Yadav Ashvini Kumar, Namdeo Divya, Khare Prashant, Nema Shashwati, Pakhare Abhijit, Chowdhary Rashmi, Biswas Debasis
Regional Virology Lab, Bhopal, India.
Department of Microbiology, All India Institute of Medical Sciences, Bhopal, India.
J Vector Borne Dis. 2025 Apr 1;62(2):135-142. doi: 10.4103/JVBD.JVBD_101_24. Epub 2024 Oct 5.
The epidemiology of dengue has been demonstrating significant changes in recent years, with rising incidence of infection in countries with known endemicity and occurrence of fresh outbreaks in previously unaffected territories. India, which has been a traditional hotspot dengue virus (DENV) transmission in the endemic south-east Asian region, has been affected by the sweeping changes in dengue epidemiology. Two remarkable developments characterize the alterations witnessed by India from 2011-2017. First, all parts of the country have witnessed abrupt replacement of existing DENV lineages with emerging novel strains. Second, co-circulation of multiple serotypes of DENV have been reported from all across the country from 2011-2017; thereby hinting at the transition of the country towards hyper-endemicity. Considering the potential clinical implications of such epidemiological transformation in terms of increasing involvement of pediatric patients and growing predisposition to serious complications, the present review provides an update on the serotypic and genotypic profile of dengue outbreaks that have been witnessed by different zones of India between 2011 and 2017. Dividing the country into northern, southern, eastern, western, central and north-eastern zones, we describe discrete zone-specific distribution patterns of DENV serotypes and genotypes and observe simultaneous circulation of different DENV strains in different parts of the country. Random shifts in the genetic characteristics of the circulating strains and widespread co-circulation of all four serotypes underscore the need for undertaking continuous and representative molecular surveillance of the circulating DENV strains across the country for prompt identification of emerging strains and novel mutants; gain insights into the formulation of dengue vaccines and develop a clearer understanding of the molecular basis of immune evasion, disease epidemiology and pathogenesis.
近年来，登革热的流行病学呈现出显著变化，在已知的流行地区感染发病率上升，在以前未受影响的地区出现了新的疫情。印度一直是东南亚流行地区登革热病毒（DENV）传播的传统热点，受到了登革热流行病学全面变化的影响。2011年至2017年期间，印度出现的变化有两个显著特点。第一，该国所有地区都出现了现有DENV谱系被新出现的毒株突然取代的情况。第二，2011年至2017年期间，全国各地都报告了多种DENV血清型的共同流行；这表明该国正朝着高度流行转变。考虑到这种流行病学转变对儿科患者参与度增加和严重并发症易感性增加的潜在临床影响，本综述提供了2011年至2017年期间印度不同地区所见证的登革热疫情的血清型和基因型概况的最新信息。我们将该国分为北部、南部、东部、西部、中部和东北部地区，描述了DENV血清型和基因型在各地区的离散分布模式，并观察到不同DENV毒株在该国不同地区同时流行。循环毒株遗传特征的随机变化以及所有四种血清型的广泛共同流行，凸显了在全国范围内对循环DENV毒株进行持续且具有代表性的分子监测的必要性，以便及时识别新出现的毒株和新突变体；深入了解登革热疫苗的配方，并更清楚地理解免疫逃逸、疾病流行病学和发病机制的分子基础。
