the evolution of dengue over a decade in delhi, india
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Journal of Clinical Virology 40 (2007) 87–88
Letter to the Editor
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eywords: Dengue fever; Outbreak; ELISA; Serology
he evolution of dengue over a decade in Delhi, India
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Delhi, the capital of India, has faced seven outbreaksf dengue virus infection due to various serotypes since967, with the last one in 2003 (Broor et al., 1997; Dar etl., 1999; Gupta et al., 2005). The first major epidemic ofengue hemorrhagic fever (DHF), due to dengue-2 virus in996 (Dar et al., 1999), led to >10,000 cases (60% of caseseported from India in 1996) with 423 deaths (Nationalector Borne Disease Control Programme NVBDCP;ttp: //mohfw.nic.in / NVBDCP % 20WEBSITE/DENGUE1.tml). Subsequently, though the virus continued to circulate,n increase in cases was seen only in 2001 (322 cases withdeaths; NVBDCP). In 2002, the number came down to
5. However, in 2003, Delhi witnessed another outbreakith >2800 cases and 35 casualties (NVBDCP). In the
ollowing years (2004 and 2005), though no outbreakccurred, sporadic cases continued to be reported (Gupta etl., 2006). Again, in the year 2006, Delhi faced yet anotherutbreak with a much higher number of cases, crossing thegure of 3000, with 65 deaths, contributing to 28% of thell dengue cases reported from all over India (NVBDCP).ur laboratory received 1110 samples for the diagnosis ofengue fever (DF). Sera were tested for dengue specific IgMntibodies, from patients with fever for ≥5 days. The clinicalasis for diagnosing DF and DHF/dengue shock syndromeDSS) was based on standard clinical criteria (Pan Americanealth Organization, 2000). Serum samples were screenedy IgM-capture ELISA (PanBio, Australia) following theanufacturer’s protocol. Optical density was measured at
50 nm using an ELISA reader (Labsystems Multiskanlus, Finland) and interpreted as per by the manufacturer’s
riteria. Of 1110 samples tested, 664 (59.8%) were positiveor dengue IgM antibodies. Samples peaked in October,ith 525 positive out of 857 received. The predominantge group involved was 21–30 years (35.5%), followed by
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1–20 years (25.6%). Males outnumbered females by 3:1,s reported earlier (Gupta et al., 2006).
In 2006 of 664 seropositive cases, 142 (21.3%) presentedith DHF. DHF had shown an increase >20% in 2005, com-ared to ∼10% in preceding years (Gupta et al., 2006). Thisay be because Delhi is now truly hyperendemic for dengue,ith all the four serotypes co-circulating (Dar et al., 2003).ven in 2006 (data not shown) all the four serotypes of dengueirus were detected, including many mixed infections. Therequency of dengue epidemics and the proportion of DHFre known to increase with hyperendemicity (Barrera et al.,002). This strong resurgence has led the Government ofndia to bring dengue under the umbrella of the Nationalector Borne Disease Control Programme, which adoptscomprehensive framework to control it through vector
urveillance and management, legislative measures, healthducation for community mobilization and inter-sectoral con-ergence.
cknowledgements
We thank Mr. Ashok Saini, Ms. Shivani Saxena, Ms.rema Nair, Mr. Salek Chand and Mr. Milan Chakrabortyor excellent technical support.
eferences
arrera R, Delgado N, Jimenez M, Valero S. Eco-epidemiological factorsassociated with hyper endemic dengue hemorrhagic fever in Maracaycity, Venezuela. Dengue Bull 2002;26:84–95.
roor S, Dar L, Sengupta S, Chakaraborty M, Wali JP, Biswas A, Kabra SK,Jain Y, Seth P. Recent dengue epidemic in Delhi, India. In: Saluzzo JE,Dodet B, editors. Factors in the emergence of arbovirus diseases. Paris:
ar L, Broor S, Sengupta S, Xess I, Seth P. The first major outbreak of denguehemorrhagic fever in Delhi, India. Emerg Infect Dis 1999;5:589–90.
ar L, Gupta E, Narang P, Broor S. Co-circulation of dengue serotypes,Delhi, India. Emerg Infect Dis 2003;12(2):352–3 (Letter to the Editor).
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upta E, Dar L, Narang P, Srivastava VK, Broor S. Serodiagnosis of dengueduring an outbreak at a tertiary care hospital in Delhi. Indian J Med Res2005;121:36–8.
upta E, Dar L, Kapoor G, Broor S. The changing epidemiology of denguein Delhi, India. Virol J 2006;3:92.
ational Vector Borne Disease Control Programme. http://mohfw.nic.in/NVBDCP%20WEBSITE/DENGUE1.html.
an American Health Organization. Epidemiol Bull 2000;21(June (2)).
Anubhav PandeyKavita Diddi
Lalit DarPreeti Bharaj
Harendra Singh ChaharDepartment of Microbiology,
All India Institute of Medical Sciences,New Delhi, India
Randeep GuleriaDepartment of Medicine,
All India Institute of Medical Sciences,New Delhi, India
cal Virology 40 (2007) 87–88
Sushil K. KabraDepartment of Pediatrics,
All India Institute of Medical Sciences,New Delhi, India
Shobha Broor ∗Department of Microbiology,
All India Institute of Medical Sciences,New Delhi, India
∗ Corresponding author. Mobile: +91 9811873410;fax: +91 11 26588663.
E-mail addresses: ap [email protected] (A. Pandey),[email protected] (K. Diddi), [email protected]
(L. Dar),[email protected] (P. Bharaj),
[email protected] (H.S. Chahar),[email protected] (R. Guleria),
[email protected] (S.K. Kabra),[email protected] (S. Broor)
21 March 2007