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Virol J. 2008; 5: 1.
Published online 2008 January 9. doi: 10.1186/1743-422X-5-1.
PMCID: PMC2253528
Concurrent infections by all four dengue virus serotypes during an outbreak of dengue in 2006 in Delhi, India
Preeti Bharaj,1 Harendra S Chahar,1 Anubhav Pandey,1 Kavita Diddi,1 Lalit Dar,1 Randeep Guleria,2 Sushil K Kabra,3 and Shobha Broorcorresponding author1
1Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
2Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
3Department of Pediatrics All India Institute of Medical Sciences, New Delhi, India
corresponding authorCorresponding author.
Preeti Bharaj: preetibhj/at/gmail.com; Harendra S Chahar: harendrachahar/at/rediffmail.com; Anubhav Pandey: ap_aiims/at/yahoo.com; Kavita Diddi: kavitadiddi/at/yahoo.com; Lalit Dar: lalitdar/at/yahoo.com; Randeep Guleria: randeepguleria2002/at/yahoo.com; Sushil K Kabra: skkabra/at/hotmail.com; Shobha Broor: shobha.broor/at/gmail.com
Received July 23, 2007; Accepted January 9, 2008.
Abstract

Background
Co-circulation of multiple dengue virus serotypes has been reported from many parts of the world including India, however concurrent infection with more than one serotype of dengue viruses in the same individual is rarely documented. An outbreak of dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) occurred in and around Delhi in 2006. This is the first report from India with high percentage of concurrent infections with different dengue virus serotypes circulating during one outbreak.

Results
Acute phase sera from patients were tested for the presence of dengue virus RNA by RT-PCR assay. Of the 69 samples tested for dengue virus RNA, 48 (69.5%) were found to be positive. All the four dengue virus serotypes were found to be co-circulating in this outbreak with DENV-3 being the predominant serotype. In addition in 9 of 48 (19%) dengue virus positive samples, concurrent infection with more than one dengue virus serotype were identified.

Conclusion
This is the first report in which concurrent infections with different dengue virus serotypes is being reported during an outbreak from India. Delhi is now truly hyperendemic for dengue.