Qdenga-induced dengue caused by minor DENV-2 subvariant(s) in the vaccine, with two amino acid substitutions in the E protein

John H-O Pettersson; Erica Tibbelin; Gabriel Heyman; Johan Aarum; Oskar Karlsson Lindsjö; Kim Blom; Klara Sondén; Jonas Klingström

doi:10.1093/jtm/taaf091

Qdenga-induced dengue caused by minor DENV-2 subvariant(s) in the vaccine, with two amino acid substitutions in the E protein

J Travel Med. 2025 Nov 23;32(7):taaf091. doi: 10.1093/jtm/taaf091.

Authors

John H-O Pettersson^{1

2

3

4}, Erica Tibbelin⁵, Gabriel Heyman⁵, Johan Aarum¹, Oskar Karlsson Lindsjö¹, Kim Blom^{1

6}, Klara Sondén^{1

7}, Jonas Klingström^{1

8}

Affiliations

¹ Public Health Agency of Sweden, Nobels väg 18, 171 82 Solna, Sweden.
² Zoonosis Science Center, Clinical Microbiology, Department of Medical Sciences, Uppsala University, Husargatan 3, 752 37 Uppsala, Sweden.
³ Department of Microbiology, Swedish Veterinary Agency, Ulls väg 2B, 751 89 Uppsala, Sweden.
⁴ Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, 792 Elizabeth St, Melbourne VIC 3000, Australia.
⁵ Department of Infectious Diseases, Västmanland County Hospital Västerås, Adelsögatan 35, 721 89 Västerås, Sweden.
⁶ Department of Clinical Microbiology, Umeå University, 901 87 Umeå, Sweden.
⁷ Department of Medicine Solna, Karolinska Institutet, 171 77 Stockholm, Sweden.
⁸ Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden.

Abstract

Highlight: We describe a Qdenga-induced DENV-2-infection in a Swedish traveller. Comparative sequencing suggests that the vaccine contained a small fraction of identical virus as detected in the patient, suggesting a selection of a DENV-2-substrain with unusual amino acid substitutions. Further research on selection of, and possible effects of, Qdenga-substrain-infections is warranted.

Keywords: Dengue virus; Qdenga Tak-003; dengue; denv substrains; travel vaccine; vaccine-induced infection.

Grants and funding

M24-0173/Åke Wiberg Foundation