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DENGUE HEMORRHAGIC FEVER CAUSED BY SEQUENTIAL DENGUE 1–3 VIRUS INFECTIONS OVER A LONG TIME INTERVAL: HAVANA EPIDEMIC, 2001–2002

A dengue epidemic caused by dengue virus 3 (DENV-3) occurred in Cuba in 2001–2002. It included cases of dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS). We report neutralizing antibody studies on sera from 54 of 78 DHF/DSS patients that provide evidence of infections occurring in the sequence DENV-1 followed by DENV-3. No sera showed infection in the sequence DENV-2 followed by DENV-3. Some sera showed a pattern of infection in the sequence DENV-1 followed by DENV-2 and then DENV-3. However definitive categorization of a tertiary infection was not possible because of broadly reactive antibodies, which could have been raised by infections in the sequence DENV-1 then DENV-3.

Received May 10, 2005. Accepted for publication March 21, 2006.

^* Address correspondence to Maria G. Guzman, Pan American Health Organization/World Health Organization Collaborating Center for the Study of Dengue and its Vector, Department of Virology, Pedro Kourí Tropical Medicine Institute, Autopista Novia del Mediodía y Carretera Central km 61/2, La Lisa, PO Box 601, Marianao 13, Havana, Cuba. E-mail: lupe{at}ipk.sld.cu

Authors’ addresses: Mayling Alvarez, Rosemari Rodriguez-Roche, Lídice Bernardo, Susana Vázquez, Luis Morier, Daniel Gonzalez, Osvaldo Castro, Gustavo Kouri, and Maria G. Guzman, Pan American Health Organization/World Health Organization Collaborating Center for the Study of Dengue and its Vector, Department of Virology, Pedro Kourí Tropical Medicine Institute, Autopista Novia del Mediodía y Carretera Central km 61/2, La Lisa, PO Box 601, Mariano 13, Havana, Cuba. Telephone: 53-7-202-0450, Fax: 53-7-204-6051, E-mail: lupe{at}ipk.sld.cu. Scott B. Halstead, Pediatric Dengue Vaccine Initiative, Bethesda, MD 20852.

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