Publication: First report of sylvatic DENV-2-associated dengue hemorrhagic fever in West Africa
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2011-08-02
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Franco, Leticia ISCIII 
Palacios, Gustavo
Martinez, José Antonio
Vazquez, Ana ISCIII 
Savji, Nazir
De Ory, Fernando de ISCIII
Sánchez-Seco, María Paz ISCIII
Martín, Dolores
Lipkin, W Ian
Tenorio, Antonio ISCIII
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Public Library of Science (PLOS)
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Abstract
Dengue virus (DENV) circulates in human and sylvatic cycles. Sylvatic strains are both ecologically and evolutionarily distinct from endemic viruses. Although sylvatic dengue cycles occur in West African countries and Malaysia, only a few cases of mild human disease caused by sylvatic strains and one single case of dengue hemorrhagic fever in Malaysia have been reported. Here we report a case of dengue hemorrhagic fever (DHF) with thrombocytopenia (13000/µl), a raised hematocrit (32% above baseline) and mucosal bleeding in a 27-year-old male returning to Spain in November 2009 after visiting his home country Guinea Bissau. Sylvatic DENV-2 West African lineage was isolated from blood and sera. This is the first case of DHF associated with sylvatic DENV-2 in Africa and the second case worldwide of DHF caused by a sylvatic strain.
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PLoS Negl Trop Dis. 2011 Aug;5(8):e1251.