The reintroduction of DENV-2 in 2011 in Panama and subsequent outbreak characteristic

Yamilka Díaz, Julio Cisneros, Hilda Guzmán, Paola Cordoba, Jean Paul Carrera, Brechla Moreno, Rubing Chen, Juan Castillo Mewa, Lourdes García, Lizbeth Cerezo, Amelia Travassos da Rosa, Nathan D. Gundacker, Blas Armién, Scott C. Weaver, Nikos Vasilakis, Sandra López-Vergès, Robert Tesh

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


The circulation of the South-east Asian/American (AS/AM) dengue 2 virus (DENV-2) genotype in the Americas has been associated with a high rate of severe disease. From 1993, the year DENV was reintroduced in Panama, until 2011 there were 29 dengue-associated deaths, 17 of which occurred in 2011, the most severe outbreak with a case fatality rate (CFR) of 44% (17 deaths out of 38 severe dengue cases). During this outbreak DENV-2 was reintroduced into the country, whereas over the prior five years DENV-1 and −3 were predominant. Herein, we describe the 2011 Panama outbreak and genetically characterize the Panamanian DENV-2 strains, which were associated with severe dengue disease in Panama. Our results suggest that the DENV-2 isolates from this outbreak belonged to the AS/AM genotype sub-clade 2BI and were genetically close to viruses described in the outbreaks in Nicaragua, Honduras, Guatemala and Mexico from 2006-2011. Sub-clade 2BI has previously been associated with severe disease in Nicaragua during outbreaks from 2005-2007.

Original languageEnglish (US)
Pages (from-to)58-65
Number of pages8
JournalActa Tropica
StatePublished - Jan 2018


  • DENV-2
  • case fatality rate
  • epidemiology
  • outbreak
  • phylogenetics

ASJC Scopus subject areas

  • Infectious Diseases
  • Parasitology


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