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. 2020 Apr 22;14(4):e0008165.
doi: 10.1371/journal.pntd.0008165. eCollection 2020 Apr.

Molecular epidemiology of dengue fever outbreaks in Bhutan, 2016-2017

Sangay Zangmo  1 , Jit Bdr Darnal  1 , Tsheten  1 , Sonam Gyeltshen  1 , Binay Thapa Thapa  1 , Prinyada Rodpradit  2 , Piyawan Chinnawirotpisan  2 , Wudtichai Manasatienkij  2 , Louis R Macareo  2 , Stefan Fernandez  2 , Sonam Wangchuk  1 , Chonticha Klungthong  2
Affiliations

Molecular epidemiology of dengue fever outbreaks in Bhutan, 2016-2017

Sangay Zangmo et al. PLoS Negl Trop Dis. .

Abstract

Dengue continues to pose a significant public health problem in tropical and subtropical countries. In Bhutan, first outbreak of dengue fever (DF) was reported in 2004 in a southern border town, followed by sporadic cases over the years. In this study, we analysed DF outbreaks that occurred in 3 different places during the years 2016 and 2017. A total of 533 cases in 2016 and 163 in 2017 were suspected of having of DF, where young adults were mostly affected. A total of 240 acute serum specimens collected and analyzed for serotype by nested RT-PCR revealed predominance of serotypes 1 and 2 (DENV-1 and 2). Phylogenetic analysis using envelope gene for both the serotypes demonstrated cosmopolitan genotype which were closely related to strains from India, indicating that they were probably imported from the neighboring country over the past few years.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Map of Bhutan depicting places from where outbreaks of DF were reported.
Year wise detection of DENV serotypes and their genotypes are provided alongside the place of outbreak. This map was created using ESRI, ArcGIS 10.5; 2016.
Fig 2
Fig 2. Flow chart demonstrating the process of specimen collection and analysis.
*Randomly selected among samples having adequate volume. †Specimens from which E gene sequences could not be obtained directly.
Fig 3
Fig 3. Epicurve of DF outbreaks that occurred in Phuntsholing (2016); Samtse and Samdrup Jongkhar (2017).
Fig 4
Fig 4. Phylogenetic tree.
Maximum likelihood tree of 731 DENV-1 E gene sequences (1,485 bp) including 15 new sequences from this study (red bold), 33 sequences from previous study in Bhutan (blue), 3 vaccine strains sequences (black bold and italics), and 680 other sequences from GenBank (black). Bootstrap values are indicated at the major nodes.
Fig 5
Fig 5. Phylogenetic tree.
Maximum likelihood tree of 175 DENV-2 E gene sequences (1,485 bp) including 5 new sequences from this study (red bold), 2 sequences from previous study in Bhutan (blue), 3 vaccine strains sequences (black bold and italics), and 165 other sequences from GenBank (black). Bootstrap values are indicated at the major nodes.
See this image and copyright information in PMC

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