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INTRODUCTION OF THE AMERICAN/ASIAN GENOTYPE OF DENGUE 2 VIRUS INTO THE YUCATAN STATE OF MEXICO

A dengue (DEN) outbreak occurred in the Yucatan State of Mexico in 2002. Three isolates were obtained from patients presenting with DEN-like symptoms, and examined by partial nucleotide sequencing and phylogenetic analysis. The isolates were identified as DEN-2 viruses of the American-Asian genotype; this is the first report of this genotype in the Yucatan State. The DEN-2 viruses of the American-Asian genotype have been associated with more severe disease outcomes. Thus, its introduction into the Yucatan State presents a serious problem to public health authorities. During this outbreak, DEN virus infection was confirmed in 18% (282 of 1,560) of the patients who presented with DEN-like symptoms. Of these, 87 (31%) patients met the World Health Organization criteria for dengue hemorrhagic fever, including two patients who died. The majority (77%) of the patients experienced secondary infections in this epidemic.

Received December 28, 2003. Accepted for publication July 7, 2004.

Acknowledgments: We are grateful to the medical personnel of the Instituto Mexicano del Seguro Social, the Secretaría de Salud, the Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, the Servicios Médicos Municipales del Ayuntamiento de Mérida, and all private clinics and physicians for sending us serum samples or the patients to conduct the tests. We thank Dr. Duane J. Gubler and Kathy Wolff (Division of Vector-Borne and Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO) for providing dengue antigens and monoclonal antibodies for the diagnosis of dengue viruses.

Financial support: This study was supported by the National Institutes of Health (grant no. AI-45430) and Sisierra-Conacyt (grant no. 980201).

Authors’ addresses: María A. Loroño-Pino, José A. Farfán Ale, Alicia L. Zapata-Peraza, Elsy P. Rosado-Paredes, Luis F. Flores-Flores and Julián E. García-Rejón, Laboratorio de Arbovirología, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatan, Av. Itzáes No. 490 x 59, Centro, Merida, Yucatan, México 97000, Telephone 999-924-6412, Fax: 999-923-1804. Francisco J. Díaz, Bradley J. Blitvich, Carol D. Blair, Ken E. Olson, William Black IV, and Barry J. Beaty, Arthropod-Borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO 80523, Telephone: 970-491-4383, Fax: 970-491-8323, E-mail: bbeaty{at}colostate.edu. Manuel Andrade-Narváez, Departamento de Medicina Preventiva, Hospital General Regional No. 12, Benito Juárez, Instituto Mexicano del Seguro Social, Av. Colon x Av. Itzáes, Merida, Yucatan, Mexico, Telephone: 999-925-0866, Fax: 999-925-0831. Eusebio Jiménez-Ríos, Dirección de Prevención y Control de Enfermedades, Secretaría de Salud de Yucatán, calle 72 No. 463 x 53 y 55, Merida, Yucatan, México, 97000, Telephone: 999-930-3050.

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