Retrospective screening of acute undifferentiated fever serum samples with universal flavivirus primers

  • Sarawut Khongwichit Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Sirikwan Libsittikul Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Sutee Yoksan Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Prasert Auewarakul Center for Emerging and Neglected Infectious Diseases, Mahidol University, Bangkok, Thailand
  • Yupin Suputtamongkol Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Duncan R. Smith Siriraj Hospital, Mahidol University, Bangkok, Thailand
Keywords: fever, dengue, serum, flavivirus, phylogeny, RT-PCR

Abstract

Introduction: Fever is a common symptom of many tropical diseases and in many cases the etiologic agent remains unidentified as a consequence of either the etiologic agent not being part of routine diagnostic screening or as a consequence of false negatives on standard diagnostic tests.

Methodology: This study screened a well characterized panel of 274 serum samples collected on day of admission from adult patients with acute undifferentiated fever admitted to a hospital in Nakhon Ratchasima, Thailand by RT-PCR using pan-flavivirus degenerate primers.

Results: Subsequent clinical diagnosis was achieved for 38 of the patients, and included 19 cases of dengue fever. RT-PCR screening identified seven positive samples (2.5%) which were revealed by sequence analysis to be dengue virus 1 (2 cases), dengue virus 2 (2 cases) and dengue virus 3 (3 cases). Only 5 out of 19 (26%) serum samples from patients subsequently diagnosed with dengue were positive, but 2 samples which clinically remained undiagnosed were shown to be positive for dengue virus. Sequence analysis suggested that the dengue virus 3 cases occurred as a result of importation of a strain of dengue from India or China. No other flaviviruses were identified.

Conclusions: No evidence was found of other flaviviruses besides dengue circulating in this population. Despite improved diagnostic tests, cases of dengue are still evading correct diagnosis.

Author Biographies

Sarawut Khongwichit, Siriraj Hospital, Mahidol University, Bangkok, Thailand

Ph.D. Student

Institute of Molecular Biosciences

Sirikwan Libsittikul, Siriraj Hospital, Mahidol University, Bangkok, Thailand

Ph.D. Student

Institute of Molecular Biosciences

Sutee Yoksan, Siriraj Hospital, Mahidol University, Bangkok, Thailand

Associate Professor

Institute of Molecular Biosciences

Prasert Auewarakul, Center for Emerging and Neglected Infectious Diseases, Mahidol University, Bangkok, Thailand

Professor

Faculty of Medicine, Siriraj Hospital

Yupin Suputtamongkol, Siriraj Hospital, Mahidol University, Bangkok, Thailand
Professor
Faculty of Medicine, Siriraj Hospital
Duncan R. Smith, Siriraj Hospital, Mahidol University, Bangkok, Thailand

Professor

Institute of Molecular Biosciences

Published
2015-07-30
How to Cite
1.
Khongwichit S, Libsittikul S, Yoksan S, Auewarakul P, Suputtamongkol Y, Smith DR (2015) Retrospective screening of acute undifferentiated fever serum samples with universal flavivirus primers. J Infect Dev Ctries 9:760-764. doi: 10.3855/jidc.5866
Section
Original Articles