In August 2023, we identified a case of dengue fever in Yantai City, which was imported from Xishuangbanna, China. To investigate its evolutionary history and population dynamics, we utilized the metatranscriptomic method to obtain the virus\' whole genome sequence. Together with 367 selected dengue virus whole genome sequences from the NCBI database, we constructed a time-scaled Maximum Clade Credibility (MCC) tree. We found that our sequence exhibited a high homology with a sequence of DENV1 (OR418422.1) uploaded by the Guangzhou Center for Disease Control and Prevention in 2023, with an estimated divergence time around 2019 (95% HPD: 2017-2023), coinciding with the emergence of SARS-CoV-2. The DENV strain obtained in this study belongs to genotype I of DENV1. Its ancestors experienced a global epidemic around 2005 (95% HPD: 2002-2010), and its progeny strains have spread extensively in Southeast Asia and China since around 2007 (95% HPD: 2006-2011). The Bayesian skyline plot indicates that the current population of DENV1 has not been affected by SARS-CoV-2 and is expected to maintain stable transmission. Hence, it is imperative to track and monitor its epidemiological trends and genomic variations to prevent potential large-scale outbreaks in the post-SARS-CoV-2 era.

BACKGROUND: Dengue infection is a mosquito-borne, endemic viral disease, particularly in developing countries. Here, we report the results of the clinicodemographic, serologic profile and the monthly occurrence of a recent dengue fever outbreak in Puntland State (Somalia).
METHODS: We analyzed the data of 956 dengue-suspected patients who were investigated using the rapid diagnostic testing (RDT) method for detecting NS1 (dengue virus non-structural protein) and IgM antibodies employing the SD Biosensor Dengue Dou NS Ag and IgM test kit (Germany) at the Puntland Public Health Referral Laboratory from November 21, 2022, to May 27, 2023.
RESULTS: We found that 118 cases were positive for dengue among the suspected patients enrolled in the present study. Of these cases, 76.2% were dengue NSI positive, 13.6% were dengue IgM positive, and 10.2% were both NSI and IgM positive. The number of females and males in the confirmed cases was equal, and most (48.3%) were aged 20 years or less. 43.1% of them lived in the Nugal region, particularly in Garowe. Clinically, fever was the most frequent symptom (88.9%). The cases peaked in December 2022 but dropped from January to March, with a slight rise in February, and then increased in April and May 2023.
CONCLUSIONS: This study highlights the clinicodemographic characteristics, seroprevalence, and monthly occurrence of dengue in Puntland. We recommend improving vector control measures, enhancing case management, strengthening dengue surveillance, developing an early warning system, and conducting future studies to characterize the circulating strains.

Introduction Dengue fever, caused by the dengue virus transmitted by Aedes aegypti mosquitoes, is a significant public health concern globally. Its resurgence in recent years, particularly in low- and middle-income countries, has led to increased morbidity and mortality rates. Atypical manifestations, involving the cardiac, liver, gut, renal, blood, bone, nervous, and respiratory systems, in dengue, can complicate both diagnosis and management. This study aimed to investigate the incidence of lung manifestations in dengue-infected individuals and their correlation with patient outcomes. Background The prevalence of dengue fever has risen dramatically over the past two decades, with Asia bearing the brunt of the burden, particularly India. The pathophysiology of lung complications in dengue remains unclear but is thought to be related to capillary leak syndrome and thrombocytopenia. Studies suggest that respiratory symptoms may be associated with severe cases and increased mortality rates. Despite limited research in India, understanding lung manifestations in dengue is crucial for improving diagnostic accuracy and patient care. Methods A retrospective study was conducted at K.S. Hegde Hospital, a tertiary care facility located in Mangalore, India, involving patients aged 18 years and above diagnosed with dengue fever between January and December 2019. Data gathered comprised patient demographics, clinical symptoms, laboratory findings, imaging results including radiographs, computed tomography (CT) scans of the chest (if accessible), ultrasound examinations of the chest and abdomen, and 2D echocardiograms, as well as patient outcomes. Diagnosis of lung manifestation was established through clinical assessment, chest X-ray interpretation, and ultrasound of the chest. Statistical analysis was conducted using SPSS Statistics (version 20), with a significance set at p<0.05. Results Out of 255 dengue cases, 10.19% (n=26) exhibited pulmonary manifestations, with pleural effusion being the most common. Older age (>50 years) and comorbidities were associated with a higher incidence of lung involvement. Respiratory symptoms, such as breathlessness, were more prevalent in patients with pulmonary complications. Laboratory parameters indicated distinct profiles in patients with lung manifestations, including elevated total count, urea, bilirubin, and liver enzymes, and reduced platelet counts. Mortality rates were higher in patients with lung involvement, older age, and comorbidities. Discussion The study findings highlight the importance of recognizing respiratory symptoms in dengue fever, particularly in older patients and those with underlying health conditions. The association between pulmonary involvement and adverse outcomes underscores the need for early detection and appropriate management strategies. Future research should focus on elucidating the pathophysiology of lung complications in dengue and developing targeted interventions to improve patient outcomes. Conclusion Lung manifestations in dengue fever represent a significant clinical challenge and are associated with increased morbidity and mortality. Early recognition of respiratory symptoms, along with prompt diagnostic evaluation and appropriate management, is essential for improving patient prognosis. Further studies are warranted to deepen our understanding of lung involvement in dengue and optimize therapeutic approaches to mitigate its impact on patient outcomes.

Recent studies have demonstrated that cytokine dysregulation has a critical role in the pathogenesis of dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). The aim of this study was to investigate the association between tumor necrosis factor (TNF- α), interleukin 6 (IL-6), interleukin 10 (IL-10), and interleukin 17 (IL-17) with infection status, and severity of dengue. A prospective cross-sectional study was conducted at three hospitals in Gianyar regency and Denpasar municipality, Bali, Indonesia, from June to December 2022. Sixty-four dengue infected patients were involved. Patients\' serum was tested for dengue infection using NS1 antigen rapid test, dengue virus immunoglobulin M (IgM) and immunoglobulin G (IgG) test, and reverse transcription polymerase chain reaction (RT-PCR). Cytokine levels (TNF-α, IL-6, IL-10, and IL-17) were measured using enzyme-linked immunosorbent assay (ELISA). Infection status was determined by combining serological and RT-PCR results, categorizing patients into primary and secondary infections. The present study found that DF patients had lower TNF-α, IL-6, and IL-17 but higher IL-10 levels compared to DHF patients (p<0.001). Elevated TNF-α, IL-6, and IL-17 levels were higher in secondary infection, while IL-10 level was higher in primary infection (p<0.001). In conclusion, cytokines play a crucial role in the interplay between cytokine dysregulation and dengue infection dynamics.

RNA-dependent RNA polymerase (RdRp) is considered a potential drug target for dengue virus (DENV) inhibition and has attracted attention in antiviral drug discovery. Here, we screened 121 natural compounds from Litsea cubeba against DENV RdRp using various approaches of computer-based drug discovery. Notably, we identified four potential compounds (Ushinsunine, Cassameridine, (+)-Epiexcelsin, (-)-Phanostenine) with good binding scores and allosteric interactions with the target protein. Moreover, molecular dynamics simulation studies were done to check the conformational stability of the complexes under given conditions. Additionally, we performed post-simulation analysis to find the stability of potential drugs in the target protein. The findings suggest Litsea cubeba-derived phytomolecules as a therapeutic solution to control DENV infection.Communicated by Ramaswamy H. Sarma.

Introduction Dengue is a tropical viral disease caused by dengue virus with varied severity ranging from dengue fever to dengue shock syndrome. In dengue infection, there is thrombocytopenia with platelet activation. According to various proposed theories, activation of platelets during thrombocytopenia leads to changes in platelet parameters like mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), and platelet index (PI). So, this study was conducted to correlate platelet parameters with the severity of thrombocytopenia in children with dengue fever at a tertiary care hospital.  Methods An observational cross-sectional study was conducted on 72 children below 18 years admitted with dengue infection at a tertiary care hospital. All 72 patients were divided into three groups depending on platelet count. Group I included individuals with a platelet count less than 50000/mm3, while group II comprised patients with platelet counts ranging between 50001/mm3 and 100000/mm3, and group III encompassed individuals with platelet counts exceeding 100001/mm3. Platelet parameters like MPV, PDW, PCT, and PI were analyzed on day one and day three of admission. These parameters on day one and day three were correlated with the severity of thrombocytopenia in all three groups. Results PCT values on day one and day three were statistically significant (p<0.05) in all three groups with p-value <0.001 with profound positive correlation, which means PCT value decreases with increasing severity of thrombocytopenia. PI in group I was statistically significant on day one (p=0.009) but not on day three (p=0.063). PI in group II was statistically significant (p<0.05) on day three (p=0.002), while in group III, PI was significant statistically on day one (p<0.001). MPV in group I, on day one (p=0.006) and in group II, on day three (p= 0.049) were statistically significant (p<0.05). PDW was statistically significant only on day one (p=0.031) in group I, while was not significant in groups II and III. Conclusion MPV, PDW, and PCT increase with a decrease in platelet count, whereas there is an increase in PI. These platelet indices could be used to predict the severity of thrombocytopenia and severity of the dengue fever. Along with MPV and PDW, PCT could be used to assess the severity of the disease progression.

In 2015 the US federal government sponsored a dengue forecasting competition using historical case data from Iquitos, Peru and San Juan, Puerto Rico. Competitors were evaluated on several aspects of out-of-sample forecasts including the targets of peak week, peak incidence during that week, and total season incidence across each of several seasons. our team was one of the winners of that competition, outperforming other teams in multiple targets/locales. In this paper we report on our methodology, a large component of which, surprisingly, ignores the known biology of epidemics at large-for example, relationships between dengue transmission and environmental factors-and instead relies on flexible nonparametric nonlinear Gaussian process (GP) regression fits that \"memorize\" the trajectories of past seasons, and then \"match\" the dynamics of the unfolding season to past ones in real-time. Our phenomenological approach has advantages in situations where disease dynamics are less well understood, or where measurements and forecasts of ancillary covariates like precipitation are unavailable, and/or where the strength of association with cases are as yet unknown. In particular, we show that the GP approach generally outperforms a more classical generalized linear (autoregressive) model (GLM) that we developed to utilize abundant covariate information. We illustrate variations of our method(s) on the two benchmark locales alongside a full summary of results submitted by other contest competitors.

AT-752 is a novel guanosine nucleotide prodrug inhibitor of the dengue virus (DENV) polymerase with sub-micromolar, pan-serotype antiviral activity. This phase 1, double-blind, placebo-controlled, first-in-human study evaluated the safety, tolerability, and pharmacokinetics of ascending single and multiple oral doses of AT-752 in healthy subjects. AT-752 was well tolerated when administered as a single dose up to 1,500 mg or when administered as multiple doses up to 750 mg three times daily (TID). No serious adverse events occurred, and the majority of treatment-emergent adverse events were mild in severity and resolved by the end of the study. In those receiving single ascending doses of AT-752, no pharmacokinetic sensitivity was observed in Asian subjects, and no food effect was observed. Plasma exposure of the guanosine nucleoside metabolite AT-273, the surrogate of the active triphosphate metabolite of the drug, increased with increasing dose levels of AT-752 and exhibited a long half-life of approximately 15-25 h. Administration of AT-752 750 mg TID led to a rapid increase in plasma levels of AT-273 exceeding the target in vitro 90% effective concentration (EC90) of 0.64 µM in inhibiting DENV replication, and maintained this level over the treatment period. The favorable safety and pharmacokinetic results support the evaluation of AT-752 as an antiviral for the treatment of dengue in future clinical studies.Registered at ClinicalTrials.gov (NCT04722627).

Dengue fever (DF) is a primary viral disease transmitted to humans by mosquitoes, imposing a significant economic and health burden in numerous regions globally. There is a lack of studies addressing the importance of health education regarding DF in Saudi Arabia. Therefore, this study aimed to assess predictors influencing knowledge, attitude, and practices of the Western region public in Saudi Arabia related to DF.
This cross-sectional study was conducted as an online self-administered questionnaire collected from July 2023 until August 2023, included 695 participants from the Western region residents aged ≥18 years. Data collected involved sociodemographics, participants\' knowledge, attitude, and practices toward DF. We presented the descriptive data as mean ± standard deviations (SD) and medians [interquartile range (IQR)] for continuous variables, while categorical variables were presented as frequencies [percent (%)].
Good participants\' knowledge and attitude toward DF were observed among participants [median score 21.0 (interquartile range 16.0-24.0)] out of 35 and [median score 4.00 (interquartile range 3.00-5.00)] out of 5, respectively. Limited practices toward DF were observed among participants [median score 3.0 (interquartile range 0.00-5.00)] out of 8. Participants\' knowledge and attitude were not correlated. Participants\' education level and employment status predicted participant\'s knowledge of DF. Participants\' age, monthly income, employment status and marital status predicted participants\' attitude toward DF. Participants\' age, marital status, education levels and income predicted participants\' practices toward DF.
Knowledge, attitude, and practices toward DF among adults in Saudi Arabia can be predicted by specific sociodemographic characteristics. Implementing interferences that focus on improving public practices toward DF is imperative.

Objectives: Dengue Fever (DF) is an arboviral disease caused by the Dengue virus (DENV). This study aims to assess the association of dengue prevalence with patients\' residential areas and hematological laboratory findings (Total platelet count, immunoglobulins, and dengue antigens) during COVID-19 pandemic. Methods: A retrospective study was conducted at the Emergency department of Jinnah Postgraduate Medical Center, Karachi from October to December 2021. All the patients irrespective of their ages presenting to the ED with either of the following complaints: fever; GIT problems; vomiting; body ache; bleeding were included in our study. Results: Our study comprised 189 patients in total in which the females (n = 172) outnumbered the males (n = 17). Out of all, 84.7% of the patients were febrile having a low-grade fever on average. Korangi district had the most dengue cases, while Keamari had the fewest. There was no significant association reported between mean platelet count, mean TLC, and mean hemoglobin levels with dengue positivity. Conclusion: There is a concerning rise in DF cases in Karachi, particularly in the Korangi district. Despite the COVID-19 pandemic, DF demands urgent attention.