Clinical and epidemiological characteristics of imported cases of dengue fever depending on the molecular genetic properties of the pathogen and the levels of endothelial dysfunction markers
Objective. Comprehensive analysis of the clinical and epidemiological characteristics of imported cases of dengue fever (DF) in patients residing in non-endemic areas and evaluation of the relationship between disease severity, virus (DENV) serotype, and markers of endothelial dysfunction.Luzhetskaya A.A., Pshenichnaya N.Yu., Gopatsa G.V., Morozkin E.S., Akimkin V.G.
Materials and methods. The study included 51 patients with DF hospitalized in infectious disease hospitals in Moscow in 2024–2025. Serotyping was performed by PCR; IgM, IgG, and cytokines (tumor necrosis factor α, interleukins (IL) 1β, 8, 10) were determined by ELISA; von Willebrand factor was determined by agglutination. DF severity was assessed according to the WHO classification (2009).
Results. The study group was dominated by women (62.7%), the average age was 33.9 years. The main countries of importation were the Maldives, Thailand and Indonesia. The dominant serotype was DENV-3 (43.1%), less common were DENV-2 (31.4%) and DENV-1 (25.5%); DENV-4 was not detected. DENV-2 was more often associated with the importation of DF from the Maldives, DENV-3 - with Thailand and Sri Lanka. In the structure of forms, DF without precursors (DF-P) was predominant (64.7%), DF with precursors (LD+P) accounted for 33.3%, severe DF - 2.0%. All patients with DF+P and severe DF had hemorrhagic syndrome. The main symptoms were fever, weakness, arthralgia, rash and diarrhea. Leukopenia, lymphopenia and thrombocytopenia are characteristic. DENV-2 infection was associated with more pronounced leukotropenia and neutropenia, while DENV-3 infection was associated with elevated alanine aminotransferase levels. DF+P was more common in women and was associated with more pronounced hematological and coagulation abnormalities, as well as elevated IL-10 (p = 0.01) and von Willebrand factor (p = 0.024) levels.
Conclusion. The data obtained confirm the feasibility of using immunological, endothelial, and biochemical markers in combination with virus serotyping to improve epidemiological surveillance and assess the severity of imported cases of DF.
Keywords
dengue fever
molecular genetic properties of dengue fever virus
markers of endothelial dysfunction
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About the Authors
Alexandra A. Luzhetskayа, Postgraduate Student, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being; Physician, 7th Infectious Diseases Department, Infectious Clinical Hospital № 1, Moscow Healthcare Department, Moscow, Russia; 98@mail.ru; https://orcid.org/0009-0004-6748-6786Professor Natalia Yu. Pshenichnaya, MD, Deputy Director for Clinical and Analytical Work, Central Research Institute of Epidemiology. Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being; Head, Department of Infectious Diseases, Russian Medical Academy of Continuing Professional Education, Ministry of Health of the Russia; Professor, Department of Infectious Diseases, M.F. Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia; pshenichnaya@cmd.su; https://orcid.org/0000-0003-2570-711X
Galina V. Gopatsa, Cand. Med, Sci., Senior Researcher, Clinical Department of Infectious Pathology, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being; Head, 7th Infectious Diseases Department, Infectious Clinical Hospital № 1, Moscow Healthcare Department; Assistant Professor, Department of Infectious Diseases, Russian Medical Academy of Continuing Professional Education, Ministry of Health of the Russia, Moscow, Russia; galentinabk@mail.ru; https://orcid.org/0000000187037671
Evgeny S. Morozkin, Cand. Chem. Sci., Head, Research Group for Developing New Methods for Diagnosing Natural Focal Diseases, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being; Moscow, Russia; morozkin@cmd.su; https://orcid.org/0000-0001-8407-2623
Professor Vasiliy G. Аkimkin, Academician of the Russian Academy, МD, Director, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; crie@pcr.ru; https://orcid.org/0000-0003-4228-9044
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