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Case report reveals sexual transmission of dengue virus serotype 1 in a couple, indicating potential transmission routes beyond mosquitoes.
BACKGROUND: Dengue is primarily transmitted by Aedes mosquitoes, whereas sexual transmission has rarely been reported. We describe a probable case of male-to-female sexual transmission of dengue virus serotype 1 (DENV-1) in southeastern China. CASE PRESENTATION: A 41-year-old woman developed fever and myalgia on March 11, 2026, and tested positive for DENV-1 RNA and NS1 antigen, with negative anti-DENV IgM and IgG, consistent with early acute infection. Her husband had developed dengue in Timor-Leste on February 18, returned to China on March 4, and had unprotected sexual intercourse with her on March 5-7. At investigation, DENV RNA was undetectable in his blood but remained detectable in semen. Local vector-borne transmission appeared less likely because no substantial dengue activity was identified, the Breteau Index was 2, no adult Aedes mosquitoes were captured, and mean daily temperatures during the relevant period were low. CONCLUSION: Taken together, the epidemiologic timeline, laboratory findings, and limited support for local mosquito-borne transmission were most consistent with probable sexual transmission of DENV-1.
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Yang et al. (2026) studied this question.
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