» Articles » PMID: 28531223

Dengue in Bali: Clinical Characteristics and Genetic Diversity of Circulating Dengue Viruses

Abstract

A high number of dengue cases are reported annually in Bali. Despite the endemicity, limited data on dengue is available for Bali localities. Molecular surveillance study was conducted to explore the clinical and virological characteristics of dengue patients in urban Denpasar and rural Gianyar areas in Bali during the peak season in 2015. A total of 205 adult dengue-suspected patients were recruited in a prospective cross-sectional study. Demographic and clinical information were obtained, and dengue screening was performed using NS1 and IgM/IgG ELISAs. Viral RNA was subsequently extracted from patients' sera for serotyping using conventional RT-PCR and Simplexa Dengue real-time RT-PCR, followed by genotyping with sequencing method. We confirmed 161 patients as having dengue by NS1 and RT-PCR. Among 154 samples successfully serotyped, the DENV-3 was predominant, followed by DENV-1, DENV-2, and DENV-4. Serotype predominance was different between Denpasar and Gianyar. Genotyping results classify DENV-1 isolates into Genotype I and DENV-2 as Cosmopolitan Genotype. The classification grouped isolates into Genotype I and II for DENV-3 and DENV-4, respectively. Clinical parameters showed no relationship between infecting serotypes and severity. We observed the genetic diversity of circulating DENV isolates and their relatedness with historical data and importation to other countries. Our data highlights the role of this tourist destination as a potential source of dengue transmission in the region.

Citing Articles

Investigation of severe dengue outbreak in Maumere, East Nusa Tenggara, Indonesia: Clinical, serological, and virological features.

Santoso M, Nara M, Nugroho D, Yohan B, Purnama A, Boro A PLoS One. 2025; 20(2):e0317854.

PMID: 39965014 PMC: 11835340. DOI: 10.1371/journal.pone.0317854.


Impact of pre-existing cross-reactive antibodies on cyclic dengue outbreaks in the hyperendemic region of Bali, Indonesia.

Balingit J, Denis D, Suzuki R, Hayati R, Ngwe Tun M, Takamatsu Y Virus Res. 2024; 348:199445.

PMID: 39089369 PMC: 11342788. DOI: 10.1016/j.virusres.2024.199445.


Unraveling Dengue Virus Diversity in Asia: An Epidemiological Study through Genetic Sequences and Phylogenetic Analysis.

Phadungsombat J, Nakayama E, Shioda T Viruses. 2024; 16(7).

PMID: 39066210 PMC: 11281397. DOI: 10.3390/v16071046.


Correlation of miR-150, hsa-let-7e, and miR- 146a and gene expression of , and during dengue virus infection.

Masyeni S, Kuntaman K, Aryati A, Sofro M, Hadi U, Mastutik G Narra J. 2024; 1(1):e31.

PMID: 38449776 PMC: 10914058. DOI: 10.52225/narraj.v1i1.31.


Scrub typhus in Indonesia: A cross-sectional analysis of archived fever studies samples.

Saraswati K, Tanganuchitcharnchai A, Ongchaikupt S, Mukaka M, Day N, Baird J Trans R Soc Trop Med Hyg. 2024; 118(5):321-327.

PMID: 38205975 PMC: 11062201. DOI: 10.1093/trstmh/trad094.


References
1.
Harris E, Roberts T, Smith L, Selle J, Kramer L, Valle S . Typing of dengue viruses in clinical specimens and mosquitoes by single-tube multiplex reverse transcriptase PCR. J Clin Microbiol. 1998; 36(9):2634-9. PMC: 105176. DOI: 10.1128/JCM.36.9.2634-2639.1998. View

2.
Soo K, Khalid B, Ching S, Chee H . Meta-Analysis of Dengue Severity during Infection by Different Dengue Virus Serotypes in Primary and Secondary Infections. PLoS One. 2016; 11(5):e0154760. PMC: 4877104. DOI: 10.1371/journal.pone.0154760. View

3.
Adams B, Holmes E, Zhang C, Mammen Jr M, Nimmannitya S, Kalayanarooj S . Cross-protective immunity can account for the alternating epidemic pattern of dengue virus serotypes circulating in Bangkok. Proc Natl Acad Sci U S A. 2006; 103(38):14234-9. PMC: 1599940. DOI: 10.1073/pnas.0602768103. View

4.
Sasmono R, Aryati A, Wardhani P, Yohan B, Trimarsanto H, Fahri S . Performance of Simplexa dengue molecular assay compared to conventional and SYBR green RT-PCR for detection of dengue infection in Indonesia. PLoS One. 2014; 9(8):e103815. PMC: 4125142. DOI: 10.1371/journal.pone.0103815. View

5.
Ong S, Yip J, Chen Y, Liu W, Harun S, Lystiyaningsih E . Periodic re-emergence of endemic strains with strong epidemic potential-a proposed explanation for the 2004 Indonesian dengue epidemic. Infect Genet Evol. 2008; 8(2):191-204. DOI: 10.1016/j.meegid.2007.12.005. View