Heringer Manoela, Nogueira Rita Maria R, de Filippis Ana Maria B, Lima Monique R Q, Faria Nieli R C, Nunes Priscila C G, Nogueira Fernanda B, dos Santos Flávia B
Flavivirus Laboratory, Oswaldo Cruz Institute/FIOCRUZ, Av Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21045-360, Brazil.
Flavivirus Laboratory, Oswaldo Cruz Institute/FIOCRUZ, Av Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21045-360, Brazil
Trans R Soc Trop Med Hyg. 2015 Apr;109(4):268-74. doi: 10.1093/trstmh/trv006. Epub 2015 Jan 28.
Rio de Janeiro (RJ) has been of major importance for the epidemiology of dengue viruses (DENVs) in Brazil. After the DENV 1-4 introductions in 1986, 1990, 2000 and 2011, respectively, the state has suffered explosive epidemics. We aimed to describe laboratorial, epidemiological and clinical aspects due to the emergence and re-emergence of distinct DENV in a 2-year period.
Suspected dengue cases (n=2833), including 190 fatal cases, were submitted to virus isolation, RT-PCR and non-structural 1 (NS1) antigen capture ELISA, IgM antibody-capture (MAC)-ELISA and IgG-ELISA.
Case confirmation was 47.5%. MAC-ELISA confirmed 32.6% of the cases, RT-PCR confirmed 56.3%; DENV was recovered in 33.1% of samples inoculated and NS1 ELISA confirmed 27.5% of the cases. DENV-2 was prevalent in 2010, DENV-1 in 2011 and DENV-4 in 2012. Individuals infected by DENV-3 and over 65 years-old, and children 15 years-old and under infected by DENV-2 had a significantly higher risk of developing a severe disease. Fatal cases confirmed (n=67) were due to DENV-1 (26.8%), DENV-2 (14.9%), DENV-3 (2.9%) and DENV-4 (7.4%).
It has been shown here that viral emergences or re-emergences may play different roles in the disease epidemiology, especially when many serotypes co-circulate.
里约热内卢（RJ）在巴西登革热病毒（DENV）的流行病学中一直具有重要意义。在1986年、1990年、2000年和2011年分别引入DENV 1 - 4后，该州遭受了疫情的爆发。我们旨在描述在两年期间不同DENV出现和再次出现时的实验室、流行病学和临床方面的情况。
对2833例疑似登革热病例（包括190例死亡病例）进行病毒分离、逆转录聚合酶链反应（RT-PCR）以及非结构蛋白1（NS1）抗原捕获酶联免疫吸附测定（ELISA）、IgM抗体捕获（MAC）-ELISA和IgG-ELISA检测。
病例确诊率为47.5%。MAC-ELISA确诊了32.6%的病例，RT-PCR确诊了56.3%；在接种的样本中有33.1%分离出DENV，NS1 ELISA确诊了27.5%的病例。2010年DENV-2流行，2011年DENV-1流行，2012年DENV-4流行。感染DENV-3且年龄超过65岁的个体，以及感染DENV-2且年龄在15岁及以下的儿童患重病的风险显著更高。确诊的死亡病例（n = 67）中，由DENV-1引起的占26.8%，DENV-2引起的占14.9%，DENV-3引起的占2.9%，DENV-4引起的占7.4%。
此处表明病毒的出现或再次出现可能在疾病流行病学中发挥不同作用，尤其是当多种血清型共同流行时。
