Kamalraj Mohan¹, Gautam Srinivas KP², Suresh Arumugam³, Pradeep Raj Meenakshi Sundaram⁸, Anandan Balakrishnan⁹, Varshini GopalaKrishnan⁴, Ignatius Roshan R⁴, Gokul G Ra⁵, Sathishkumar Elumalai⁶, Jeevan Malaiyan^4,6,7*

¹1Department of Microbiology, Meenakshi Medical College Hospital and Research Institute, Meenakshi Academy of Higher Education and Research, Kancheepuram, India
²Department of General Medicine, Meenakshi Medical College Hospital and Research Institute, Meenakshi Academy of Higher Education and Research, Kancheepuram, India
³Central Research Facility, Meenakshi Medical College Hospital and Research Institute, Meenakshi Academy of Higher Education and Research, Kancheepuram, India
⁴Division of Virology, Department of Microbiology, Sri Muthukumaran Medical College Hospital and Research Institute, Affiliated to The Tamil Nadu Dr. M.G.R. Medical University, Chikkarayapuram, Chennai, India
⁵Department of General Medicine, Sri Muthukumaran Medical College Hospital and Research Institute, Affiliated to The Tamil Nadu Dr. M.G.R. Medical University, Chikkarayapuram, Chennai, India
⁶Central Research Facility, Sri Muthukumaran Medical College Hospital and Research Institute, Affiliated to The Tamil Nadu Dr. M.G.R. Medical University, Chikkarayapuram, Chennai, India
⁷Department of Microbiology, Annaii Medical College and Hospital, College Road, Pennalur, Sriperumbudur, Chennai, Tamil Nadu, India
⁸Department of General Medicine, Annaii Medical College and Hospital, College Road, Pennalur, Sriperumbudur, Chennai, Tamil Nadu, India
⁹Department of Genetics, Dr. ALM Post Graduate Institute of Basic Medical Sciences, University of Madras, Taramani campus, Chennai, India

*Corresponding Author: Jeevan Malaiyan, DDivision of Virology, Department of Microbiology and Central Research Facility, Sri Muthukumaran Medical College Hospital and Research Institute, Affiliated to The Tamil Nadu Dr. M.G.R. Medical University, Chikkarayapuram, Chennai, India.

Received: January 22, 2024; Published: February 11, 2024

Abstract

Objectives: The classic presentation of dengue fever has expanded its horizon by involving severe forms as atypical manifestations and hemorrhagic fever with reason unknown. This study aimed to characterize dengue viruses (DENV) causing hemorrhagic fever.

Methods: Clinically suspected cases of dengue fever were confirmed by NS1 antigen, IgM and IgG antibody. Following clinical confirmation dengue virus isolates were subjected to reverse transcriptase polymerase chain reaction (RT-PCR), sequenced, aligned using Clustal W and serotype based phylogenetic analysis was performed.

Results: A total of 308 cases were screened, during 2015-18 of which 106 (34%) samples were positive for dengue infection. 42 (40%) cases showed atypical dengue manifestations, 14 (13%) presented with hemorrhagic fever. Among the atypical manifestations, hepatomegaly and splenomegaly were the most common, followed by ascites 12 (11%), pleural effusion 9 (8%), bradycardia 6 (6%), meningitis 6 (6%), acalculous cholecystitis 04 (4%), haemoptysis 3 (3%) and acute pancreatitis 2 (2%). Dengue hemorrhagic fever (n = 14) was caused by, DENV-1 (n = 7), DENV-2 (n = 5) and DENV- 4 (n = 2). Serotype DENV-3 was not isolated in any of the samples. A new clade of genotype I (GI) was predominant in DENV-1; Genotype IVC (GIVC)was predominant in DENV-2 showing mixed clustering suggesting lineage C; clade B of lineage C, genotype I (GI)was seen in DENV-4. The amino acid changes were observed in M51I, L72F, S93N in DENV-1 and M104V, V112A in DENV-2 of C-prM regions of hemorrhagic isolates when compared to standard strains.

Conclusions: Multiple amino acid changes may have influenced the emergence of new clade, lineages and resulted in higher magnitude of severity dengue and presented as hemorrhagic fever (DHF).

Keywords: Atypical Manifestation; Characterization; Dengue Viruses; Hemorrhagic Fever; Phylogenetic Analysis

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Citation

Citation: Kamalraj Mohan.,et al. “Molecular Characterization of Dengue Viruses Causing Hemorrhagic Fever from the Atypical Dengue Cases in Chennai, India".Acta Scientific Microbiology 7.3 (2024): 31-40.

Copyright

Copyright: © 2024 Jeevan Malaiyan., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.