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A fever surveillance study was conducted for evaluation of the clinical, epidemiological, and molecular patterns of dengue, prior to Chikungunya and Zika epidemics.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>In November 2011\u2013February 2014, a passive facility-based surveillance was implemented in Santa Cruz Hospital, Medellin, and enrolled eligible febrile patients between 1 and 65\u2009years-of-age. Acute and convalescent blood samples were collected 10\u201321\u2009days apart and tested for dengue using IgM\/IgG ELISA. RNA was extracted for serotyping using RT-PCR on acute samples and genotyping was performed by sequencing.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Among 537 febrile patients enrolled during the study period, 29% (<jats:italic>n<\/jats:italic>\u2009=\u2009155) were identified to be dengue-positive. Only 7% of dengue cases were hospitalized, but dengue-positive patients were 2.6 times more likely to be hospitalized, compared to non-dengue cases, based on a logistic regression. From those tested with RT-PCR (<jats:italic>n<\/jats:italic>\u2009=\u2009173), 17 were dengue-confirmed based on PCR and\/or virus isolation showing mostly DENV-3 (<jats:italic>n<\/jats:italic>\u2009=\u20099) and DENV-4 (<jats:italic>n<\/jats:italic>\u2009=\u20097) with 1 DENV-1. Genotyping results showed that: DENV-1 isolate belongs to the genotype V or American\/African genotype; DENV-3 isolates belong to genotype III; and DENV-4 isolates belong to the II genotype and specifically to the IIb sub-genotype or linage.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Our surveillance documented considerable dengue burden in Santa Cruz comuna during non-epidemic years, and genetic diversity of circulating DENV isolates, captured prior to Chikungunya epidemic in 2014 and Zika epidemic in 2015. Our study findings underscore the need for continued surveillance and monitoring of dengue and other arboviruses and serve as epidemiological and molecular evidence base for future studies to assess changes in DENV transmission in Medellin, given emerging and re-emerging arboviral diseases in the region.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12879-020-05172-7","type":"journal-article","created":{"date-parts":[[2020,7,2]],"date-time":"2020-07-02T07:24:46Z","timestamp":1593674686000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Epidemiology and genetic diversity of circulating dengue viruses in Medellin, Colombia: a fever surveillance study"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6744-7825","authenticated-orcid":false,"given":"Jacqueline Kyungah","family":"Lim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mabel","family":"Carabali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erwin","family":"Camacho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana Carolina","family":"Velez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Trujillo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Egurrola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kang-Sung","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan Dario","family":"Velez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge E.","family":"Osorio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,7,2]]},"reference":[{"key":"5172_CR1","doi-asserted-by":"publisher","unstructured":"Villar LA, Rojas DP, Besada-Lombana S, Sarti E. 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For subjects 7\u2009years old or younger, a written informed consent was obtained from at least one parent or legal guardian. For those aged between 8 and 18\u2009years, a written assent form was obtained, plus written informed consent from at least one parent or legal guardian. The protocol obtained ethical approvals from the Ethics Committee of the Universidad de Antioquia, Secretaria de Salud de Medellin, Metrosalud E.S.E\/ Unidad Hospitalaria Santa Cruz and the Institutional Review Board (IRB) of International Vaccine Institute (IVI).","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"None. I certify that the authors do not have any relevant financial relationships or potential conflicts of interest to disclose regarding the material discussed in this manuscript.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"466"}}