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Open Access Case report

Emergence of dengue virus 4 genotype II in Guangzhou, China, 2010: Survey and molecular epidemiology of one community outbreak

Qin-Long Jing12, Zhi-Cong Yang1*, Lei Luo1, Xin-Cai Xiao1, Biao Di1, Peng He3, Chuan-Xi Fu1, Ming Wang1 and Jia-Hai Lu24*

Author Affiliations

1 Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, People's Republic of China

2 School of Public Health, Sun Yat-Sen University, Guangzhou 510080, People's Republic of China

3 Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou 510080, People's Republic of China

4 Key Laboratory of Tropical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou 510080, People's Republic of China

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BMC Infectious Diseases 2012, 12:87  doi:10.1186/1471-2334-12-87

Published: 12 April 2012

Abstract

Background

The re-emergence of dengue virus 4 (DENV-4) has become a public health concern in South America, Southeast Asia and South Asia. However, it has not been known to have caused a local outbreak in China for the past 20 years. The purpose of this study was to elucidate the epidemiology of one local community outbreak caused by DENV-4 in Guangzhou city, China, in 2010; and to determine the molecular characteristics of the genotype II virus involved.

Case presentations

During September and October of 2010, one imported case, a Guangzhou resident who travelled back from Thailand, resulted in 18 secondary autochthonous cases in Guangzhou City, with an incidence rate of 5.53 per 10,000 residents. In indigenous cases, 14 serum samples tested positive for IgM against DENV and 7 for IgG from a total of 15 submitted serum samples, accompanied by 5 DENV-4 isolates. With identical envelope gene nucleotide sequences, the two isolates (D10168-GZ from the imported index case and Guangzhou 10660 from the first isolate in the autochthonous cases) were grouped into DENV-4 genotype II after comparison to 32 previous DENV-4 isolates from GenBank that originated from different areas.

Conclusions

Based on epidemiological and phylogenetic analyses, the outbreak, which was absent for 20 years after the DENV-4 genotype I outbreak in 1990, was confirmed as DENV-4 genotype II and initially traced to the imported index case, a Guangzhou resident who travelled back from Thailand.