Clinical and Epidemiological Characterization of the First Recognized Outbreak of Dengue Virus-Type 2 in Mozambique, 2014

Marilia Massangaie National Directorate of Public Health, Ministry of Health, Maputo, Mozambique; National Institute of Health, Ministry of Health, Maputo, Mozambique; Cabo Delgado Provincial Health Directorate, Pemba, Mozambique; Nampula Provincial Health Directorate, Nampula, Mozambique; Centre for Emerging and Zoonotic Diseases, National Institute of Communicable Disease, Johannesburg, South Africa; Center for Global Health, Centers for Disease Control and Prevention, Maputo, Mozambique; Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique

Search for other papers by Marilia Massangaie in
Current site
Google Scholar
PubMed
Close
,
Gabriela Pinto National Directorate of Public Health, Ministry of Health, Maputo, Mozambique; National Institute of Health, Ministry of Health, Maputo, Mozambique; Cabo Delgado Provincial Health Directorate, Pemba, Mozambique; Nampula Provincial Health Directorate, Nampula, Mozambique; Centre for Emerging and Zoonotic Diseases, National Institute of Communicable Disease, Johannesburg, South Africa; Center for Global Health, Centers for Disease Control and Prevention, Maputo, Mozambique; Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique

Search for other papers by Gabriela Pinto in
Current site
Google Scholar
PubMed
Close
,
Fernando Padama National Directorate of Public Health, Ministry of Health, Maputo, Mozambique; National Institute of Health, Ministry of Health, Maputo, Mozambique; Cabo Delgado Provincial Health Directorate, Pemba, Mozambique; Nampula Provincial Health Directorate, Nampula, Mozambique; Centre for Emerging and Zoonotic Diseases, National Institute of Communicable Disease, Johannesburg, South Africa; Center for Global Health, Centers for Disease Control and Prevention, Maputo, Mozambique; Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique

Search for other papers by Fernando Padama in
Current site
Google Scholar
PubMed
Close
,
Geraldo Chambe National Directorate of Public Health, Ministry of Health, Maputo, Mozambique; National Institute of Health, Ministry of Health, Maputo, Mozambique; Cabo Delgado Provincial Health Directorate, Pemba, Mozambique; Nampula Provincial Health Directorate, Nampula, Mozambique; Centre for Emerging and Zoonotic Diseases, National Institute of Communicable Disease, Johannesburg, South Africa; Center for Global Health, Centers for Disease Control and Prevention, Maputo, Mozambique; Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique

Search for other papers by Geraldo Chambe in
Current site
Google Scholar
PubMed
Close
,
Mariana da Silva National Directorate of Public Health, Ministry of Health, Maputo, Mozambique; National Institute of Health, Ministry of Health, Maputo, Mozambique; Cabo Delgado Provincial Health Directorate, Pemba, Mozambique; Nampula Provincial Health Directorate, Nampula, Mozambique; Centre for Emerging and Zoonotic Diseases, National Institute of Communicable Disease, Johannesburg, South Africa; Center for Global Health, Centers for Disease Control and Prevention, Maputo, Mozambique; Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique

Search for other papers by Mariana da Silva in
Current site
Google Scholar
PubMed
Close
,
Inocêncio Mate National Directorate of Public Health, Ministry of Health, Maputo, Mozambique; National Institute of Health, Ministry of Health, Maputo, Mozambique; Cabo Delgado Provincial Health Directorate, Pemba, Mozambique; Nampula Provincial Health Directorate, Nampula, Mozambique; Centre for Emerging and Zoonotic Diseases, National Institute of Communicable Disease, Johannesburg, South Africa; Center for Global Health, Centers for Disease Control and Prevention, Maputo, Mozambique; Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique

Search for other papers by Inocêncio Mate in
Current site
Google Scholar
PubMed
Close
,
Celia Chirindza National Directorate of Public Health, Ministry of Health, Maputo, Mozambique; National Institute of Health, Ministry of Health, Maputo, Mozambique; Cabo Delgado Provincial Health Directorate, Pemba, Mozambique; Nampula Provincial Health Directorate, Nampula, Mozambique; Centre for Emerging and Zoonotic Diseases, National Institute of Communicable Disease, Johannesburg, South Africa; Center for Global Health, Centers for Disease Control and Prevention, Maputo, Mozambique; Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique

Search for other papers by Celia Chirindza in
Current site
Google Scholar
PubMed
Close
,
Sadia Ali National Directorate of Public Health, Ministry of Health, Maputo, Mozambique; National Institute of Health, Ministry of Health, Maputo, Mozambique; Cabo Delgado Provincial Health Directorate, Pemba, Mozambique; Nampula Provincial Health Directorate, Nampula, Mozambique; Centre for Emerging and Zoonotic Diseases, National Institute of Communicable Disease, Johannesburg, South Africa; Center for Global Health, Centers for Disease Control and Prevention, Maputo, Mozambique; Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique

Search for other papers by Sadia Ali in
Current site
Google Scholar
PubMed
Close
,
Sãozinha Agostinho National Directorate of Public Health, Ministry of Health, Maputo, Mozambique; National Institute of Health, Ministry of Health, Maputo, Mozambique; Cabo Delgado Provincial Health Directorate, Pemba, Mozambique; Nampula Provincial Health Directorate, Nampula, Mozambique; Centre for Emerging and Zoonotic Diseases, National Institute of Communicable Disease, Johannesburg, South Africa; Center for Global Health, Centers for Disease Control and Prevention, Maputo, Mozambique; Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique

Search for other papers by Sãozinha Agostinho in
Current site
Google Scholar
PubMed
Close
,
Daniel Chilaule National Directorate of Public Health, Ministry of Health, Maputo, Mozambique; National Institute of Health, Ministry of Health, Maputo, Mozambique; Cabo Delgado Provincial Health Directorate, Pemba, Mozambique; Nampula Provincial Health Directorate, Nampula, Mozambique; Centre for Emerging and Zoonotic Diseases, National Institute of Communicable Disease, Johannesburg, South Africa; Center for Global Health, Centers for Disease Control and Prevention, Maputo, Mozambique; Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique

Search for other papers by Daniel Chilaule in
Current site
Google Scholar
PubMed
Close
,
Jacqueline Weyer National Directorate of Public Health, Ministry of Health, Maputo, Mozambique; National Institute of Health, Ministry of Health, Maputo, Mozambique; Cabo Delgado Provincial Health Directorate, Pemba, Mozambique; Nampula Provincial Health Directorate, Nampula, Mozambique; Centre for Emerging and Zoonotic Diseases, National Institute of Communicable Disease, Johannesburg, South Africa; Center for Global Health, Centers for Disease Control and Prevention, Maputo, Mozambique; Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique

Search for other papers by Jacqueline Weyer in
Current site
Google Scholar
PubMed
Close
,
Chantel le Roux National Directorate of Public Health, Ministry of Health, Maputo, Mozambique; National Institute of Health, Ministry of Health, Maputo, Mozambique; Cabo Delgado Provincial Health Directorate, Pemba, Mozambique; Nampula Provincial Health Directorate, Nampula, Mozambique; Centre for Emerging and Zoonotic Diseases, National Institute of Communicable Disease, Johannesburg, South Africa; Center for Global Health, Centers for Disease Control and Prevention, Maputo, Mozambique; Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique

Search for other papers by Chantel le Roux in
Current site
Google Scholar
PubMed
Close
,
Ana Paula Abilio National Directorate of Public Health, Ministry of Health, Maputo, Mozambique; National Institute of Health, Ministry of Health, Maputo, Mozambique; Cabo Delgado Provincial Health Directorate, Pemba, Mozambique; Nampula Provincial Health Directorate, Nampula, Mozambique; Centre for Emerging and Zoonotic Diseases, National Institute of Communicable Disease, Johannesburg, South Africa; Center for Global Health, Centers for Disease Control and Prevention, Maputo, Mozambique; Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique

Search for other papers by Ana Paula Abilio in
Current site
Google Scholar
PubMed
Close
,
Cynthia Baltazar National Directorate of Public Health, Ministry of Health, Maputo, Mozambique; National Institute of Health, Ministry of Health, Maputo, Mozambique; Cabo Delgado Provincial Health Directorate, Pemba, Mozambique; Nampula Provincial Health Directorate, Nampula, Mozambique; Centre for Emerging and Zoonotic Diseases, National Institute of Communicable Disease, Johannesburg, South Africa; Center for Global Health, Centers for Disease Control and Prevention, Maputo, Mozambique; Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique

Search for other papers by Cynthia Baltazar in
Current site
Google Scholar
PubMed
Close
,
Timothy J. Doyle National Directorate of Public Health, Ministry of Health, Maputo, Mozambique; National Institute of Health, Ministry of Health, Maputo, Mozambique; Cabo Delgado Provincial Health Directorate, Pemba, Mozambique; Nampula Provincial Health Directorate, Nampula, Mozambique; Centre for Emerging and Zoonotic Diseases, National Institute of Communicable Disease, Johannesburg, South Africa; Center for Global Health, Centers for Disease Control and Prevention, Maputo, Mozambique; Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique

Search for other papers by Timothy J. Doyle in
Current site
Google Scholar
PubMed
Close
,
Julie Cliff National Directorate of Public Health, Ministry of Health, Maputo, Mozambique; National Institute of Health, Ministry of Health, Maputo, Mozambique; Cabo Delgado Provincial Health Directorate, Pemba, Mozambique; Nampula Provincial Health Directorate, Nampula, Mozambique; Centre for Emerging and Zoonotic Diseases, National Institute of Communicable Disease, Johannesburg, South Africa; Center for Global Health, Centers for Disease Control and Prevention, Maputo, Mozambique; Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique

Search for other papers by Julie Cliff in
Current site
Google Scholar
PubMed
Close
,
Janusz Paweska National Directorate of Public Health, Ministry of Health, Maputo, Mozambique; National Institute of Health, Ministry of Health, Maputo, Mozambique; Cabo Delgado Provincial Health Directorate, Pemba, Mozambique; Nampula Provincial Health Directorate, Nampula, Mozambique; Centre for Emerging and Zoonotic Diseases, National Institute of Communicable Disease, Johannesburg, South Africa; Center for Global Health, Centers for Disease Control and Prevention, Maputo, Mozambique; Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique

Search for other papers by Janusz Paweska in
Current site
Google Scholar
PubMed
Close
, and
Eduardo Samo Gudo National Directorate of Public Health, Ministry of Health, Maputo, Mozambique; National Institute of Health, Ministry of Health, Maputo, Mozambique; Cabo Delgado Provincial Health Directorate, Pemba, Mozambique; Nampula Provincial Health Directorate, Nampula, Mozambique; Centre for Emerging and Zoonotic Diseases, National Institute of Communicable Disease, Johannesburg, South Africa; Center for Global Health, Centers for Disease Control and Prevention, Maputo, Mozambique; Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique

Search for other papers by Eduardo Samo Gudo in
Current site
Google Scholar
PubMed
Close
Restricted access

Since the first reported epidemic of dengue in Pemba, the capital of Cabo Delgado province, in 1984–1985, no further cases have been reported in Mozambique. In March 2014, the Provincial Health Directorate of Cabo Delgado reported a suspected dengue outbreak in Pemba, associated with a recent increase in the frequency of patients with nonmalarial febrile illness. An investigation conducted between March and June detected a total of 193 clinically suspected dengue patients in Pemba and Nampula, the capital of neighboring Nampula Province. Dengue virus-type 2 (DENV-2) was detected by reverse transcriptase polymerase chain reaction in sera from three patients, and 97 others were classified as probable cases based on the presence of DENV nonstructural protein 1 antigen or anti-DENV immunoglobulin M antibody. Entomological investigations demonstrated the presence of Aedes aegypti mosquitos in both Pemba and Nampula cities.

Author Notes

* Address correspondence to Marilia Massangaie, National Directorate of Public Health, Ministry of Health, Av Eduardo Mondlane 1008, Maputo, Mozambique. E-mail: mariliamassangaie@yahoo.com.br

Authors' addresses: Marilia Massangaie, Gabriela Pinto, Fernando Padama, Geraldo Chambe, Mariana da Silva, and Inocêncio Mate, National Directorate of Public Health, Ministry of Health, Maputo, Mozambique, E-mails: mariliamassangaie@yahoo.com.br, gabbydocarmo@gmail.com, ferpadama@yahoo.com.br, geraldochambe@yahoo.com.br, m.sillva@yahoo.com.br, and inomate@yahoo.com.br. Celia Chirindza and Sadia Ali, Virus Isolation Laboratory, National Institute of Health, Maputo, Mozambique, E-mails: celia.chir@gmail.com and sadia.abdul.ali@gmail.com. Sãozinha Agostinho, Ministry of Health, Cabo Delgado Provincial Health Directorate, Pemba, Mozambique, E-mail: saozinhagostinho@gmail.com. Daniel Chilaule, Nampula Provincial Health Directorate, Ministry of Health, Nampula, Mozambique, E-mail: dachilaule@hotmail.com. Jacqueline Weyer and Chantel le Roux, National Institute for Communicable Diseases, Centre for Emerging and Zoonotic Diseases, Johannesburg, South Africa, E-mails: jacquelinew@nicd.ac.za and chantell@nicd.ac.za. Ana Paula Abilio, Cynthia Baltazar, and Eduardo Samo Gudo, National Institute of Health, Maputo, Mozambique, E-mails: anabilio1408@gmail.com, cynthiasema@yahoo.com, and esamogudojr@gmail.com. Timothy J. Doyle, Centers for Disease Control and Prevention, Center for Global Health, Maputo, Mozambique, E-mail: tdoyle@cdc.gov. Julie Cliff, Faculty of Medicine, Community Health Department, Maputo, Mozambique, E-mail: julie.cliff@gmail.com. Janusz Paweska, National Institute for Communicable Diseases, Special Pathogens Unit, Johannesburg, South Africa, E-mail: januszp@nicd.ac.za.

  • 1.

    Guzman MG, Halstead SB, Artsob H, Buchy P, Farrar J, Gubler DJ, Hunsperger E, Kroeger A, Margolis HS, Martinez E, Nathan MB, Pelegrino JL, Simmons C, Yoksan S, Peeling RW, 2010. Dengue: a continuing global threat. Nat Rev Microbiol 8: S7S16.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Bhatt S, Gething PW, Brady OJ, Messina JP, Farlow AW, Moyes CL, Drake JM, Brownstein JS, Hoen AG, Sankoh O, Myers MF, George DB, Jaenisch T, Win GR, Simmons CP, Scot TW, Farrar JJ, Hay SI, 2013. The global distribution and burden of dengue. Nature 496: 504507.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Guzman A, Isturiz RE, 2010. Update on the global spread of dengue. Int J Antimicrob Agents 36 (Suppl 1): S40S42.

  • 4.

    Brady OJ, Gething PW, Bhatt S, Messina JP, Brownstein JS, Hoen AG, Moyes CL, Farlow AW, Scott TW, Hay SI, 2012. Refining the global spatial limits of dengue virus transmission by evidence-based consensus. PLoS Negl Trop Dis 6: e1760.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Jaenisch T, Junghanss T, Wills B, Brady OJ, Eckerle I, Farlow A, Hay SI, McCall PJ, Messina JP, Ofula V, Sall AA, Sakuntabhai A, Velayudhan R, Wint W, Zeller H, Margolis HS, Sankoh O, Dengue in Africa Study Group, 2014. Dengue expansion in Africa-not recognized or not happening? Emerg Infect Dis 20: e140487.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Amarasinghe A, Kuritsk JN, Letson GW, Margolis HS, 2011. Dengue virus infection in Africa. Emerg Infect Dis 17: 13491354.

  • 7.

    CDC, 2013. Ongoing dengue epidemic - Angola, June 2013. MMWR Morb Mortal Wkly Rep 62: 504507.

  • 8.

    Johnson BK, Ocheng D, Gichogo A, Okiro M, Libondo D, Kinyanjui P, Tukei PM, 1982. Epidemic dengue fever caused by dengue type 2 virus in Kenya: preliminary results of human virological and serological studies. East Afr Med J 59: 781784.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Hertz JT, Munishi OM, Ooi EE, Howe S, Lim WY, Chow A, Morissey AB, Bartlett JA, Onyango JJ, Maro VP, Kinabo GD, Saganda W, Gubler DJ, Crump JA, 2012. Chikungunya and dengue fever among hospitalized febrile patients in northern Tanzania. Am J Trop Med Hyg 86: 171177.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Kanesa-thasan N, Chang GJ, Smoak BL, Magill A, Burrous MJ, Hoke CH, 1998. Molecular and epidemiologic analysis of dengue virus isolates from Somalia. Emerg Infect Dis 4: 299303.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Gubler DJ, Sather GE, Kuno G, Cabral JR, 1986. Dengue 3 virus transmission in Africa. Am J Trop Med Hyg 35: 12801284.

  • 12.

    Kuno G, Chang GJ, Tsuchiya KR, Karabatsos N, Cropp CB, 1998. Phylogeny of the genus Flavivirus. J Virol 72: 7383.

  • 13.

    Hume JC, Barnish G, Mangal T, Armazio L, Streat E, Bates I, 2008. Household cost of malaria overdiagnosis in rural Mozambique. Malar J 7: 33.

  • 14.

    Barat L, Chipipa J, Kolczak M, Sukwa T, 1999. Does the availability of blood slide microscopy for malaria at health centers improve the management of persons with fever in Zambia? Am J Trop Med Hyg 60: 10241030.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Messina JP, Brady OJ, Scott TW, Zou C, Pigott DM, Duda KA, Bhatt S, Katzelnick L, Howes RE, Battle KE, Simmons CP, Hay SI, 2014. Global spread of dengue virus types: mapping the 70 year history. Trends Microbiol 22: 138146.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Chipwaza B, Mugasa JP, Selemani M, Amuri M, Mosha F, Ngatunga SD, Gwakisa PS, 2014. Dengue and Chikungunya fever among viral diseases in outpatient febrile children in Kilosa district hospital, Tanzania. PLoS Negl Trop Dis 8: e3335.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Higa Y, Abílio AP, Futami K, Lázaro MAF, Minakawa N, Gudo ES, 2014. Abundant Aedes (Stegomyia) aegypti aegypti mosquitoes in the 2014 dengue outbreak area of Mozambique. Trop Med Health 43: 107109.

    • PubMed
    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 527 426 20
Full Text Views 518 14 1
PDF Downloads 208 15 1
 
 
 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save