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

MARÍA A. LOROÑO-PINO Laboratorio de Arbovirología, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatan, Merida, Yucatan, Mexico; Arthropod-Borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado; Departamento de Medicina Preventiva, Hospital General Regional No. 12, Benito Juárez, Instituto Mexicano del Seguro Social, Merida, Yucatan, Mexico; Dirección de Prevención y Control de Enfermedades, Secretaría de Salud de Yucatán, Merida, Yucatan, Mexico

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JOSÉ A. FARFÁN-ALE Laboratorio de Arbovirología, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatan, Merida, Yucatan, Mexico; Arthropod-Borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado; Departamento de Medicina Preventiva, Hospital General Regional No. 12, Benito Juárez, Instituto Mexicano del Seguro Social, Merida, Yucatan, Mexico; Dirección de Prevención y Control de Enfermedades, Secretaría de Salud de Yucatán, Merida, Yucatan, Mexico

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ALICIA L. ZAPATA-PERAZA Laboratorio de Arbovirología, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatan, Merida, Yucatan, Mexico; Arthropod-Borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado; Departamento de Medicina Preventiva, Hospital General Regional No. 12, Benito Juárez, Instituto Mexicano del Seguro Social, Merida, Yucatan, Mexico; Dirección de Prevención y Control de Enfermedades, Secretaría de Salud de Yucatán, Merida, Yucatan, Mexico

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ELSY P. ROSADO-PAREDES Laboratorio de Arbovirología, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatan, Merida, Yucatan, Mexico; Arthropod-Borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado; Departamento de Medicina Preventiva, Hospital General Regional No. 12, Benito Juárez, Instituto Mexicano del Seguro Social, Merida, Yucatan, Mexico; Dirección de Prevención y Control de Enfermedades, Secretaría de Salud de Yucatán, Merida, Yucatan, Mexico

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LUIS F. FLORES-FLORES Laboratorio de Arbovirología, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatan, Merida, Yucatan, Mexico; Arthropod-Borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado; Departamento de Medicina Preventiva, Hospital General Regional No. 12, Benito Juárez, Instituto Mexicano del Seguro Social, Merida, Yucatan, Mexico; Dirección de Prevención y Control de Enfermedades, Secretaría de Salud de Yucatán, Merida, Yucatan, Mexico

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JULIÁN E. GARCÍA-REJÓN Laboratorio de Arbovirología, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatan, Merida, Yucatan, Mexico; Arthropod-Borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado; Departamento de Medicina Preventiva, Hospital General Regional No. 12, Benito Juárez, Instituto Mexicano del Seguro Social, Merida, Yucatan, Mexico; Dirección de Prevención y Control de Enfermedades, Secretaría de Salud de Yucatán, Merida, Yucatan, Mexico

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FRANCISCO J. DÍAZ Laboratorio de Arbovirología, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatan, Merida, Yucatan, Mexico; Arthropod-Borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado; Departamento de Medicina Preventiva, Hospital General Regional No. 12, Benito Juárez, Instituto Mexicano del Seguro Social, Merida, Yucatan, Mexico; Dirección de Prevención y Control de Enfermedades, Secretaría de Salud de Yucatán, Merida, Yucatan, Mexico

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BRADLEY J. BLITVICH Laboratorio de Arbovirología, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatan, Merida, Yucatan, Mexico; Arthropod-Borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado; Departamento de Medicina Preventiva, Hospital General Regional No. 12, Benito Juárez, Instituto Mexicano del Seguro Social, Merida, Yucatan, Mexico; Dirección de Prevención y Control de Enfermedades, Secretaría de Salud de Yucatán, Merida, Yucatan, Mexico

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MANUEL ANDRADE-NARVÁEZ Laboratorio de Arbovirología, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatan, Merida, Yucatan, Mexico; Arthropod-Borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado; Departamento de Medicina Preventiva, Hospital General Regional No. 12, Benito Juárez, Instituto Mexicano del Seguro Social, Merida, Yucatan, Mexico; Dirección de Prevención y Control de Enfermedades, Secretaría de Salud de Yucatán, Merida, Yucatan, Mexico

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EUSEBIO JIMÉNEZ-RÍOS Laboratorio de Arbovirología, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatan, Merida, Yucatan, Mexico; Arthropod-Borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado; Departamento de Medicina Preventiva, Hospital General Regional No. 12, Benito Juárez, Instituto Mexicano del Seguro Social, Merida, Yucatan, Mexico; Dirección de Prevención y Control de Enfermedades, Secretaría de Salud de Yucatán, Merida, Yucatan, Mexico

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CAROL D. BLAIR Laboratorio de Arbovirología, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatan, Merida, Yucatan, Mexico; Arthropod-Borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado; Departamento de Medicina Preventiva, Hospital General Regional No. 12, Benito Juárez, Instituto Mexicano del Seguro Social, Merida, Yucatan, Mexico; Dirección de Prevención y Control de Enfermedades, Secretaría de Salud de Yucatán, Merida, Yucatan, Mexico

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KEN E. OLSON Laboratorio de Arbovirología, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatan, Merida, Yucatan, Mexico; Arthropod-Borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado; Departamento de Medicina Preventiva, Hospital General Regional No. 12, Benito Juárez, Instituto Mexicano del Seguro Social, Merida, Yucatan, Mexico; Dirección de Prevención y Control de Enfermedades, Secretaría de Salud de Yucatán, Merida, Yucatan, Mexico

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WILLIAM BLACK IV Laboratorio de Arbovirología, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatan, Merida, Yucatan, Mexico; Arthropod-Borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado; Departamento de Medicina Preventiva, Hospital General Regional No. 12, Benito Juárez, Instituto Mexicano del Seguro Social, Merida, Yucatan, Mexico; Dirección de Prevención y Control de Enfermedades, Secretaría de Salud de Yucatán, Merida, Yucatan, Mexico

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BARRY J. BEATY Laboratorio de Arbovirología, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatan, Merida, Yucatan, Mexico; Arthropod-Borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado; Departamento de Medicina Preventiva, Hospital General Regional No. 12, Benito Juárez, Instituto Mexicano del Seguro Social, Merida, Yucatan, Mexico; Dirección de Prevención y Control de Enfermedades, Secretaría de Salud de Yucatán, Merida, Yucatan, Mexico

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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.

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