Delfina Rosario

Instituto de Medicina Tropical “Pedro Kourí”

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María G. Guzmán

Instituto de Medicina Tropical “Pedro Kourí”

MÁ

Mayling Álvarez

Instituto de Medicina Tropical “Pedro Kourí”

R. Rodríguez

Instituto de Investigación Biomédica de Salamanca

Susana Vázquez

Hospital del Mar Research Institute

Gustavo Kourí

Instituto de Medicina Tropical “Pedro Kourí”

Irina Prado

Instituto de Medicina Tropical “Pedro Kourí”

Lisset Hermida

Zhejiang Yongning Pharma (China)

Gerardo Guillén

Centro de Ingeniería Genética y Biotecnología

Ana Beatriz Alvarez Pérez

Instituto de Medicina Tropical “Pedro Kourí”

María V. Cabrera

Instituto de Medicina Tropical “Pedro Kourí”

Cooperative Institutions

Instituto de Medicina Tropical “Pedro Kourí”

Centro de Ingeniería Genética y Biotecnología

Instituto de Medicina Tropical

Pan American Health Organization (Cuba)

Instituto Nacional de Higiene, Epidemiología y Microbiología

University of Havana

National Center for Genetic Engineering and Biotechnology

ORCID

Latin American School of Medicine

Instituto de Salud Carlos III

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Classical dengue hemorrhagic fever resulting from two dengue infections spaced 20 years or more apart: Havana, Dengue 3 epidemic, 2001–2002

International Journal of Infectious Diseases (2005)

Daniel González Osvaldo Castro Gustavo Kourí Jorge Pérez Eric Martínez

To report the clinical, laboratory and sonographic findings in 76 adult cases of dengue hemorrhagic fever (DHF).A dengue 3 epidemic occurred in Havana City from June 2001 to March 2002. 12,889 cases were reported, with 81 DHF cases. From this, 76 serologically confirmed cases were studied descriptively.Bronchial asthma and white race were important risk factors for the severe form of the disease. Fever (100%), headache (92.1%), myalgia (76.3%), arthralgia (73.7%) and retro-orbital pain (57.7%) were the most frequent general symptoms. Vomiting and abdominal pain were observed in 59.2% and 48.6% of cases, respectively. The most common bleeding site was the vagina (64%), followed by the skin (55.2%). Eighteen patients (23.6%) had shock syndrome. Laboratory findings included thrombocytopenia (100%), hemoconcentration (93.4%), an increase in liver enzymes (82.8%), and leukopenia (71%). Ultrasound detected thickening of the gallbladder wall in 35.1%, pleural effusion in 20.3%, and splenomegaly in 12.9% of cases.These findings contribute to a better understanding of the clinical aspects of DHF in adult patients due to the dengue 3 virus.

myalgia

Ecchymosis

Leukopenia

10.1016/j.ijid.2004.07.012

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Citations (95)

Amino acid changes in the recombinant Dengue 3 Envelope domain III determine its antigenicity and immunogenicity in mice

Virus Research (2006)

Aı́da Zulueta Jorge Martı́n Lisset Hermida Mayling Álvarez Iris Valdés

Antigenicity

Dengue vaccine

10.1016/j.virusres.2006.04.003

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Citations (41)

Virological and Serological Markers in Dengue Patients from Venezuela and Nicaragua

OALib (2017)

Didye Ruiz Susana Vázquez Elci Villegas Ángel Balmaseda Maritza Pupo

Latest estimates suggest 390 million infections of dengue occur each year, of which 100 million results in symptomatic disease.The new clinical classification proposed by WHO-TRD 2009 simplifies dengue fever (DF) into dengue (D) and severe dengue (SD) with an intermediary group of "dengue with warning signs" (DWS).Early, sensitive and specific diagnosis of dengue is needed for appropriate patient management as well as for early epidemic detection.Virological and serological markers in sera from dengue confirmed patients from Venezuela and Nicaragua were evaluated.A total of 232 sera collected in the acute (days 1 to 5 of fever onset) and convalescent (days 7 to 14) phases of illness were tested by Platelia NS1 antigen ELISA and IgM, IgA and IgE capture ELISA methods.NS1 was detected with highest OD values in the acute phase for primary and secondary cases.IgM was detected in primary and secondary groups but the highest OD figures were observed after defervescence day.IgA and IgE detection were almost absent for primary cases, contrary to secondary cases which showed higher values but after defervescence day.NS1 could be used as effective diagnostic marker in the acute phase of illness for primary and secondary dengue infections.IgM detection is still an invaluable tool for routine dengue diagnosis but delay.IgA detection could define secondary infection in early phase of illness.IgA/IgE could be evaluated as prognostic markers associated to SD cases.

10.4236/oalib.1103309

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Citations (1)

Biological and molecular properties of Dengue 2 strains Isolated during the DHF/DSS Cuban epidemic, 1981

International Journal of Biomedical Science (2007)

María G. Guzmán Léster González Mayling Álvarez Delfina Rosario Alequis Pavón

To study some biological and molecular properties of nine DENV-2 strains isolated during the 1981 Cuban epidemic, temperature sensitivity, viral plaque size, the kinetic of virus replication in newborn mice inoculated by intracerebral route, the influence of pH medium on virus-cell attachment phase and the restriction enzyme pattern were studied. Strains were classified in two patterns according to temperature sensitivity, plaque size, virus replication in mouse brain and cell culture and restriction enzymatic pattern The changes observed differentiate clearly the strains isolated at the beginning and at the end of the epidemic suggesting that viruses with different characteristics circulated.

Replication

10.59566/ijbs.2007.3138

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Reacción en cadena de la polimerasa para la detección rápida y determinación del serotipo de virus del dengue en muestras clínicas

Revista Panamericana de Salud Pública (1998)

Delfina Rosario Mayling Álvarez Javier Díaz Rodolfo Contreras R. Rodríguez

El trabajo que aquí se presenta describe las ventajas de usar la reacción en cadena de la polimerasa con transcriptasa inversa (RCP-TI) para detectar e identificar con rapidez virus del dengue en muestras clínicas. Se sometieron directamente a RCP-TI 27 muestras obtenidas de pacientes con fiebre de dengue y fiebre hemorrágica de dengue durante epidemias en Colombia, Nicaragua y Panamá. El ADN de cadena doble obtenido con la RCP-TI se identificó mediante una segunda amplificación (RCP de anidación) utilizando cebadores específicos para cada tipo de virus, aislamiento vírico e inmunofluorescencia indirecta (IFI) y con electroinmunoensayo enzimático detector de anticuerpos IgM contra el virus del dengue. El genoma vírico amplificado se detectó e identificó en un máximo de 8 horas. Los parámetros calculados para hacer el diagnóstico por RCP-TI, usando el aislamiento vírico y la IFI como estándar de oro, fueron una sensibilidad de 100%; una especificidad de 78%; un valor predictivo positivo de 69% y un valor predictivo negativo de 100%. Cabe notar que dos de los especímenes que dieron resultados positivos a la prueba de RCP-TI anidada y negativos al aislamiento vírico mostraron anticuerpos específicos de tipo IgM. Los resultados de la RCP-TI en general mostraron una estrecha concordancia con los del aislamiento vírico, lo cual sugiere que la RCP es un procedimiento que facilita enormemente el diagnóstico rápido y temprano del dengue.

IIf

Gold standard (test)

Viral culture

10.1590/s1020-49891998000700001

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Citations (29)

Virus Role During Intraepidemic Increase in Dengue Disease Severity

Vector-Borne and Zoonotic Diseases (2011)

R. Rodríguez Lizet Sánchez Yaima Burgher Delfina Rosario Mayling Álvarez

Dengue epidemics in Cuba have repeatedly demonstrated a month-to-month increase in clinical severity during secondary infections. The dengue 2 outbreak that occurred in Santiago de Cuba in 1997 was accompanied by the most severe intraepidemic increase in disease severity reported to date. It was initially proposed that the appearance of neutralization escape mutants during the course of the epidemic might explain this phenomenon. Recent studies have revealed that during the course of this epidemic, nucleotide substitutions appeared only in nonstructural (NS) genes, most of which were silent, except for one change in the NS1 gene. To study whether or not variation in the NS1 gene might be associated with increased disease severity during the epidemic, this gene was partially sequenced from 15 isolates obtained at different times during the 1997 epidemic. Early epidemic isolates differed from those obtained later by replacement only of threonine with serine at position 164 in the NS1 protein, an amino acid rarely found in any genotype of dengue 2 virus. All viruses isolated from patients located in Health Districts, where dengue 2 transmissions occurred late in the epidemic, contained Serine at position 164, indicating that this change was fixed within a few months. Here we argue that this single mutation contributes to viral survival or replication efficiency, resulting in enhanced infection in the presence of enhancing antibodies, a phenomenon that we term increased virus "fitness" in contrast to "virulence," an intrinsic property of the virus.

10.1089/vbz.2010.0177

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Citations (37)

Role of the virology diagnosis laboratory in the surveillance of rubella virus

Vaccine (2004)

María de los Ángeles Ribas Miguel Galindo Gisset Torres Marlen Valcarsel Reynel Cancio

Rubella virus

Rubella vaccine

10.1016/j.vaccine.2004.04.023

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Citations (4)

La epidemiología del dengue y del dengue hemorrágico en Santiago de Cuba, 1997

Revista Panamericana de Salud Pública (1999)

Luis Valdés María G. Guzmán Gustavo Kourí Jorge Delgado Isabel Torres Carbonell

En 1977, Cuba informó de su primera epidemia de dengue, durante la cual se registraron más de 500 000 casos de fiebre del dengue causados por el serotipo 1 del virus. En 1981, se produjo una gran epidemia de dengue hemorrágico causada por el serotipo 2. Esa vez se notificaron 344 203 casos en total, 10 312 casos clínicos de dengue hemorrágico y 158 defunciones, de las cuales 101 correspondieron a niños. Por medio de una búsqueda activa con confirmación de laboratorio, en el municipio de Santiago de Cuba de la provincia del mismo nombre se detectó precozmente en enero de 1997 la reintroducción del dengue, específicamente del virus del tipo 2, genotipo Jamaica. En este trabajo se presentan los aspectos epidemiológicos de mayor interés referentes a esa epidemia. Se notificaron 3 012 casos confirmados por serología, 205 clasificados como fiebre hemorrágica del dengue/síndrome de choque del dengue, de los cuales 12 fallecieron (todos adultos). La infección secundaria por virus del dengue fue uno de los principales factores de riesgo en el desarrollo de dengue hemorrágico y 98% de los casos, así como 92% de los fallecidos, manifestaron una respuesta de tipo secundario. Por primera vez se observó la posibilidad de contraer dengue hemorrágico en personas con una infección secundaria de 16 a 20 años después de la primera infección. Pertenecer a la raza blanca fue otro factor de riesgo de importancia, tal como se había observado desde la epidemia de 1981. En la última epidemia se demostró que la llamada alerta de fiebre no es útil para la detección temprana de una epidemia. Las medidas tomadas por las autoridades sanitarias del país evitaron la extensión de la epidemia a otros municipios que estaban infestados por Aedes aegypti.

Dengue hemorrhagic fever

10.1590/s1020-49891999000600003

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Citations (71)

Fatal dengue hemorrhagic fever in Cuba, 1997

International Journal of Infectious Diseases (1999)

María G. Guzmán Mayling Álvarez R. Rodríguez Delfina Rosario Susana Vázquez

OQectives: After more than 15 years without dengue activity, a dengue II epidemic was reported in Cuba in 1997.Three thousand and twelve serologically confirmed cases were reported, with 205 dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) cases and 12 fatalities.This report presents the clinical, serologic, and virologic findings in the 12 fatal DHF/DSS cases Methods: Serum and necropsy samples were studied by viral isolation in C636 cell line and polymerase chain reaction.Serum samples were tested by IgM capture enzyme-linked immunoassay (ELISA) and ELISA inhibition method (EIM).Results: All 12 cases were classified as DHF/DSS according to the Pan American Health Organization Guidelines for Control and Prevention of Dengue and Dengue HemorrhagicFever in the Americas.All patients were older than 15 years.Women were more frequently affected.The symptoms and signs presented by these patients were similar to those previously described in DHF/DSS cases.Clinical deterioration occurred on average at day 3.75.Abdominal pain and persistent vomiting were the earliest and most frequent warning signs.Dengue infection was confirmed in all cases.IgM antibodies were detected in 11 of 12 cases, all of them with a secondary infection.Dengue II virus was detected by viral isolation in 12 samples and by polymerase chain reaction in 17.Virus or RNA was detected in various tissues, including kidney, heart, lung, and brain. Conclusion:The clinical, pathologic, and laboratory features of 12 cases of fatal dengue hemorrhagic fever were reviewed.The results obtained demonstrate that adults with a primary dengue infection are at risk of developing the severe disease (DHF) if they are infected with a different serotype.

Dengue hemorrhagic fever

10.1016/s1201-9712(99)90033-4

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Citations (151)

Population structure of the dengue viruses, Aragua, Venezuela, 2006–2007. Insights into dengue evolution under hyperendemic transmission

Infection Genetics and Evolution (2011)

R. Rodríguez Elci Villegas Shelley Cook Pauline A.W. Poh Kim Yoandri Hinojosa

During the past three decades there has been a notable increase in dengue disease severity in Venezuela.Nevertheless, the population structure of the viruses being transmitted in this country is not well understood.Here, we present a molecular epidemiological study on dengue viruses (DENV) circulating in Aragua State, Venezuela during 2006-2007.Twenty-one DENV full-length genomes representing all of the four serotypes were amplified and sequenced directly from the serum samples.Notably, only DENV-2 was associated with severe disease.Phylogenetic trees constructed using Bayesian methods indicated that only one genotype was circulating for each serotype.However, extensive viral genetic diversity was found in DENV isolated from the same area during the same period, indicating significant in situ evolution since the introduction of these genotypes.Collectively, the results suggest that the non-structural (NS) proteins may play an important role in DENV evolution, particularly NS1, NS2A and NS4B proteins.The phylogenetic data provide evidence to suggest that multiple introductions of DENV have occurred from the Latin American region into Venezuela and vice versa.The implications of the significant viral genetic diversity generated during hyperendemic transmission, particularly in NS protein are discussed and considered in the context of future development and use of human monoclonal antibodies as antivirals and tetravalent vaccines.

10.1016/j.meegid.2011.12.005

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Citations (21)