the assay with only 1 to 5 deviations. The number of deviations from protocol, however, was not correlated with the user laboratory experience. The accuracy of the results was also not affected by user laboratory experience. The concordance of the assay results against that of the expected was at 89.3%. The user satisfaction towards the RT-RPA protocol and interpretation of results was 90% and 100%, respectively.
CONCLUSIONS: The dengue RT-RPA assay can be successfully performed by simply following the provided written instructions. Deviations from the written protocols did not adversely affect the outcome of the assay. These suggest that the RT-RPA assay is indeed a simple, robust and efficient laboratory method for detection of dengue virus. Furthermore, high new user acceptance of the RT-RPA assay suggests that this assay could be successfully deployed into new laboratories where RT-RPA was not previously performed.

Matched MeSH terms: Dengue; Dengue Virus
Acute disseminated encephalomyelitis in dengue viral infection

Wan Sulaiman WA, Inche Mat LN, Hashim HZ, Hoo FK, Ching SM, Vasudevan R, et al.

J Clin Neurosci, 2017 Sep;43:25-31.
PMID: 28625589 DOI: 10.1016/j.jocn.2017.05.033

Dengue is the most common arboviral disease affecting many countries worldwide. An RNA virus from the flaviviridae family, dengue has four antigenically distinct serotypes (DEN-1-DEN-4). Neurological involvement in dengue can be classified into dengue encephalopathy immune-mediated syndromes, encephalitis, neuromuscular or dengue muscle dysfunction and neuro-ophthalmic involvement. Acute disseminated encephalomyelitis (ADEM) is an immune mediated acute demyelinating disorder of the central nervous system following recent infection or vaccination. This monophasic illness is characterised by multifocal white matter involvement. Many dengue studies and case reports have linked ADEM with dengue virus infection but the association is still not clear. Therefore, this article is to review and discuss concerning ADEM in dengue as an immune-medicated neurological complication; and the management strategy required based on recent literature.

Matched MeSH terms: Dengue; Dengue Virus
Dengue fever with compartment syndrome of the right arm

Khoo C, Chu G, Rosaida MS, Chidambaram SK

J R Coll Physicians Edinb, 2016 Dec;46(4):241-243.
PMID: 28504777 DOI: 10.4997/JRCPE.2016.406

A 44-year-old woman was admitted to our hospital with dengue fever. She developed a haematoma in the right arm at the site of a previous arterial line insertion. Due to coexisting thrombocytopenia, the bleeding was severe enough to cause compartment syndrome. An emergency fasciotomy was performed and her limb salvaged. The case illustrates one important potential complication of this common infectious disease.

Matched MeSH terms: Dengue/complications*
Unusual presentation of severe dengue: Dengue maculopathy

Chuah KH, Ng CW, Zabri K, Wong CL

Med J Malaysia, 2017 02;72(1):73-74.
PMID: 28255149 MyJurnal

Dengue infection is epidemic but ocular complications of dengue are less reported. We report a case of dengueinfected patient with disturbing ocular symptoms. He was admitted for severe dengue. Subsequently, he presented with symptoms of bilateral central scotoma with metamorphosia. Fundus examination revealed cotton wool spots and flame-shaped haemorrhages at the macula, with dull foveal light reflex. He was diagnosed with bilateral dengue maculopathy. The patient was managed conservatively with surveillance. One week later, his eye symptoms improved and were resolved six months later. Early recognition and close monitoring remains the key to successful management and interventions are rarely needed.

Matched MeSH terms: Dengue; Severe Dengue
Fulltext Clinical manifestations of dengue in relation to dengue serotype and genotype in Malaysia: A retrospective observational study

Suppiah J, Ching SM, Amin-Nordin S, Mat-Nor LA, Ahmad-Najimudin NA, Low GK, et al.

PLoS Negl Trop Dis, 2018 09;12(9):e0006817.
PMID: 30226880 DOI: 10.1371/journal.pntd.0006817

BACKGROUND: Malaysia experienced an unprecedented dengue outbreak from the year 2014 to 2016 that resulted in an enormous increase in the number of cases and mortality as compared to previous years. The causes that attribute to a dengue outbreak can be multifactorial. Viral factors, such as dengue serotype and genotype, are the components of interest in this study. Although only a small number of studies investigated the association between the serotype of dengue virus and clinical manifestations, none of these studies included analyses on dengue genotypes. The present study aims to investigate dengue serotype and genotype-specific clinical characteristics among dengue fever and severe dengue cases from two Malaysian tertiary hospitals between 2014 and mid-2017.
METHODOLOGY AND PRINCIPAL FINDINGS: A total of 120 retrospective dengue serum specimens were subjected to serotyping and genotyping by Taqman Real-Time RT-PCR, sequencing and phylogenetic analysis. Subsequently, the dengue serotype and genotype data were statistically analyzed for 101 of 120 corresponding patients' clinical manifestations to generate a descriptive relation between the genetic components and clinical outcomes of dengue infected patients. During the study period, predominant dengue serotype and genotype were found to be DENV 1 genotype I. Additionally, non-severe clinical manifestations were commonly observed in patients infected with DENV 1 and DENV 3. Meanwhile, patients with DENV 2 infection showed significant warning signs and developed severe dengue (p = 0.007). Cases infected with DENV 2 were also commonly presented with persistent vomiting (p = 0.010), epigastric pain (p = 0.018), plasma leakage (p = 0.004) and shock (p = 0.038). Moreover, myalgia and arthralgia were highly prevalent among DENV 3 infection (p = 0.015; p = 0.014). The comparison of genotype-specific clinical manifestations showed that DENV 2 Cosmopolitan was significantly common among severe dengue patients. An association was also found between genotype I of DENV 3 and myalgia. In a similar vein, genotype III of DENV 3 was significantly common among patients with arthralgia.
CONCLUSION: The current data contended that different dengue serotype and genotype had caused distinct clinical characteristics in infected patients.

Matched MeSH terms: Dengue/pathology*; Dengue/virology*; Dengue Virus/classification*; Dengue Virus/genetics; Dengue Virus/immunology; Dengue Virus/isolation & purification*
Fulltext Platelet Transcriptome-based approaches in the fight against dengue and other diseases

Suppiah, J., Sakinah, S., Chan, S.Y., Wong, Y.P., Subbiah, S.K., Chee, H.Y., et al.

Pertanika Journal of Science & Technology, 2018;26(3):933-946.
MyJurnal

Human platelets are anucleate cells that lack in deoxyribonucleic acid (DNA), thus hampering genomic study on them. However, the presence of their own messenger ribonucleic acid (mRNA) transcript allows functional study via the transcriptome approach. Transcriptome not only allows profiling of platelet but also aids in studying gene regulation in virus infections and other diseases that have an impact on platelets. Some viruses are known to affect the platelet either by causing a reduction or destruction. Dengue virus is one of the most postulated virus having such effect and frequently linked to platelet reduction. The transcriptome approach has a pivotal role in providing a deeper insight to link certain diseases and their effect on platelets. This review critically discusses role of platelet in dengue and other viral diseases of public health relevance, with a specific focus on the methods currently used in platelet transcriptome profiling.

Matched MeSH terms: Dengue; Dengue Virus
Evaluation of the spatial risk factors for high incidence of dengue fever and dengue hemorrhagic fever using GIS application

Aziz Shafie

Sains Malaysiana, 2011;40:1179-1186.

In Malaysia, the incidence of Dengue Fever (DF) and Dengue Hemorrhagic Fever (DHF) have risen dramatically in the last twenty years. With the use of Geographical Information System an explanation for the spread and control of these diseases can be obtained. This study aims to develop a spatial modeling that can predict the risks for DF and DHF based on environmental factors such as physical surroundings, land use, rainfall, temperature and GIS application using logistic regression. A total of 16 variables were used in the process of spatial modeling development. At the significant level of 0.05, the results of logistic regression showed that only 10 out of 16 significant variables in the modeling process. The accuracy of the resulting model is 70.3%. A crucial feature of this study is a risk area map for incidence of DF and DHF in the study area. This study also highlights the application of spatial analysis in planning and implementing the process for the prevention and control activities of DF and DHF in Malaysia.

Matched MeSH terms: Dengue; Severe Dengue
Infectious Diseases: Antiviral Wolbachia Limits Dengue in Malaysia

Chrostek E, Hurst GDD, McGraw EA

Curr Biol, 2020 01 06;30(1):R30-R32.
PMID: 31910374 DOI: 10.1016/j.cub.2019.11.046

Vector-borne viral diseases pose an urgent public health challenge, particularly in the tropics. Field releases of mosquitoes carrying bacterial symbionts that reduce vector competence are ongoing in Kuala Lumpur, Malaysia. Early results show that wAlbB Wolbachia can persist in mosquitoes in urban settings and decrease dengue incidence in humans.

Matched MeSH terms: Dengue Virus*
Fulltext The Conserved Molecular Determinants of Virulence in Dengue Virus

Ahmad Z, Poh CL

Int J Med Sci, 2019;16(3):355-365.
PMID: 30911269 DOI: 10.7150/ijms.29938

Dengue virus belongs to the Flaviviridae family which also includes viruses such as the Zika, West Nile and yellow fever virus. Dengue virus generally causes mild disease, however, more severe forms of the dengue virus infection, dengue haemorrhagic fever (DHF) and dengue haemorrhagic fever with shock syndrome (DSS) can also occur, resulting in multiple organ failure and even death, especially in children. The only dengue vaccine available in the market, CYD-TDV offers limited coverage for vaccinees from 9-45 years of age and is only recommended for individuals with prior dengue exposure. A number of mutations that were shown to attenuate virulence of dengue virus in vitro and/or in vivo have been identified in the literature. The mutations which fall within the conserved regions of all four dengue serotypes are discussed. This review hopes to provide information leading to the construction of a live attenuated dengue vaccine that is suitable for all ages, irrespective of the infecting dengue serotype and prior dengue exposure.

Matched MeSH terms: Dengue/prevention & control; Dengue Virus/genetics*; Dengue Virus/pathogenicity*; Dengue Vaccines/immunology; Dengue Vaccines/pharmacology*
A LEGO inspired fiber probe analytical platform for early diagnosis of Dengue fever

Hosseini S, Azari P, Cardenas-Benitez B, Martínez-Guerra E, Aguirre-Tostado FS, Vázquez-Villegas P, et al.

Mater Sci Eng C Mater Biol Appl, 2020 Apr;109:110629.
PMID: 32228934 DOI: 10.1016/j.msec.2020.110629

Based on the concept of LEGO toys, a fiber probe analytical platform (FPAP) was developed as a powerful diagnostic tool offering higher sensitivity in detection of infectious agents compared to established methods. Using the form and the function of LEGO toys, this protocol describes a fiber-based, 96-well plate, which suspends a new class of chemically-designed, electrospun fibers within the assay. This clamping strategy allows both sides of the developed fiber mats to interact with biomolecules within the assay thus benefiting from the tailored chemical and physical properties of these fiber-based bioreceptors in attracting the biomolecules to the surface. The fabrication method of FPAP involves one-step electrospinning of the chemically designed fibers, 3D printing of the LEGO-like probing segments, and assembly of the device followed by ELISA procedure. FPAP follows the same principles of operation as that of a conventional enzyme linked immunosorbent assay (ELISA), therefore, it can be run by lab technicians, expert in ELISA. FPAP was used for early diagnosis of Dengue fever and provided an 8-fold higher sensitivity while the limit of detection (LOD) was recorded to be in femto-gram per milliliter range which is significantly low when compared to other existing techniques or conventional assay. This platform allows different types of paper/fiber bio-receptive platforms to be incorporated within the design that promises simultaneous recognition of multiple infectious agents.

Matched MeSH terms: Dengue Virus/immunology*
Developing a dengue prediction model based on climate in Tawau, Malaysia

Jayaraj VJ, Avoi R, Gopalakrishnan N, Raja DB, Umasa Y

Acta Trop, 2019 Sep;197:105055.
PMID: 31185224 DOI: 10.1016/j.actatropica.2019.105055

Dengue is fast becoming the most urgent health issue in Malaysia, recording close to a 10-fold increase in cases over the last decade. With much uncertainty hovering over the recently introduced tetravalent vaccine and no effective antiviral drugs, vector control remains the most important strategy in combating dengue. This study analyses the relationship between weather predictors including its lagged terms, and dengue incidence in the District of Tawau over a period of 12 years, from 2006 to 2017. A forecasting model purposed to predict future outbreaks in Tawau was then developed using this data. Monthly dengue incidence data, mean temperature, maximum temperature, minimum temperature, mean relative humidity and mean rainfall over a period of 12 years from 2006 to 2017 in Tawau were retrieved from Tawau District Health Office and the Malaysian Meteorological Department. Cross-correlation analysis between weather predictors, lagged terms of weather predictors and dengue incidences established statistically significant cross-correlation between lagged periods of weather predictors-namely maximum temperature, mean relative humidity and mean rainfall with dengue incidence at time lags of 4-6 months. These variables were then employed into 3 different methods: a multivariate Poisson regression model, a Seasonal Autoregressive Integrated Moving Average (SARIMA) model and a SARIMA with external regressors for selection. Three models were selected but the SARIMA with external regressors model utilising maximum temperature at a lag of 6 months (p-value:0.001), minimum temperature at a lag of 4 months (p-value:0.01), mean relative humidity at a lag of 2 months (p-value:0.001), and mean rainfall at a lag of 6 months (p-value:0.001) produced an AIC of 841.94, and a log-likelihood score of -413.97 establishing it as the best fitting model of the methodologies utilised. In validating the models, they were utilised to develop forecasts with the model selected with the highest accuracy of predictions being the SARIMA model predicting 1 month in advance (MAE: 7.032, MSE: 83.977). This study establishes the effect of weather on the intensity and magnitude of dengue incidence as has been previously studied. A prediction model remains a novel method of evidence-based forecasting in Tawau, Sabah. The model developed in this study, demonstrated an ability to forecast potential dengue outbreaks 1 to 4 months in advance. These findings are not dissimilar to what has been previously studied in many different countries- with temperature and humidity consistently being established as powerful predictors of dengue incidence magnitude. When used in prognostication, it can enhance- decision making and allow judicious use of resources in public health setting. Nevertheless, the model remains a work in progress- requiring larger and more diverse data.

Matched MeSH terms: Dengue/epidemiology*
Dengue vector control in malaysia: a review for current and alternative strategies

Ong SQ

Sains Malaysiana, 2016;45:777-785.

Dengue is a major issue in Malaysia as the dramatic emerge of infection. Yet an effective vaccine or medicine is not
yet available, although many attempts are undergoing. Dengue vector control is still considered the most effective way
for controlling and preventing the transmission of dengue virus. Nonetheless, as the conventional approaches are less
successful in managing the dengue transmission, it is time to review the current applied and other available approaches.
Current dengue vector relied greatly on the chemical approach as space treatment either thermal or ULV fogging, however,
the approach seem like under the expectation. Beside space treatment, new control methods for example biological
control (bacterium Bacillus thuringiensis, predatory mosquito Toxorhynchites) and attractive trap were carried out
at certain location of Malaysia. Moreover, new emerged approaches such as mass release of genetic modification or
artificially Wolbachia infected male dengue vector for the objective of generating sterile offspring when mate with
wild population is urge to be tested in Malaysia, although concerns have to be taken before the actual mass release. In
conclusion, control of dengue vector shall not consist exclusively for a single approach, neither genetic modification
of artificially Wolbachia infected technique, nor the conventional insecticidal treatment. It should, however, comprise
of the environment management as the fundamental approach, a well-planned integrated control program and a good
cooperation among the organization.

Matched MeSH terms: Dengue; Dengue Virus
Viability of dengue virus in culture stocks is efficiently preserved by storage in diluted forms

Suppiah J, Nadaraju S, Hamzah S, Chee HY

Trop Biomed, 2020 Jun 01;37(2):282-287.
PMID: 33612798

Storage of dengue virus (DENV) culture stocks in -80°C is a common laboratory practice to maintain the viability of the virus for long-term usage. However, the efficiency of this method could still be hindered by multiple factors. In our laboratory, we observed a constant and substantial deterioration in the titer of DENV in Vero culture supernatant stored in -80°C. Such incident had badly hampered the laboratory work and prompted an investigation to determine the cause. DENV isolates representing all four serotypes were propagated and the culture supernatants were harvested and stored in aliquots of original stock and 10 fold dilutions (10-1 -10-4). DENV titer in these stocks was determined prior to storage and reassessed on the third and sixth month of storage by focus forming unit assay (FFUA). The result demonstrated a constant preservation of titer ranging from 104 ffu/ml to 105 ffu/ml in the diluted DENV virus culture stocks of 10-1, and 10-2 of DENV1-4, a minor reduction of titer from 103 ffu/ml to 102 ffu/ml at dilution 10-3 for DENV4 only and complete deterioration in undiluted culture stock and lower dilution (10-4) within 6 months of storage in -80°C for all serotypes. It is recommended that propagated DENV in Vero cells are stored in 10 fold dilutions as compared to the original form to preserve the titer for long-term usage.

Matched MeSH terms: Dengue Virus/physiology*
Diversity and evolution of the envelope gene of dengue virus type 1 circulating in India in recent times

Dey S, Nandy A, Nandy P, Das S

Int J Bioinform Res Appl, 2015;11(6):469-82.
PMID: 26642358 DOI: 10.1504/ijbra.2015.073235

Dengue viral attacks have been reported in various parts of India in recent years. In this paper we report on our studies of the characterisation and evolutionary aspects of gene sequences of the envelope glycoprotein of the prevalent Indian dengue virus type 1. Comparison with sequences from other countries shows that the envelope genes identified in India are closely related to strains from Malaysia. From the evolutionary point of view the envelope gene sequences of this dengue virus of India for past few years show that a marked mutational shift in the nucleotide sequences of the envelope gene have taken place from around the year 2000. Also, phylogenetic relationship with other three sera of dengue virus reported in India from 2005 shows that the dengue virus 1 is more closely related to dengue viruses 3 and 4 and relatively distantly to dengue virus 2.

Matched MeSH terms: Dengue; Dengue Virus
Thrombotic Thrombocytopenic Purpura in Dengue Fever

Tee TY, Cader RA

Acta Med Indones, 2021 Apr;53(2):208-212.
PMID: 34251350

Thrombotic thrombocytopenic purpura is a rare but life threatening medical condition. Early recognition and treatment of thrombotic thrombocytopenic purpura is important especially in patients who do not present with the classic pentad to reduce the high mortality. Herein, we describe a case of a patient who does not fulfil the classic pentad features thrombotic thrombocytopenic purpura that was induced by dengue fever. The patients' initial full blood picture did not have all the typical features of microangiopathic haemolytic anaemia but there were fragmented red blood cells. However, even a small number of fragmented red blood cells in the peripheral blood should alert physicians of the possible diagnosis of thrombotic thrombocytopenic purpura together with other symptoms. Furthermore, signs and symptoms of thrombotic thrombocytopenic purpura and dengue fever can overlap such as fever, thrombocytopenia, neurological deficit mimicking dengue encephalopathy and dengue induced acute kidney injury.

Matched MeSH terms: Dengue/complications*
The Cytokines CXCL10 and CCL2 and the Kynurenine Metabolite Anthranilic Acid Accurately Predict Patients at Risk of Developing Dengue With Warning Signs

Jusof FF, Lim CK, Aziz FN, Soe HJ, Raju CS, Sekaran SD, et al.

J Infect Dis, 2022 Nov 28;226(11):1964-1973.
PMID: 35767283 DOI: 10.1093/infdis/jiac273

BACKGROUND: The resolution or aggravation of dengue infection depends on the patient's immune response during the critical phase. Cytokines released by immune cells increase with the worsening severity of dengue infections. Cytokines activate the kynurenine pathway (KP) and the extent of KP activation then influences disease severity.
METHODS: KP metabolites and cytokines in plasma samples of patients with dengue infection (dengue without warning signs [DWS-], dengue with warning signs [DWS+], or severe dengue) were analyzed. Cytokines (interferon gamma [IFN-ɣ], tumor necrosis factor, interleukin 6, CXCL10/interferon-inducile protein 10 [IP-10], interleukin 18 [IL-18], CCL2/monocyte chemoattractant protein-1 [MCP-1], and CCL4/macrophage inflammatory protein-1beta [MIP-1β] were assessed by a Human Luminex Screening Assay, while KP metabolites (tryptophan, kynurenine, anthranilic acid [AA], picolinic acid, and quinolinic acid) were assessed by ultra-high-performance liquid chromatography and Gas Chromatography Mass Spectrophotometry [GCMS] assays.
RESULTS: Patients with DWS+ had increased activation of the KP where kynurenine-tryptophan ratio, anthranilic acid, and picolinic acid were elevated. These patients also had higher levels of the cytokines IFN-ɣ, CXCL10, CCL4, and IL-18 than those with DWS-. Further receiver operating characteristic analysis identified 3 prognostic biomarker candidates, CXCL10, CCL2, and AA, which predicted patients with higher risks of developing DWS+ with an accuracy of 97%.
CONCLUSIONS: The data suggest a unique biochemical signature in patients with DWS+. CXCL10 and CCL2 together with AA are potential prognostic biomarkers that discern patients with higher risk of developing DWS+ at earlier stages of infection.

Matched MeSH terms: Severe Dengue*
Unusual co-infection of severe malaria by Plasmodium vivax and dengue virus in Mexico

Queb-Pech NM, Núñez-Oreza LA, Estrada-Méndez A, Tamay-Segovia P, Collí-Heredia JP, Blum-Domínguez SC

Trop Biomed, 2022 Dec 01;39(4):575-578.
PMID: 36602218 DOI: 10.47665/tb.39.4.014

Malaria and dengue fever are among the most common mosquito-borne diseases worldwide; however, reports of coinfection are rare. We present a case of severe malaria and dengue coinfection in a 16-yearold female patient presenting with fever, thrombocytopenia, pleural effusion, myopericarditis, and acute respiratory distress syndrome. Dengue infection was confirmed by the presence of immunoglobin M antibodies and nonstructural protein 1, while malaria was confirmed by the presence of Plasmodium vivax in thick and thin blood smears. This is the first report of a dengue/malaria coinfection in Mexico.

Matched MeSH terms: Dengue Virus*
Development of novel antiviral peptides against dengue serotypes 1-4

Lee MF, Anasir MI, Poh CL

Virology, 2023 Mar;580:10-27.
PMID: 36739680 DOI: 10.1016/j.virol.2023.01.016

Dengue infections pose a critical threat to public health worldwide. Since there are no clinically approved antiviral drugs to treat dengue infections caused by the four dengue virus (DENV) serotypes, there is an urgent need to develop effective antivirals. Peptides are promising antiviral candidates due to their specificity and non-toxic properties. The DENV envelope (E) protein was selected for the design of antiviral peptides due to its importance in receptor binding and viral fusion to the host cell membrane. Twelve novel peptides were designed to mimic regions containing critical amino acid residues of the DENV E protein required for interaction with the host. A total of four peptides were identified to exhibit potent inhibitory effects against at least three or all four DENV serotypes. Peptide 3 demonstrated all three modes of action: cell protection and inhibition of post-infection against all four DENV serotypes, whereas direct virus-inactivating effects were only observed against DENV-2, 3, and 4. Peptide 4 showed good direct virus-inactivating effects against DENV-2 (74.26%) as well as good inhibitions of DENV-1 (80.37%) and DENV-4 (72.22%) during the post-infection stage. Peptide 5 exhibited direct virus-inactivating effects against all four DENV serotypes, albeit at lower inhibition levels against DENV-1 and DENV-3. It also exhibited highly significant inhibition of DENV-4 (89.31%) during post-infection. Truncated peptide 5F which was derived from peptide 5 showed more significant inhibition of DENV-4 (91.58%) during post-infection and good direct virus-inactivating effects against DENV-2 (77.55%) at a lower concentration of 100 μM. Peptide 3 could be considered as the best antiviral candidate for pre- and post-infection treatments of DENV infections in regions with four circulating dengue serotypes. However, if the most predominant dengue serotype for a particular region could be identified, peptides with significantly high antiviral activities against that particular dengue serotype could serve as more suitable antiviral candidates. Thus, peptide 5F serves as a more suitable antiviral candidate for post-infection treatment against DENV-4.

Matched MeSH terms: Dengue*

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