1. Isolation of dengue virus from the upper respiratory tract of four patients with dengue fever
- Author
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Nai Ming Cheng, Susan Shin Jung Lee, Yao Shen Chen, Tsi Shu Huang, Cheng Len Sy, and Bao Chen Chen
- Subjects
0301 basic medicine ,RNA viruses ,Male ,Viral Diseases ,Pulmonology ,Physiology ,Respiratory System ,Fevers ,Artificial Gene Amplification and Extension ,Disease ,Dengue virus ,medicine.disease_cause ,Pathology and Laboratory Medicine ,Polymerase Chain Reaction ,Dengue fever ,Dengue Fever ,0302 clinical medicine ,Medicine and Health Sciences ,Medicine ,Child ,Fluorescent Antibody Technique, Indirect ,medicine.diagnostic_test ,Transmission (medicine) ,lcsh:Public aspects of medicine ,Middle Aged ,Body Fluids ,medicine.anatomical_structure ,Infectious Diseases ,Blood ,Medical Microbiology ,Viral Pathogens ,Viruses ,Physical Sciences ,RNA, Viral ,Female ,Pathogens ,Anatomy ,Research Article ,Neglected Tropical Diseases ,lcsh:Arctic medicine. Tropical medicine ,Adolescent ,lcsh:RC955-962 ,Materials by Structure ,030231 tropical medicine ,Mucocutaneous zone ,Materials Science ,Taiwan ,Research and Analysis Methods ,Microbiology ,Virus ,Throat culture ,Throat ,03 medical and health sciences ,Signs and Symptoms ,Diagnostic Medicine ,Humans ,Severe Dengue ,Molecular Biology Techniques ,Microbial Pathogens ,Molecular Biology ,Aerosols ,Biology and life sciences ,Flaviviruses ,business.industry ,Public Health, Environmental and Occupational Health ,Organisms ,lcsh:RA1-1270 ,Reverse Transcriptase-Polymerase Chain Reaction ,Dengue Virus ,medicine.disease ,Tropical Diseases ,030104 developmental biology ,Mixtures ,Immunology ,Respiratory Infections ,business ,Neck ,Respiratory tract - Abstract
Background Dengue fever is an important arboviral disease. The clinical manifestations vary from a mild non-specific febrile syndrome to severe life-threatening illness. The virus can usually be detected in the blood during the early stages of the disease. Dengue virus has also been found in isolated cases in the cerebrospinal fluid, urine, nasopharyngeal sections and saliva. In this report, we describe the isolation of dengue virus from the upper respiratory tract of four confirmed cases of dengue. Methods We reviewed all laboratory reports of the isolation of dengue virus from respiratory specimens at the clinical microbiology laboratory of the Kaohsiung Veterans General Hospital during 2007 to 2015. We then examined the medical records of the cases from whom the virus was isolated to determine their demographic characteristics, family contacts, clinical signs and symptoms, course of illness and laboratory findings. Results Dengue virus was identified in four patients from a nasopharyngeal or throat culture. Two were classified as group A dengue (dengue without warning signs), one as group B (dengue with warning signs) and one as group C (severe dengue). All had respiratory symptoms. Half had family members with similar respiratory symptoms during the period of their illnesses. All of the patients recovered uneventfully. Conclusions The isolation of dengue virus from respiratory specimens of patients with cough, rhinorrhea and nasal congestion, although rare, raises the possibility that the virus is capable of transmission by the aerosol route among close contacts. This concept is supported by studies that show that the virus can replicate in cultures of respiratory epithelium and can be transmitted through mucocutaneous exposure to blood from infected patients. However, current evidence is insufficient to prove the hypothesis of transmission through the respiratory route. Further studies will be needed to determine the frequency of respiratory colonization, viable virus titers in respiratory secretions and molecular genetic evidence of transmission among close contacts., Author summary Dengue virus is rarely identified in respiratory specimens. We retrospectively identified four patients with dengue fever who had the virus isolated from their nose or throat. All the patients had respiratory signs or symptoms. Half had family members who also had respiratory symptoms. Further studies are needed to evaluate the possibility of respiratory transmission of this virus.
- Published
- 2017