Serotype and genomic diversity of dengue virus during the 2023 outbreak in Pakistan reveals the circulation of genotype III of DENV-1 and cosmopolitan genotype of DENV-2

J Med Virol. 2024 Jun;96(6):e29727. doi: 10.1002/jmv.29727.

Abstract

Dengue, a mosquito-borne viral disease, poses a significant public health challenge in Pakistan, with a significant outbreak in 2023, prompting our investigation into the serotype and genomic diversity of the dengue virus (DENV). NS-1 positive blood samples from 153 patients were referred to the National Institute of Health, Pakistan, between July and October 2023. Among these, 98 (64.1%) tested positive using multiplex real-time PCR, with higher prevalence among males (65.8%) and individuals aged 31-40. Serotyping revealed DENV-1 as the predominant serotype (84.7%), followed by DENV-2 (15.3%). Whole-genome sequencing of 18 samples (DENV-1 = 17, DENV-2 = 01) showed that DENV-1 (genotype III) samples were closely related (>99%) to Pakistan outbreak samples (2022), and approx. > 98% with USA (2022), Singapore and China (2016), Bangladesh (2017), and Pakistan (2019). The DENV-2 sequence (cosmopolitan genotype; clade IVA) shared genetic similarity with Pakistan outbreak sequences (2022), approx. > 99% with China and Singapore (2018-2019) and showed divergence from Pakistan sequences (2008-2013). No coinfection with dengue serotypes or other viruses were observed. Comparisons with previous DENV-1 sequences highlighted genetic variations affecting viral replication efficiency (NS2B:K55R) and infectivity (E:M272T). These findings contribute to dengue epidemiology understanding and underscore the importance of ongoing genomic surveillance for future outbreak responses in Pakistan.

Keywords: DENV‐1; DENV‐2; Pakistan; cosmopolitan genotype; dengue outbreak 2023; serotype; whole genome sequencing.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Dengue Virus* / classification
  • Dengue Virus* / genetics
  • Dengue Virus* / isolation & purification
  • Dengue* / epidemiology
  • Dengue* / virology
  • Disease Outbreaks*
  • Female
  • Genetic Variation*
  • Genome, Viral* / genetics
  • Genotype*
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Pakistan / epidemiology
  • Phylogeny*
  • RNA, Viral / genetics
  • Serogroup*
  • Serotyping
  • Whole Genome Sequencing*
  • Young Adult

Substances

  • RNA, Viral