Papua New Guinea (PNG), the largest island nation in the Pacific, is home to approximately 9 million inhabitants. Since 1944, the presence of dengue has been a confirmed reality in the country, initially marked by the isolation of the DENV-2 strain (DENV-2 New Guinea C) in an American soldier. That same year, DENV-1 was also identified among military personnel stationed in the territory.
Contrary to the trend observed in other regions of the southern Pacific, where the disease exhibits epidemic behavior, recent research points to a continuous circulation of endemic DENV variants in PNG. Although records of dengue outbreaks date back to the 1970s, no severe cases with hemorrhagic manifestations were reported until a significant outbreak in Port Moresby, the capital, in 2016.
The first documented epidemic outbreak in PNG occurred in Rabaul in 1971, triggering more than 1,100 DENV-2 infections. This event was followed by other outbreaks in 1976 and 1983, of unspecified serotypes. A serological study conducted in Madang, on the north coast, between October 2007 and June 2008, revealed an acute dengue infection rate of 8% (46/578) in outpatient patients with fever.
Between 2015 and 2016, outbreaks were recorded in Daru, Western Province, and in Port Moresby, with a total of 170 and 15 cases respectively. Recent research, covering from December 2015 to June 2017, indicates a predominance of the DENV-1 and DENV-2 serotypes, along with a minor circulation of DENV-3 and the Zika virus.
Complete genomic sequencing of selected samples has shown a prevalence of endemic autochthonous strains, mainly DENV-1 (genotype IV) and DENV-2 (genotype C), which have circulated in the country for up to a decade. A sublineage of DENV-2 linked to severe dengue outbreaks in PNG and the Solomon Islands has also been identified.
During World War II, DENV emerged as one of the main causes of morbidity among soldiers in Asia and the Pacific, with the first strains of DENV-1 and DENV-2 isolated in 1944. The DENV-3 and DENV-4 viruses were identified in the 1950s, during an outbreak in the Philippines.
The history of dengue in PNG suggests the need for continuous surveillance, as well as efforts to mitigate the mosquito population and health education programs, in order to minimize the impact of future outbreaks. Retrospective serum studies have confirmed the circulation of multiple DENV serotypes along the north coast before 1963, underscoring the persistence of dengue as a significant tropical disease in the region.
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