Reemergence of dengue virus type-3 (subtype-III) in India:: Implications for increased incidence of DHF & DSS

Background: Dengue virus infection has recently taken endemic proportion in India implicating all the four known dengue serotypes. There was a major dengue outbreak in northern India including Delhi in October-December, 2003 and again in 2004. We have carried out a detailed investigation of the 2004 outbreak by Serosurveillance, RT-PCR, nested PCR, virus isolation and genotyping. We also report the molecular epidemiological investigation of these outbreaks. Results: The serological investigation of 162 suspected serum samples using an in-house dengue dipstick ELISA revealed 11%-IgM, 51%-IgG and 38%-both IgM and IgG antibody positivity. The RTPCR analysis revealed presence of dengue RNA in 17 samples. Further subtyping and genotyping by nested PCR and nucleotide sequencing of C-prM gene junction revealed the association of subtype III of dengue virus type 3 in the outbreak. Conclusion: The sudden shifting and dominance of the dengue virus serotype-3 ( subtype III) replacing the earlier circulating serotype-2 ( subtype IV) is a point of major concern and may be attributed to increased incidence of DHF and DSS in India.