RESUMEN
OBJECTIVES: To describe an epidemic of dengue type 3 that occurred in far north Queensland in 1997-1999 and its influence on the further development of dengue prevention and control strategies. DESIGN: Epidemiological and laboratory investigation of cases, entomological surveys and phylogenetic analysis of dengue virus isolates. MAIN OUTCOME MEASURES: Numbers and characteristics of confirmed cases; Breteau Index (BI; number of containers breeding Aedes aegypti per 100 premises); effect of control measures on mosquito populations; genetic homology of epidemic virus with other dengue virus isolates. RESULTS: The epidemic lasted 70 weeks and comprised 498 confirmed cases in three towns (Cairns, Port Douglas and Mossman); 101 patients (20%) were admitted to hospital. Median interval between symptom onset and notification was seven days (range, 0-53 days), and cumulative duration of viraemia of public health significance was 2,072 days. BIs in affected areas were high, particularly in Mossman (45) and Port Douglas (31). Control measures significantly reduced mosquito populations (assessed as number of ovitraps containing Ae. aegypti eggs and mean number of eggs per trap [P< 0.05 for both]). However, transmission persisted in several foci, in part due to undetected waterfilled containers breeding Ae. aegypti. The epidemic virus belonged to serotype 3; phylogenetic analysis suggested it was imported from Thailand. CONCLUSIONS: The epidemic had greater morbidity than other recent Queensland epidemics of dengue and was harder to control, necessitating substantial revision of the Dengue Fever Management Plan for North Queensland. The epidemic's severity supports the hypothesis that dengue viruses from South East Asia are more virulent than others.
Asunto(s)
Virus del Dengue/aislamiento & purificación , Dengue/epidemiología , Dengue/prevención & control , Brotes de Enfermedades/prevención & control , Aedes/crecimiento & desarrollo , Animales , ADN Viral/aislamiento & purificación , Virus del Dengue/clasificación , Pruebas de Inhibición de Hemaglutinación , Humanos , Insectos Vectores/crecimiento & desarrollo , Control de Mosquitos , Reacción en Cadena de la Polimerasa , Queensland/epidemiología , Encuestas y CuestionariosRESUMEN
Of a panel of forty-six anti-dengue 3 monoclonal antibodies (MAbs) only three neutralised infection of BHK cells by dengue 3 virus. Attempts to select neutralisation escape mutants (n.e.m.) with two of these antibodies failed. The n.e.m. population selected in the presence of the third neutralising antibody, 1H9, had a nucleotide change at position 1157 of the E protein gene resulting in a non-conservative amino acid change at E386 for a Lys to an Asn. A dengue 2 n.e.m. was selected with the flavivirus crossreactive IgG monoclonal antibody 4G2, had deduced amino acid changes at E169 (Ser to Pro) and E275 (Gly to Arg). This dengue 2 n.e.m. population produced smaller plaques in BHK cells than the parental virus, decreased fusion activity (FFWI) and had lost the ability to agglutinate gander erythrocyes at pH 6.0 to 6.7.
Asunto(s)
Anticuerpos Monoclonales/inmunología , Antígenos Virales/inmunología , Virus del Dengue/inmunología , Mapeo Epitopo , Epítopos/inmunología , Proteínas del Envoltorio Viral/inmunología , Animales , Anticuerpos Antivirales/inmunología , Línea Celular , Dengue/virología , Virus del Dengue/clasificación , Pruebas de Inhibición de Hemaglutinación , Humanos , Isotipos de Inmunoglobulinas/inmunología , Pruebas de NeutralizaciónRESUMEN
In December 1998, a 37-year-old Queensland woman died from a rabies-like illness, 27 months after being bitten by a flying fox (fruit bat). Molecular techniques enabled diagnosis of infection with Australian bat lyssavirus (ABL), the second human case to be recognised and the first to be acquired from a flying fox. It must be assumed that any bat in Australia could transmit ABL; anyone bitten or scratched by a bat should immediately wash the wounds thoroughly with soap and water and promptly seek medical advice.
Asunto(s)
Mordeduras y Picaduras/virología , Quirópteros/virología , Lyssavirus , Infecciones por Rhabdoviridae/epidemiología , Adulto , Animales , Australia/epidemiología , Femenino , Humanos , Infecciones por Rhabdoviridae/diagnóstico , Infecciones por Rhabdoviridae/transmisiónRESUMEN
OBJECTIVES: To investigate two outbreaks of dengue type 2 in north Queensland, one in the Torres Strait beginning in late 1996, the other in a Cairns suburb in early 1997. DESIGN: Epidemiological investigation of all laboratory-confirmed cases of dengue, entomological investigation of the local environment, and laboratory analysis of the isolated dengue viruses. MAIN OUTCOME MEASURES: Numbers of confirmed and of locally acquired cases; virus serotype; comparison of nucleotide sequences between viruses isolated from the two outbreaks; and Breteau Index (BI = number of containers with larvae of the mosquito vector Aedes aegypti found per 100 houses investigated) on the affected islands and in the Cairns suburb. RESULTS: There were 201 confirmed cases of dengue in the Torres Strait outbreak, which lasted nearly seven months, and seven confirmed cases in the Cairns outbreak, which lasted about nearly 11 weeks. Most (190) were confirmed as dengue type 2. Nucleotide sequencing of viruses isolated from the two outbreaks showed they were identical. Ae. aegypti breeding sites were very common on the five Torres Strait islands surveyed (BIs, 73-219--high risk), but less so in the Cairns suburb (BI, 23). The most common breeding sites were water storage reservoirs, particularly rainwater tanks, on the outer Torres Strait islands, discarded containers (such as plastic containers, buckets and tyres) on Thursday Island, and garden items (such as flowerpot bases and jars) in Cairns. CONCLUSIONS: The virus responsible for the Cairns outbreak was most probably introduced from the Torres Strait, whereas the virus responsible for the Torres Strait outbreak was imported from Papua New Guinea. Preventive strategies tailored to specific locations are needed to reduce breeding of Ae. aegypti in north Queensland, and the consequent risk of future outbreaks of dengue.