{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T19:11:40Z","timestamp":1785179500592,"version":"3.55.0"},"reference-count":63,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T00:00:00Z","timestamp":1712880000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Joint Research of Tribhuvan University and Institute of Tropical Medicine, Nagasaki University","award":["2023-Ippan 25"],"award-info":[{"award-number":["2023-Ippan 25"]}]},{"name":"Joint Research of Tribhuvan University and Institute of Tropical Medicine, Nagasaki University","award":["JP223fa627004"],"award-info":[{"award-number":["JP223fa627004"]}]},{"name":"Joint Research of Tribhuvan University and Institute of Tropical Medicine, Nagasaki University","award":["JP23fk0108656"],"award-info":[{"award-number":["JP23fk0108656"]}]},{"name":"Japan Agency of Medical Research and Development (AMED)","award":["2023-Ippan 25"],"award-info":[{"award-number":["2023-Ippan 25"]}]},{"name":"Japan Agency of Medical Research and Development (AMED)","award":["JP223fa627004"],"award-info":[{"award-number":["JP223fa627004"]}]},{"name":"Japan Agency of Medical Research and Development (AMED)","award":["JP23fk0108656"],"award-info":[{"award-number":["JP23fk0108656"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>In 2023, Nepal faced its second largest dengue outbreak ever, following a record-breaking number of dengue cases in 2022, characterized by the expansion of infections into areas of higher altitudes. However, the characteristics of the 2023 circulating dengue virus (DENV) and the vector density remain poorly understood. Therefore, we performed DENV serotyping, clinical and laboratory assessment, and entomological analysis of the 2023 outbreak in central Nepal. A total of 396 fever cases in Dhading hospital suspected of being DENV positive were enrolled, and blood samples were collected and tested by different techniques including PCR. Of these, 278 (70.2%) had confirmed DENV infection. Multiple serotypes (DENV-1, -2, and -3) were detected. DENV-2 (97.5%) re-emerged after six years in Dhading while DENV-3 was identified for the first time. Dengue inpatients had significantly higher frequency of anorexia, myalgia, rash, diarrhea, nausea, vomiting, abdominal pain, and thrombocytopenia (p &lt; 0.05). In this area, Aedes mosquitoes largely predominated (90.7%) with the majority being A.\u00a0aegypti (60.7%). We also found high levels of Aedes index (20.0%) and container index (16.7%). We confirmed multiple DENV serotype circulation with serotype re-emergence and new serotype introduction, and high vector density in 2023. These findings call for the urgent initiation and scaling up of DENV molecular surveillance in human and mosquito populations for dengue control and prevention in Nepal.<\/jats:p>","DOI":"10.3390\/v16040594","type":"journal-article","created":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T04:44:26Z","timestamp":1712897066000},"page":"594","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Molecular and Entomological Characterization of 2023 Dengue Outbreak in Dhading District, Central Nepal"],"prefix":"10.3390","volume":"16","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"}]},{"given":"Sunita Wagle","family":"Paudel","sequence":"additional","affiliation":[{"name":"Dhading Hospital, Dhading Besi 45100, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0820-4556","authenticated-orcid":false,"given":"Yogendra","family":"Shah","sequence":"additional","affiliation":[{"name":"Seti Provincial Hospital, Dhangadhi 10900, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Govinda","family":"Bhandari","sequence":"additional","affiliation":[{"name":"Dhading Hospital, Dhading Besi 45100, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kishor","family":"Pandey","sequence":"additional","affiliation":[{"name":"Central Department of Zoology, Tribhuvan University, Kathmandu 44601, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjana","family":"Kharbuja","sequence":"additional","affiliation":[{"name":"Central Department of Microbiology, Tribhuvan University, Kathmandu 44601, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merveille","family":"Kapandji","sequence":"additional","affiliation":[{"name":"Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ishan","family":"Gautam","sequence":"additional","affiliation":[{"name":"Natural History Museum, Tribhuvan University, Swayambhu, Kathmandu 44620, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajshree","family":"Bhujel","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":"Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudramani","family":"Bhandari","sequence":"additional","affiliation":[{"name":"Dhading Hospital, Dhading Besi 45100, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chonticha","family":"Klungthong","sequence":"additional","affiliation":[{"name":"Armed Forces Research Institute of Medical Sciences, Bangkok 10400, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjaya Kumar","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Walter-Reed AFRIMS Research Unit Nepal, Kathmandu 44600, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Armed Forces Research Institute of Medical Sciences, Bangkok 10400, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gathsaurie Neelika","family":"Malavige","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences, University of Sri Jayewardenepura, Colombo 10250, Sri Lanka"}],"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":"DEJIMA Infectious Disease Research Alliance, Nagasaki University, Nagasaki 852-8523, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Urano","sequence":"additional","affiliation":[{"name":"DEJIMA Infectious Disease Research Alliance, Nagasaki University, Nagasaki 852-8523, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kouichi","family":"Morita","sequence":"additional","affiliation":[{"name":"Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan"},{"name":"DEJIMA Infectious Disease Research Alliance, Nagasaki University, Nagasaki 852-8523, Japan"},{"name":"Center for Vaccines and Therapeutic Antibodies for Emerging Infectious Diseases, Shimane University, Izumo 690-8504, Japan"},{"name":"Department of Tropical Viral Vaccine Development, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8986-6307","authenticated-orcid":false,"given":"Mya 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