Retrospective screening of acute undifferentiated fever serum samples with universal flavivirus primers

Introduction: Fever is a common symptom of many tropical diseases and in many cases the etiologic agent remains unidentified as a consequence of either the etiologic agent not being part of routine diagnostic screening or as a consequence of false negatives on standard diagnostic tests. Methodology...

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Main Authors: Sarawut Khongwichit, Sirikwan Libsittikul, Sutee Yoksan, Prasert Auewarakul, Yupin Suputtamongkol, Duncan R. Smith
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2015-07-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/5866
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author Sarawut Khongwichit
Sirikwan Libsittikul
Sutee Yoksan
Prasert Auewarakul
Yupin Suputtamongkol
Duncan R. Smith
author_facet Sarawut Khongwichit
Sirikwan Libsittikul
Sutee Yoksan
Prasert Auewarakul
Yupin Suputtamongkol
Duncan R. Smith
author_sort Sarawut Khongwichit
collection DOAJ
description Introduction: Fever is a common symptom of many tropical diseases and in many cases the etiologic agent remains unidentified as a consequence of either the etiologic agent not being part of routine diagnostic screening or as a consequence of false negatives on standard diagnostic tests. Methodology: This study screened a well characterized panel of 274 serum samples collected on day of admission from adult patients with acute undifferentiated fever admitted to a hospital in Nakhon Ratchasima, Thailand by RT-PCR using pan-flavivirus degenerate primers. Results: Subsequent clinical diagnosis was achieved for 38 of the patients, and included 19 cases of dengue fever. RT-PCR screening identified seven positive samples (2.5%) which were revealed by sequence analysis to be dengue virus 1 (2 cases), dengue virus 2 (2 cases) and dengue virus 3 (3 cases). Only 5 out of 19 (26%) serum samples from patients subsequently diagnosed with dengue were positive, but 2 samples which clinically remained undiagnosed were shown to be positive for dengue virus. Sequence analysis suggested that the dengue virus 3 cases occurred as a result of importation of a strain of dengue from India or China. No other flaviviruses were identified. Conclusions: No evidence was found of other flaviviruses besides dengue circulating in this population. Despite improved diagnostic tests, cases of dengue are still evading correct diagnosis.
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institution Kabale University
issn 1972-2680
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publisher The Journal of Infection in Developing Countries
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spelling doaj-art-e3fa9407e7ec4363836dcb8bccdcc9952025-08-20T03:52:42ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802015-07-0190710.3855/jidc.5866Retrospective screening of acute undifferentiated fever serum samples with universal flavivirus primersSarawut Khongwichit0Sirikwan Libsittikul1Sutee Yoksan2Prasert Auewarakul3Yupin Suputtamongkol4Duncan R. Smith5Siriraj Hospital, Mahidol University, Bangkok, ThailandSiriraj Hospital, Mahidol University, Bangkok, ThailandSiriraj Hospital, Mahidol University, Bangkok, ThailandCenter for Emerging and Neglected Infectious Diseases, Mahidol University, Bangkok, ThailandSiriraj Hospital, Mahidol University, Bangkok, ThailandSiriraj Hospital, Mahidol University, Bangkok, ThailandIntroduction: Fever is a common symptom of many tropical diseases and in many cases the etiologic agent remains unidentified as a consequence of either the etiologic agent not being part of routine diagnostic screening or as a consequence of false negatives on standard diagnostic tests. Methodology: This study screened a well characterized panel of 274 serum samples collected on day of admission from adult patients with acute undifferentiated fever admitted to a hospital in Nakhon Ratchasima, Thailand by RT-PCR using pan-flavivirus degenerate primers. Results: Subsequent clinical diagnosis was achieved for 38 of the patients, and included 19 cases of dengue fever. RT-PCR screening identified seven positive samples (2.5%) which were revealed by sequence analysis to be dengue virus 1 (2 cases), dengue virus 2 (2 cases) and dengue virus 3 (3 cases). Only 5 out of 19 (26%) serum samples from patients subsequently diagnosed with dengue were positive, but 2 samples which clinically remained undiagnosed were shown to be positive for dengue virus. Sequence analysis suggested that the dengue virus 3 cases occurred as a result of importation of a strain of dengue from India or China. No other flaviviruses were identified. Conclusions: No evidence was found of other flaviviruses besides dengue circulating in this population. Despite improved diagnostic tests, cases of dengue are still evading correct diagnosis. https://jidc.org/index.php/journal/article/view/5866feverdengueserumflavivirusphylogenyRT-PCR
spellingShingle Sarawut Khongwichit
Sirikwan Libsittikul
Sutee Yoksan
Prasert Auewarakul
Yupin Suputtamongkol
Duncan R. Smith
Retrospective screening of acute undifferentiated fever serum samples with universal flavivirus primers
Journal of Infection in Developing Countries
fever
dengue
serum
flavivirus
phylogeny
RT-PCR
title Retrospective screening of acute undifferentiated fever serum samples with universal flavivirus primers
title_full Retrospective screening of acute undifferentiated fever serum samples with universal flavivirus primers
title_fullStr Retrospective screening of acute undifferentiated fever serum samples with universal flavivirus primers
title_full_unstemmed Retrospective screening of acute undifferentiated fever serum samples with universal flavivirus primers
title_short Retrospective screening of acute undifferentiated fever serum samples with universal flavivirus primers
title_sort retrospective screening of acute undifferentiated fever serum samples with universal flavivirus primers
topic fever
dengue
serum
flavivirus
phylogeny
RT-PCR
url https://jidc.org/index.php/journal/article/view/5866
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AT prasertauewarakul retrospectivescreeningofacuteundifferentiatedfeverserumsampleswithuniversalflavivirusprimers
AT yupinsuputtamongkol retrospectivescreeningofacuteundifferentiatedfeverserumsampleswithuniversalflavivirusprimers
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