Analysis of Dengue Serotype 4 in Sri Lanka during the 2012–2013 Dengue Epidemic

Anna Uehara Duke-NUS Medical School, Singapore;

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Hasitha Aravinda Tissera Epidemiology Unit, Ministry of Health, Colombo, Sri Lanka;

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Champica K. Bodinayake Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka;

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Ananda Amarasinghe Epidemiology Unit, Ministry of Health, Colombo, Sri Lanka;

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Ajith Nagahawatte Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka;

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L. Gayani Tillekeratne Duke Global Health Institute, Durham, North Carolina;

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Jie Cui Key Laboratory of Special Pathogens and Biosafety, Center for Emerging Infectious Diseases, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China;

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Megan E. Reller Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, Maryland;

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Paba Palihawadana Epidemiology Unit, Ministry of Health, Colombo, Sri Lanka;

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Sunethra Gunasena Medical Research Institute, Colombo, Sri Lanka;

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Aruna Dharshan Desilva Genetech Research Institute, Colombo, Sri Lanka;

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Annelies Wilder-Smith Umea University, Umea, Sweden;
Institute of Public Health, University of Heidelberg, Heidelberg, Germany

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Duane J. Gubler Duke-NUS Medical School, Singapore;

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Christopher W. Woods Duke Global Health Institute, Durham, North Carolina;

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October M. Sessions Duke-NUS Medical School, Singapore;

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The four serotypes of dengue virus (DENV-1, -2, -3, and -4) have had a rapidly expanding geographic range and are now endemic in over 100 tropical and subtropical countries. Sri Lanka has experienced periodic dengue outbreaks since the 1960s, but since 1989 epidemics have become progressively larger and associated with more severe disease. The dominant virus in the 2012 epidemic was DENV-1, but DENV-4 infections were also commonly observed. DENV-4 transmission was first documented in Sri Lanka when it was isolated from a traveler in 1978, but has been comparatively uncommon since dengue surveillance began in the early 1980s. To better understand the molecular epidemiology of DENV-4 infections in Sri Lanka, we conducted whole-genome sequencing on dengue patient samples from two different geographic locations. Phylogenetic analysis indicates that all sequenced DENV-4 strains belong to genotype 1 and are most closely related to DENV-4 viruses previously found in Sri Lanka and those recently found to be circulating in India and Pakistan.

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Author Notes

Address correspondence to October M. Sessions, Duke-NUS Medical School, 8 College Road, Singapore 169857. E-mail: october.sessions@duke-nus.edu.sg

Financial support: This study was funded through a grant from the Office of Naval Research to the Program in Emerging Infectious Diseases, Duke-NUS Graduate Medical School, Singapore; in part by a block grant from the Singapore Ministry of Health to Duke-NUS Graduate Medical School and by the European Union, Dengue Tools Project Grant Agreement no. 282589. Jie Cui is funded by CAS Pioneer Hundred Talents Program. Staff from Duke-NUS Medical School, Singapore, Duke University, Durham, NC, Medical Research Institute, Sri Lanka, and Genetech Research Institute, Sri Lanka, are acknowledged for their contribution.

Authors’ addresses: Anna Uehara, October M. Sessions, and Duane J. Gubler, Emerging Infectious Diseases Program, Duke-NUS Graduate Medical School, Singapore, E-mails: anna.uehara@u.duke.nus.edu, october.sessions@duke-nus.edu.sg, and duane.gubler@duke-nus.edu.sg. Hasitha Aravinda Tissera, Ananda Amarasinghe, and Paba Palihawadana, Epidemiology Unit, Ministry of Health, Colombo, Sri Lanka, E-mails: dr_korelege@yahoo.co.uk, ana_amarasinghe@yahoo.co.uk, and papa@health.gov.lk. Champica K. Bodinayake, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka, E-mail: bodinayake@yahoo.co.uk. Ajith Nagahawatte, Department of Microbiology, University of Ruhuna, Galle, Sri Lanka, E-mail: ajithnagahawatte@yahoo.co.uk. L. Gayani Tillekeratne, Duke Global Health Institute, Duke University, Durham, NC, E-mail: gayani.tillekeratne@duke.edu. Jie Cui, Wuhan Institute of Virology, Wuhan University, Wuhan, China, E-mail: jiecui@wh.iov.cn. Megan E. Reller, Department of Pathology, Johns Hopkins University, Baltimore, MD, E-mail: mreller1@jhmi.edu. Sunethra Gunasena, Department of Virology, Medical Research Institute, Colombo, Sri Lanka, E-mail: sunethra.gunasena@gmail.com. Aruna Dharshan Desilva, Genetech Research Institute, Colombo, Sri Lanka, E-mail: dslv90@yahoo.com. Annelies Wilder-Smith, Institute of Public Health, University of Heidelberg, Heidelberg, Germany, E-mail: annelies.wilder-smith@umu.se. Christopher W. Woods, Department of Medicine, Duke University, Durham, NC, E-mail: chris.woods@duke.edu.

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