Detection of dengue virus serotype 3 in Cajamarca, Peru: Molecular diagnosis and clinical characteristics
Miguel Angel Aguilar-Luis1, Hugo Carrillo-Ng2, Sungmin Kym3, Wilmer Silva-Caso1, Eduardo Verne2, Luis J del Valle4, Jorge Bazán-Mayra5, Victor Zavaleta-Gavidia5, Daniel Cornejo-Pacherres5, Yordi Tarazona-Castro1, Ronald Aquino-Ortega1, Angela Cornejo-Tapia6, Juana del Valle-Mendoza1
1 School of Medicine, Research and Innovation Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas; Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru
2 Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
3 Division of Infectious Diseases, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
4 Barcelona Research Center for Multiscale Science and Engineering, Departament d’Enginyeria Química, EEBE, Universitat Politècnica de Catalunya (UPC), Barcelona, Spain
5 Laboratorio Regional de Cajamarca, Dirección Regional de Salud de Cajamarca (DIRESA), Cajamarca, Peru
6 School of Medicine, Research and Innovation Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
Juana del Valle-Mendoza
School of Medicine, Research and Innovation Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas; Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima
Source of Support: This research was supported by Universidad Peruana de Ciencias Aplicadas, Lima, Peru (Grant Nr. A-005-2019). This research was supported by the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI20C0195), Conflict of Interest: None
Objective: To describe and molecularly characterize an outbreak of dengue virus (DENV) infection in Cajamarca, an Andean region in Peru.
Methods: A total of 359 serum samples from patients with acute febrile illness were assessed for the presence of DENV via RT-PCR, ELISA NS1, IgM and IgG in Cajamarca, Peru from January 2017 to June 2017. The evaluation of the different diagnostic tests and their applicability was performed.
Results: Dengue virus was detected in 24.7% of samples by RT-PCR. Meanwhile, serological analysis detected 30.3% positive cases via ELISA NS1 antigen, 16.7% via ELISA IgG and 9.7% via ELISA IgM. Most of the cases corresponded to DENV-3 (77.5%). The use of RT-PCR performed better in primary infections (P<0.01), while detection of ELISA IgM performed better in secondary infections (P<0.01). The combination of NS1 and IgM performed better than the other assays in detecting primary (92.5%) and secondary infections (96.6%). The most frequent symptoms associated with fever were headaches, myalgias, and arthralgias across all groups.
Conclusions: We report an important outbreak of dengue infection caused by DENV-3 in Cajamarca, Peru. Our findings encourage the use of NS1 antigen and IgM co-detection. These findings demonstrate an increasing expansion of DENV-3 in Peru and highlight the importance of molecular diagnosis and serotype characterization among the clinically defined dengue cases to strengthen the Peruvian epidemiological surveillance.