{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T20:29:22Z","timestamp":1780432162677,"version":"3.54.1"},"reference-count":28,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,1,24]],"date-time":"2022-01-24T00:00:00Z","timestamp":1642982400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Objectives: Quang Nam province in the Centre of Vietnam has faced an outbreak of dengue hemorrhagic fever (DHF) in 2018. Although DHF is a recurrent disease in this area, no epidemiological and microbiological reports on dengue virus serotypes have been conducted mainly due to lack of facilities for such a kind of advanced surveillance. The aim of this study was to detect different dengue virus serotypes in patients\u2019 blood samples. Design and Methods: Suspected cases living in Quang Nam province (Vietnam) and presenting clinical and hematological signs of dengue hemorrhagic fever were included in the study. The screening was performed, and the results were compared by using two methodologies: RT real-time PCR (RT-rPCR) and the Dengue NS1 rapid test. Results: From December 2018 to February 2019, looking both at RT-rPCR [+] and NS1 [+] methodologies, a total of 488 patients were screened and 336 were positive for dengue virus detection (74 children and 262 adults); 273 of these patients (81.3%) underwent viral serotype identification as follows: 12.82% (35\/273) D1 serotype, 17.95% (49\/273) D2, 0.37% (1\/273) D3, 68.50 (187\/283) D4, and 0.37% (1\/273) D2+D4 serotypes. The RT-rPCR outcomes showed higher sensitivity during the first three days of infection compared to NS1 (92.3% vs. 89.7%). The NS1 increased sensitivity after the first 3 days whilst the RT-rPCR decreased. Conclusions: Advanced surveillance with dengue virus serotypes identification, if performed routinely, may help to predict and prevent further DHF epidemics based on the exposure of the different serotypes during different periods that lead to the intensification of disease severity as a consequence of antibody-dependent enhancement (ADE).<\/jats:p>","DOI":"10.3390\/ijerph19031285","type":"journal-article","created":{"date-parts":[[2022,1,25]],"date-time":"2022-01-25T20:38:58Z","timestamp":1643143138000},"page":"1285","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["The Distribution of Dengue Virus Serotype in Quang Nam Province (Vietnam) during the Outbreak in 2018"],"prefix":"10.3390","volume":"19","author":[{"given":"Duong Q.","family":"Phan","sequence":"first","affiliation":[{"name":"The General Hospital of Quang Nam, X\u00e3 Tam Hi\u1ec7p 51000, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linh D. N.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Phan Chau Trinh University, Danang City 550000, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4206-1747","authenticated-orcid":false,"given":"Son T.","family":"Pham","sequence":"additional","affiliation":[{"name":"School of Medicine, The University of Sydney, Sydney, NSW 2006, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tai","family":"Nguyen","sequence":"additional","affiliation":[{"name":"The General Hospital of Quang Nam, X\u00e3 Tam Hi\u1ec7p 51000, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phuong T. T.","family":"Pham","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Phan Chau Trinh University, Danang City 550000, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suong T. H.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Phan Chau Trinh University, Danang City 550000, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dien T.","family":"Pham","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Phan Chau Trinh University, Danang City 550000, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huong T.","family":"Pham","sequence":"additional","affiliation":[{"name":"Pham Ngoc Thach University of Medicine, Ho Chi Minh City 70000, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8773-3933","authenticated-orcid":false,"given":"Duy K.","family":"Tran","sequence":"additional","affiliation":[{"name":"NK-Biotek Laboratories, Ho Chi Minh City 70000, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sa H.","family":"Le","sequence":"additional","affiliation":[{"name":"NK-Biotek Laboratories, Ho Chi Minh City 70000, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tung T.","family":"Pham","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Phan Chau Trinh University, Danang City 550000, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kieu C. D.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Medicine, University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5947-8987","authenticated-orcid":false,"given":"Gianna","family":"Dipalma","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Medicine, University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6366-1039","authenticated-orcid":false,"given":"Alessio Danilo","family":"Inchingolo","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Medicine, University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4556-6182","authenticated-orcid":false,"given":"Prisco","family":"Piscitelli","sequence":"additional","affiliation":[{"name":"Euro Mediterranean Scientific Biomedical Institute (ISBEM), 72023 Mesagne, Italy"},{"name":"Italian Society of Environmental Medicine (SIMA), 20123 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Miani","sequence":"additional","affiliation":[{"name":"Italian Society of Environmental Medicine (SIMA), 20123 Milan, Italy"},{"name":"Department of Environmental Science and Policy, University of Milan, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2717-2489","authenticated-orcid":false,"given":"Scacco","family":"Salvatore","sequence":"additional","affiliation":[{"name":"Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9521-2521","authenticated-orcid":false,"given":"Stefania","family":"Cantore","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Medicine, University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergey K.","family":"Aityan","sequence":"additional","affiliation":[{"name":"Department of Multidisciplinary Research Centre, Lincoln University, Oakland, CA 94612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8758-1415","authenticated-orcid":false,"given":"Andrea","family":"Ballini","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"},{"name":"Department of Precision Medicine, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3797-5883","authenticated-orcid":false,"given":"Francesco","family":"Inchingolo","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Medicine, University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciro","family":"Gargiulo Isacco","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Medicine, University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Van H.","family":"Pham","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Phan Chau Trinh University, Danang City 550000, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e88","DOI":"10.1016\/S1473-3099(16)30473-X","article-title":"DHFD: Knowledge gaps, unmet needs, and research priorities","volume":"17","author":"Katzelnick","year":"2017","journal-title":"Lancet Infect. Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.jcv.2014.08.031","article-title":"Advances in the understanding, management, and prevention of DHFD","volume":"64","author":"Hermann","year":"2015","journal-title":"J. Clin. Virol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1179\/2047773214Y.0000000131","article-title":"Comparative performance of the probable case definitions of DHFD by WHO (2009) and the WHO-SEAR expert group (2011)","volume":"108","author":"Nujum","year":"2014","journal-title":"Pathog. Glob. Health"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1590","DOI":"10.1111\/jocn.15229","article-title":"Pitfalls in acute febrile illness diagnosis: Interobserver agreement of signs and symptoms during a DHFD epidemics","volume":"29","author":"Buonora","year":"2020","journal-title":"J. Clin. Nurs."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1900407","DOI":"10.2807\/1560-7917.ES.2019.24.29.1900407","article-title":"DHFD virus serotype 2 (DENV-2) epidemics, French Polynesia 2019","volume":"24","author":"Aubry","year":"2019","journal-title":"Euro Surveill."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1093\/trstmh\/trx079","article-title":"Prophylactic and therapeutic interventions for bleeding in DHFD: A systematic review","volume":"111","author":"Rajapakse","year":"2017","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_7","first-page":"53","article-title":"Compliance with management guidelines in patients with suspected DHFD","volume":"108","author":"Lugo","year":"2016","journal-title":"Bol. Asoc. Med. Puerto Rico"},{"key":"ref_8","unstructured":"(2019, March 10). Laodong. Available online: https:laodong.vn\/y-te\/dich-sot-xuat-huyet-tang-cao-tai-quang-nam-747103.ldo."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1445","DOI":"10.1007\/s00705-013-1645-3","article-title":"Secondary infection as a risk factor for DHFD hemorrhagic fever\/DHFD shock syndrome: An historical perspective and role of antibody-dependent enhancement of infection","volume":"158","author":"Guzman","year":"2013","journal-title":"Arch. Virol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Fried, J.R., Gibbons, R.V., Kalayanarooj, S., Thomas, S.J., Srikiatkhachorn, A., Yoon, I.K., Jarman, R.G., Green, S., Rothman, A.L., and Cummings, D.A. (2010). Serotype-Specific Differences in the Risk of DHFD Hemorrhagic Fever: An Analysis of Data Collected in Bangkok, Thailand from 1994 to 2006. PLoS Negl. Trop. Dis., 4.","DOI":"10.1371\/journal.pntd.0000617"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.4269\/ajtmh.2006.75.1113","article-title":"DHFD Hemorrhagic Fever Caused by Sequential DHFD 1\u20133 Virus Infections Over a Long Time Interval: Havana Epidemic, 2001\u20132002","volume":"75","author":"Alvarez","year":"2006","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"9395","DOI":"10.1038\/s41598-019-45816-6","article-title":"Cross-serotype interactions and disease outcome prediction of DHFD infections in Vietnam","volume":"9","author":"Aguas","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1474","DOI":"10.3201\/eid0812.020170","article-title":"DHFD hemorrhagic fever in infants: Research opportunities ignored","volume":"8","author":"Halstead","year":"2002","journal-title":"Emerg. Infect. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Santiago, G.A., Vergne, E., Quiles, Y., Cosme, J., Vazquez, J., Medina, J.F., Medina, F., Col\u00f3n, C., Margolis, H., and Mu\u00f1oz-Jord\u00e1n, J.L. (2013). Analytical and clinical performance of the CDC real time RT-PCR assay for detection and typing of DHFD virus. PLoS Negl. Trop. Dis., 7.","DOI":"10.1371\/annotation\/ae27d48b-025f-47ce-8427-4af59f821ad7"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1038\/s41467-018-03772-1","article-title":"Performance of the Trioplexreal-time RT-PCR assay for detection of Zika, DHFD, and chikungunya virus","volume":"9","author":"Santiago","year":"2018","journal-title":"Nat. Commun."},{"key":"ref_16","unstructured":"Pham, V.H. (2015, January 8\u20139). The solution for the low-income countries to establish the automatic extraction of the nucleic acid from the clinical samples. Proceedings of the Asean Congress on Medical Biotechnology and Molecular Biosciences, Bangkok, Thailand."},{"key":"ref_17","unstructured":"Pham, V.H., Thanh, B.T., and Quoc, N.V. (2017). Production and Evaluation of the Kit Using Magnetic Silica Coated Nano-Ironbeads to Extract the Nucleic Acid from Different Samples, ISAAR, BEXCO."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/S0966-842X(01)02288-0","article-title":"Epidemic DHFD\/DHFD hemorrhagic fever as a public health, social and economic problem in the 21st century","volume":"10","author":"Gubler","year":"2002","journal-title":"Trends. Microbiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1007\/s15010-002-3052-7","article-title":"Travel-acquired DHFD infection: Clinical spectrum and diagnostic aspects","volume":"30","author":"Stephan","year":"2002","journal-title":"Infections"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1348","DOI":"10.3201\/eid0910.020681","article-title":"DHFD hemorrhagic fever, Uttaradit, Thailand","volume":"9","author":"Patumanond","year":"2003","journal-title":"Emerg. Infect. Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.virol.2009.10.023","article-title":"Protection against DHFD virus by non-replicating and live attenuated vaccines used together in a prime boost vaccination strategy","volume":"396","author":"Simmons","year":"2010","journal-title":"Virology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/1423-0127-20-40","article-title":"An emerging role for the anti-inflammatory cytokine interleukin-10 in DHFD virus infection","volume":"20","author":"Tsai","year":"2013","journal-title":"J. Biomed. Sci."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1038\/nature02225","article-title":"Travelling waves in the occurrence of DHFD haemorrhagic fever in Thailand","volume":"427","author":"Cummings","year":"2004","journal-title":"Nature"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"14234","DOI":"10.1073\/pnas.0602768103","article-title":"Cross-protective immunity.can account for the alternating epidemic pattern of DHFD virus.serotypes circulating in Bangkok","volume":"103","author":"Adams","year":"2006","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"172","DOI":"10.4269\/ajtmh.2004.70.172","article-title":"Clinical diagnosis and assessment of severity of confirmed DHFD infection in Vietnamese childrens: Is the WHO classification system helpful?","volume":"70","author":"Phuong","year":"2004","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Quoc, C.H., Henrik, S., Isabel, R.B., In-Kyu, Y., Chau, N.V., Hung, N.T., Tuan, H.M., Lan, P.T., Willis, B., and Nisalak, A. (2016). Synchrony of DHFD Incidence in Ho Chi Minh City and Bangkok. PLoS Negl. Trop. Dis., 10.","DOI":"10.1371\/journal.pntd.0005188"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.apjtm.2015.12.008","article-title":"Surveillance of DHFD and chikungunya infection in Dong Thap, Vietnam: A 13-month study","volume":"9","author":"Lien","year":"2016","journal-title":"Asian Pac. J. Trop. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"151967","DOI":"10.1155\/2012\/151967","article-title":"Commercial DHFD Rapid Diagnostic Tests for Point-of-Care Application: Recent Evaluations and Future Needs?","volume":"2012","author":"Blacksell","year":"2012","journal-title":"J. Biomed. Biotechnol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/3\/1285\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:06:38Z","timestamp":1760133998000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/3\/1285"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,24]]},"references-count":28,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["ijerph19031285"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19031285","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,24]]}}}