2008, World Health Organization 2009, Soares et al

2008, World Health Organization 2009, Soares et al. during the study period. These findings heighten the need for dengue monitoring in the southern United States. mosquitoes, and DF is due to illness with one of four closely-related serotypes, DENV1C4 (Gubler 1998). The spectrum of illness ranges from a nonspecific acute febrile illness to severe dengue, with symptoms ranging from plasma leakage, hemorrhagic manifestations, hypovolemic shock, and the possibility of death. Illness uncommonly manifests as encephalitis (Lum et al. 1996, Jackson et al. 2008, Wasay et al. 2008, World Health Business 2009, Soares et al. 2010), having a medical presentation much like WNV encephalitis. Historically, Texas was the site of several dengue epidemics until the early 1900s, and local transmission of DENV has recently occurred in the southern part of the state (Rice 1922, Centers for Disease Control and Prevention 1994, Rawlings et al. 1998, Centers for Disease Control and Prevention 2001, Reiter et al. 2003, Brunkard et al. 2007, Ramos et al. 2008). Houston’s proximity to the dengue-endemic areas of PD 334581 southern Texas and northern Mexico puts it at risk for DENV emergence. Additional factors also increase the risk for intro and sustained transmission, including vast shipping, a high volume of both air flow and ship travel access, many of its 4 million occupants who regularly travel to and from dengue-endemic areas, and an abundance of proficient vectors, including and mosquitoes (Sprenger et al. 1986, Brown et al. 2011). On the basis of our hypothesis of risk of DENV emergence, we carried out a retrospective study to determine if any instances of suspected arboviral illness in the Houston area were attributable to DENV illness, and, if so, to determine if there was evidence of locally acquired illness. Materials and Methods Ethics statement All specimens submitted to the City of Houston Division of Health and Human being Services (HDHHS) General public Health Laboratory for WNV screening and were found negative were included in this study. This lender of specimens included 1630 serum and 2138 cerebrospinal PD 334581 fluid (CSF) specimens from individuals with arboviral-like illness in the Houston area between 2003 and 2005. Specimens were de-identified prior to transfer to the University or college of Texas Health Science Center (UTHSC) in the Houston School of Public Health. Acquisition of specimens and data for the purpose of this study was examined and authorized by UTHSC’s Committee for the Safety of Human being Subjects (HSC-SPH-05-008) PD 334581 and the internal review table of HDHHS. Upon recognition of DENV-positive specimens, the HDHHS performed medical chart reviews and carried out interviews as part of their legal mandate LIN41 antibody to investigate DENV infections, which are reportable in Texas. Because of this legal mandate, knowledgeable consent was not acquired. Data from medical records and interviews were de-identified and shared with UTHSC for epidemiological analysis and for inclusion with this manuscript. Acquisition of this additional de-identified data was also examined and authorized by the UTHSC’s Committee for the Safety of Human being Subjects (HSC-SPH-09-0183). Laboratory methods All 3768 specimens experienced previously tested bad by enzyme-linked immunosorbent assay (ELISA) PD 334581 for immunoglobulin M (IgM) antibodies to WNV and St. Louis encephalitis computer virus (SLEV) from the HDHHS. All specimens were tested in the UTHSCCHouston for the presence PD 334581 of anti-DENV IgM antibodies using the Panbio Dengue IgM ELISA Capture Kit (Panbio Inc., Queensland, Australia) according to the manufacturer’s instructions, with the exception of an additional positive control per plate. Serum and CSF specimens were tested at a dilution of 1 1:100 and 1:2, respectively (Prince et al. 2004). Test results with an index value 0.9 were interpreted as negative, equivocal if between 0.9 and 1.1, and positive if 1.1. All positive and equivocal specimens were repeated to verify results. Only those with positive results were.