{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T22:42:40Z","timestamp":1790376160665,"version":"4.1.0"},"reference-count":48,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,2,11]],"date-time":"2023-02-11T00:00:00Z","timestamp":1676073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u201cHigher Education Reform Project (HERP) DLI -7B Research Grant, Nepal\u201d and the \u201cJapan Agency of Medical Research and Development (AMED)\u201d","award":["JP223fa627004"],"award-info":[{"award-number":["JP223fa627004"]}]},{"name":"\u201cHigher Education Reform Project (HERP) DLI -7B Research Grant, Nepal\u201d and the \u201cJapan Agency of Medical Research and Development (AMED)\u201d","award":["JP22wm0125006"],"award-info":[{"award-number":["JP22wm0125006"]}]},{"name":"\u201cHigher Education Reform Project (HERP) DLI -7B Research Grant, Nepal\u201d and the \u201cJapan Agency of Medical Research and Development (AMED)\u201d","award":["JP22jm0210079"],"award-info":[{"award-number":["JP22jm0210079"]}]},{"name":"\u201cHigher Education Reform Project (HERP) DLI -7B Research Grant, Nepal\u201d and the \u201cJapan Agency of Medical Research and Development (AMED)\u201d","award":["JP22fk0108123"],"award-info":[{"award-number":["JP22fk0108123"]}]},{"name":"\u201cHigher Education Reform Project (HERP) DLI -7B Research Grant, Nepal\u201d and the \u201cJapan Agency of Medical Research and Development (AMED)\u201d","award":["JP20wm0225017"],"award-info":[{"award-number":["JP20wm0225017"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>The largest dengue outbreak in the history of Nepal occurred in 2022, with a significant number of casualties. It affected all 77 districts, with the nation\u2019s capital, Kathmandu (altitude 1300 m), being the hardest hit. However, the molecular epidemiology of this outbreak, including the dengue virus (DENV) serotype(s) responsible for this epidemic, remain unknown. Here, we report the epidemic trends, clinico-laboratory features, and virus serotypes and their viral load profiles that are associated with this outbreak in Nepal. Dengue-suspected febrile patients were investigated by routine laboratory, serological, and molecular tools, including a real-time quantitative polymerase chain reaction (qRT-PCR). Of the 538 dengue-suspected patients enrolled, 401 (74.5%) were diagnosed with dengue. Among these dengue cases, 129 (32.2%) patients who required hospital admission had significant associations with myalgia, rash, diarrhea, retro-orbital pain, bleeding, and abdominal pain. DENV-1, -2, and -3 were identified during the 2022 epidemic, with a predominance of DENV-1 (57.1%) and DENV-3 (32.1%), exhibiting a new serotype addition. We found that multiple serotypes circulated in 2022, with a higher frequency of hospitalizations, more severe dengue, and more deaths than in the past. Therefore, precise mapping of dengue and other related infections through integrated disease surveillance, evaluation of the dynamics of population-level immunity and virus evolution should be the urgent plans of action for evidence-based policy-making for dengue control and prevention in the country.<\/jats:p>","DOI":"10.3390\/v15020507","type":"journal-article","created":{"date-parts":[[2023,2,13]],"date-time":"2023-02-13T04:32:58Z","timestamp":1676262778000},"page":"507","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Co-Circulation of Dengue Virus Serotypes 1, 2, and 3 during the 2022 Dengue Outbreak in Nepal: A Cross-Sectional Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8064-3625","authenticated-orcid":false,"given":"Sandesh","family":"Rimal","sequence":"first","affiliation":[{"name":"Central Department of Microbiology, Tribhuvan University, Kathmandu 44601, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9522-8547","authenticated-orcid":false,"given":"Sabin","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Central Department of Microbiology, Tribhuvan University, Kathmandu 44601, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0619-9108","authenticated-orcid":false,"given":"Kishor","family":"Pandey","sequence":"additional","affiliation":[{"name":"Central Department of Zoology, Tribhuvan University, Kathmandu 44601, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5071-0380","authenticated-orcid":false,"given":"Thanh Vu","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Institute of Tropical Medicine, DEJIMA Infectious Disease Research Allience, Nagasaki University, Nagasaki 852-8523, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parmananda","family":"Bhandari","sequence":"additional","affiliation":[{"name":"Sukraraj Tropical and Infectious Diseases Hospital, Teku, Kathmandu 44600, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yogendra","family":"Shah","sequence":"additional","affiliation":[{"name":"Seti Provincial Hospital, Kailali 10900, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhiraj","family":"Acharya","sequence":"additional","affiliation":[{"name":"Cleveland Clinic, Florida Research and Innovation Center, Port Saint Lucie, FL 34987, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabaraj","family":"Adhikari","sequence":"additional","affiliation":[{"name":"Central Department of Microbiology, Tribhuvan University, Kathmandu 44601, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6281-8236","authenticated-orcid":false,"given":"Komal Raj","family":"Rijal","sequence":"additional","affiliation":[{"name":"Central Department of Microbiology, Tribhuvan University, Kathmandu 44601, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2503-412X","authenticated-orcid":false,"given":"Prakash","family":"Ghimire","sequence":"additional","affiliation":[{"name":"Central Department of Microbiology, Tribhuvan University, Kathmandu 44601, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Takamatsu","sequence":"additional","affiliation":[{"name":"Institute of Tropical Medicine, DEJIMA Infectious Disease Research Allience, Nagasaki University, Nagasaki 852-8523, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7992-7586","authenticated-orcid":false,"given":"Basu Dev","family":"Pandey","sequence":"additional","affiliation":[{"name":"Department of Molecular Epidemiology, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok 10400, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kouichi","family":"Morita","sequence":"additional","affiliation":[{"name":"Institute of Tropical Medicine, DEJIMA Infectious Disease Research Allience, Nagasaki University, Nagasaki 852-8523, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mya Myat","family":"Ngwe Tun","sequence":"additional","affiliation":[{"name":"Institute of Tropical Medicine, DEJIMA Infectious Disease Research Allience, Nagasaki University, Nagasaki 852-8523, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4072-0745","authenticated-orcid":false,"given":"Shyam Prakash","family":"Dumre","sequence":"additional","affiliation":[{"name":"Central Department of Microbiology, Tribhuvan University, Kathmandu 44601, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"16055","DOI":"10.1038\/nrdp.2016.55","article-title":"Dengue infection","volume":"2","author":"Guzman","year":"2016","journal-title":"Nat. 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