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Epidemiology and characteristics of the dengue outbreak in Guangdong, Southern China, in 2014

European Journal of Clinical Microbiology & Infectious Diseases volume 35, pages 269–277 (2016)Cite this article

Abstract

Dengue is a rapidly spreading mosquito-borne disease caused by the dengue virus (DENV) and has emerged as a severe public health problem around the world. Guangdong, one of the southern Chinese provinces, experienced a serious outbreak of dengue in 2014, which was believed to be the worst dengue epidemic in China over the last 20 years. To better understand the epidemic, we collected the epidemiological data of the outbreak and analyzed 14,594 clinically suspected dengue patients from 25 hospitals in Guangdong. Dengue cases were then laboratory-confirmed by the detection of DENV non-structural protein 1 (NS1) antigen and/or DENV RNA. Afterwards, clinical manifestations of dengue patients were analyzed and 93 laboratory-positive serum specimens were chosen for the DENV serotyping and molecular analysis. Our data showed that the 2014 dengue outbreak in Guangdong had spread to 20 cities and more than 45 thousand people suffered from dengue fever. Of 14,594 participants, 11,387 were definitively diagnosed. Most manifested with a typical non-severe clinical course, and 1.96 % developed to severe dengue. The strains isolated successfully from the serum samples were identified as DENV-1. Genetic analyses revealed that the strains were classified into genotypes I and V of DENV-1, and the dengue epidemic of Guangdong in 2014 was caused by indigenous cases and imported cases from the neighboring Southeast Asian countries of Malaysia and Singapore. Overall, our study is informative and significant to the 2014 dengue outbreak in Guangdong and will provide crucial implications for dengue prevention and control in China and elsewhere.

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Acknowledgments

We thank all the participants who consented to take part in this study, as well as the doctors and nurses for recruitment. Especially, we sincerely thank the laboratory technicians from the 25 hospitals who helped us collect and interpret the data.

Author information

Author notes

    Affiliations

    1. Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, People’s Republic of China

      L. Huang, X. Luo, J. Shao, H. Yan, Y. Xu, Z. Luo, M. Liao, H. Wang, L. Sun, H. Li & C. Duan

    2. Department of Clinical Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, People’s Republic of China

      L. Huang, X. Luo, H. Yan, Y. Xu, Z. Luo, M. Liao, H. Wang, L. Sun, H. Li & C. Duan

    3. Medical Research Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, People’s Republic of China

      J. Shao

    4. Laboratory Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, People’s Republic of China

      Y. Qiu & D. Sun

    5. Department of Clinical Laboratory, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, 510120, People’s Republic of China

      P. Ke

    6. Department of Clinical Laboratory, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510080, People’s Republic of China

      W. Zheng

    7. Department of Laboratory Medicine, Guangzhou First Municipal People’s Hospital, Affiliated Hospital of Guangzhou Medical College, Guangzhou, Guangdong, 510180, People’s Republic of China

      B. Xu

    8. Department of Clinical Laboratory, The First People’s Hospital of Foshan, Foshan, Guangdong, 528000, People’s Republic of China

      W. Li

    9. Department of Laboratory Medicine, Guangdong No.2 Provincial People’s Hospital, Guangzhou, Guangdong, 510317, People’s Republic of China

      D. Cao

    10. Department of Clinical Laboratory, Zhanjiang Center People’s Hospital, Zhanjiang, Guangdong, 524037, People’s Republic of China

      C. Chen

    11. Luohu District Center for Disease Control and Prevention, Shenzhen, Guangdong, 518020, People’s Republic of China

      F. Zhuo

    12. Department of Clinical Laboratory, Shantou Central Hospital, Shantou, Guangdong, 515021, People’s Republic of China

      X. Lin

    13. Department of Clinical Laboratory, Zhuhai People’s Hospital, Zhuhai Hospital of Jinan University, Zhuhai, Guangdong, 522000, China

      F. Tang

    14. Department of Clinical Laboratory, 12th Guangzhou People’s Hospital, Guangzhou, Guangdong, 510420, People’s Republic of China

      B. Bao

    15. Department of Clinical Laboratory, Guangzhou Xinhai Hospital, Guangzhou, Guangdong, 510300, People’s Republic of China

      Y. Zhou

    16. Department of Laboratory Diagnosis, Sun Yat-sen University Affiliated Zhongshan Hospital, Sun Yat-sen University, Zhongshan, Guangdong, 528403, China

      X. Zhang

    17. Department of Clinical Laboratory, Zhaoqing People’s Hospital, Zhaoqing, Guangdong, 526040, China

      H. Li

    18. Department of Clinical Laboratory, Qingyuan People’s Hospital, Qingyuan, Guangdong, 511518, China

      J. Li

    19. Department of Clinical Laboratory, Dongguan People’s Hospital, Dongguan, Guangdong, 523059, China

      D. Wan

    20. Department of Clinical Laboratory, Chaozhou Central Hospital, Chaozhou, Guangdong, 521021, China

      L. Yang

    21. Department of Clinical Laboratory, Maoming People’s Hospital, Maoming, Guangdong, 525000, China

      Y. Chen

    22. Department of Clinical Laboratory, Jieyang People’s Hospital, Jieyang, Guangdong, 522000, China

      Q. Zhong

    23. Department of Clinical Laboratory, Heyuan People’s Hospital, Heyuan, Guangdong, 517000, China

      X. Gu

    24. Department of Clinical Laboratory, Huizhou First Municipal People’s Hospital, Huizhou, Guangdong, 516003, China

      J. Liu

    25. Department of Clinical Laboratory, Shaoguan People’s Hospital, Shaoguan, Guangdong, 512000, China

      L. Huang

    26. Department of Clinical Laboratory, Yunfu People’s Hospital, Yunfu, Guangdong, 527300, China

      R. Xie

    27. Department of Clinical Laboratory, Shanwei Yihui Foundation Hospital, Shanwei, Guangdong, 516600, China

      X. Li

    28. Department of Pathobiology, University of Illinois at Urbana-Champaign, Urbana, IL, 61802, USA

      G. W. Lau

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    Corresponding author

    Correspondence to C. Duan.

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    None declared.

    Funding

    This work was supported by the Guangdong Natural Science Foundation (grant number S2013010014007, 2014A030313070) and Guangdong Province Science & Technology Project Plan & Social Development Foundation (grant number 2010A030400006).

    Additional information

    Lisi Huang and Xiaohong Luo contributed equally to this work.

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    The workflow of clinical data collection from 25 hospitals in Guangdong (GIF 29 kb)

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    Huang, L., Luo, X., Shao, J. et al. Epidemiology and characteristics of the dengue outbreak in Guangdong, Southern China, in 2014. Eur J Clin Microbiol Infect Dis 35, 269–277 (2016). https://doi.org/10.1007/s10096-015-2540-5

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    • DOI: https://doi.org/10.1007/s10096-015-2540-5

    Keywords

    • Dengue Virus
    • Dengue Hemorrhagic Fever
    • Dengue Infection
    • Southeast Asian Country
    • DENV Infection