First report of natural Wolbachia infections in mosquitoes from Cuba.

Mosquitoes are extensively responsible for the transmission of pathogens. Novel strategies using Wolbachia could transform that scenario, since these bacteria manipulate mosquito reproduction, and can confer a pathogen transmission-blocking phenotype in culicids. Here, we screened the Wolbachia surface protein region by PCR in eight Cuban mosquito species. We confirmed the natural infections by sequencing and assessed the phylogenetic relationships among the Wolbachia strains detected. We identified four Wolbachia hosts: Aedes albopictus, Culex quinquefasciatus, Mansonia titillans, and Aedes mediovittatus (first report worldwide). Knowledge of Wolbachia strains and their natural hosts is essential for future operationalization of this vector control strategy in Cuba.

Spatio-temporal distribution of vertically transmitted dengue viruses by Aedes aegypti (Diptera: Culicidae) from Arroyo Naranjo, Havana, Cuba.

OBJECTIVE: To study the distribution of vertical transmission of dengue viruses in field-collected Aedes aegypti larvae in the municipality of Arroyo Naranjo in Havana, Cuba. METHODS: Aedes aegypti larvae and pupae were collected monthly between September 2013 and July 2014 in the seven Municipal Health Areas of Arroyo Naranjo. Pools formed of 30-55 larvae were examined through PCR and sequencing to detect the presence of each serotype. RESULTS: We analysed 111 pools of larvae and pupae (4102 individuals) of which 37 tested positive for at least one DENV. More than one DENV type was observed in 10 of the 37 positive pools. Infected pools were detected every month, except in January, suggesting a sustained circulation of DENV in the vector populations. DENV-1 and DENV-3 were the most frequent and dispersed, though all four DENV types were detected. Nucleotide sequencing from positive pools confirmed RT-PCR results for DENV-1 (genotype V), DENV-3 (genotype III) and DENV-4 (genotype II). DENV-2 was detected by RT-PCR but could not be confirmed by nucleotide sequencing. CONCLUSION: Our study of the distribution of natural vertical transmission of dengue virus types highlights extrinsic virus activity patterns in the area and could be used as a new surveillance tool.

First record of natural vertical transmission of dengue virus in Aedes aegypti from Cuba.

While horizontal transmission (human-mosquito-human) of dengue viruses largely determines the epidemiology of the disease, vertical transmission (infected female mosquito- infected offspring) has been suggested as a mechanism that ensures maintenance of the virus during adverse conditions for horizontal transmission to occur. The purpose of this study was to analyze the natural infection of larval stages of Aedes aegypti (Diptera: Culicidae) with the dengue virus (DENV) in Cuba. Here, we report vertical transmission of DENV-3 genotype III in natural populations of Ae. aegypti through RT-PCR detection and serotyping plus sequencing. Our report constitutes the first record of vertical transmission of DENV in Ae. aegypti from Cuba with details of its serotype and genotype.

Relación genética del virus dengue 1 aislado en Cuba durante la epidemia de 1977 / Genetic relationship of dengue virus 1 isolated in Cuba, 1977

Introducción: el dengue es una enfermedad aguda causada por cuatro serotipos del virus del dengue (DENV-1 al 4) y transmitida al hombre por el mosquito Aedes aegypti. En Cuba, la primera epidemia de dengue con confirmación de laboratorio ocurrió en 1977, identificándose al DENV-1 como agente causal. Se plantea que el virus se dispersó en varios países de Latinoamérica y el Caribe partir de su introducción en Jamaica en 1977. Objetivos: explicar la caracterización molecular y determinar la relación genética del DENV-1 aislado en Cuba, 1977. Métodos: a partir de un aislamiento de DENV-1 obtenido en Cuba en el año 1977 conservado en el Banco de Cepas del Laboratorio Nacional de Referencia de Arbovirus (Instituto de Medicina Tropical Pedro Kourí) se realizó la amplificación y secuenciación nucleotídica del gen de la envoltura con cebadores específicos. A partir de la secuencia obtenida se construyó un árbol filogenético de Máxima Verosimilitud, utilizando secuencias de cepas de DENV-1 circulantes a nivel mundial. Resultados: el aislamiento de DENV-1 correspondiente a la epidemia cubana de 1977, se agrupó dentro del genotipo I, relacionándose genéticamente con la cepa de Referencia Hawaii/1943. Es significativo que, el resto de los aislamientos de Latinoamérica de ese mismo período pertenecen al genotipo V, reconocido como el genotipo Americano/Africano. Conclusiones: los resultados del presente trabajo indican que durante la epidemia cubana de 1977 circuló una cepa de DENV-1 del genotipo I, lo que constituye la primera evidencia sobre la presencia de este genotipo en la región de Latinoamérica y el Caribe. No obstante, este hallazgo no descarta la posibilidad de una co-circulación de los genotipos I y V(AU)

Introduction: dengue is an acute disease caused by four dengue virus serotypes (DENV-1 to -4) and transmitted to humans by Aedes aegypti mosquitoes. The first laboratory confirmed dengue epidemic in Cuba occurred in 1977, with DENV-1 as the causative agent. It has been stated that the virus spread to several Latin American and Caribbean countries after being introduced in Jamaica in 1977. Objectives: perform a molecular characterization and determine the genetic relationship of DENV-1 isolated in Cuba in 1997. Methods: Based on a DENV-1 isolate obtained in Cuba in the year 1997 and preserved at the Strain Bank of the National Arbovirus Reference Laboratory (Pedro Kouri Tropical Medicine Institute), nucleotide amplification and sequencing was performed of the envelope gene using specific primers. Starting from the sequence obtained, a maximum likelihood phylogenetic tree was developed using sequences of DENV-1 strains circulating worldwide. Results: the DENV-1 isolate corresponding to the Cuban 1977 epidemic was classed as genotype I and genetically related to the reference strain Hawaii 1943. It is noteworthy that the remaining Latin American isolates from that period belong to genotype V, recognized as the American/African genotype. Conclusions: results show that a DENV-1 strain of genotype I circulated during the Cuban 1977 epidemic. This is the first evidence of the presence of this genotype in the Latin American and Caribbean region. However, this finding does not rule out the possibility of co-circulation of genotypes I and V1(AU)

Relación genética del virus dengue 1 aislado en Cuba durante la epidemia de 1977 / Genetic relationship of dengue virus 1 isolated in Cuba, 1977

Introducción: el dengue es una enfermedad aguda causada por cuatro serotipos del virus del dengue (DENV-1 al 4) y transmitida al hombre por el mosquito Aedes aegypti. En Cuba, la primera epidemia de dengue con confirmación de laboratorio ocurrió en 1977, identificándose al DENV-1 como agente causal. Se plantea que el virus se dispersó en varios países de Latinoamérica y el Caribe partir de su introducción en Jamaica en 1977.Objetivos: realizar la caracterización molecular y determinar la relación genética del DENV-1 aislado en Cuba, 1977.Métodos: a partir de un aislamiento de DENV-1 obtenido en Cuba en el año 1977 conservado en el Banco de Cepas del Laboratorio Nacional de Referencia de Arbovirus (Instituto de Medicina Tropical “Pedro Kourí”) se realizó la amplificación y secuenciación nucleotídica del gen de la envoltura con cebadores específicos. A partir de la secuencia obtenida se construyó un árbol filogenético de Máxima Verosimilitud, utilizando secuencias de cepas de DENV-1 circulantes a nivel mundial.Resultados: el aislamiento de DENV-1 correspondiente a la epidemia cubana de 1977, se agrupó dentro del genotipo I, relacionándose genéticamente con la cepa de Referencia Hawaii/1943. Es significativo que, el resto de los aislamientos de Latinoamérica de ese mismo período pertenecen al genotipo V, reconocido como el genotipo Americano/Africano.Conclusiones: los resultados del presente trabajo indican que durante la epidemia cubana de 1977 circuló una cepa de DENV-1 del genotipo I, lo que constituye la primera evidencia sobre la presencia de este genotipo en la región de Latinoamérica y el Caribe. No obstante, este hallazgo no descarta la posibilidad de una co-circulación de los genotipos I y V(AU)

Increasing Clinical Severity during a Dengue Virus Type 3 Cuban Epidemic: Deep Sequencing of Evolving Viral Populations.

UNLABELLED: During the dengue virus type 3 (DENV-3) epidemic that occurred in Havana in 2001 to 2002, severe disease was associated with the infection sequence DENV-1 followed by DENV-3 (DENV-1/DENV-3), while the sequence DENV-2/DENV-3 was associated with mild/asymptomatic infections. To determine the role of the virus in the increasing severity demonstrated during the epidemic, serum samples collected at different time points were studied. A total of 22 full-length sequences were obtained using a deep-sequencing approach. Bayesian phylogenetic analysis of consensus sequences revealed that two DENV-3 lineages were circulating in Havana at that time, both grouped within genotype III. The predominant lineage is closely related to Peruvian and Ecuadorian strains, while the minor lineage is related to Venezuelan strains. According to consensus sequences, relatively few nonsynonymous mutations were observed; only one was fixed during the epidemic at position 4380 in the NS2B gene. Intrahost genetic analysis indicated that a significant minor population was selected and became predominant toward the end of the epidemic. In conclusion, greater variability was detected during the epidemic's progression in terms of significant minority variants, particularly in the nonstructural genes. An increasing trend of genetic diversity toward the end of the epidemic was observed only for synonymous variant allele rates, with higher variability in secondary cases. Remarkably, significant intrahost genetic variation was demonstrated within the same patient during the course of secondary infection with DENV-1/DENV-3, including changes in the structural proteins premembrane (PrM) and envelope (E). Therefore, the dynamic of evolving viral populations in the context of heterotypic antibodies could be related to the increasing clinical severity observed during the epidemic. IMPORTANCE: Based on the evidence that DENV fitness is context dependent, our research has focused on the study of viral factors associated with intraepidemic increasing severity in a unique epidemiological setting. Here, we investigated the intrahost genetic diversity in acute human samples collected at different time points during the DENV-3 epidemic that occurred in Cuba in 2001 to 2002 using a deep-sequencing approach. We concluded that greater variability in significant minor populations occurred as the epidemic progressed, particularly in the nonstructural genes, with higher variability observed in secondary infection cases. Remarkably, for the first time significant intrahost genetic variation was demonstrated within the same patient during the course of secondary infection with DENV-1/DENV-3, including changes in structural proteins. These findings indicate that high-resolution approaches are needed to unravel molecular mechanisms involved in dengue pathogenesis.

First dengue haemorrhagic fever epidemic in the Americas, 1981: insights into the causative agent.

Historical records describe a disease in North America that clinically resembled dengue haemorrhagic fever during the latter part of the slave-trading period. However, the dengue epidemic that occurred in Cuba in 1981 was the first laboratory-confirmed and clinically diagnosed outbreak of dengue haemorrhagic fever in the Americas. At that time, the presumed source of the dengue type 2 strain isolated during this epidemic was considered controversial, partly because of the limited sequence data and partly because the origin of the virus appeared to be southern Asia. Here, we present a molecular characterisation at the whole-genome level of the original strains isolated at different time points during the epidemic. Phylogenetic trees constructed using Bayesian methods indicated that 1981 Cuban strains group within the Asian 2 genotype. In addition, the study revealed that viral evolution occurred during the epidemic - a fact that could be related to the increasing severity from month to month. Moreover, the Cuban strains exhibited particular amino acid substitutions that differentiate them from the New Guinea C prototype strain as well as from dengue type 2 strains isolated globally.

Títulos de anticuerpos neutralizantes en sueros de individuos posconvalescientes con dengue / Neutralizing antibody titers in sera from patients post-convalescing from dengue

Introducción: la inmunidad del hospedero desempeña un papel importante en determinar el desarrollo de las infecciones por dengue y del cuadro severo de la enfermedad. Sin embargo, otros factores intervienen en el complejo mecanismo de la patogénesis, como la variación entre las cepas virales. Objetivos: evaluación de la capacidad neutralizante de un grupo de sueros de posconvalescientes frente a 2 cepas de dengue 4 pertenecientes a un mismo genotipo. Métodos: se emplearon sueros de 68 individuos con un cuadro de fiebre del dengue y 35 con un cuadro clínico de fiebre hemorrágica del dengue. Resultados: los títulos de anticuerpos neutralizantes en los sueros estudiados fueron bajos y se observó una capacidad neutralizante diferente entre las 2 cepas de dengue 4 del genotipo II. Se observaron diferencias significativas en los títulos de anticuerpos neutralizantes de los sueros procedentes de individuos con infección secundaria y con la forma severa de la enfermedad. Conclusiones: estos resultados demuestran la complejidad de los anticuerpos neutralizantes, que se producen después de una infección por el virus dengue con diferentes cepas de un mismo serotipo, lo cual conduce a obtener resultados diversos por esta técnica que podría ser la causa de la trasmisión continuada de múltiples cepas de dengue.(AU)

Introduction: host immunity plays an important role in determining the development of dengue infections and the severe form of the disease. However, other factors, such as the variation between viral strains, are also involved in this complex pathogenesis mechanism. Objectives: evaluate the neutralizing capacity of a number of sera from post-convalescing patients against two dengue 4 strains from the same genotype. Methods: examination was conducted of sera from 68 individuals with dengue fever and 35 with dengue hemorrhagic fever. Results: neutralizing antibody titers were low in the sera analyzed. Different neutralizing capacity was found between the two dengue 4 strains from genotype II. Significant differences were observed between neutralizing antibody titers in sera from individuals with secondary infection and with the severe form of the disease. Conclusions: results reveal the complex nature of the neutralizing antibodies produced after a dengue infection with different strains of the same serotype, leading to diverse results by this technique, which could be the cause of the continued transmission of multiple dengue strains.(AU)

Títulos de anticuerpos neutralizantes en sueros de individuos posconvalescientes con dengue / Neutralizing antibody titers in sera from patients post-convalescing from dengue

Introducción: la inmunidad del hospedero desempeña un papel importante en determinar el desarrollo de las infecciones por dengue y del cuadro severo de la enfermedad. Sin embargo, otros factores intervienen en el complejo mecanismo de la patogénesis, como la variación entre las cepas virales. Objetivos: evaluación de la capacidad neutralizante de un grupo de sueros de posconvalescientes frente a 2 cepas de dengue 4 pertenecientes a un mismo genotipo. Métodos: se emplearon sueros de 68 individuos con un cuadro de fiebre del dengue y 35 con un cuadro clínico de fiebre hemorrágica del dengue. Resultados: los títulos de anticuerpos neutralizantes en los sueros estudiados fueron bajos y se observó una capacidad neutralizante diferente entre las 2 cepas de dengue 4 del genotipo II. Se observaron diferencias significativas en los títulos de anticuerpos neutralizantes de los sueros procedentes de individuos con infección secundaria y con la forma severa de la enfermedad. Conclusiones: estos resultados demuestran la complejidad de los anticuerpos neutralizantes, que se producen después de una infección por el virus dengue con diferentes cepas de un mismo serotipo, lo cual conduce a obtener resultados diversos por esta técnica que podría ser la causa de la trasmisión continuada de múltiples cepas de dengue.

Introduction: host immunity plays an important role in determining the development of dengue infections and the severe form of the disease. However, other factors, such as the variation between viral strains, are also involved in this complex pathogenesis mechanism. Objectives: evaluate the neutralizing capacity of a number of sera from post-convalescing patients against two dengue 4 strains from the same genotype. Methods: examination was conducted of sera from 68 individuals with dengue fever and 35 with dengue hemorrhagic fever. Results: neutralizing antibody titers were low in the sera analyzed. Different neutralizing capacity was found between the two dengue 4 strains from genotype II. Significant differences were observed between neutralizing antibody titers in sera from individuals with secondary infection and with the severe form of the disease. Conclusions: results reveal the complex nature of the neutralizing antibodies produced after a dengue infection with different strains of the same serotype, leading to diverse results by this technique, which could be the cause of the continued transmission of multiple dengue strains.

Understanding the dengue viruses and progress towards their control.

Traditionally, the four dengue virus serotypes have been associated with fever, rash, and the more severe forms, haemorrhagic fever and shock syndrome. As our knowledge as well as understanding of these viruses increases, we now recognise not only that they are causing increasing numbers of human infections but also that they may cause neurological and other clinical complications, with sequelae or fatal consequences. In this review we attempt to highlight some of these features in the context of dengue virus pathogenesis. We also examine some of the efforts currently underway to control this "scourge" of the tropical and subtropical world.

Propiedades biológicas de cepas de dengue virus-3 aisladas durante la epidemia ocurrida en La Habana, 2001-2002 / Biological properties of virus dengue-3 strains isolated during the epidemic ocurred in Havana, 2001-2002

Introducción: durante epidemias de dengue ocurridas en Cuba se ha observado de forma reiterada, un incremento de severidad clínica con la progresión de las epidemias en el tiempo, particularmente en infecciones secundarias. Se considera que este incremento pudiera estar relacionado con cambios genéticos del virus circulante. Objetivo: estudiar algunas propiedades biológicas de cepas aisladas en diferentes momentos de la epidemia de La Habana, 2001-2002. Métodos: se estudiaron 9 cepas de dengue virus-3, se evaluó el efecto citopatogénico y el crecimiento viral en las líneas celulares C6/36 HT y Vero, tamaño de las placas virales, sensibilidad a la temperatura, neurovirulencia en ratones lactantes y la influencia del pH en la unión del virus a la célula, así como en el medio de multiplicación de este. Resultados: las cepas de dengue virus-3 resultaron más citopatogénicas en células Vero, sin embargo, en C6/36 HT se obtuvieron títulos superiores. El conjunto de cepas mostró reducción del título viral y del tamaño de placa al aumentar la temperatura y fueron poco neurovirulentas. En cuanto a la unión del virus a la célula, a pH básico se observaron los mejores títulos, mientras que a pH ácido solo se observó el crecimiento de algunas cepas aisladas al final de la epidemia. El medio de multiplicación del virus a pH 6,5-7 favoreció el crecimiento de las cepas del inicio de la epidemia, mientras que las cepas del final tuvieron títulos superiores a pH 7-8. Conclusiones: se pudo comprobar la existencia de cambios fenotípicos entre cepas de diferentes momentos de la epidemia, que pudieran estar asociados con diferencias en cuanto a su adecuación viral o en su potencial virulento. No obstante, algunas de las propiedades biológicas estudiadas sugieren que las cepas de dengue virus-3 son menos virulentas que las cepas cubanas de dengue virus-2 de 1997(AU)

Introduction: during dengue epidemics in Cuba, an increase in clinical severity with the epidemics progression in time, particularly in secondary infections, have been frequently observed. It is considered that this increase could be related with genetic changes in the circulating virus. Objective: to study some biological attributes related to strains isolated at different points of time during the dengue epidemic occurred in Havana city, 2001-2002. Methods: nine DENV-3 strains were studied. Cytopathogenic effect, viral growth in C6/36 HT and Vero cell lines, viral plaque sizes, temperature sensitivity, neurovirulence in newborn mice and pH influence in the binding of the virus and the cell as well as in the multiplication medium were evaluated. Results: DENV-3 strains were more cytopathogenic in Vero Cells. However, higher titres were obtained in C6/36 HT cells. All the strains showed reduction of viral titres and plaque size with temperature increasing and low neurovirulence. Basic pH favoured virus-cell binding whereas acid pH was only permissive for some strains isolated at the end of the epidemic. On the other hand, at pH 6.5-7, the viral multiplication medium favoured the growth of strains isolated at the beginning of the epidemic whereas the growth of those isolated at the endof the epidemic was noticeable at pH 7-8. Conclusions: this study proved the phenotypical changes among strains isolated at different points of time in the epidemic. They might be related to differences in viral fitness or in virulent potential. Nevertheless, some of the studied biological properties suggest that dengue virus-3 strains are less virulent than the Cuban dengue virus 2 strains isolated in 1997(AU)

Propiedades biológicas de cepas de dengue virus-3 aisladas durante la epidemia ocurrida en La Habana, 2001-2002 / Biological properties of virus dengue-3 strains isolated during the epidemic ocurred in Havana, 2001-2002

Introducción: durante epidemias de dengue ocurridas en Cuba se ha observado de forma reiterada, un incremento de severidad clínica con la progresión de las epidemias en el tiempo, particularmente en infecciones secundarias. Se considera que este incremento pudiera estar relacionado con cambios genéticos del virus circulante. Objetivo: estudiar algunas propiedades biológicas de cepas aisladas en diferentes momentos de la epidemia de La Habana, 2001-2002. Métodos: se estudiaron 9 cepas de dengue virus-3, se evaluó el efecto citopatogénico y el crecimiento viral en las líneas celulares C6/36 HT y Vero, tamaño de las placas virales, sensibilidad a la temperatura, neurovirulencia en ratones lactantes y la influencia del pH en la unión del virus a la célula, así como en el medio de multiplicación de este. Resultados: las cepas de dengue virus-3 resultaron más citopatogénicas en células Vero, sin embargo, en C6/36 HT se obtuvieron títulos superiores. El conjunto de cepas mostró reducción del título viral y del tamaño de placa al aumentar la temperatura y fueron poco neurovirulentas. En cuanto a la unión del virus a la célula, a pH básico se observaron los mejores títulos, mientras que a pH ácido solo se observó el crecimiento de algunas cepas aisladas al final de la epidemia. El medio de multiplicación del virus a pH 6,5-7 favoreció el crecimiento de las cepas del inicio de la epidemia, mientras que las cepas del final tuvieron títulos superiores a pH 7-8. Conclusiones: se pudo comprobar la existencia de cambios fenotípicos entre cepas de diferentes momentos de la epidemia, que pudieran estar asociados con diferencias en cuanto a su adecuación viral o en su potencial virulento. No obstante, algunas de las propiedades biológicas estudiadas sugieren que las cepas de dengue virus-3 son menos virulentas que las cepas cubanas de dengue virus-2 de 1997.

Introduction: during dengue epidemics in Cuba, an increase in clinical severity with the epidemics progression in time, particularly in secondary infections, have been frequently observed. It is considered that this increase could be related with genetic changes in the circulating virus. Objective: to study some biological attributes related to strains isolated at different points of time during the dengue epidemic occurred in Havana city, 2001-2002. Methods: nine DENV-3 strains were studied. Cytopathogenic effect, viral growth in C6/36 HT and Vero cell lines, viral plaque sizes, temperature sensitivity, neurovirulence in newborn mice and pH influence in the binding of the virus and the cell as well as in the multiplication medium were evaluated. Results: DENV-3 strains were more cytopathogenic in Vero Cells. However, higher titres were obtained in C6/36 HT cells. All the strains showed reduction of viral titres and plaque size with temperature increasing and low neurovirulence. Basic pH favoured virus-cell binding whereas acid pH was only permissive for some strains isolated at the end of the epidemic. On the other hand, at pH 6.5-7, the viral multiplication medium favoured the growth of strains isolated at the beginning of the epidemic whereas the growth of those isolated at the endof the epidemic was noticeable at pH 7-8. Conclusions: this study proved the phenotypical changes among strains isolated at different points of time in the epidemic. They might be related to differences in viral fitness or in virulent potential. Nevertheless, some of the studied biological properties suggest that dengue virus-3 strains are less virulent than the Cuban dengue virus 2 strains isolated in 1997.

Prophylactic platelets in dengue: survey responses highlight lack of an evidence base.

Dengue is the most important arboviral infection of humans. Thrombocytopenia is frequently observed in the course of infection and haemorrhage may occur in severe disease. The degree of thrombocytopenia correlates with the severity of infection, and may contribute to the risk of haemorrhage. As a result of this prophylactic platelet transfusions are sometimes advocated for the prevention of haemorrhage. There is currently no evidence to support this practice, and platelet transfusions are costly and sometimes harmful. We conducted a global survey to assess the different approaches to the use of platelets in dengue. Respondents were all physicians involved with the treatment of patients with dengue. Respondents were asked that their answers reflected what they would do if they were the treating physician. We received responses from 306 physicians from 20 different countries. The heterogeneity of the responses highlights the variation in clinical practice and lack of an evidence base in this area and underscores the importance of prospective clinical trials to address this key question in the clinical management of patients with dengue.

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

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.

[Biological properties of virus dengue-3 strains isolated during the epidemic ocurred in Havana, 2001-2002]. / Propiedades biológicas de cepas de dengue virus-3 aisladas durante la epidemia ocurrida en La Habana, 2001-2002.

INTRODUCTION: During dengue epidemics in Cuba, an increase in clinical severity with the epidemics progression in time, particularly in secondary infections, have been frequently observed. It is considered that this increase could be related with genetic changes in the circulating virus. OBJECTIVE: To study some biological attributes related to strains isolated at different points of time during the dengue epidemic occurred in Havana city, 2001-2002. METHODS: Nine DENV-3 strains were studied. Cytopathogenic effect, viral growth in C6/36 HT and Vero cell lines, viral plaque sizes, temperature sensitivity, neurovirulence in newborn mice and pH influence in the binding of the virus and the cell as well as in the multiplication medium were evaluated. RESULTS: DENV-3 strains were more cytopathogenic in Vero Cells. However, higher titres were obtained in C6/36 HT cells. All the strains showed reduction of viral titres and plaque size with temperature increasing and low neurovirulence. Basic pH favoured virus-cell binding whereas acid pH was only permissive for some strains isolated at the end of the epidemic. On the other hand, at pH 6.5-7, the viral multiplication medium favoured the growth of strains isolated at the beginning of the epidemic whereas the growth of those isolated at the endof the epidemic was noticeable at pH 7-8. CONCLUSIONS: This study proved the phenotypical changes among strains isolated at different points of time in the epidemic. They might be related to differences in viral fitness or in virulent potential. Nevertheless, some of the studied biological properties suggest that dengue virus-3 strains are less virulent than the Cuban dengue virus 2 strains isolated in 1997.

Propiedades biológicas de cepas de virus dengue serotipo 2 aisladas durante la epidemia en Santiago de Cuba, 1997 / Biological properties of dengue virus serotype 2 strains isolated from the epidemic occurred in Santiago de Cuba in 1997

Introducción: durante la epidemia cubana de dengue ocurrida en Santiago de Cuba, 1997, se evidenció un incremento de la severidad en el tiempo en términos de proporción de casos graves y muertes por dengue hemorrágico, que pudiera estar dado por la aparición de mutantes de escape a la neutralización, con mayor potencial virulento. Objetivos: estudiar algunas propiedades biológicas de cepas aisladas en diferentes momentos de la epidemia de Santiago de Cuba en 1997. MÚtodos: se estudiaron 9 cepas de DENV-2, se evaluó el efecto citopatogénico y el crecimiento viral en las líneas celulares C6/36 HT y Vero, tamaño de las placas virales, sensibilidad a la temperatura, neurovirulencia en ratones lactantes y la influencia del pH en la unión del virus a la célula, así como en el medio de multiplicación. Resultados: las cepas del final de la epidemia mostraron propiedades que las diferencian de las aisladas al inicio, entre las que se encuentran un mayor efecto citopatogénico en células C6/36 HT, títulos virales superiores y una mayor neurovirulencia en ratones lactantes. Por otra parte, en la unión del virus a la célula las cepas del inicio de la epidemia resultaron favorecidas por un pH ácido mientras que a las cepas del final de la epidemia las favoreció un pH básico. Conclusiones: pudo demostrarse que además de los cambios genotípicos observados previamente, existen diferencias fenotípicas entre cepas de distintos momentos de la epidemia, que pudieran estar asociados con diferencias en cuanto a la adecuación viral de estas y(o) en su potencial virulento(AU)

Introduction: during the Cuban epidemic that occurred in Santiago de Cuba in 1997, there was observed increasing severity in the course of time, in terms of proportion of serious dengue haemorrhagic cases and deaths that could be due to the emergence of escape mutants to neutralization with greater virulent potential. Objective: to study some biological attributes of a group of strains isolated at different points of time during the Santiago de Cuba epidemic in 1997. Methods: nine DENV-2 strains were studied. The cytopathogenic effect, the viral growth in C6/36 HT and VERO cell lines, the virus plaque sizes, the sensitivity to temperatures, the neurovirulence in newborn mice and the influence of the pH in the union of the virus to the cell as well as in the multiplication medium were all evaluated. Results: the strains isolated at the end of the epidemic differed from those of the beginning showing increased neurovirulence in newborn mice and higher viral titers and greater cytopathogenic effect in HT C6/36 cells. On the other hand, the virus and the cell union was favored by acid pH when testing strains from the beginning of the epidemic, whereas this union was favored by the basic PH in the strains isolated at the end of the epidemic Conclusions: the present study managed to show that in addition to the previously observed genotypical changes, there were phenotypical differences among the strains isolated at different points of time in the epidemic; all these aspects may be associated with differences in the viral fitness and/or in the virulent potential of these strains(AU)

Propiedades biológicas de cepas de virus dengue serotipo 2 aisladas durante la epidemia en Santiago de Cuba, 1997 / Biological properties of dengue virus serotype 2 strains isolated from the epidemic occurred in Santiago de Cuba in 1997

Introducción: durante la epidemia cubana de dengue ocurrida en Santiago de Cuba, 1997, se evidenció un incremento de la severidad en el tiempo en términos de proporción de casos graves y muertes por dengue hemorrágico, que pudiera estar dado por la aparición de mutantes de escape a la neutralización, con mayor potencial virulento. Objetivos: estudiar algunas propiedades biológicas de cepas aisladas en diferentes momentos de la epidemia de Santiago de Cuba en 1997. Métodos: se estudiaron 9 cepas de DENV-2, se evaluó el efecto citopatogénico y el crecimiento viral en las líneas celulares C6/36 HT y Vero, tamaño de las placas virales, sensibilidad a la temperatura, neurovirulencia en ratones lactantes y la influencia del pH en la unión del virus a la célula, así como en el medio de multiplicación. Resultados: las cepas del final de la epidemia mostraron propiedades que las diferencian de las aisladas al inicio, entre las que se encuentran un mayor efecto citopatogénico en células C6/36 HT, títulos virales superiores y una mayor neurovirulencia en ratones lactantes. Por otra parte, en la unión del virus a la célula las cepas del inicio de la epidemia resultaron favorecidas por un pH ácido mientras que a las cepas del final de la epidemia las favoreció un pH básico. Conclusiones: pudo demostrarse que además de los cambios genotípicos observados previamente, existen diferencias fenotípicas entre cepas de distintos momentos de la epidemia, que pudieran estar asociados con diferencias en cuanto a la adecuación viral de estas y(o) en su potencial virulento.

Introduction: during the Cuban epidemic that occurred in Santiago de Cuba in 1997, there was observed increasing severity in the course of time, in terms of proportion of serious dengue haemorrhagic cases and deaths that could be due to the emergence of escape mutants to neutralization with greater virulent potential. Objective: to study some biological attributes of a group of strains isolated at different points of time during the Santiago de Cuba epidemic in 1997. Methods: nine DENV-2 strains were studied. The cytopathogenic effect, the viral growth in C6/36 HT and VERO cell lines, the virus plaque sizes, the sensitivity to temperatures, the neurovirulence in newborn mice and the influence of the pH in the union of the virus to the cell as well as in the multiplication medium were all evaluated. Results: the strains isolated at the end of the epidemic differed from those of the beginning showing increased neurovirulence in newborn mice and higher viral titers and greater cytopathogenic effect in HT C6/36 cells. On the other hand, the virus and the cell union was favored by acid pH when testing strains from the beginning of the epidemic, whereas this union was favored by the basic PH in the strains isolated at the end of the epidemic Conclusions: the present study managed to show that in addition to the previously observed genotypical changes, there were phenotypical differences among the strains isolated at different points of time in the epidemic; all these aspects may be associated with differences in the viral fitness and/or in the virulent potential of these strains.

Virus role during intraepidemic increase in dengue disease severity.

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.