Recent emergence of dengue hemorrhagic fever in the Indian subcontinent has been well documented in Sri Lanka. We compare recent (2003–2006) and past (1980–1997) dengue surveillance data for Sri Lanka. The 4 dengue virus (DENV) serotypes have been cocirculating in Sri Lanka for>30 years. Over this period, a new genotype of DENV-1 has replaced an old genotype. Moreover, new clades of DENV-3 genotype III viruses have replaced older clades. Emergence of new clades of DENV-3 in 1989 and 2000 coincided with abrupt increases in the number of reported dengue cases, implicating this serotype in severe epidemics. In 1980– 1997, most reported dengue cases were in children. Recent epidemics have been characterized by many cases in children and adults. Changes in local transmission dynamics and genetic changes in DENV-3 are likely increasing emergence of severe dengue epidemics in Sri Lanka. Dengue viruses (DENVs) are mosquito-borne flaviviruses that each year infect millions of persons living in tropical and subtropical regions of the world. Several hundred thousand of these infections, especially in children, progress to a life-threatening disease known as dengue hemorrhagic fever (DHF). Dengue has emerged in many regions of the world and the number of cases and the range of the virus continue to increase every year (1). The DENV complex consists of 4 distinct serotypes
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