Molecular and Entomological Characterization of 2023 Dengue Outbreak in Dhading District, Central Nepal

In 2023, Nepal faced its second largest dengue outbreak ever, following a record-breaking number of dengue cases in 2022, characterized by the expansion of infections into areas of higher altitudes. However, the characteristics of the 2023 circulating dengue virus (DENV) and the vector density remai...

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Published in:	Viruses Vol. 16; no. 4; p. 594
Main Authors:	Rimal, Sandesh, Shrestha, Sabin, Paudel, Sunita Wagle, Shah, Yogendra, Bhandari, Govinda, Pandey, Kishor, Kharbuja, Anjana, Kapandji, Merveille, Gautam, Ishan, Bhujel, Rajshree, Takamatsu, Yuki, Bhandari, Rudramani, Klungthong, Chonticha, Shrestha, Sanjaya Kumar, Fernandez, Stefan, Malavige, Gathsaurie Neelika, Pandey, Basu Dev, Urano, Takeshi, Morita, Kouichi, Ngwe Tun, Mya Myat, Dumre, Shyam Prakash
Format:	Journal Article
Language:	English
Published:	Switzerland MDPI AG 12-04-2024 MDPI
Subjects:	Adolescent Adult Aedes Aedes - virology Aedes spp Animals Anorexia Child Child, Preschool Dengue Dengue - epidemiology Dengue - virology Dengue fever dengue outbreak 2023 Dengue Virus - classification Dengue Virus - genetics Dengue Virus - isolation & purification dengue virus serotypes Dengue viruses Development and progression Diarrhea Disease Outbreaks entomological investigation Entomology Epidemics Ethylenediaminetetraacetic acid Evaluation Female Health aspects Hospitals Humans Infections Laboratories Male Methods Middle Aged Mosquito Vectors - virology Mosquitoes Myalgia Nepal Nepal - epidemiology Patients Pest outbreaks Phylogeny Polymerase chain reaction Questionnaires Serogroup Serotypes Serotyping Thrombocytopenia Trends vector density Young Adult Nepal Japan India Bangladesh United States > US dengue outbreak 2023 dengue virus serotypes entomological investigation Aedes spp Nepal vector density
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Summary:	In 2023, Nepal faced its second largest dengue outbreak ever, following a record-breaking number of dengue cases in 2022, characterized by the expansion of infections into areas of higher altitudes. However, the characteristics of the 2023 circulating dengue virus (DENV) and the vector density remain poorly understood. Therefore, we performed DENV serotyping, clinical and laboratory assessment, and entomological analysis of the 2023 outbreak in central Nepal. A total of 396 fever cases in Dhading hospital suspected of being DENV positive were enrolled, and blood samples were collected and tested by different techniques including PCR. Of these, 278 (70.2%) had confirmed DENV infection. Multiple serotypes (DENV-1, -2, and -3) were detected. DENV-2 (97.5%) re-emerged after six years in Dhading while DENV-3 was identified for the first time. Dengue inpatients had significantly higher frequency of anorexia, myalgia, rash, diarrhea, nausea, vomiting, abdominal pain, and thrombocytopenia ( < 0.05). In this area, mosquitoes largely predominated (90.7%) with the majority being (60.7%). We also found high levels of index (20.0%) and container index (16.7%). We confirmed multiple DENV serotype circulation with serotype re-emergence and new serotype introduction, and high vector density in 2023. These findings call for the urgent initiation and scaling up of DENV molecular surveillance in human and mosquito populations for dengue control and prevention in Nepal.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1999-4915 1999-4915
DOI:	10.3390/v16040594