Characteristics of the initial dengue outbreaks in a region without dengue prior to mid-2009 in a dengue-endemic country

Authors

  • Kalamathy Murugananthan Department of Microbiology, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka https://orcid.org/0000-0003-2223-9728
  • Dinesh Coonghe Department of Community and Family Medicine, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka
  • Thirunawukarasu Kumanan Department of Medicine, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka
  • Arumugam Murugananthan Department of Parasitology, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka https://orcid.org/0000-0001-5609-8543
  • Gowri Selvaratnam Department of Medicine, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka
  • Sivapalan Sivansuthan Teaching Hospital, Jaffna, Sri Lanka
  • Gitanjali Sathiadas Department of Paediatrics, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka
  • Natkunam Ketheesan Science and Technology, University of New England, Armadale, Australia
  • Faizal A Careem Department of Ecosystem and Public Health, University of Calgary, Alberta, Canada
  • Faseeha Noordeen Diagnostic and Research Virology Laboratory, Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka

DOI:

https://doi.org/10.3855/jidc.15493

Keywords:

Dengue, initial outbreaks, clinical, laboratory, virological characteristics

Abstract

Introduction: The present study evaluated the characteristics of the initial dengue outbreaks in the Jaffna peninsula, a region without dengue prior to mid-2009 in dengue-endemic Sri Lanka, a tropical island nation.

Methodology: This is a cross-sectional study conducted using a total of 765 dengue patients’ clinical data and samples collected from the Teaching Hospital, Jaffna during the initial dengue outbreaks. Clinical, non-specific, and specific virological laboratory characteristics including the platelet count, NS1 antigen, and anti-DENV IgM/IgG were evaluated as correlates of dengue virus (DENV) infection in the two initial outbreaks of 2009/2010 and 2011/2012 in Northern Sri Lanka.

Results: Firstly, affected age and clinical characteristics were significantly different between the outbreaks (p < 0.005). Secondly, NS1 antigen detection in patients with fever days < 5 was statistically significant (p < 0.005). Thirdly, platelet count, detection of NS1 antigen, and anti-DENV IgM/IgG profiles were adequate to diagnose 90% of the patients; hepatomegaly and platelet count of < 25,000/mm3 were identified as predictors of severe disease. Fourthly, secondary DENV infections were detected in the early stages of the illness in many patients. Finally, infecting DENV serotypes were different between the two outbreaks.

Conclusions: Clinical and non-specific laboratory characteristics and the infecting DENV serotypes between the two initial outbreaks in Northern Sri Lanka were significantly different. NS1 antigen, anti-DENV IgM/IgG, and platelet counts were identified 90% of the dengue patients. Hepatomegaly and platelet count of < 25,000/mm3 were able to predict the disease severity in this study.

Author Biographies

Kalamathy Murugananthan, Department of Microbiology, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka

Senior Lecturer - Department of Microbiology, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka

Dinesh Coonghe, Department of Community and Family Medicine, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka

Senior Lecturer - Departm ent of Community and Family Medicine, Faculty of Medicine,

University of Jaffna, Jaffna, Sri Lanka

Thirunawukarasu Kumanan, Department of Medicine, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka

Physician & Senior Lecturer - Department of Medicine, Faculty of Medicine,

University of Jaffna, Jaffna, Sri Lanka

Arumugam Murugananthan, Department of Parasitology, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka

Senior Lecturer - Department of Parasitology, Faculty of Medicine,

University of Jaffna, Jaffna, Sri Lanka

Gowri Selvaratnam, Department of Medicine, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka

Senior Lecturer - Department of Medicine, Faculty of Medicine,

University of Jaffna, Jaffna, Sri Lanka

Sivapalan Sivansuthan, Teaching Hospital, Jaffna, Sri Lanka

Physician - Teaching Hospital, Jaffna, Sri Lanka

Gitanjali Sathiadas, Department of Paediatrics, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka

Paediatrician & Senior lecturer - Department of Paediatrics, Faculty of Medicine,

University of Jaffna, Jaffna, Sri Lanka

Natkunam Ketheesan, Science and Technology, University of New England, Armadale, Australia

Professor & Research Scientist - Science & Technology,

University of New England, Armadale, Australia

Faizal A Careem, Department of Ecosystem and Public Health, University of Calgary, Alberta, Canada

Professor & Research Scientist & Virologist - Department of Ecosystem and Public Health,

University of Calgary, Alberta, Canada

Faseeha Noordeen, Diagnostic and Research Virology Laboratory, Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka

Research scientist & Virologist - Department of Microbiology, Faculty of Medicine,

University of Peradeniya, Peradeniya, Sri Lanka

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Published

2023-02-28

How to Cite

1.
Murugananthan K, Coonghe D, Kumanan T, Murugananthan A, Selvaratnam G, Sivansuthan S, Sathiadas G, Ketheesan N, A Careem F, Noordeen F (2023) Characteristics of the initial dengue outbreaks in a region without dengue prior to mid-2009 in a dengue-endemic country. J Infect Dev Ctries 17:260–267. doi: 10.3855/jidc.15493

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Original Articles