CIRCULATION OF DENGUE VIRUSES ASSOCIATED WITH CASES OF COINFECTION DURING THE 2013 EPIDEMIC IN TEFÉ, AMAZONAS, BRAZIL Dengue in Tefé, Amazonas

Abstract

Dengue is an infectious disease highly endemic in tropical countries and is rapidly becoming a global burden, globalization, increased air travel and unplanned urbanization have led to an increase in the rate of DENV infection and helped in the expansion of its geographic distribution. and demographic. In Brazil, dengue epidemics have shown a cyclical pattern, with a shift in the predominant serotypes, intense epidemic peaks interspersed with interepidemic periods of 3-4 years, which have decreased in duration in recent years. After the first dengue epidemic in Amazonas in 1998-1999, other major outbreaks occurred in 2001, 2008, 2011 and 2013. In 2013, in addition to Manaus, the most affected municipalities were Coari, Tabatinga, Humaitá, São Gabriel of the Cachoeira, Careiro, Manacapuru and Tefé. Objective: This study presents cases of DENV monoinfection and coinfection that occurred in 2013 in Tefé, a municipality in the state of Amazonas. Methodology: viral RNA was extracted from sera stored at -80° C, subjected to reverse transcription-conjugated polymerase chain reaction (RT-PCR), followed by semi-nested multiplex PCR with primers encoding structural proteins Capsid/ premembrane (C/PrM). Results: 118 cases of single infection, 3 DENV1, 1 DENV2, 60 DENV3, 54 DENV4 and 27 cases of coinfection, 2 DENV1/4 and 25 DENV3/4, all patients fully recovered. These results show the importance of the differential diagnosis in regions where different etiological agents and vectors circulate at home and around the home, the underreporting of cases of dengue and other arboviruses that can be clinically confused with dengue, and the high number of coinfections that highlights the need for clinical and epidemiological studies to better understand the clinical evolution of the disease in these cases.