Background: In the context of the largest dengue outbreak in the state of Kerala, India in 2017, along with global evidence of changing epidemiology of dengue virus and its distribution, this study was planned to understand the epidemiological pattern of dengue infection and contemplate the clinical presentations of different serotypes.
Methods: This cross-sectional study was conducted in the Thiruvananthapuram and Kollam districts of Kerala, India, spanning 3 y from 2017 to 2019. We recruited adult patients based on the World Health Organization case definition of probable dengue fever to study their virological, spatial and clinical characteristics.