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Bos S, Zambrana JV, Duarte E, Graber AL, Huffaker J, Montenegro C, Premkumar L, Gordon A, Balmaseda A, Harris E. Inapparent primary dengue virus infections reveal hidden serotype-specific epidemiological patterns and spectrum of infection outcome: a cohort study in Nicaragua. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.05.24305281. [PMID: 38633800 PMCID: PMC11023678 DOI: 10.1101/2024.04.05.24305281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Background Dengue is the most prevalent mosquito-borne viral disease and a major public health problem worldwide. Most primary infections with the four dengue virus serotypes (DENV1-4) are inapparent; nevertheless, prior research has primarily focused on symptomatic infections, which has limited our understanding of the epidemiological burden and spectrum of disease of each DENV serotype. Our study addresses this bottleneck in dengue research by providing a new method and a detailed examination of primary inapparent infections. Methods Here we present (1) the evaluation of a multiplex DENV1-4 envelope domain III multiplex microsphere-based assay (EDIII-MMBA) to serotype inapparent primary infections and (2) its application leveraging 17 years of prospective sample collection from the Nicaraguan Pediatric Dengue Cohort Study. After evaluation, we analyzed 46% (N=574) of total inapparent primary DENV infections with the EDIII-MMBA. Remaining infections were inferred using stochastic imputation, taking year and neighborhood of infection into account. Findings The EDIII-MMBA demonstrated excellent diagnostic accuracy of symptomatic and inapparent primary DENV infections when evaluated against gold-standard serotyping methods. Significant within- and between-year variation in serotype distribution between symptomatic and inapparent infections and circulation of serotypes undetected in symptomatic cases were observed in multiple years. Our findings reveal that a significant majority of primary infections remained inapparent: 76.8% for DENV1, 79.9% for DENV2, and 63.9% for DENV3. DENV3 exhibited the highest likelihood of symptomatic and severe primary infections (Pooled OR compared to DENV1 = 2.13, 95% CI 1.28-3.56, and 6.75, 2.01-22.62, respectively), whereas DENV2 had similar likelihood to DENV1 in both analyses. Interpretation Our study indicates that case surveillance skews the perceived epidemiological footprint of DENV and reveals a more complex and intricate pattern of serotype distribution in inapparent infections. Further, the significant differences in infection outcomes by serotype emphasizes the need for serotype-informed public health strategies. Funding NIH/NIAID P01AI106695, U01AI153416. Research in context Evidence before this study: We conducted a search in PubMed for studies published up to February 2024. Keywords included "dengue virus" and "DENV" in combination with "inapparent infections", "asymptomatic infections", "primary infections by serotype", "FoI by serotype", "force of infection", "force of infection by serotype", and identified a significant gap in the current understanding of dengue epidemiology. Despite acknowledging the high prevalence of inapparent DENV infections in endemic regions, previous research has focused primarily on symptomatic infections, potentially biasing our understanding of the DENV epidemiological landscape and hindering our capacity to determine the complete disease spectrum of the different DENV serotypes. While cross-sectional studies have provided preliminary insights into this gap, there is a need for more comprehensive and detailed serotype-specific insights to evaluate the epidemiological impact of inapparent infections. The lack of comprehensive characterization of inapparent infections reflects methodological challenges, particularly the need for prospective cohort studies designed to capture and accurately serotype these infections. Moreover, the reliance on labor-intensive and low-throughput antibody neutralization assays for serotyping, despite their accuracy, has constrained high-throughput analysis required for large-scale epidemiological studies.Added value of this study: Our study, spanning 17 years of prospective cohort data in Nicaragua, addresses this bottleneck in dengue research by providing a detailed examination of primary inapparent infections. The introduction of a novel envelope domain III (EDIII) multiplex microsphere-based assay for DENV serotyping represents a significant methodological advance, offering an efficient, scalable alternative for large epidemiological studies. A key contribution of our study is the intricate pattern of serotype distribution among inapparent infections. In contrast to the serotype predominance observed in symptomatic infections, inapparent infections exhibit a complex landscape with co-circulation of multiple DENV serotypes, including serotypes undetected in symptomatic surveillance in multiple years. Our systematic documentation of the entire disease spectrum provides unprecedented insights into the serotype-specific disease burden in primary infection, including the proportion of symptomatic versus inapparent infection and its temporal variations, thus providing a more complete picture of DENV epidemiology than has been available to date. Notably, we demonstrate striking differences in disease severity by serotype, with DENV3 infections being significantly more symptomatic and more severe compared to DENV1 and DENV2, the latter displaying the highest rate of inapparent infection.Implications of all the available evidence: Our research challenges prior assumptions by demonstrating that inapparent and symptomatic primary DENV infections present distinct epidemiological profiles, revealing that the epidemiological footprint of DENV is broader and more nuanced than previously recognized through symptomatic cases alone. These findings underscore the utility for continuous and comprehensive surveillance systems that capture both symptomatic and inapparent infections to accurately assess the epidemiological burden of DENV and inform public health interventions. Additionally, they provide critical insight for enhancing the accuracy of predictive DENV transmission modeling. Furthermore, the marked differences in infection outcomes by serotype emphasize the need for serotype-informed public health strategies. This nuanced understanding is pivotal for the crafting of targeted interventions, vaccine development and vaccination strategies, and efficient resource allocation, ultimately contributing to the global effort to mitigate the impact of dengue.
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Alam R, Fathema K, Yasmin A, Roy U, Hossen K, Rukunuzzaman M. Prediction of severity of dengue infection in children based on hepatic involvement. JGH Open 2024; 8:e13049. [PMID: 38486877 PMCID: PMC10938065 DOI: 10.1002/jgh3.13049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 02/10/2024] [Accepted: 02/18/2024] [Indexed: 03/17/2024]
Abstract
Background and Aim To assess the spectrum of hepatic involvement in children with dengue fever (DF) and prediction of severity of dengue infection by early detection of elevated liver enzymes. Methods This prospective observational study was conducted at a tertiary care hospital from June 2019 to September 2019. Children admitted with DF were included. Severity of DF was graded as dengue without warning sign (DNWS), with warning sign (DWS), and severe dengue fever (SDF) according to WHO criteria. Liver injury (LI) was defined as alanine aminotransferase (ALT) more than upper limit of normal irrespective of sex. Results Of 190 children (male, 109) with DF, 60 had DNWS, 49 had DWS, and 81 had SDF. A total of 100 children (52.6%) had LI. The distribution of hepatic involvement spectrum involves hepatomegaly (26.3%), hepatic tenderness (25.2%), features of acute liver failure (1.5%), raised level of ALT (52.6%), raised level of aspartateaminotransferase (AST) (65.8%), prolonged prothrombin time (7.3%), and reduced level of serum albumin (44.7%) in children. Of them, 5.8% and 6.8% of children had >tenfold increase in ALT and AST values. The degree of liver function derangement significantly (P < 0.05) increased with DF severity. In our study, ALT at 422 IU/L (10 times upper limit of normal [ULN]) and AST 689 IU/L (17 times ULN) had similar sensitivity and specificity as WHO recommended cutoff of 1000 IU/L (25 times of ULN) to detect SDF. Conclusion ALT ≥10 times and AST ≥17 times of ULN are as sensitive as ≥25 times (as recommended by WHO) to detect SDF.
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Affiliation(s)
- Rubaiyat Alam
- Department of Pediatric Gastroenterology and NutritionBangabandhu Sheikh Mujib Medical UniversityDhakaBangladesh
| | - Kaniz Fathema
- Department of PediatricsSir Salimullah Medical College and HospitalDhakaBangladesh
| | - Afsana Yasmin
- Department of Pediatric Gastroenterology and NutritionBangabandhu Sheikh Mujib Medical UniversityDhakaBangladesh
| | - Urmi Roy
- Department of Pediatric Gastroenterology and NutritionBangabandhu Sheikh Mujib Medical UniversityDhakaBangladesh
| | - Kamal Hossen
- Department of PediatricsDhaka Medical College and HospitalDhakaBangladesh
| | - Md Rukunuzzaman
- Department of Pediatric Gastroenterology and NutritionBangabandhu Sheikh Mujib Medical UniversityDhakaBangladesh
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Hamins-Puértolas M, Buddhari D, Salje H, Cummings DAT, Fernandez S, Farmer A, Kaewhiran S, Khampaen D, Iamsirithaworn S, Srikiatkhachorn A, Waickman A, Thomas SJ, Rothman AL, Endy T, Rodriguez-Barraquer I, Anderson KB. Household immunity and individual risk of infection with dengue virus in a prospective, longitudinal cohort study. Nat Microbiol 2024; 9:274-283. [PMID: 38110699 PMCID: PMC10895643 DOI: 10.1038/s41564-023-01543-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 11/02/2023] [Indexed: 12/20/2023]
Abstract
Although it is known that household infections drive the transmission of dengue virus (DENV), it is unclear how household composition and the immune status of inhabitants affect the individual risk of infection. Most population-based studies to date have focused on paediatric cohorts because more severe forms of dengue mainly occur in children, and the role of adults in dengue transmission is understudied. Here we analysed data from a multigenerational cohort study of 470 households, comprising 2,860 individuals, in Kamphaeng Phet, Thailand, to evaluate risk factors for DENV infection. Using a gradient-boosted regression model trained on annual haemagglutination inhibition antibody titre inputs, we identified 1,049 infections, 90% of which were subclinical. By analysing imputed infections, we found that individual antibody titres, household composition and antibody titres of other members in the same household affect an individual's risk of DENV infection. Those individuals living in households with high average antibody titres, or households with more adults, had a reduced risk of infection. We propose that herd immunity to dengue acts at the household level and may provide insight into the drivers of the recent change in the shifting age distribution of dengue cases in Thailand.
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Affiliation(s)
| | - Darunee Buddhari
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Henrik Salje
- Department of Genetics, University of Cambridge, Cambridge, UK
- Department of Biology, University of Florida, Gainesville, FL, USA
| | - Derek A T Cummings
- Department of Biology, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Stefan Fernandez
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Aaron Farmer
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | | | | | | | - Anon Srikiatkhachorn
- Institute for Immunology and Informatics, Department of Cell and Molecular Biology, University of Rhode Island, Providence, RI, USA
- Faculty of Medicine, King Mongkut's Institute of Technology Ladkrabang, Bangkok, Thailand
| | - Adam Waickman
- Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Stephen J Thomas
- Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY, USA
- Institute for Global Health and Translational Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Alan L Rothman
- Institute for Immunology and Informatics, Department of Cell and Molecular Biology, University of Rhode Island, Providence, RI, USA
| | - Timothy Endy
- Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY, USA
- Coalition for Epidemic Preparedness Innovations (CEPI), Washington DC, USA
| | | | - Kathryn B Anderson
- Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY, USA.
- Institute for Global Health and Translational Sciences, SUNY Upstate Medical University, Syracuse, NY, USA.
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Henriques P, Rosa A, Caldeira-Araújo H, Soares P, Vigário AM. Flying under the radar - impact and factors influencing asymptomatic DENV infections. Front Cell Infect Microbiol 2023; 13:1284651. [PMID: 38076464 PMCID: PMC10704250 DOI: 10.3389/fcimb.2023.1284651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/06/2023] [Indexed: 12/18/2023] Open
Abstract
The clinical outcome of DENV and other Flaviviruses infections represents a spectrum of severity that ranges from mild manifestations to severe disease, which can ultimately lead to death. Nonetheless, most of these infections result in an asymptomatic outcome that may play an important role in the persistent circulation of these viruses. Also, although little is known about the mechanisms that lead to these asymptomatic infections, they are likely the result of a complex interplay between viral and host factors. Specific characteristics of the infecting viral strain, such as its replicating efficiency, coupled with host factors, like gene expression of key molecules involved in the immune response or in the protection against disease, are among crucial factors to study. This review revisits recent data on factors that may contribute to the asymptomatic outcome of the world's widespread DENV, highlighting the importance of silent infections in the transmission of this pathogen and the immune status of the host.
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Affiliation(s)
- Paulo Henriques
- Projecto Medicina, Faculdade de Ciências da Vida, Universidade da Madeira, Funchal, Portugal
| | - Alexandra Rosa
- Projecto Medicina, Faculdade de Ciências da Vida, Universidade da Madeira, Funchal, Portugal
| | - Helena Caldeira-Araújo
- Projecto Medicina, Faculdade de Ciências da Vida, Universidade da Madeira, Funchal, Portugal
- CQM-Centro de Química da Madeira, Universidade da Madeira, Funchal, Portugal
| | - Pedro Soares
- Department of Biology, CBMA (Centre of Molecular and Environmental Biology), Braga, Portugal
- Department of Biology, Institute of Science and Innovation for Bio-Sustainability (IB-S), University of Minho, Braga, Portugal
| | - Ana Margarida Vigário
- Projecto Medicina, Faculdade de Ciências da Vida, Universidade da Madeira, Funchal, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
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Shepard DS, Agarwal‐Harding P, Jiamton S, Undurraga EA, Kongsin S. Enrollment of dengue patients in a prospective cohort study in Umphang District, Thailand, during the COVID-19 pandemic: Implications for research and policy. Health Sci Rep 2023; 6:e1657. [PMID: 38028707 PMCID: PMC10630743 DOI: 10.1002/hsr2.1657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 09/29/2023] [Accepted: 10/11/2023] [Indexed: 12/01/2023] Open
Abstract
Background and Aims Dengue is endemic in Thailand and imposes a high burden on the health system and society. We conducted a prospective cohort study in Umphang District, Tak Province, Thailand, to investigate the share of dengue cases with long symptoms and their duration. Here we present the results of the enrollment process during the COVID-19 pandemic with implications and challenges for research and policy. Methods In a prospective cohort study conducted in Umphang District, Thailand, we examined the prevalence of persistent symptoms in dengue cases. Clinically diagnosed cases were offered free laboratory testing, We enrolled ambulatory dengue patients regardless of age who were confirmed through a highly sensitive laboratory strategy (positive NS1 and/or IgM), agreed to follow-up visits, and gave informed consent. We used multivariate logistic regressions to assess the probability of clinical dengue being laboratory confirmed. To determine the factors associated with study enrollment, we analyzed the relationship of patient characteristics and month of screening to the likelihood of participation. To identify underrepresented groups, we compared the enrolled cohort to external data sources. Results The 150 clinical cases ranged from 1 to 85 years old. Most clinical cases (78%) were confirmed by a positive laboratory test, but only 19% of those confirmed enrolled in the cohort study. Women, who were half as likely to enroll as men, were underrepresented in the cohort. Conclusions The Thai physicians' clinical diagnoses at this rural district hospital had good agreement with laboratory diagnoses. By identifying underrepresented groups and disparities, future studies can ensure the creation of statistically representative cohorts to maximize their scientific value. This involves recruiting and retaining underrepresented groups in health research, such as women in this study. Promising strategies for meaningful inclusion include multi-site enrollment, offering in-home or virtual services, and providing in-kind benefits like childcare for underrepresented groups.
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Affiliation(s)
- Donald S. Shepard
- Schneider Institutes for Health PolicyHeller School for Social Policy and Management, Brandeis UniversityWalthamMassachusettsUSA
| | - Priya Agarwal‐Harding
- Schneider Institutes for Health PolicyHeller School for Social Policy and Management, Brandeis UniversityWalthamMassachusettsUSA
| | - Sukhum Jiamton
- Research Centre for Health Economics and Evaluation, Faculty of Public HealthMahidol UniversityBangkokThailand
- Department of Dermatology, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Eduardo A. Undurraga
- Escuela de GobiernoPontificia Universidad Católica de ChileSantiagoChile
- Research Center for Integrated Disaster Risk Management (CIGIDEN)SantiagoChile
- CIFAR Azrieli Global Scholars ProgramTorontoOntarioCanada
| | - Sukhontha Kongsin
- Research Centre for Health Economics and Evaluation, Faculty of Public HealthMahidol UniversityBangkokThailand
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Asish PR, Dasgupta S, Rachel G, Bagepally BS, Girish Kumar CP. Global prevalence of asymptomatic dengue infections - a systematic review and meta-analysis. Int J Infect Dis 2023; 134:292-298. [PMID: 37463631 DOI: 10.1016/j.ijid.2023.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/20/2023] [Accepted: 07/13/2023] [Indexed: 07/20/2023] Open
Abstract
OBJECTIVES The burden of asymptomatic dengue infections is understudied. Therefore, we systematically reviewed the literature to estimate the global prevalence of asymptomatic dengue infections. METHODS We searched cross-sectional studies reporting the prevalence of asymptomatic dengue infections from PubMed, Scopus, and Embase. Prevalence of asymptomatic dengue infections was pooled and reported as proportions with a 95% confidence interval (CI). This systematic review protocol was a priori registered in The International Prospective Register of Systematic Reviews (Reg: No. CRD42020218446). RESULTS We included 41 studies with 131,953 cases in our analysis. The overall pooled prevalence of asymptomatic dengue infections was 59.26% (95% CI: 43.76-74.75, I2 = 99.93%), with 65.52% (95% CI: 38.73-92.32, I2 = 99.95%) during outbreaks and 30.78% (95% CI: 21.39-40.16, I2 = 98.78%) during non-outbreak periods. The pooled prevalence among the acutely infected individuals was 54.52% (95% CI: 17.73-46.76, I2 = 99.91%), whereas, among primary and secondary asymptomatic dengue infections, it was 65.36% (95% CI: 45.76-84.96, I2 = 98.82) and 48.99% (95% CI: 27.85-70.13, I2 = 99.08%) respectively. CONCLUSION The majority of dengue cases are asymptomatic and may play a significant role in disease transmission. Public health strategies aimed at dengue outbreak response and mitigation of disease burden should include early detection of asymptomatic cases.
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Affiliation(s)
| | | | - Gladys Rachel
- ICMR-National Institute of Epidemiology, Chennai, India
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De Santis O, Bouscaren N, Flahault A. Asymptomatic dengue infection rate: A systematic literature review. Heliyon 2023; 9:e20069. [PMID: 37809992 PMCID: PMC10559824 DOI: 10.1016/j.heliyon.2023.e20069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 09/04/2023] [Accepted: 09/11/2023] [Indexed: 10/10/2023] Open
Abstract
Objectives Dengue infection is spreading worldwide. The clinical spectrum is broad and includes asymptomatic infections. This review provides an overview of the different proportions of asymptomatic infections described in epidemiological studies according to definitions, study designs, and detection methods. Methods Medline and Embase databases were searched without restriction of date or language. Studies were included if they reported data on the incidence or prevalence of asymptomatic dengue infections. The data were summarized and classified according to the definitions of the term 'asymptomatic'. Results A total of 74 studies were included. The mean proportion of asymptomatic infections among dengue-infected persons was 54% in 50 included studies. The prevalence of dengue infections detected in healthy persons was 0.2% in 24 included studies. The term 'asymptomatic' has been used to refer to 'clinically undetectable infection', but also to 'undiagnosed infection' or 'mild infection'. Only 8% were clinically undetectable laboratory-confirmed dengue infections. Conclusion The proportion of asymptomatic dengue infections varied greatly. Studies proving data on clinically undetectable laboratory-confirmed dengue infections were very few, but provided consistent results of low proportions of asymptomatic infections. These data challenge the assumption that the majority of dengue cases are asymptomatic.
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Affiliation(s)
- Olga De Santis
- Institute of Global Health, Faculty of Medicine, University of Geneva, 1202 Geneva, Switzerland
- Direction de la recherche, de l'innovation et de la coopération internationale, CHU de La Réunion, 97410, Saint-Pierre, France
| | - Nicolas Bouscaren
- Service de Santé Publique et Soutien à la Recherche, Inserm CIC1410, CHU de La Réunion, 97410 Saint-Pierre, France
| | - Antoine Flahault
- Institute of Global Health, Faculty of Medicine, University of Geneva, 1202 Geneva, Switzerland
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Park H, Lee H, Lee M, Baek C, Park JA, Jang M, Kwon Y, Min J, Lee T. Synthesis of Isolated DNA Aptamer and Its Application of AC-Electrothermal Flow-Based Rapid Biosensor for the Detection of Dengue Virus in a Spiked Sample. Bioconjug Chem 2023; 34:1486-1497. [PMID: 37527337 DOI: 10.1021/acs.bioconjchem.3c00249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
Dengue fever is an infectious disease caused by the dengue virus (DENV) and is transmitted by mosquitoes in tropical and subtropical regions. The early detection method at a low cost is essential. To address this, we synthesized the isolated DENV aptamer for fabricating a rapid electrochemical biosensor on a Au interdigitated microgap electrode (AuIMGE). The DENV aptamers were generated using the SELEX (systemic evolution of ligands by exponential enrichment) method for binding to DENV surface envelope proteins. To reduce the manufacturing cost, unnecessary nucleotide sequences were excluded from the isolation process of the DENV aptamer. To reduce the detection time, the alternating current electrothermal flow (ACEF) technique was applied to the fabricated biosensor, which can shorten the detection time to 10 min. The performance of the biosensor was evaluated using cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS). In the diluted DENV protein solution, the linear range of the concentrations was from 1 pM to 1 μM and the LOD was 76.7 fM. Moreover, the proposed biosensor detected DENV in a diluted spiked sample at a linear range of 10-6 to 106 TCID50/mL, while the detection performance was proven with an LOD of 1.74 × 10-7 TCID50/mL along with high selectivity.
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Affiliation(s)
- Hanbin Park
- Department of Chemical Engineering, Kwangwoon University, 20 Kwangwoon-Ro, Nowon-Gu, Seoul 01897, Republic of Korea
| | - Hoseok Lee
- Department of Electrical and Computer Engineering, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08727, Republic of Korea
| | - Myoungro Lee
- Department of Chemical Engineering, Kwangwoon University, 20 Kwangwoon-Ro, Nowon-Gu, Seoul 01897, Republic of Korea
| | - Changyoon Baek
- School of Integrative Engineering, Chung-Ang University, Heukseok-dong, Dongjak-gu, Seoul 06974, Republic of Korea
| | - Jeong Ah Park
- Department of Chemical Engineering, Kwangwoon University, 20 Kwangwoon-Ro, Nowon-Gu, Seoul 01897, Republic of Korea
| | - Moonbong Jang
- Department of Chemical Engineering, Kwangwoon University, 20 Kwangwoon-Ro, Nowon-Gu, Seoul 01897, Republic of Korea
| | - Yein Kwon
- Department of Chemical Engineering, Kwangwoon University, 20 Kwangwoon-Ro, Nowon-Gu, Seoul 01897, Republic of Korea
| | - Junhong Min
- School of Integrative Engineering, Chung-Ang University, Heukseok-dong, Dongjak-gu, Seoul 06974, Republic of Korea
| | - Taek Lee
- Department of Chemical Engineering, Kwangwoon University, 20 Kwangwoon-Ro, Nowon-Gu, Seoul 01897, Republic of Korea
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Odio CD, Sánchez-González L, Delorey M, Adams LE, Jones ES, Lorenzi O, Munoz-Jordan J, Rivera-Amill V, Paz–Bailey G. The Effect of Age on Dengue Presentation and the Diagnostic Accuracy of the 2015 Pan American Health Organization Case Criteria in a Puerto Rican Cohort. Open Forum Infect Dis 2023; 10:ofad373. [PMID: 37663092 PMCID: PMC10468746 DOI: 10.1093/ofid/ofad373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/14/2023] [Indexed: 09/05/2023] Open
Abstract
Background We evaluated dengue presentation by age, the performance of the 2015 Pan American Health Organization (PAHO) case criteria in identifying dengue cases, and variables to improve specificity. Methods Patients with fever ≤7 days (N = 10 408) were recruited from 2 emergency departments from May 2012 through December 2015. Serum samples were tested for dengue, chikungunya, and nasopharyngeal swabs for respiratory viruses. Smoothing splines assessed differences in the frequencies of signs/symptoms by age. Least absolute shrinkage and selection operator regressions identified the variables that best predicted dengue. Results Among 985 dengue cases, children aged <5 years were least likely to have leukopenia, but most likely to have rash and petechiae. Adults had the highest odds of aches/pains and headaches/retro-orbital pain. The 2015 PAHO criteria had sensitivity of 93% and specificity of 25%. Specificity could be improved by requiring at least 2 of the following criteria: vomiting/nausea, petechiae, rash, or leukopenia (specificity 68%, sensitivity 71%) or by using 2015 PAHO criteria plus either (1) aspartate aminotransferase >50 IU/L or platelet count <100 000 platelets/μL (specificity 81%, sensitivity 56%) or (2) itchy skin or absence of rhinorrhea or cough (specificity 51%, sensitivity 82%). Conclusions The 2015 PAHO dengue case criteria had excellent sensitivity but poor specificity. This can be improved by adding signs/symptoms associated with dengue diagnosis.
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Affiliation(s)
- Camila D Odio
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Bethesda, Maryland 20814, USA
| | - Liliana Sánchez-González
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Bethesda, Maryland 20814, USA
| | - Mark Delorey
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention,Fort Collins, Colorado
| | - Laura E Adams
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Bethesda, Maryland 20814, USA
| | - Emma S Jones
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention,Fort Collins, Colorado
| | - Olga Lorenzi
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Bethesda, Maryland 20814, USA
| | - Jorge Munoz-Jordan
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Bethesda, Maryland 20814, USA
| | | | - Gabriela Paz–Bailey
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Bethesda, Maryland 20814, USA
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Scroggs SLP, Offerdahl DK, Stewart PE, Shaia C, Griffin AJ, Bloom ME. Of Murines and Humans: Modeling Persistent Powassan Disease in C57BL/6 Mice. mBio 2023; 14:e0360622. [PMID: 36809119 PMCID: PMC10128018 DOI: 10.1128/mbio.03606-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 01/09/2023] [Indexed: 02/23/2023] Open
Abstract
Powassan infection is caused by two closely related, tick-transmitted viruses of the genus Flavivirus (family Flaviviridae): Powassan virus lineage I (POWV) and lineage II (known as deer tick virus [DTV]). Infection is typically asymptomatic or mild but can progress to neuroinvasive disease. Approximately 10% of neuroinvasive cases are fatal, and half of the survivors experience long-term neurological sequelae. Understanding how these viruses cause long-term symptoms as well as the possible role of viral persistence is important for developing therapies. We intraperitoneally inoculated 6-week-old C57BL/6 mice (50% female) with 103 focus-forming units (FFU) DTV and assayed for infectious virus, viral RNA, and inflammation during acute infection and 21, 56, and 84 days postinfection (dpi). Although most mice (86%) were viremic 3 dpi, only 21% of the mice were symptomatic and 83% recovered. Infectious virus was detected only in the brains of mice sampled during the acute infection. Viral RNA was detected in the brain until 84 dpi, but the magnitude decreased over time. Meningitis and encephalitis were visible in acute mice and from mice sampled at 21 dpi. Inflammation was observed until 56 dpi in the brain and 84 dpi in the spinal cord, albeit at low levels. These results suggest that the long-term neurological symptoms associated with Powassan disease are likely caused by lingering viral RNA and chronic inflammation in the central nervous system rather than by a persistent, active viral infection. The C57BL/6 model of persistent Powassan mimics illness in humans and can be used to study the mechanisms of chronic disease. IMPORTANCE Half of Powassan infection survivors experience long-term, mild to severe neurological symptoms. The progression from acute to chronic Powassan disease is not well understood, severely limiting treatment and prevention options. Infection of C57BL/6 mice with DTV mimics clinical disease in humans, and the mice exhibit CNS inflammation and viral RNA persistence until at least 86 dpi, while infectious virus is undetectable after 12 dpi. These findings suggest that the long-term neurological symptoms of chronic Powassan disease are in part due the persistence of viral RNA and the corresponding long-term inflammation of the brain and spinal cord. Our work demonstrates that C57BL/6 mice can be used to study the pathogenesis of chronic Powassan disease.
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Affiliation(s)
- Stacey L. P. Scroggs
- Biology of Vector-Borne Viruses Section, Laboratory of Virology, Rocky Mountain Laboratories, Division of Intramural Research, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana, USA
- Arthropod-Borne Animal Disease Research Unit, Center for Grain and Animal Health Research, Agricultural Research Service, United States Department of Agriculture, Manhattan, Kansas, USA
| | - Danielle K. Offerdahl
- Biology of Vector-Borne Viruses Section, Laboratory of Virology, Rocky Mountain Laboratories, Division of Intramural Research, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana, USA
| | - Philip E. Stewart
- Biology of Vector-Borne Viruses Section, Laboratory of Virology, Rocky Mountain Laboratories, Division of Intramural Research, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana, USA
| | - Carl Shaia
- Rocky Mountain Veterinary Branch, Rocky Mountain Laboratories, Division of Intramural Research, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana, USA
| | - Amanda J. Griffin
- Office of the Chief, Laboratory of Virology, Rocky Mountain Laboratories, Division of Intramural Research, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana, USA
| | - Marshall E. Bloom
- Biology of Vector-Borne Viruses Section, Laboratory of Virology, Rocky Mountain Laboratories, Division of Intramural Research, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana, USA
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11
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Thomas SJ. Is new dengue vaccine efficacy data a relief or cause for concern? NPJ Vaccines 2023; 8:55. [PMID: 37061527 PMCID: PMC10105158 DOI: 10.1038/s41541-023-00658-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 03/29/2023] [Indexed: 04/17/2023] Open
Abstract
Dengue is a major global public health problem requiring a safe and efficacious vaccine as the foundation of a comprehensive countermeasure strategy. Despite decades of attempts, the world has a single dengue vaccine licensed in numerous countries, but restrictions and conditions of its use have deterred uptake. Recently, clinical efficacy data has been revealed for two additional dengue vaccine candidates and the data appears encouraging. In this perspective I discuss dengue, the complexities of dengue vaccine development, early development setbacks, and how the latest data from the field may be cause for measured optimism. Finally, I provide some perspectives on evaluating dengue vaccine performance and how the pursuit of the perfect dengue vaccine may prevent advancement of vaccines which are good enough.
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Affiliation(s)
- Stephen J Thomas
- SUNY Upstate Medical University, Institute for Global Health and Translational Sciences, Syracuse, NY, USA.
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12
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Estimating Dengue Transmission Intensity in China Using Catalytic Models Based on Serological Data. Trop Med Infect Dis 2023; 8:tropicalmed8020116. [PMID: 36828532 PMCID: PMC9967418 DOI: 10.3390/tropicalmed8020116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/06/2023] [Accepted: 02/09/2023] [Indexed: 02/17/2023] Open
Abstract
In recent decades, the global incidence of dengue has risen sharply, with more than 75% of infected people showing mild or no symptoms. Since the year 2000, dengue in China has spread quickly. At this stage, there is an urgent need to fully understand its transmission intensity and spread in China. Serological data provide reliable evidence for symptomatic and recessive infections. Through a literature search, we included 23 studies that collected age-specific serological dengue data released from 1980 to 2021 in China. Fitting four catalytic models to these data, we distinguished the transmission mechanisms by deviation information criterion and estimated force of infection and basic reproduction number (R0), important parameters for quantifying transmission intensity. We found that transmission intensity varies over age in most of the study populations, and attenuation of antibody protection is identified in some study populations; the R0 of dengue in China is between 1.04-2.33. Due to the scarceness of the data, the temporal trend cannot be identified, but data shows that transmission intensity weakened from coastal to inland areas and from southern to northern areas in China if assuming it remained temporally steady during the study period. The results should be useful for the effective control of dengue in China.
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13
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Arthropod-Borne Flaviviruses in Pregnancy. Microorganisms 2023; 11:microorganisms11020433. [PMID: 36838398 PMCID: PMC9959669 DOI: 10.3390/microorganisms11020433] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/04/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023] Open
Abstract
Flaviviruses are a diverse group of enveloped RNA viruses that cause significant clinical manifestations in the pregnancy and postpartum periods. This review highlights the epidemiology, pathophysiology, clinical features, diagnosis, and prevention of the key arthropod-borne flaviviruses of concern in pregnancy and the neonatal period-Zika, Dengue, Japanese encephalitis, West Nile, and Yellow fever viruses. Increased disease severity during pregnancy, risk of congenital malformations, and manifestations of postnatal infection vary widely amongst this virus family and may be quite marked. Laboratory confirmation of infection is complex, especially due to the reliance on serology for which flavivirus cross-reactivity challenges diagnostic specificity. As such, a thorough clinical history including relevant geographic exposures and prior vaccinations is paramount for accurate diagnosis. Novel vaccines are eagerly anticipated to ameliorate the impact of these flaviviruses, particularly neuroinvasive disease manifestations and congenital infection, with consideration of vaccine safety in pregnant women and children pivotal. Moving forward, the geographical spread of flaviviruses, as for other zoonoses, will be heavily influenced by climate change due to the potential expansion of vector and reservoir host habitats. Ongoing 'One Health' engagement across the human-animal-environment interface is critical to detect and responding to emergent flavivirus epidemics.
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14
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Morrison AC, Paz-Soldan VA, Vazquez-Prokopec GM, Lambrechts L, Elson WH, Barrera P, Astete H, Briesemeister V, Leguia M, Jenkins SA, Long KC, Kawiecki AB, Reiner RC, Perkins TA, Lloyd AL, Waller LA, Hontz RD, Stoddard ST, Barker CM, Kitron U, Elder JP, Rothman AL, Scott TW. Quantifying heterogeneities in arbovirus transmission: Description of the rationale and methodology for a prospective longitudinal study of dengue and Zika virus transmission in Iquitos, Peru (2014-2019). PLoS One 2023; 18:e0273798. [PMID: 36730229 PMCID: PMC9894416 DOI: 10.1371/journal.pone.0273798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/15/2022] [Indexed: 02/03/2023] Open
Abstract
Current knowledge of dengue virus (DENV) transmission provides only a partial understanding of a complex and dynamic system yielding a public health track record that has more failures than successes. An important part of the problem is that the foundation for contemporary interventions includes a series of longstanding, but untested, assumptions based on a relatively small portion of the human population; i.e., people who are convenient to study because they manifest clinically apparent disease. Approaching dengue from the perspective of people with overt illness has produced an extensive body of useful literature. It has not, however, fully embraced heterogeneities in virus transmission dynamics that are increasingly recognized as key information still missing in the struggle to control the most important insect-transmitted viral infection of humans. Only in the last 20 years have there been significant efforts to carry out comprehensive longitudinal dengue studies. This manuscript provides the rationale and comprehensive, integrated description of the methodology for a five-year longitudinal cohort study based in the tropical city of Iquitos, in the heart of the Peruvian Amazon. Primary data collection for this study was completed in 2019. Although some manuscripts have been published to date, our principal objective here is to support subsequent publications by describing in detail the structure, methodology, and significance of a specific research program. Our project was designed to study people across the entire continuum of disease, with the ultimate goal of quantifying heterogeneities in human variables that affect DENV transmission dynamics and prevention. Because our study design is applicable to other Aedes transmitted viruses, we used it to gain insights into Zika virus (ZIKV) transmission when during the project period ZIKV was introduced and circulated in Iquitos. Our prospective contact cluster investigation design was initiated by detecttion of a person with a symptomatic DENV infection and then followed that person's immediate contacts. This allowed us to monitor individuals at high risk of DENV infection, including people with clinically inapparent and mild infections that are otherwise difficult to detect. We aimed to fill knowledge gaps by defining the contribution to DENV transmission dynamics of (1) the understudied majority of DENV-infected people with inapparent and mild infections and (2) epidemiological, entomological, and socio-behavioral sources of heterogeneity. By accounting for factors underlying variation in each person's contribution to transmission we sought to better determine the type and extent of effort needed to better prevent virus transmission and disease.
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Affiliation(s)
- Amy C. Morrison
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, Davis, California, United States of America
- * E-mail: ,
| | - Valerie A. Paz-Soldan
- Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, New Orleans, Lousiana, United States of America
| | | | - Louis Lambrechts
- Institut Pasteur, Université Paris Cité, CNRS UMR2000, Insect-Virus Interactions Unit, Paris, France
| | - William H. Elson
- Department of Entomology and Nematology, University of California Davis, Davis, California, United States of America
| | - Patricia Barrera
- Department of Entomology and Nematology, University of California Davis, Davis, California, United States of America
- Genomics Laboratory, Pontificia Universidad Católica del Peru, Lima, Peru
| | - Helvio Astete
- Virology and Emerging Infections Department, United States Naval Medical Research Unit No. 6, Lima, Peru
- Department of Entomology, United States Naval Medical Research Unit No. 6, Lima, Peru
| | - Veronica Briesemeister
- Department of Entomology and Nematology, University of California Davis, Davis, California, United States of America
| | - Mariana Leguia
- Genomics Laboratory, Pontificia Universidad Católica del Peru, Lima, Peru
| | - Sarah A. Jenkins
- Virology and Emerging Infections Department, United States Naval Medical Research Unit No. 6, Lima, Peru
| | - Kanya C. Long
- Department of Family Medicine and Public Health, University of California San Diego School of Medicine, La Jolla, California, United States of America
| | - Anna B. Kawiecki
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, Davis, California, United States of America
| | - Robert C. Reiner
- University of Washington, Seattle, Washington, United States of America
| | - T. Alex Perkins
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, Notre Dame, Indiana, United States of America
| | - Alun L. Lloyd
- Biomathematics Graduate Program and Department of Mathematics, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Lance A. Waller
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Robert D. Hontz
- Virology and Emerging Infections Department, United States Naval Medical Research Unit No. 6, Lima, Peru
| | - Steven T. Stoddard
- School of Public Health, San Diego State University, San Diego, California, United States of America
| | - Christopher M. Barker
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, Davis, California, United States of America
| | - Uriel Kitron
- Institut Pasteur, Université Paris Cité, CNRS UMR2000, Insect-Virus Interactions Unit, Paris, France
| | - John P. Elder
- School of Public Health, San Diego State University, San Diego, California, United States of America
| | - Alan L. Rothman
- Institute for Immunology and Informatics and Department of Cell and Molecular Biology, University of Rhode Island, Providence, Rhode Island, United States of America
| | - Thomas W. Scott
- Department of Entomology and Nematology, University of California Davis, Davis, California, United States of America
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Arbovirus Seroprevalence Study in Bangphae District, Ratchaburi Province, Thailand: Comparison between ELISA and a Multiplex Rapid Diagnostic Test (Chembio DPP® ZCD IgG). Trop Med Infect Dis 2022; 7:tropicalmed7110378. [DOI: 10.3390/tropicalmed7110378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/11/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022] Open
Abstract
Arboviruses, particularly dengue virus (DENV), Zika virus (ZIKV), and Chikungunya virus (CHIKV), pose a growing threat to global public health. For disease burden estimation and disease control, seroprevalence studies are paramount. This study was performed to determine the prevalence of DENV, ZIKV, and CHIKV on healthy individuals aged from 1–55 years old in Bangphae district, Ratchaburi province, Thailand. Enzyme-linked immunosorbent assays (ELISAs) and rapid diagnostic tests (RDTs) were performed on archived samples from a dengue serological survey conducted from 2012–2015. All 2012 samples had been previously tested using an anti-DENV immunoglobulin (Ig)G ELISA, and 400 randomly selected samples stratified by age, sex, and residential area were assessed by an in-house anti-ZIKV IgG ELISA and a commercial anti-CHIKV IgG ELISA to determine virus-specific antibody levels. An RDT (Chembio DPP® ZCD IgM/IgG System) was also used to investigate the presence of antibodies against DENV, ZIKV, or CHIKV. The ELISA results indicate that the seroprevalences of DENV, ZIKV, and CHIKV were 84.3%, 58.0%, and 22.5%, respectively. The youngest age group had the lowest seroprevalence for all three arboviruses, and the seroprevalences for these viruses were progressively higher with increasing participant age. The DPP® IgG sensitivities, as compared with ELISAs, for DENV, ZIKV, and CHIKV were relatively low, only 43.92%, 25.86%, and 37.78%, respectively. The ELISA results indicate that 16% of the study population was seropositive for all three viruses. DENV had the highest seroprevalence. ZIKV and CHIKV were also circulating in Bangphae district, Ratchaburi province, Thailand. The DPP® ZCD rapid test is not sensitive enough for use in seroprevalence studies.
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16
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Qualitative Analysis of the Transmission Dynamics of Dengue with the Effect of Memory, Reinfection, and Vaccination. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:7893570. [PMID: 36238487 PMCID: PMC9553356 DOI: 10.1155/2022/7893570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 07/14/2022] [Indexed: 11/17/2022]
Abstract
Dengue fever has a huge impact on people’s physical, social, and economic lives in low-income locations worldwide. Researchers use epidemic models to better understand the transmission patterns of dengue fever in order to recommend effective preventative measures and give data for vaccine and treatment development. We use fractional calculus to organise the transmission phenomena of dengue fever, including immunisation, reinfection, therapy, and asymptotic carriers. In addition, we focused our study on the dynamical behavior and qualitative approach of dengue infection. The existence and uniqueness of the solution of the suggested dengue dynamics are inspected through the fixed point theorems of Schaefer and Banach. The Ulam-Hyers stability of the suggested dengue model is established. To illustrate the contribution of the input factors on the system of dengue infection, the solution paths are studied using the Laplace Adomian decomposition approach. Furthermore, numerical simulations are used to show the effects of fractional-order, immunity loss, vaccination, asymptotic fraction, biting rate, and therapy. We have established that asymptomatic carriers, bite rates, and immunity loss rates are all important factors that might make controlling more challenging. The intensity of dengue fever may be controlled by reducing mosquito bite rates, whereas the asymptotic fraction is risky and can transmit the illness to noninfected regions. Vaccination, fractional order, index of memory, and medication can be employed as proper control parameters.
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17
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Huang Y, Forshee RA, Fares-Gusmao R, Chancey C, Rios M, Anderson SA, Yang H. A Risk Assessment Model for Transfusion Transmission of Dengue. Lett Appl Microbiol 2022; 75:1330-1335. [PMID: 35947088 DOI: 10.1111/lam.13802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 07/29/2022] [Accepted: 08/01/2022] [Indexed: 11/27/2022]
Abstract
Dengue virus (DENV) is a disease-causing agent normally transmitted from person to person through the bite of an infected mosquito. In addition to mosquito-borne cases of dengue, there are instances of transmission of dengue after receipt of blood products or donor organs or tissue. To improve blood safety, we developed a quantitative risk assessment model to estimate the dengue risk of transmission to blood transfusion recipients from preclinical and subclinical blood donors. We derived predictive coefficients from model simulations for predicting the risk outcomes such as monthly infectious blood units and transfusion-transmitted DENV cases based on the rate of reported clinical cases. The model was validated with a previous study where donor blood samples from the 2012 dengue transmission season in Rio de Janeiro, Brazil were tested for DENV RNA by a transcription-mediated amplification (TMA) assay. In that study about 69.4% donations were tested by the TMA assay and 78 samples were found positive, indicating that 112 DENV RNA-positive donations would have been detected if testing screening had been performed on all donations. Our model estimated a mean of 93 (2.5th%ile -97.5th%ile : 47 - 186) infected units among the donations, which was consistent with the reported numbers.
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Affiliation(s)
- Yin Huang
- FDA Center for Biologics Evaluation and Research, Office of Biostatistics and Pharmacovigilance
| | - Richard A Forshee
- FDA Center for Biologics Evaluation and Research, Office of Biostatistics and Pharmacovigilance
| | - Rafaelle Fares-Gusmao
- FDA Center for Biologics Evaluation and Research, Office of Blood Research and Review
| | - Caren Chancey
- FDA Center for Biologics Evaluation and Research, Office of Blood Research and Review
| | - Maria Rios
- FDA Center for Biologics Evaluation and Research, Office of Blood Research and Review
| | - Steven A Anderson
- FDA Center for Biologics Evaluation and Research, Office of Biostatistics and Pharmacovigilance
| | - Hong Yang
- FDA Center for Biologics Evaluation and Research, Office of Biostatistics and Pharmacovigilance
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Suresh KP, Nayak A, Dhanze H, Bhavya AP, Shivamallu C, Achar RR, Silina E, Stupin V, Barman NN, Kumar SK, Syed A, Kollur SP, Shreevatsa B, Patil SS. Prevalence of Japanese encephalitis (JE) virus in mosquitoes and animals of the Asian continent: A systematic review and meta-analysis. J Infect Public Health 2022; 15:942-949. [PMID: 35914358 DOI: 10.1016/j.jiph.2022.07.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/08/2022] [Accepted: 07/21/2022] [Indexed: 10/16/2022] Open
Abstract
BACKGROUND Japanese encephalitis (JE) is a viral zoonotic disease that has been found in several countries of Asia and is responsible for high mortality and morbidity of men and animals in rural and sub-urban endemic areas due to the virus re-circulation among diverse hosts and vectors. The present study estimates the prevalence of the JE virus in the vector and animal population of the Asian continent using a systematic review and meta-analysis. METHODS The Cochran collaborators' Preferred Reporting Items for Systematic Reviews and Meta-Analysis [PRISMA] guidelines were used for systematic review and meta-analysis. The heterogeneity was observed in meta-regression analysis due to several factors including region, species, and different diagnostic assays used in various studies. Thus we did sensitivity and subgroup analysis. RESULTS The prevalence of the JE virus was calculated using a total sample size of 47,391. Subgroup analysis revealed the JE virus prevalence of 39% in the Southeast Asia region, followed by East Asia with 35% and South Asia with 15% prevalence. Hence, the overall pooled prevalence of the JE virus was 26% in the Asian continent. CONCLUSIONS The highest proportion of infection was found in pigs amongst all animals, reinforcing the fact that they can be used as sentinels to predict outbreaks in humans. The findings of this study will enable researchers and policymakers in better understanding the disease's spatial and temporal distribution, as well as in creating and implementing location-specific JE prevention and control measures.
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Affiliation(s)
| | - Akshata Nayak
- ICAR-National Institute of Veterinary Epidemiology and Disease Informatics (NIVEDI), Bengaluru, Karnataka, India
| | - Himani Dhanze
- ICAR-Indian Veterinary Research Institute, Bareilly, UP, India
| | - Anenahalli Panduranga Bhavya
- ICAR-National Institute of Veterinary Epidemiology and Disease Informatics (NIVEDI), Bengaluru, Karnataka, India
| | - Chandan Shivamallu
- Department of Biotechnology and Bioinformatics, School of Life Sciences, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - Raghu Ram Achar
- Division of Biochemistry, School of Life Sciences, JSS Academy of Higher Education and Research, Mysuru, India
| | - Ekaterina Silina
- Department of Surgery, N.I. Pirogov National Research Medical University (RNRMU), Moscow, Russia
| | - Victor Stupin
- Department of Surgery, N.I. Pirogov National Research Medical University (RNRMU), Moscow, Russia
| | - Nagendra Nath Barman
- Department of Microbiology, College of Veterinary Sciences (AAU), Guwahati, Assam, India
| | - Seethakempanahalli Kempanna Kumar
- Department of Ethnoveterinary Sciences and Practices, The University of Trans-Disciplinary Health Science and Technology, Jarakabandekaval, Yelahanka, Bengaluru, India
| | - Asad Syed
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Shiva Prasad Kollur
- Department of Sciences, Amrita School of Arts and Sciences, Amrita Vishwa Vidyapeetham, Mysuru Campus, Mysuru, Karnataka, India
| | - Bhargav Shreevatsa
- Department of Biotechnology and Bioinformatics, School of Life Sciences, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - Sharanagouda S Patil
- ICAR-National Institute of Veterinary Epidemiology and Disease Informatics (NIVEDI), Bengaluru, Karnataka, India.
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Lima Chagas GC, Rangel AR, Noronha LM, Veloso FCS, Kassar SB, Oliveira MJC, Meneses GC, da Silva Junior GB, Daher EDF. Risk Factors for Mortality in Patients with Dengue: A Systematic Review and Meta-Analysis. Trop Med Int Health 2022; 27:656-668. [PMID: 35761748 DOI: 10.1111/tmi.13797] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate risk factors for mortality in dengue. METHODS Systematic review and meta-analysis searching MEDLINE, Embase, SciELO, LILACS Bireme, and OpenGrey to identify eligible observational studies of patients with dengue, of both genders, aged 14 years or older, that analyzed risk factors associated with mortality and reported adjusted risk measures with their respective confidence intervals (CIs). We estimated the pooled weighted mean difference and 95% CIs with a DerSimonian and Laird random-effects model. Methodological quality was assessed using the Newcastle-Ottawa Scale. RESULTS Of 1,170 citations reviewed, 18 papers, with a total of 25,851 patients, were included in the systematic review and 12 in the meta-analysis. Severe hepatitis (OR 29.222, 95% CI: 3.876-220.314), dengue shock syndrome (OR 23.575, 95% CI 3.664-151.702), altered mental status (OR 3.76, 95% CI 1.67-8.42), diabetes mellitus (OR 3.698, 95% CI 1.196-11.433), and higher pulse rate (OR 1.039, 95% CI 1.011-1.067) are associated with mortality in patients with dengue. All studies included were classified as having a high quality. CONCLUSIONS Proper identification and management of these risk factors should be considered to improve patient outcomes and reduce the hidden burden of this neglected tropical disease. Future well-designed studies are needed to investigate the association of other clinical, radiological, and laboratorial findings with mortality in dengue, as well as to develop prognostic models based on the risk factors found in our study.
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Affiliation(s)
- Gabriel Cavalcante Lima Chagas
- Federal University of Ceará, Faculty of Medicine, Department of Internal Medicine, Post-Graduation Program in Medical Sciences, Fortaleza, Brazil
| | - Amanda Ribeiro Rangel
- Federal University of Ceará, Faculty of Medicine, Department of Internal Medicine, Post-Graduation Program in Medical Sciences, Fortaleza, Brazil
| | - Luísa Macambira Noronha
- Federal University of Ceará, Faculty of Medicine, Department of Internal Medicine, Post-Graduation Program in Medical Sciences, Fortaleza, Brazil
| | - Felipe Camilo Santiago Veloso
- Federal University of Alagoas, Faculty of Medicine, Department of Internal Medicine, Post-Graduation Program in Medical Sciences, Maceió, Brazil
| | - Samir Buainain Kassar
- Federal University of Alagoas, Faculty of Medicine, Department of Internal Medicine, Post-Graduation Program in Medical Sciences, Maceió, Brazil
| | | | - Gdayllon Cavalcante Meneses
- Federal University of Ceará, Faculty of Medicine, Department of Internal Medicine, Post-Graduation Program in Medical Sciences, Fortaleza, Brazil
| | - Geraldo Bezerra da Silva Junior
- Federal University of Ceará, Faculty of Medicine, Department of Internal Medicine, Post-Graduation Program in Medical Sciences, Fortaleza, Brazil.,University of Fortaleza, School of Medicine, Health Sciences, Public Health and Medical Sciences Graduate Programs, Fortaleza, Brazil
| | - Elizabeth De Francesco Daher
- Federal University of Ceará, Faculty of Medicine, Department of Internal Medicine, Post-Graduation Program in Medical Sciences, Fortaleza, Brazil
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20
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Jan R, Shah Z, Deebani W, Alzahrani E. Analysis and dynamical behavior of a novel dengue model via fractional calculus. INT J BIOMATH 2022. [DOI: 10.1142/s179352452250036x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The infection of dengue is an intimidating vector-borne disease caused by a pathogenic agent that affects different temperature areas and brings many losses in human health and economy. Thus, it is valuable to identify the most influential parameters in the transmission process for the control of dengue to lessen these losses and to turn down the economic burden of dengue. In this research, we formulate the transmission phenomena of dengue infection with vaccination, treatment and reinfection via Atangana–Baleanu operator to thoroughly explore the intricate system of the disease. Furthermore, to come up with more realistic, dependable and valid results through fractional derivative rather than classical order derivative. The next-generation approach has been utilized to compute the basic reproduction number for the suggested fractional model, indicated by [Formula: see text]; moreover, we conducted sensitivity test of [Formula: see text] to recognize and point out the role of parameters on [Formula: see text]. Our numerical results predict that the reproduction number of the system of dengue infection can be controlled by controlling the index of memory. The uniqueness and existence result has been proved for the solution of the system. A novel numerical method is presented to highlight the time series of dengue system. Eventually, we get numerical results for different assumptions of [Formula: see text] with specifying factors to conceptualize the effect of [Formula: see text] on the dynamics. It has been noted that the fractional-order derivative offers realistic, clear-cut and valid information about the dynamics of dengue fever. Moreover, we note through our analysis that the input parameters’ index of memory, biting rate, transmission probability and recruitment rate of mosquitos can be used as control parameter to lower the level of infection.
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Affiliation(s)
- Rashid Jan
- Department of Mathematics, University of Swabi, Swabi 23561, KPK, Pakistan
| | - Zahir Shah
- Department of Mathematical Sciences, University of Lakki Marwat, Lakki Marwat 28420, KPK, Pakistan
| | - Wejdan Deebani
- Department of Mathematics, College of Science & Arts, King Abdulaziz University, P. O. Box 344, Rabigh 21911, Saudi Arabia
| | - Ebraheem Alzahrani
- Department of Mathematics, Faculty of Science, King Abdulaziz University, P. O. Box 80203, Jeddah 21589, Saudi Arabia
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21
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Selvarajoo S, Liew JWK, Chua TH, Tan W, Zaki RA, Ngui R, Sulaiman WYW, Ong PS, Vythilingam I. Dengue surveillance using gravid oviposition sticky (GOS) trap and dengue non-structural 1 (NS1) antigen test in Malaysia: randomized controlled trial. Sci Rep 2022; 12:571. [PMID: 35022501 PMCID: PMC8755775 DOI: 10.1038/s41598-021-04643-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 12/29/2021] [Indexed: 11/09/2022] Open
Abstract
Dengue remains a major public threat and existing dengue control/surveillance programs lack sensitivity and proactivity. More efficient methods are needed. A cluster randomized controlled trial was conducted for 18 months to determine the efficacy of using a combination of gravid oviposition sticky (GOS) traps and dengue non-structural 1 (NS1) antigen for early surveillance of dengue among Aedes mosquito. Eight residential apartments were randomly assigned into intervention and control groups. GOS traps were placed at the intervention apartments weekly to trap Aedes mosquitoes and these tested for dengue NS1 antigen. When dengue-positive pool was detected, the community were notified and advised to execute protective measures. Fewer dengue cases were recorded in the intervention group than the control. Detection of NS1-positive mosquitoes was significantly associated with GOS Aedes index (rs = 0.68, P < 0.01) and occurrence of dengue cases (rs = 0.31, P < 0.01). Participants' knowledge, attitude, and practice (KAP) toward dengue control indicated significant improvement for knowledge (P < 0.01), practice (P < 0.01) and total scores (P < 0.01). Most respondents thought this surveillance method is good (81.2%) and supported its use nationwide. Thus, GOS trap and dengue NS1 antigen test can supplement the current dengue surveillance/control, in alignment with the advocated integrated vector management for reducing Aedes-borne diseases.
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Affiliation(s)
- Sivaneswari Selvarajoo
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Jonathan Wee Kent Liew
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia.,Enviromental Health Institute, National Environment Agency, Singapore, 569874, Singapore
| | - Tock H Chua
- Department of Pathobiology and Medical Diagnostics, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Sabah, Malaysia
| | - Wing Tan
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Rafdzah Ahmad Zaki
- Department of Social and Preventive Medicine, Faculty of Medicine, Centre for Epidemiology and Evidence Based Practice, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Romano Ngui
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Wan Yusoff Wan Sulaiman
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Poo Soon Ong
- Petaling Jaya City Council, 46675, Petaling Jaya, Selangor, Malaysia
| | - Indra Vythilingam
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia.
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22
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Limkittikul K, Chanthavanich P, Lee KS, Lee JS, Chatchen S, Lim SK, Arunsodsai W, Yoon IK, Lim JK. Dengue virus seroprevalence study in Bangphae district, Ratchaburi, Thailand: A cohort study in 2012-2015. PLoS Negl Trop Dis 2022; 16:e0010021. [PMID: 34982768 PMCID: PMC8726468 DOI: 10.1371/journal.pntd.0010021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 11/24/2021] [Indexed: 11/18/2022] Open
Abstract
Background To determine the seroprevalence and transmission dynamics of dengue virus (DENV), age-stratified longitudinal serological surveys were conducted in Bangphae district, Ratchaburi province, Thailand, for 3 years between April 2012 and April 2015. Methodology The surveys enrolled 2012 healthy children and adults between 1 and 55 years-of-age, and a longitudinal serosurvey of six repeated bleeds of the same cohort of individuals was conducted every 8 months for the first 2 years (M0, M8, M16) and every half a year (M24, M30, M36) for the rest of the study period. All samples were tested using in-house indirect sandwich dengue IgG ELISA to determine DENV antibody titer, and 640 paired samples which showed rising of DENV IgG titers in paired serum were further tested using in-house neutralization assay, Plaque Reduction Neutralization Test (PRNT50). Principal findings When compared against the gold standard based on the results of PRNT50, sensitivity and specificity of indirect ELISA were found to be both about 85%. The overall DENV IgG positivity determined by ELISA was 74.3% in 2012 and increased to 79.4% by the final sample collection in 2015. In our study sample, more than 98% of subjects older than 25 years were found to be seropositive. Among 518 IgG negative subjects at enrollment, the seroconversion rates were measured in paired bleeds; the rates (between successive visits, approximately 6 months) ranged between 4.8% (between M16 and M24) and 14.7% (between M0 and M8). The dominant serotype of primary DENV infection cases based on seroconversion was identified from the PRNT results and it was DENV-2. Conclusions Our study documented high levels of seroprevalence and rate of transmission. Given the importance of the serostatus and disease burden in consideration for dengue vaccine introduction, our data could be used in decision-making on implementation of various dengue control and preventive measures. To estimate the proportion of individuals with past exposure to dengue virus (DENV), we conducted repeated serological surveys in Bangphae district, Ratchaburi province, Thailand, between April 2012 and April 2015. About 45% of the subjects were under 15 years-of-age. The surveys enrolled 2012 healthy individuals between 1 and 55 years-of-age, and a longitudinal serosurvey of six repeated bleeds of the same cohort of individuals was conducted approximately every 6 months. All samples were tested using an indirect dengue IgG ELISA and a subset of paired samples which showed rising of IgG values in pairs were tested using neutralization assay, used as the gold standard. When compared against the gold standard, sensitivity and specificity of indirect ELISA were found to be both 85%. The proportion of the study population with past DENV infection measured by IgG ELISA was 74.3% in 2012 and increased to 79.4% by 2015. More than 98% of subjects older than 25 years showed to have past exposure to dengue. Among 518 subjects without past exposure, the rate of getting infection was between 4.8–14.7% (between successive visits, approximately 6 months). The dominant serotype was DENV-2. The level of proportion of individuals with past DENV infection is an important consideration, and our data could be used in decision-making for dengue vaccine introduction.
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Affiliation(s)
- Kriengsak Limkittikul
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Pornthep Chanthavanich
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Kang Sung Lee
- International Vaccine Institute, Seoul, Republic of Korea
| | - Jung-Seok Lee
- International Vaccine Institute, Seoul, Republic of Korea
| | - Supawat Chatchen
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Sl-Ki Lim
- International Vaccine Institute, Seoul, Republic of Korea
| | - Watcharee Arunsodsai
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - In-Kyu Yoon
- Coalition for Epidemic Preparedness Innovations, Washington, DC, United States of America
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23
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Islam MT, Quispe C, Herrera-Bravo J, Sarkar C, Sharma R, Garg N, Fredes LI, Martorell M, Alshehri MM, Sharifi-Rad J, Daştan SD, Calina D, Alsafi R, Alghamdi S, Batiha GES, Cruz-Martins N. Production, Transmission, Pathogenesis, and Control of Dengue Virus: A Literature-Based Undivided Perspective. BIOMED RESEARCH INTERNATIONAL 2021; 2021:4224816. [PMID: 34957305 PMCID: PMC8694986 DOI: 10.1155/2021/4224816] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 11/11/2021] [Accepted: 11/26/2021] [Indexed: 12/18/2022]
Abstract
Dengue remains one of the most serious and widespread mosquito-borne viral infections in human beings, with serious health problems or even death. About 50 to 100 million people are newly infected annually, with almost 2.5 billion people living at risk and resulting in 20,000 deaths. Dengue virus infection is especially transmitted through bites of Aedes mosquitos, hugely spread in tropical and subtropical environments, mostly found in urban and semiurban areas. Unfortunately, there is no particular therapeutic approach, but prevention, adequate consciousness, detection at earlier stage of viral infection, and appropriate medical care can lower the fatality rates. This review offers a comprehensive view of production, transmission, pathogenesis, and control measures of the dengue virus and its vectors.
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Affiliation(s)
- Muhammad Torequl Islam
- Department of Pharmacy, Life Science Faculty, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj (Dhaka)8100, Bangladesh
| | - Cristina Quispe
- Facultad de Ciencias de la Salud, Universidad Arturo Prat, Avda. Arturo Prat 2120, Iquique 1110939, Chile
| | - Jesús Herrera-Bravo
- Departamento de Ciencias Básicas, Facultad de Ciencias, Universidad Santo Tomas, Chile
- Center of Molecular Biology and Pharmacogenetics, Scientific and Technological Bioresource Nucleus, Universidad de La Frontera, Temuco 4811230, Chile
| | - Chandan Sarkar
- Department of Pharmacy, Life Science Faculty, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj (Dhaka)8100, Bangladesh
| | - Rohit Sharma
- Department of Rasa Shastra & Bhaishajya Kalpana, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221005, Uttar Pradesh, India
| | - Neha Garg
- Department of Medicinal Chemistry, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221005, Uttar Pradesh, India
| | | | - Miquel Martorell
- Department of Nutrition and Dietetics, Faculty of Pharmacy, and Centre for Healthy Living, University of Concepción, 4070386 Concepción, Chile
- Universidad de Concepción, Unidad de Desarrollo Tecnológico, UDT, Concepción 4070386, Chile
| | - Mohammed M. Alshehri
- Pharmaceutical Care Department, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | | | - Sevgi Durna Daştan
- Department of Biology, Faculty of Science, Sivas Cumhuriyet University, 58140 Sivas, Turkey
- Beekeeping Development Application and Research Center, Sivas Cumhuriyet University, 58140 Sivas, Turkey
| | - Daniela Calina
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Radi Alsafi
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Saad Alghamdi
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, Egypt
| | - Natália Cruz-Martins
- Faculty of Medicine, University of Porto, Porto, Portugal
- Institute for Research and Innovation in Health (i3S), University of Porto, Porto, Portugal
- Institute of Research and Advanced Training in Health Sciences and Technologies (CESPU), Rua Central de Gandra, 1317, 4585-116 Gandra PRD, Portugal
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24
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Ahmad J, Ahmad M, Usman ARA, Al-Wabel MI. Prevalence of human pathogenic viruses in wastewater: A potential transmission risk as well as an effective tool for early outbreak detection for COVID-19. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2021; 298:113486. [PMID: 34391102 PMCID: PMC8352675 DOI: 10.1016/j.jenvman.2021.113486] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 08/01/2021] [Accepted: 08/05/2021] [Indexed: 05/09/2023]
Abstract
Millions of human pathogenic viral particles are shed from infected individuals and introduce into wastewater, subsequently causing waterborne diseases worldwide. These viruses can be transmitted from wastewater to human beings via direct contact and/or ingestion/inhalation of aerosols. Even the advanced wastewater treatment technologies are unable to remove pathogenic viruses from wastewater completely, posing a serious health risk. Recently, coronavirus disease 2019 (COVID-19) has been urged globally due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which has resulted in >4.1 million deaths until July 2021. A rapid human-to-human transmission, uncertainties in effective vaccines, non-specific medical treatments, and unclear symptoms compelled the world into complete lockdown, social distancing, air-travel suspension, and closure of educational institutions, subsequently damaging the global economy and trade. Although, few medical treatments, rapid detection tools, and vaccines have been developed so far to curb the spread of COVID-19; however, several uncertainties exist in their applicability. Further, the acceptance of vaccines among communities is lower owing to the fear of side effects such as blood-clotting and heart inflammation. SARS-CoV-2, an etiologic agent of COVID-19, has frequently been detected in wastewater, depicting a potential transmission risk to healthy individuals. Contrarily, the occurrence of SARS-CoV-2 in wastewater can be used as an early outbreak detection tool via water-based epidemiology. Therefore, the spread of SARS-CoV-2 through fecal-oral pathway can be reduced and any possible outbreak can be evaded by proper wastewater surveillance. In this review, wastewater recycling complications, potential health risks of COVID-19 emergence, and current epidemiological measures to control COVID-19 spread have been discussed. Moreover, the viability of SARS-CoV-2 in various environments and survival in wastewater has been reviewed. Additionally, the necessary actions (vaccination, face mask, social distancing, and hand sanitization) to limit the transmission of SARS-CoV-2 have been recommended. Therefore, wastewater surveillance can serve as a feasible, efficient, and reliable epidemiological measure to lessen the spread of COVID-19.
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Affiliation(s)
- Jahangir Ahmad
- Soil Sciences Department, College of Food and Agricultural Sciences, King Saud University, P.O. Box 2460, Riyadh, 11451, Saudi Arabia
| | - Munir Ahmad
- Soil Sciences Department, College of Food and Agricultural Sciences, King Saud University, P.O. Box 2460, Riyadh, 11451, Saudi Arabia
| | - Adel R A Usman
- Soil Sciences Department, College of Food and Agricultural Sciences, King Saud University, P.O. Box 2460, Riyadh, 11451, Saudi Arabia; Department of Soils and Water, Faculty of Agriculture, Assiut University, Assiut, 71526, Egypt
| | - Mohammad I Al-Wabel
- Soil Sciences Department, College of Food and Agricultural Sciences, King Saud University, P.O. Box 2460, Riyadh, 11451, Saudi Arabia; Department of Science and Environmental Studies, The Education University of Hong Kong, Hong Kong.
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25
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Cilião-Alves DC, Barcelos SMD, Bezerra ALO, Almeida IS, Silveira JVM, Alencar JPD, Pimentel BMS, Araújo WND, Haddad R. High seroprevalence of anti-DENV IgM in blood donors in an early outbreak in the Federal District of Brazil, 2019. J Med Microbiol 2021; 70. [PMID: 34668855 DOI: 10.1099/jmm.0.001444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Dengue is endemic in Brazil, and several Brazilian cities are affected by frequent seasonal outbreaks of the disease. During the outbreaks the possibility of transfusion-transmitted dengue (TTD) is increased, mainly by the presence of asymptomatic or oligosymptomatic infections in eligible blood donors. The retrospective assessment of anti-DENV IgM and NS1 seroprevalence during a given time interval may indicate the need for measures for the previous screening of DENV infection in blood donors. In this context, we performed retrospective screening for anti-DENV IgM and NS1 in blood donors from the Federal District of Brazil during the early outbreak that occurred in 2019, the largest outbreak in recent years. In total, 450 blood donations were screened for anti-DENV IgM and DENV NS1 using commercial enzyme-linked immunosorbent assay kits (Panbio Dengue IgM Capture ELISA and Platelia Dengue NS1 Ag, respectively). Among the tested plasma samples, 16 % (72/450) presented anti-DENV IgM; no samples presented DENV NS1. Despite the apparent absence of antigenaemia in tested blood donations, the high prevalence of anti-DENV IgM highlights the importance of DENV screening in blood donors, principally during outbreak periods.
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Affiliation(s)
| | | | | | | | | | | | | | - Wildo Navegantes de Araújo
- Faculty of Ceilândia, University of Brasilia, Federal District, Brazil.,Center for Tropical Medicine, University of Brasilia, Federal District, Brazil
| | - Rodrigo Haddad
- Faculty of Ceilândia, University of Brasilia, Federal District, Brazil.,Center for Tropical Medicine, University of Brasilia, Federal District, Brazil
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26
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A Cluster of Dengue Cases in Travelers: A Clinical Series from Thailand. Trop Med Infect Dis 2021; 6:tropicalmed6030152. [PMID: 34449752 PMCID: PMC8396219 DOI: 10.3390/tropicalmed6030152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/11/2021] [Accepted: 08/12/2021] [Indexed: 12/19/2022] Open
Abstract
Dengue is an overlooked tropical disease for which billions of people are at risk. The disease, caused by a Flavivirus with four distinct serotypes, is transmitted primarily by urban Aedes mosquito species. The infection leads to a spectrum of clinical manifestations, with the majority being asymptomatic. Primary dengue fever and, to a greater extent, a subsequent infection with a different serotype is associated with increased severity. Increased global travel and recreational tourism expose individuals naïve to the dengue viruses, the most common arboviral infections among travelers. We describe a cluster of possible primary acute dengue infections in a group of 12 individuals who presented to Bangkok Hospital for Tropical Diseases in 2017. Infection was confirmed by dengue NS1 antigen and multiplex real-time RT-PCR. Nine individuals required hospitalization, and four developed dengue warning signs. Leukocytes, neutrophils, and platelets declined towards defervescence and were negatively correlated with day of illness. Six clinical isolates were identified as dengue serotype-1, with 100% nucleotide identity suggesting that these patients were infected with the same virus.
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27
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Sanchez-Vargas LA, Anderson KB, Srikiatkhachorn A, Currier JR, Friberg H, Endy TP, Fernandez S, Mathew A, Rothman AL. Longitudinal Analysis of Dengue Virus-Specific Memory T Cell Responses and Their Association With Clinical Outcome in Subsequent DENV Infection. Front Immunol 2021; 12:710300. [PMID: 34394112 PMCID: PMC8355709 DOI: 10.3389/fimmu.2021.710300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 07/14/2021] [Indexed: 11/13/2022] Open
Abstract
Memory T cells resulting from primary dengue virus (DENV) infection are hypothesized to influence the clinical outcome of subsequent DENV infection. However, the few studies involving prospectively collected blood samples have found weak and inconsistent associations with outcome and variable temporal trends in DENV-specific memory T cell responses between subjects. This study used both ex-vivo and cultured ELISPOT assays to further evaluate the associations between DENV serotype-cross-reactive memory T cells and severity of secondary infection. Using ex-vivo ELISPOT assays, frequencies of memory T cells secreting IFN-γ in response to DENV structural and non-structural peptide pools were low in PBMC from multiple time points prior to symptomatic secondary DENV infection and showed a variable response to infection. There were no differences in responses between subjects who were not hospitalized (NH, n=6) and those who were hospitalized with dengue hemorrhagic fever (hDHF, n=4). In contrast, responses in cultured ELISPOT assays were more reliably detectable prior to secondary infection and showed more consistent increases after infection. Responses in cultured ELISPOT assays were higher in individuals with hDHF (n=8) compared to NH (n=9) individuals before the secondary infection, with no difference between these groups after infection. These data demonstrate an association of pre-existing DENV-specific memory responses with the severity of illness in subsequent DENV infection, and suggest that frequencies of DENV-reactive T cells measured after short-term culture may be of particular importance for assessing the risk for more severe dengue disease.
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Affiliation(s)
- Luis Alberto Sanchez-Vargas
- Department of Cell and Molecular Biology, Institute for Immunology and Informatics, University of Rhode Island, Providence, RI, United States
| | - Kathryn B Anderson
- Department of Medicine, Department of Microbiology and Immunology, Institute for Global Health and Translational Sciences, State University of New York-Upstate Medical University, Syracuse, NY, United States
| | - Anon Srikiatkhachorn
- Department of Cell and Molecular Biology, Institute for Immunology and Informatics, University of Rhode Island, Providence, RI, United States.,Faculty of Medicine, King Mongkut's Institute of Technology Ladkrabang, Bangkok, Thailand
| | - Jeffrey R Currier
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | - Heather Friberg
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | - Timothy P Endy
- Department of Medicine, Department of Microbiology and Immunology, Institute for Global Health and Translational Sciences, State University of New York-Upstate Medical University, Syracuse, NY, United States
| | - Stefan Fernandez
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Anuja Mathew
- Department of Cell and Molecular Biology, Institute for Immunology and Informatics, University of Rhode Island, Providence, RI, United States
| | - Alan L Rothman
- Department of Cell and Molecular Biology, Institute for Immunology and Informatics, University of Rhode Island, Providence, RI, United States
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28
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Perera L, De Zoysa N, Jayarajah U, Senanayake N, De Zoysa I, Seneviratne SL. Transfusion-transmissible dengue infections. Trans R Soc Trop Med Hyg 2021; 114:866-882. [PMID: 32879985 DOI: 10.1093/trstmh/traa075] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/24/2020] [Accepted: 08/03/2020] [Indexed: 12/16/2022] Open
Abstract
Dengue is an important global health problem and is endemic in many developing and developed countries. Transmission of dengue may occur in several ways and information on transfusion-transmitted dengue is limited. We conducted a literature search on transfusion-related dengue using the PubMed, Scopus, Embase and Google Scholar databases and have summarized the findings. A number of apparently healthy blood donors have been found to be infected with the dengue virus (DENV) and thus may transmit the virus onto recipients of this blood. It is not possible to identify and exclude such donors at the donor selection stage and thus reliable screening tests should be available in highly endemic areas to ensure a safe blood supply.
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Affiliation(s)
- Lakshika Perera
- Department of Surgery, Faculty of Medicine, University of Colombo, Colombo 8, Sri Lanka.,Dengue Research Group, Colombo, Sri Lanka
| | | | - Umesh Jayarajah
- Department of Surgery, Faculty of Medicine, University of Colombo, Colombo 8, Sri Lanka.,Dengue Research Group, Colombo, Sri Lanka
| | - Nilanthi Senanayake
- Department of Microbiology, Faculty of Medicine, University of Colombo, Colombo 8, Sri Lanka
| | - Ishan De Zoysa
- Department of Surgery, Faculty of Medicine, University of Colombo, Colombo 8, Sri Lanka.,Dengue Research Group, Colombo, Sri Lanka
| | - Suranjith L Seneviratne
- Department of Surgery, Faculty of Medicine, University of Colombo, Colombo 8, Sri Lanka.,Dengue Research Group, Colombo, Sri Lanka
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29
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Buddhari D, Anderson KB, Gromowski GD, Jarman RG, Iamsirithaworn S, Thaisomboonsuk B, Hunsawong T, Srikiatkhachorn A, Rothman AL, Jones AR, Fernandez S, Thomas SJ, Endy TP. Correlation between reported dengue illness history and seropositivity in rural Thailand. PLoS Negl Trop Dis 2021; 15:e0009459. [PMID: 34129599 PMCID: PMC8232416 DOI: 10.1371/journal.pntd.0009459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 06/25/2021] [Accepted: 05/10/2021] [Indexed: 11/19/2022] Open
Abstract
In the latest World Health Organization (WHO) recommendation for Dengvaxia implementation, either serological testing or a person's history of prior dengue illness may be used as supporting evidence to identify dengue virus (DENV)-immune individuals eligible for vaccination, in areas with limited capacity for laboratory confirmation. This analysis aimed to estimate the concordance between self-reported dengue illness histories and seropositivity in a prospective cohort study for dengue virus infection in Kamphaeng Phet province, a dengue-endemic area in northern Thailand. The study enrolled 2,076 subjects from 516 multigenerational families, with a median age of 30.6 years (range 0-90 years). Individual and family member dengue illness histories were obtained by questionnaire. Seropositivity was defined based on hemagglutination inhibition (HAI) assays. Overall seropositivity for DENV was 86.5% among those aged 9-45 years, which increased with age. 18.5% of participants reported a history of dengue illness prior to enrollment; 30.1% reported a previous DENV infection in the family, and 40.1% reported DENV infection in either themselves or a family member. Relative to seropositivity by HAI in the vaccine candidate group, the sensitivity and specificity of individual prior dengue illness history were 18.5% and 81.6%, respectively; sensitivity and specificity of reported dengue illness in a family member were 29.8% and 68.0%, and of either the individual or a family member were 40.1% and 60.5%. Notably, 13.4% of individuals reporting prior dengue illness were seronegative. Given the high occurrence of asymptomatic and mild DENV infection, self-reported dengue illness history is poorly sensitive for prior exposure and may misclassify individuals as 'exposed' when they were not. This analysis highlights that a simple, highly sensitive, and highly specific test for determining serostatus prior to Dengvaxia vaccination is urgently needed.
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Affiliation(s)
- Darunee Buddhari
- Department of Virology, USAMD-AFRIMS, Bangkok, Thailand
- * E-mail:
| | - Kathryn B. Anderson
- Department of Virology, USAMD-AFRIMS, Bangkok, Thailand
- State University of New York Upstate Medical University, Syracuse, New York, United States of America
| | | | - Richard G. Jarman
- Walter Reed Army Institute of Research, Silver Spring, Maryland, United States
| | | | | | | | - Anon Srikiatkhachorn
- University of Rhode Island, Providence, Rhode Island, United States of America
- Faculty of Medicine, King Mongkut’s Institute of Technology Ladkrabang, Bangkok, Thailand
| | - Alan L. Rothman
- University of Rhode Island, Providence, Rhode Island, United States of America
| | | | | | - Stephen J. Thomas
- State University of New York Upstate Medical University, Syracuse, New York, United States of America
| | - Timothy P. Endy
- State University of New York Upstate Medical University, Syracuse, New York, United States of America
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30
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Rathore APS, Mantri CK, Tan MW, Shirazi R, Nishida A, Aman SAB, Morrison J, St John AL. Immunological and Pathological Landscape of Dengue Serotypes 1-4 Infections in Immune-Competent Mice. Front Immunol 2021; 12:681950. [PMID: 34168651 PMCID: PMC8219075 DOI: 10.3389/fimmu.2021.681950] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/18/2021] [Indexed: 11/13/2022] Open
Abstract
Dengue virus (DENV), a Flavivirus, causes a broad spectrum of disease in humans with key clinical signs including thrombocytopenia, vascular leakage and hemorrhaging. A major obstacle to understanding DENV immunity has been the lack of a validated immune-competent mouse model. Here, we report the infection profiles of human clinical isolates of DENV serotypes 1-4 in an immune-competent mouse model. We detected replicating DENV in the peritoneal cells, liver and the spleen that was generally resolved within 2 weeks. The DENV target cell types for infection were monocytes/macrophages, dendritic cells, endothelial cells, and we identified a novel DENV cellular target, fibroblast reticular cells of the spleen. We observed gross pathologies in the spleen and liver that are consistent with dengue disease, including hemorrhaging as well as transcriptional patterns suggesting that antiviral responses and tissue damage were induced. Key clinical blood parameters that define human DENV disease such as hemoconcentration, leukopenia and reduced number of platelets were also observed. Thus, immune-competent mice sustain replicating infection and experience signs, such as hemorrhaging, that define DENV disease in humans. This study thoroughly characterizes DENV1-4 infection in immune-competent mice and confirms the wild-type mouse model as a valid and reproducible system for investigating the mechanisms of DENV pathogenesis.
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Affiliation(s)
- Abhay P S Rathore
- Program in Emerging Infectious Diseases, Duke-National University of Singapore, Singapore, Singapore
| | - Chinmay K Mantri
- Program in Emerging Infectious Diseases, Duke-National University of Singapore, Singapore, Singapore
| | - Meredith W Tan
- Program in Emerging Infectious Diseases, Duke-National University of Singapore, Singapore, Singapore
| | - Roksana Shirazi
- Department of Microbiology and Plant Pathology, University of California, Riverside, CA, United States
| | - Andrew Nishida
- Department of Microbiology, University of Washington, Seattle, WA, United States
| | - Siti A B Aman
- Program in Emerging Infectious Diseases, Duke-National University of Singapore, Singapore, Singapore
| | - Juliet Morrison
- Department of Microbiology and Plant Pathology, University of California, Riverside, CA, United States
| | - Ashley L St John
- Program in Emerging Infectious Diseases, Duke-National University of Singapore, Singapore, Singapore.,Department of Pathology, Duke University Medical Center, Durham, NC, United States.,Department of Microbiology and Immunology, Young Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Lim JK, Chanthavanich P, Limkittikul K, Lee JS, Sirivichayakul C, Lee KS, Lim SK, Yoon IK, Hattasingh W. Clinical and epidemiologic characteristics associated with dengue fever in 2011-2016 in Bang Phae district, Ratchaburi province, Thailand. PLoS Negl Trop Dis 2021; 15:e0009513. [PMID: 34191799 PMCID: PMC8244866 DOI: 10.1371/journal.pntd.0009513] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 05/28/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Dengue is a major public health problem in Thailand, but data are often focused on certain dengue-endemic areas. Methods: To better understand dengue epidemiology and clinical characteristics in Thailand, a fever surveillance study was conducted among patients aged 1-55 years, who presented with non-localized febrile illness at Bang Phae Community Hospital in Ratchaburi province, Thailand from October 2011 to September 2016. RESULTS Among 951 febrile episodes, 130 were dengue-confirmed. Individuals aged 10-14 years were mostly affected, followed by those 15-19 years-of-age, with about 15% of dengue-confirmed cases from adults 25 years and older. There were annual peaks of dengue occurrence between June-November. Most prevalent serotype in circulation was DENV-2 in 2012, DENV-3 in 2014, and DENV-4 & -3 in 2015. Among dengue cases, 65% were accurately detected using the dengue NS1 RDT. Detection rate was similar between secondary and primary dengue cases where 66% of secondary vs. 60% of primary dengue cases had positive results on the NS1 RDT. Among dengue cases, 66% were clinically diagnosed with suspected dengue or DHF, prior to lab confirmation. Dengue was positively associated with rash, headache, hematemesis and alterations to consciousness, when compared to non-dengue. Dengue patients were 10.6 times more likely to be hospitalized, compared to non-dengue cases. Among dengue cases, 95 were secondary and 35 were primary infections. There were 8 suspected DHF cases and all were identified to be secondary dengue. Secondary dengue cases were 3.5 times more likely to be hospitalized compared to primary dengue cases. Although the majority of our dengue-positive patients were secondary dengue cases, with few patients showing manifestations of DHF, our dengue cases were mostly mild disease. Even among children < 10 years-of-age, 61% had secondary infection and the rate of secondary infection increased with age. CONCLUSION While the majority of dengue-confirmed cases were children, almost three-quarters of dengue-confirmed cases in this study were secondary dengue. Our study results consistent with previous data from the country confirm the hyperendemic transmission of DENV in Thailand, even in the non-epidemic years. With various interventions becoming available for dengue prevention and control, including dengue vaccines, decision-making on future implementation strategies should be based on such burden of disease data.
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Affiliation(s)
| | | | | | - Jung-Seok Lee
- International Vaccine Institute, Seoul, Republic of Korea
| | | | - Kang Sung Lee
- International Vaccine Institute, Seoul, Republic of Korea
| | - Sl-Ki Lim
- International Vaccine Institute, Seoul, Republic of Korea
| | - In-Kyu Yoon
- Coalition for Epidemic Preparedness Innovations (CEPI), Oslo, Norway
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Kyaw AK, Ngwe Tun MM, Naing ST, Htwe TT, Mar TT, Khaing TM, Aung T, Aye KS, Thant KZ, Morita K. Inapparent dengue virus infection among students in Mandalay, Myanmar. Trans R Soc Trop Med Hyg 2021; 114:57-61. [PMID: 31638146 DOI: 10.1093/trstmh/trz071] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 06/18/2019] [Accepted: 07/02/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND A school- and laboratory-based cross-sectional descriptive study was conducted to find out the burden of inapparent dengue virus (DENV) infection in Mandalay where DENV is endemic and there is circulation of all four DENV serotypes. METHODS A total of 420 students who had no history of fever and visited the hospital within 6 months were recruited from three monastic schools. Serum samples were collected and the DENV genome was checked by conventional one-step RT-PCR and anti-DENV IgM and IgG antibodies were determined. Inapparent dengue (DEN) infection is defined as individuals who were either RT-PCR-positive or anti-DENV IgM-positive with no clinical manifestations or mild symptoms, and which are not linked to a visit to a healthcare provider. RESULTS Among 420 students, 38 students (9.0%, 95% CI, 6.4 to 12.2) were confirmed as recent inapparent DEN infection. The DENV serotype-1 was detected in six students. Thirty-one out of 38 (81.6%) laboratory-confirmed inapparent DEN-infected students had primary infections and seven (18.4%) had secondary infections. CONCLUSION This study explored the prevalence of inapparent DEN infection rate in urban monastic schools in Mandalay and showed that the rate of primary infection among inapparent DENV-infected children was high.
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Affiliation(s)
- Aung Kyaw Kyaw
- Department of Medical Research, Pyin Oo Lwin Branch, Ward No (16), Near Anisakhan Airport, Pyin Oo Lwin, Mandalay Region, Myanmar, PO-05062
| | - Mya Myat Ngwe Tun
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto Nagasaki, Japan, PO 852-8523
| | - Shine Thura Naing
- Department of Medical Research, Pyin Oo Lwin Branch, Ward No (16), Near Anisakhan Airport, Pyin Oo Lwin, Mandalay Region, Myanmar, PO-05062
| | - Thein Thein Htwe
- Department of Medical Research, Pyin Oo Lwin Branch, Ward No (16), Near Anisakhan Airport, Pyin Oo Lwin, Mandalay Region, Myanmar, PO-05062
| | - Tu Tu Mar
- Department of Medical Research, Pyin Oo Lwin Branch, Ward No (16), Near Anisakhan Airport, Pyin Oo Lwin, Mandalay Region, Myanmar, PO-05062
| | - Tin Moe Khaing
- Department of Medical Research, Pyin Oo Lwin Branch, Ward No (16), Near Anisakhan Airport, Pyin Oo Lwin, Mandalay Region, Myanmar, PO-05062
| | - Thidar Aung
- Department of Medical Research, Pyin Oo Lwin Branch, Ward No (16), Near Anisakhan Airport, Pyin Oo Lwin, Mandalay Region, Myanmar, PO-05062
| | - Khin Saw Aye
- Department of Medical Research, Pyin Oo Lwin Branch, Ward No (16), Near Anisakhan Airport, Pyin Oo Lwin, Mandalay Region, Myanmar, PO-05062
| | - Kyaw Zin Thant
- Department of Medical Research, Pyin Oo Lwin Branch, Ward No (16), Near Anisakhan Airport, Pyin Oo Lwin, Mandalay Region, Myanmar, PO-05062
| | - Kouichi Morita
- Department of Medical Research, Pyin Oo Lwin Branch, Ward No (16), Near Anisakhan Airport, Pyin Oo Lwin, Mandalay Region, Myanmar, PO-05062
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Rajan JV, McCracken M, Mandel-Brehm C, Gromowski G, Pollett S, Jarman R, DeRisi JL. Phage display demonstrates durable differences in serological profile by route of inoculation in primary infections of non-human primates with Dengue Virus 1. Sci Rep 2021; 11:10823. [PMID: 34031504 PMCID: PMC8144558 DOI: 10.1038/s41598-021-90318-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 04/29/2021] [Indexed: 11/21/2022] Open
Abstract
Natural dengue virus (DENV) infections occur by mosquito bite but how the inoculation route affects the humoral immune response is unknown. We serologically profiled 20 non-human primates (NHP) from a prior study of DENV1 infection where animals were inoculated by mosquito (N = 10) or subcutaneous injection (N = 10). Using a comprehensive, densely tiled and highly redundant pan-flavivirus programmable phage library containing 91,562 overlapping 62 amino acid peptides, we produced a high-resolution map of linear peptide sequences enriched during DENV seroconversion. Profiles in mosquito-inoculated and subcutaneously-inoculated animals were similar up to 90 days after primary infection, but diverged at 1 year with differences in sero-reactivity in the Envelope (E; residues 215–406; p < 0.08), and Nonstructural-3 (NS3; residues 549–615; p < 0.05) proteins in mosquito-inoculated versus subcutaneously-inoculated animals. Within the E protein, residues 339–384 in domain III accounted for > 99% of the observed sero-reactivity difference. Antibody breadth did not vary by mode of inoculation. The differential reactivity to E domain III seen by phage display validated orthogonally by ELISA, but did not correlate with late neutralization titers. Serological profiling of humoral immune responses to DENV infection in NHP by programmable phage display demonstrated durable differences in sero-reactivity by route of inoculation.
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Affiliation(s)
- Jayant V Rajan
- University of California, San Francisco, San Francisco, CA, USA.
| | | | | | - Greg Gromowski
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Simon Pollett
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Richard Jarman
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Joseph L DeRisi
- University of California, San Francisco, San Francisco, CA, USA.,Chan-Zuckerberg Biohub, San Francisco, CA, USA
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Srivastava HM, Jan R, Jan A, Deebani W, Shutaywi M. Fractional-calculus analysis of the transmission dynamics of the dengue infection. CHAOS (WOODBURY, N.Y.) 2021; 31:053130. [PMID: 34240948 DOI: 10.1063/5.0050452] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 04/29/2021] [Indexed: 06/13/2023]
Abstract
In this research paper, a novel approach in dengue modeling with the asymptomatic carrier and reinfection via the fractional derivative is suggested to deeply interrogate the comprehensive transmission phenomena of dengue infection. The proposed system of dengue infection is represented in the Liouville-Caputo fractional framework and investigated for basic properties, that is, uniqueness, positivity, and boundedness of the solution. We used the next-generation technique in order to determine the basic reproduction number R0 for the suggested model of dengue infection; moreover, we conduct a sensitivity test of R0 through a partial rank correlation coefficient technique to know the contribution of input factors on the output of R0. We have shown that the infection-free equilibrium of dengue dynamics is globally asymptomatically stable for R0<1 and unstable in other circumstances. The system of dengue infection is then structured in the Atangana-Baleanu framework to represent the dynamics of dengue with the non-singular and non-local kernel. The existence and uniqueness of the solution of the Atangana-Baleanu fractional system are interrogated through fixed-point theory. Finally, we present a novel numerical technique for the solution of our fractional-order system in the Atangana-Baleanu framework. We obtain numerical results for different values of fractional-order ϑ and input factors to highlight the consequences of fractional-order ϑ and input parameters on the system. On the basis of our analysis, we predict the most critical parameters in the system for the elimination of dengue infection.
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Affiliation(s)
- H M Srivastava
- Department of Mathematics and Statistics, University of Victoria, Victoria, British Columbia V8W 3R4, Canada
| | - Rashid Jan
- Department of Mathematics, University of Swabi, Swabi 23561, Pakistan
| | - Asif Jan
- Department of Pathogenic Microbiology & Immunology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, Xi'an 710061, People's Republic of China
| | - Wejdan Deebani
- Department of Mathematics, College of Science & Arts, King Abdulaziz University, P.O. Box 344, Rabigh 21911, Saudi Arabia
| | - Meshal Shutaywi
- Department of Mathematics, College of Science & Arts, King Abdulaziz University, P.O. Box 344, Rabigh 21911, Saudi Arabia
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Li Z, Wang J, Cheng X, Hu H, Guo C, Huang J, Chen Z, Lu J. The worldwide seroprevalence of DENV, CHIKV and ZIKV infection: A systematic review and meta-analysis. PLoS Negl Trop Dis 2021; 15:e0009337. [PMID: 33909610 PMCID: PMC8109817 DOI: 10.1371/journal.pntd.0009337] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 05/10/2021] [Accepted: 03/28/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND As the three major arthropod-borne viruses, dengue virus (DENV), chikungunya virus (CHIKV), and zika virus (ZIKV) are posing a growing threat to global public health and socioeconomic development. Our study aimed to systematically review the global seroprevalences of these arboviruses from existing publications. METHODS Articles published between Jan 01, 2000 and Dec 31, 2019 in the databases of Embase, Pubmed and Web of Science were searched and collected. Countries or areas with known local presence of Aedes vector mosquitoes were included. Random effects model was utilized to estimate the pooled seroprevalences and the proportion of inapparent infection. RESULTS Out of 1375, a total of 133 articles involving 176,001 subjects were included for our analysis. The pooled seroprevalences of DENV, CHIKV and ZIKV were 38%, 25% and 18%, respectively; and their corresponding proportions of inapparent infections were 80%, 40% and 50%. The South-East Asia Region had the highest seroprevalences of DENV and CHIKV, while the Region of the Americas had the highest seroprevalence of ZIKV. The seroprevalences of DENV and CHIKV were similar when comparing developed and developing countries, urban and rural areas, or among different populations. In addition, we observed a decreased global seroprevalences in the new decade (2010-2019) comparing to the decade before (2000-2009) for CHIKV. For ZIKV, the positive rates tested with the nucleic acid detection method were lower than those tested with the antibody detection method. Lastly, numerous cases of dual seropositivity for CHIKV and DENV were reported. CONCLUSIONS Our results revealed a varied prevalence of arbovirus infections in different geographical regions and countries, and the inapparent infection accounted an unneglected portion of infections that requires more attention. This study will shed lights on our understanding of the true burden of arbovirus infections and promote appropriate vaccination in the future.
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Affiliation(s)
- Zhihui Li
- School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Jin Wang
- School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Xiaomin Cheng
- School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Huan Hu
- School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Cheng Guo
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York City, New York, United States of America
| | - Jingyi Huang
- Songgang People’s Hospital of Bao’an District, Shenzhen, Guangdong Province, China
| | - Zeliang Chen
- School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
- * E-mail: (ZC); (JL)
| | - Jiahai Lu
- School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
- * E-mail: (ZC); (JL)
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Kinoshita K, Fukuchi S, Fukuda K, Okamoto K, Ogawa R, Matsunari O, Mizukami K, Okimoto T, Kodama M, Murakami K. A case of dengue fever that should be considered as imported infectious disease with digestive symptoms. Clin J Gastroenterol 2021; 14:1115-1120. [PMID: 33768451 DOI: 10.1007/s12328-021-01391-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/16/2021] [Indexed: 01/10/2023]
Abstract
Patients with dengue fever usually present with fever and rash, but non-specific symptoms such as headache, myalgia, arthralgia, and digestive symptoms are sometimes seen. We report a case of dengue fever with digestive symptoms in a patient who traveled to Indonesia. A 35-year-old man presented with fever, diarrhea, headache, and arthralgia. He later developed generalized rash. Dengue fever was clinically suspected from the travel history and confirmed by laboratory tests. He tested positive for anti-dengue virus antibodies, so dengue fever was diagnosed. Dengue fever should be included in the differential diagnosis of patients with digestive symptoms after returning to Japan.
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Affiliation(s)
- Keisuke Kinoshita
- Department of Gastroenterology, Oita University Faculty of Medicine Graduate School of Medicine, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan.
| | - Satoshi Fukuchi
- Department of Gastroenterology, Oita University Faculty of Medicine Graduate School of Medicine, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan.,Department of Gastroenterology, Almeida Memorial Hospital, Oita, Japan
| | - Kensuke Fukuda
- Department of Gastroenterology, Oita University Faculty of Medicine Graduate School of Medicine, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Kazuhisa Okamoto
- Department of Gastroenterology, Oita University Faculty of Medicine Graduate School of Medicine, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Ryo Ogawa
- Department of Gastroenterology, Oita University Faculty of Medicine Graduate School of Medicine, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Osamu Matsunari
- Department of Gastroenterology, Oita University Faculty of Medicine Graduate School of Medicine, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Kazuhiro Mizukami
- Department of Gastroenterology, Oita University Faculty of Medicine Graduate School of Medicine, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Tadayoshi Okimoto
- Department of Gastroenterology, Oita University Faculty of Medicine Graduate School of Medicine, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Masaaki Kodama
- Department of Gastroenterology, Oita University Faculty of Medicine Graduate School of Medicine, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Kazunari Murakami
- Department of Gastroenterology, Oita University Faculty of Medicine Graduate School of Medicine, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
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Nujum ZT, Beegum MS, Meenakshy V, Vijayakumar K. Cost analysis of dengue from a State in south India. Indian J Med Res 2021; 152:490-497. [PMID: 33707391 PMCID: PMC8157903 DOI: 10.4103/ijmr.ijmr_1641_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background & objectives: Improved dengue cost estimates offer the potential to provide a baseline measure to determine the cost-effectiveness of interventions. The objective of this study was to estimate the cost of dengue prevention, treatment and fatalities in Kerala, India, over a period of one year. Methods: The study was done in Kerala, a southern State in India. Costing of treatment was done from a family perspective. It was found by primary data collection in a sample of 83 dengue patients from Thiruvananthapuram district and estimated for Kerala using the reported number of cases in 2016. Costing of prevention was done from the government perspective for the entire State. In-depth interviews with State programme officers and experts in the field were conducted. The present value of lifetime earnings was used to value lives. Results: The cost of treatment of dengue in the State was ₹137 milion (2.16 million US$). The cost of prevention in the State was ₹535 million (8.3 million US$). The cost of fatalities was the highest among costs at ₹1760 million (27.7 million US$). US$ 38 million was the least possible estimate of total cost of dengue. The total out-of-pocket spending (OOPS) of >60 yr was significantly (P<0.05) higher than other age groups. The total OOPS was significantly (P<0.001) higher in private sector compared to public. Interpretation & conclusions: Although deaths due to dengue were few, the cost of fatalities was 12 times more than the cost of treatment and three times the cost of prevention. Focusing on mortality reduction and disease prevention in elderly would be beneficial.
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Affiliation(s)
- Zinia T Nujum
- Department of Community Medicine, Government Medical College, Thiruvananthapuram, Kerala, India
| | - M Saboora Beegum
- Department of Biochemistry, Government Medical College, Thiruvananthapuram, Kerala, India
| | - V Meenakshy
- Deputy Director of Health Services, Kerala, India
| | - K Vijayakumar
- Department of Community Medicine, Amrita Institute of Medical Sciences, Kochi, Kerala, India
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Ahmad N, Khan T, Jamal SM. A Comprehensive Study of Dengue Epidemics and Persistence of Anti-Dengue Virus Antibodies in District Swat, Pakistan. Intervirology 2020; 63:46-56. [PMID: 33049733 DOI: 10.1159/000510347] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/17/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Dengue fever is one of the most common human arbovirus infections worldwide. In Pakistan, dengue initially became endemic in the big cities and then expanded to remote areas of the country. The current study reports the dengue epidemics, anti-DENV antibodies prevalence during the active and post-dengue infection, risk factors, disease symptoms, and spotting dengue infection densities in district Swat of Pakistan. METHODS Clinical signs and demographic data of dengue suspected individuals were collected at the time of screening through non-structural protein-1 antigen detection test during 2013-2015. Moreover, selected dengue confirmed individuals were screened for the presence of anti-dengue immunoglobulin (Ig) M and G during the active infection period and post-dengue infection. RESULTS A total of 8,770 individuals were infected with dengue in 2013 with 36 (0.41%) case fatalities, 307 in 2014 with no case fatality, and 13 in 2015 with no case fatality. The number of male and female cases were 6,139 and 2,631 in 2013, 183 and 124 in 2014, and only 10 and 3 in 2015, respectively. Among all the localities, Tehsil Babozai, an urban setting, reported the highest number of dengue patients during all the study years, that is, 7,673 (87.49% of the total cases) in 2013, 294 (95.76% of the total cases) in 2014, and 13 (100% cases) in 2015. Among 6 age groups, 21-30 years was found to be highly infected in 2013 (37.13% of all cases) and 2014 (33.55%). Furthermore, 1,231 (21.94% of all cases) had IgM antibodies and 71 (1.26%) had IgG antibodies in 2013, 78 (26% of all cases) had IgM antibodies and 7 (2.33%) had IgG antibodies in 2014, and only 4 (30.76%) patients had IgM and 0 (0%) had IgG antibodies in 2015. Furthermore, urban areas had the highest infection density in district Swat. The majority of the patients in rural areas had a traveling history to the urban areas before their illness. CONCLUSION To sum up, male gender, young individuals, and those living in urban areas were at the greater risk of dengue infection.
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Affiliation(s)
- Naveed Ahmad
- Department of Biotechnology, University of Malakand, Chakdara, Pakistan
| | - Tariq Khan
- Department of Biotechnology, University of Malakand, Chakdara, Pakistan
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Matangkasombut P, Manopwisedjaroen K, Pitabut N, Thaloengsok S, Suraamornkul S, Yingtaweesak T, Duong V, Sakuntabhai A, Paul R, Singhasivanon P. Dengue viremia kinetics in asymptomatic and symptomatic infection. Int J Infect Dis 2020; 101:90-97. [PMID: 32992011 DOI: 10.1016/j.ijid.2020.09.1446] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/22/2020] [Accepted: 09/22/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Dengue infection is a global health threat. While symptomatic cases contribute to morbidity and mortality, the majority of infected people are asymptomatic but serve as an important reservoir. However, the kinetics of viremia in asymptomatic infections remains unknown. METHODS We enrolled 279 hospital-based symptomatic index cases and quantified dengue virus (DENV) RNA at enrollment and at the day of defervescence. To identify asymptomatic cases, 175 household members of index cases were monitored for clinical symptoms during follow-up, and blood was taken twice weekly to test for and quantify DENV RNA until cleared. RESULTS We detected DENV in thirteen asymptomatic household members (7.43%). Their DENV serotypes were primarily the same as those of their family index cases. The median peak DENV viremia in asymptomatic subjects was lower than that of symptomatic individuals during the febrile phase, and the viral decay rate was slower in asymptomatic infections. CONCLUSIONS DENV level and kinetics in asymptomatic individuals differed significantly from those of symptomatic cases. Despite the lower viremia, the slower decay rate in asymptomatic infections could lead to their prolonging the infectious reservoir. The improvement of transmission control to prevent such long-lived asymptomatic infections from transmitting the DENV is needed.
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Affiliation(s)
- Ponpan Matangkasombut
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok, Thailand; Systems Biology of Diseases Research Unit, Faculty of Science, Mahidol University, Bangkok, Thailand.
| | | | - Nada Pitabut
- Office of Research Services, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Faculty of Medicine, King Mongkut's Institute of Technology Ladkrabang, Bangkok, Thailand
| | - Sasikanya Thaloengsok
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok, Thailand
| | | | | | - Veasna Duong
- Virology Unit, Institut Pasteur du Cambodge, Institut Pasteur International Network, PO Box 983, Phnom Penh, Cambodia
| | - Anavaj Sakuntabhai
- Institut Pasteur, Functional Genetics of Infectious Diseases Unit, UMR 2000 (CNRS), Paris 75015, France
| | - Richard Paul
- Institut Pasteur, Functional Genetics of Infectious Diseases Unit, UMR 2000 (CNRS), Paris 75015, France
| | - Pratap Singhasivanon
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
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Shukla R, Beesetti H, Brown JA, Ahuja R, Ramasamy V, Shanmugam RK, Poddar A, Batra G, Krammer F, Lim JK, Kale S, Lal AA, Swaminathan S, Khanna N. Dengue and Zika virus infections are enhanced by live attenuated dengue vaccine but not by recombinant DSV4 vaccine candidate in mouse models. EBioMedicine 2020; 60:102991. [PMID: 32949997 PMCID: PMC7501058 DOI: 10.1016/j.ebiom.2020.102991] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 08/03/2020] [Accepted: 08/20/2020] [Indexed: 01/21/2023] Open
Abstract
Background A tetravalent live attenuated dengue vaccine, Dengvaxia, sensitised naïve recipients to severe dengue illness upon a subsequent natural dengue infection and is suspected to be due to antibody-dependent enhancement (ADE). ADE has also been implicated in the severe neurological outcomes of Zika virus (ZIKV) infection. It has become evident that cross-reactive antibodies targeting the viral pre-membrane protein and fusion-loop epitope are ADE-competent. A pre-clinical tetravalent dengue sub-unit vaccine candidate, DSV4, eliminates these ADE-competent epitopes. Methods We compared protective efficacy and ADE-competence of murine polyclonal antibodies induced by DSV4, Dengvaxia and an ‘in house’ tetravalent mixture of all four laboratory DENV strains, TV DENV, using established mouse models. Findings DSV4-induced antibodies, known to be predominantly type-specific, provided significant protection against lethal DENV challenge, but did not promote ADE of either DENV or ZIKV infection in vivo. Antibodies elicited by Dengvaxia and TV DENV, which are predominantly cross-reactive, not only failed to offer protection against lethal DENV challenge, but also promoted ADE of both DENV and ZIKV infection in vivo. Interpretation Protective efficacy against DENV infection may be linked to the induction of neutralising antibodies which are type-specific rather than cross-reactive. Whole virus-based dengue vaccines may be associated with ADE risk, despite their potent virus-neutralising capacity. Vaccines designed to eliminate ADE-competent epitopes may help eliminate/minimise ADE risk. Funding This study was supported partly by ICGEB, India, the National Biopharma Mission, DBT, Government of India, Sun Pharmaceutical Industries Limited, India, and NIAID, NIH, USA.
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Affiliation(s)
- Rahul Shukla
- Translational Health Group, Molecular Medicine Division, International Centre for Genetic Engineering & Biotechnology, New Delhi, India
| | - Hemalatha Beesetti
- Dengue Laboratory, Sun Pharmaceutical Industries Ltd., Gurugram, Haryana, India
| | - Julia A Brown
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Richa Ahuja
- Translational Health Group, Molecular Medicine Division, International Centre for Genetic Engineering & Biotechnology, New Delhi, India
| | - Viswanathan Ramasamy
- Translational Health Group, Molecular Medicine Division, International Centre for Genetic Engineering & Biotechnology, New Delhi, India
| | - Rajgokul K Shanmugam
- Translational Health Group, Molecular Medicine Division, International Centre for Genetic Engineering & Biotechnology, New Delhi, India
| | - Ankur Poddar
- Translational Health Group, Molecular Medicine Division, International Centre for Genetic Engineering & Biotechnology, New Delhi, India
| | - Gaurav Batra
- Centre for Biodesign and Diagnostics, Translational Health Science & Technology Institute, NCR Biotech Science Cluster, Faridabad, India
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Jean K Lim
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Sachin Kale
- Dengue Laboratory, Sun Pharmaceutical Industries Ltd., Gurugram, Haryana, India
| | - Altaf A Lal
- Dengue Laboratory, Sun Pharmaceutical Industries Ltd., Gurugram, Haryana, India
| | - Sathyamangalam Swaminathan
- Translational Health Group, Molecular Medicine Division, International Centre for Genetic Engineering & Biotechnology, New Delhi, India.
| | - Navin Khanna
- Translational Health Group, Molecular Medicine Division, International Centre for Genetic Engineering & Biotechnology, New Delhi, India.
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41
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Anderson KB, Buddhari D, Srikiatkhachorn A, Gromowski GD, Iamsirithaworn S, Weg AL, Ellison DW, Macareo L, Cummings DAT, Yoon IK, Nisalak A, Ponlawat A, Thomas SJ, Fernandez S, Jarman RG, Rothman AL, Endy TP. An Innovative, Prospective, Hybrid Cohort-Cluster Study Design to Characterize Dengue Virus Transmission in Multigenerational Households in Kamphaeng Phet, Thailand. Am J Epidemiol 2020; 189:648-659. [PMID: 31971570 PMCID: PMC7393304 DOI: 10.1093/aje/kwaa008] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 01/07/2020] [Accepted: 01/09/2020] [Indexed: 01/30/2023] Open
Abstract
Difficulties inherent in the identification of immune correlates of protection or severe disease have challenged the development and evaluation of dengue vaccines. There persist substantial gaps in knowledge about the complex effects of age and sequential dengue virus (DENV) exposures on these correlations. To address these gaps, we were conducting a novel family-based cohort-cluster study for DENV transmission in Kamphaeng Phet, Thailand. The study began in 2015 and is funded until at least 2023. As of May 2019, 2,870 individuals in 485 families were actively enrolled. The families comprise at least 1 child born into the study as a newborn, 1 other child, a parent, and a grandparent. The median age of enrolled participants is 21 years (range 0–93 years). Active surveillance is performed to detect acute dengue illnesses, and annual blood testing identifies subclinical seroconversions. Extended follow-up of this cohort will detect sequential infections and correlate antibody kinetics and sequence of infections with disease outcomes. The central goal of this prospective study is to characterize how different DENV exposure histories within multigenerational family units, from DENV-naive infants to grandparents with multiple prior DENV exposures, affect transmission, disease, and protection at the level of the individual, household, and community.
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Affiliation(s)
- Kathryn B Anderson
- Correspondence to Dr. Kathryn B. Anderson, Department of Medicine, Upstate Medical University, 750 E. Adams Street, Syracuse, NY 13210 (e-mail: )
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Pierson TC, Diamond MS. The continued threat of emerging flaviviruses. Nat Microbiol 2020; 5:796-812. [PMID: 32367055 DOI: 10.1038/s41564-020-0714-0] [Citation(s) in RCA: 434] [Impact Index Per Article: 108.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 03/27/2020] [Indexed: 12/18/2022]
Abstract
Flaviviruses are vector-borne RNA viruses that can emerge unexpectedly in human populations and cause a spectrum of potentially severe diseases including hepatitis, vascular shock syndrome, encephalitis, acute flaccid paralysis, congenital abnormalities and fetal death. This epidemiological pattern has occurred numerous times during the last 70 years, including epidemics of dengue virus and West Nile virus, and the most recent explosive epidemic of Zika virus in the Americas. Flaviviruses are now globally distributed and infect up to 400 million people annually. Of significant concern, outbreaks of other less well-characterized flaviviruses have been reported in humans and animals in different regions of the world. The potential for these viruses to sustain epidemic transmission among humans is poorly understood. In this Review, we discuss the basic biology of flaviviruses, their infectious cycles, the diseases they cause and underlying host immune responses to infection. We describe flaviviruses that represent an established ongoing threat to global health and those that have recently emerged in new populations to cause significant disease. We also provide examples of lesser-known flaviviruses that circulate in restricted areas of the world but have the potential to emerge more broadly in human populations. Finally, we discuss how an understanding of the epidemiology, biology, structure and immunity of flaviviruses can inform the rapid development of countermeasures to treat or prevent human infections as they emerge.
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Affiliation(s)
- Theodore C Pierson
- Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases, the National Institutes of Health, Bethesda, MD, USA.
| | - Michael S Diamond
- Departments of Medicine, Molecular Microbiology, Pathology & Immunology, Andrew M. and Jane M. Bursky Center for Human Immunology and Immunotherapy Programs, Washington University School of Medicine, St. Louis, MO, USA.
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Cutaneous Dengue Virus Inoculation Triggers Strong B Cell Reactions but Contrastingly Poor T Cell Responses. Virol Sin 2020; 35:575-587. [PMID: 32314276 PMCID: PMC7168571 DOI: 10.1007/s12250-020-00213-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 12/24/2019] [Indexed: 01/19/2023] Open
Abstract
Dengue is a global health problem without current specific treatment nor safe vaccines available. While severe dengue is related to pre-existing non-neutralizing dengue virus (DENV) antibodies, the role of T cells in protection or pathology is unclear. Using cutaneous DENV infection in immunocompetent mice we previously showed the generation of PNA+ germinal centers (GCs), now we assessed the activation and proliferation of B and T cells in draining lymph nodes (DLNs). We found a drastic remodelling of DLN compartments from 7 to 14 days post-infection (dpi) with greatly enlarged B cell follicles, occupying almost half of the DLN area compared to ~24% in naïve conditions. Enormous clusters of proliferating (Ki-67+) cells inside B follicles were found 14 dpi, representing ~33% of B cells in DLNs but only ~2% in non-infected mice. Inside GCs, we noticed an important recruitment of tingle body macrophages removing apoptotic cells. In contrast, the percentage of paracortex area and total T cells decreased by 14–16 dpi, compared to controls. Scattered randomly distributed Ki-67+ T cells were found, similar to non-infected mice. CD69 expression by CD4+ and CD8+ T cells was minor, while it was remarkable in B cells, representing 1764.7% of change from basal levels 3 dpi. The apparent lack of T cell responses cannot be attributed to apoptosis since no significant differences were observed compared to non-infected mice. This study shows massive B cell activation and proliferation in DLNs upon DENV infection. In contrast, we found very poor, almost absent CD4+ and CD8+ T cell responses.
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Tan W, Liew JWK, Selvarajoo S, Lim XY, Foo CJ, Refai WF, Robson N, Othman S, Hadi HA, Mydin FHM, Malik TFA, Lau YL, Vythilingam I. Inapparent dengue in a community living among dengue-positive Aedes mosquitoes and in a hospital in Klang Valley, Malaysia. Acta Trop 2020; 204:105330. [PMID: 31917959 DOI: 10.1016/j.actatropica.2020.105330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/05/2020] [Accepted: 01/05/2020] [Indexed: 12/25/2022]
Abstract
The public health burden of dengue is most likely under reported. Current dengue control measures only considered symptomatic dengue transmission. Hence, there is a paucity of information on the epidemiology of inapparent dengue. This study reports that many people have been unknowingly exposed to dengue infection. Almost 10% and 70% of individuals without any history of dengue infection and living in a dengue hotspot, in Selangor, Malaysia, were dengue IgM and IgG positive respectively. When dengue-positive mosquitoes were detected in the hotspot, 11 (6.3%) of the 174 individuals tested were found to have dengue viremia, of which 10 were asymptomatic. Besides, upon detection of a dengue-infected mosquito, transmission was already widespread. In a clinical setting, it appears that people living with dengue patients have been exposed to dengue, whether asymptomatic or symptomatic. They can either have circulating viral RNA and/or presence of NS1 antigen. It is also possible that they are dengue seropositive. Collectively, the results indicate that actions taken to control dengue transmission after the first report of dengue cases may be already too late. The current study also revealed challenges in diagnosing clinically inapparent dengue in hyperendemic settings. There is no one best method for diagnosing inapparent dengue. This study demonstrates empirical evidence of inapparent dengue in different settings. Early dengue surveillance in the mosquito population and active serological/virological surveillance in humans can go hand in hand. More studies are required to investigate the epidemiology, seroprevalence, diagnostics, and control of inapparent dengue. It is also crucial to educate the public, health staff and medical professionals on asymptomatic dengue and to propagate awareness, which is important for controlling transmission.
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Kang JY, Aldstadt J, Vandewalle R, Yin D, Wang S. A cyberGIS approach to spatiotemporally explicit uncertainty and global sensitivity analysis for agent-based modeling of vector-borne disease transmission. ANNALS OF THE AMERICAN ASSOCIATION OF GEOGRAPHERS 2020; 110:1855-1873. [PMID: 35106407 PMCID: PMC8803269 DOI: 10.1080/24694452.2020.1723400] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 11/27/2019] [Accepted: 11/04/2019] [Indexed: 06/14/2023]
Abstract
While agent-based models (ABMs) provide an effective means for investigating complex interactions between heterogeneous agents and their environment, they may hinder an improved understanding of phenomena being modeled due to inherent challenges associated with uncertainty in model parameters. This study uses uncertainty analysis and global sensitivity analysis (UA-GSA) to examine the effects of such uncertainty on model outputs. The statistics used in UA-GSA, however, are likely to be affected by the modifiable areal unit problem (MAUP). Therefore, to examine the scale varying-effects of model inputs, UA-GSA needs to be performed at multiple spatiotemporal scales. Unfortunately, performing comprehensive UA-GSA comes with considerable computational cost. In this paper, our cyberGIS-enabled spatiotemporally explicit UA-GSA approach helps to not only resolve the computational burden, but also to measure dynamic associations between model inputs and outputs. A set of computational and modeling experiments shows that input factors have scale-dependent impacts on modeling output variability. In other words, most of the input factors have relatively large impacts in a certain region, but may not influence outcomes in other regions. Furthermore, our spatiotemporally explicit UA-GSA approach sheds light on the effects of input factors on modeling outcomes that are particularly spatially and temporally clustered, such as the occurrence of communicable disease transmission.
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Affiliation(s)
- Jeon-Young Kang
- CyberGIS Center for Advanced Digital and Spatial Studies; Department of Geography and Geographic Information Science, University of Illinois at Urbana-Champaign
| | - Jared Aldstadt
- Department of Geography, State University of New York at Buffalo
| | - Rebecca Vandewalle
- CyberGIS Center for Advanced Digital and Spatial Studies; Department of Geography and Geographic Information Science, University of Illinois at Urbana-Champaign
| | - Dandong Yin
- CyberGIS Center for Advanced Digital and Spatial Studies; Department of Geography and Geographic Information Science, University of Illinois at Urbana-Champaign
| | - Shaowen Wang
- CyberGIS Center for Advanced Digital and Spatial Studies; Department of Geography and Geographic Information Science, University of Illinois at Urbana-Champaign
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46
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Anderson KB, Stewart-Ibarra AM, Buddhari D, Beltran Ayala EF, Sippy RJ, Iamsirithaworn S, Ryan SJ, Fernandez S, Jarman RG, Thomas SJ, Endy TP. Key Findings and Comparisons From Analogous Case-Cluster Studies for Dengue Virus Infection Conducted in Machala, Ecuador, and Kamphaeng Phet, Thailand. Front Public Health 2020; 8:2. [PMID: 32117847 PMCID: PMC7028768 DOI: 10.3389/fpubh.2020.00002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 01/03/2020] [Indexed: 11/21/2022] Open
Abstract
Dengue viruses (DENV) pose a significant and increasing threat to human health across broad regions of the globe. Currently, prevention, control, and treatment strategies are limited. Promising interventions are on the horizon, including multiple vaccine candidates under development and a renewed and innovative focus on controlling the vector, Aedes aegypti. However, significant gaps persist in our understanding of the similarities and differences in DENV epidemiology across regions of potential implementation and evaluation. In this manuscript, we highlight and compare findings from two analogous cluster-based studies for DENV transmission and pathogenesis conducted in Thailand and Ecuador to identify key features and questions for further pursuit. Despite a remarkably similar incidence of DENV infection among enrolled neighborhood contacts at the two sites, we note a higher occurrence of secondary infection and severe illness in Thailand compared to Ecuador. A higher force of infection in Thailand, defined as the incidence of infection among susceptible individuals, is suggested by the higher number of captured Aedes mosquitoes per household, the increasing proportion of asymptomatic infections with advancing age, and the high proportion of infections identified as secondary-type infections by serology. These observations should be confirmed in long-term, parallel prospective cohort studies conducted across regions, which would advantageously permit characterization of baseline immune status (susceptibility) and contemporaneous assessment of risks and risk factors for dengue illness.
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Affiliation(s)
- Kathryn B Anderson
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, United States.,Armed Forces Research Institute of Medical Science, Bangkok, Thailand.,Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY, United States.,Institute for Global Health and Translational Science, SUNY Upstate Medical University, Syracuse, NY, United States
| | - Anna M Stewart-Ibarra
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, United States.,Department of Montevideo, Inter-American Institute for Global Change Research (IAI), Montevideo, Uruguay
| | - Darunee Buddhari
- Armed Forces Research Institute of Medical Science, Bangkok, Thailand
| | | | - Rachel J Sippy
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, United States.,Department of Geography, University of Florida, Gainesville, FL, United States
| | | | - Sadie J Ryan
- Department of Geography, University of Florida, Gainesville, FL, United States.,Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States
| | - Stefan Fernandez
- Armed Forces Research Institute of Medical Science, Bangkok, Thailand
| | - Richard G Jarman
- Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | - Stephen J Thomas
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, United States.,Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY, United States.,Institute for Global Health and Translational Science, SUNY Upstate Medical University, Syracuse, NY, United States
| | - Timothy P Endy
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, United States.,Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY, United States.,Institute for Global Health and Translational Science, SUNY Upstate Medical University, Syracuse, NY, United States
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Abstract
Dengue virus (DENV) belongs to the family Flaviviridae, genus Flavivirus. It is a single-stranded positive-sense ribonucleic acid virus with 10,700 bases. The genus Flavivirus includes other arthropod borne viruses such as yellow fever virus, West Nile virus, Zika virus, tick-borne encephalitis virus. It infects ~50–200 million people annually, putting over 3.6 billion people living in tropical regions at risk and causing ~20,000 deaths annually. The expansion of dengue is attributed to factors such as the modern dynamics of climate change, globalization, travel, trade, socioeconomics, settlement, and also viral evolution. There are four antigenically different serotypes of DENV based on the differences in their viral structural and nonstructural proteins. DENV infection causes a spectrum of illness ranging from asymptomatic to dengue fever to severe dengue shock syndrome. Infection with one serotype confers lifelong immunity against that serotype, but heterologus infection leads to severe dengue hemorrhagic fever due to antibody-dependent enhancement. Diagnosis of dengue infections is based mainly on serological detection of either antigen in acute cases or antibodies in both acute and chronic infection. Viral detection and real-time PCR detection though helpful is not feasible in resource poor setup. Treatment of dengue depends on symptomatic management along with fluid resuscitation and may require platelet transfusion. Although vaccine development is in late stages of development, developing a single vaccine against four serotypes often causes serious challenges to researchers; hence, the main stay of prevention is vector control and management.
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Miksch F, Jahn B, Espinosa KJ, Chhatwal J, Siebert U, Popper N. Why should we apply ABM for decision analysis for infectious diseases?-An example for dengue interventions. PLoS One 2019; 14:e0221564. [PMID: 31454373 PMCID: PMC6711507 DOI: 10.1371/journal.pone.0221564] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 08/10/2019] [Indexed: 12/24/2022] Open
Abstract
For the evaluation of infectious-diseases interventions, the transmissible nature of such diseases plays a central role. Agent-based models (ABM) allow for dynamic transmission modeling but publications are limited. We aim to provide an overview of important characteristics of ABM for decision-analytic modeling of infectious diseases. A case study of dengue epidemics illustrates model characteristics, conceptualization, calibration and model analysis. First, major characteristics of ABM are outlined and discussed based on ISPOR and ISPOR-SMDM Good Practice guidelines. Second, in our case study, we modeled a dengue outbreak in Cebu City (Philippines) to assess the impact interventions to control the relative growth of the mosquito population. Model outcomes include prevalence and incidence of infected persons. The modular ABM simulates persons and mosquitoes over an annual time horizon considering daily time steps. The model was calibrated and validated. ABM is a dynamic, individual-level modeling approach that is capable to reproduce direct and indirect effects of interventions for infectious diseases. The ability to replicate emerging behavior and to include human behavior or the behavior of other agents is a distinguishing modeling characteristic (e.g., compared to Markov models). Modeling behavior may, however, require extensive calibration and validation. The analyzed hypothetical effectiveness of dengue interventions showed that a reduced human-mosquito ratio of 1:2.5 during rainy seasons leads already to a substantial decrease of infected persons. ABM can support decision-analyses for infectious diseases including disease dynamics, emerging behavior, and providing a high level of reusability due to modularity.
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Affiliation(s)
- Florian Miksch
- dwh Gmbh, Vienna, Austria
- Department of Computer Science, University of the Philippines Cebu, Cebu City, Philippines
| | - Beate Jahn
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT-University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
- * E-mail:
| | - Kurt Junshean Espinosa
- Department of Computer Science, University of the Philippines Cebu, Cebu City, Philippines
| | - Jagpreet Chhatwal
- Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Uwe Siebert
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT-University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
- Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Division of Health Technology Assessment and Bioinformatics, ONCOTYROL - Center for Personalized Cancer Medicine, Innsbruck, Austria
- Center for Health Decision Science, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
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Halstead SB, Dans LF. Dengue infection and advances in dengue vaccines for children. THE LANCET CHILD & ADOLESCENT HEALTH 2019; 3:734-741. [PMID: 31378686 DOI: 10.1016/s2352-4642(19)30205-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 05/23/2019] [Accepted: 06/10/2019] [Indexed: 12/26/2022]
Abstract
Dengue viruses are endemic in most tropical and subtropical countries where they produce disease ranging from a mild fever to a severe, potentially fatal vascular permeability syndrome. We reviewed the status of development and testing in children of three vaccines designed to protect against the four dengue viruses. The first dengue virus vaccine, Dengvaxia, now licensed in 20 endemic countries, the EU and the USA, provides protection against severe dengue in seropositive individuals but increases the risk for naive recipients to develop severe dengue and to be hospitalised. We discuss mechanisms and implications of shortcomings of the licensed vaccine and describe the structure and attributes of two other dengue virus vaccines. Based upon human dengue challenge studies, one of these vaccines promises to deliver solid, long-lasting immunity after a single dose. Because dengue virus infections are ubiquitous in residents and visitors to tropical countries, in the absence of a protective vaccine paediatricians should recognise the early signs and clinical presentation of severe dengue, understand its pathophysiology and appropriate management.
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Affiliation(s)
- Scott B Halstead
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
| | - Leonila F Dans
- Departments of Pediatrics and Clinical Epidemiology, College of Medicine, University of the Philippines, Manila, Philippines
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50
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Tan LK, Low SL, Sun H, Shi Y, Liu L, Lam S, Tan HH, Ang LW, Wong WY, Chua R, Teo D, Ng LC, Cook AR. Force of Infection and True Infection Rate of Dengue in Singapore: Implications for Dengue Control and Management. Am J Epidemiol 2019; 188:1529-1538. [PMID: 31062837 PMCID: PMC6670050 DOI: 10.1093/aje/kwz110] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 04/24/2019] [Accepted: 04/26/2019] [Indexed: 12/23/2022] Open
Abstract
National data on dengue notifications do not capture all dengue infections and do not reflect the true intensity of disease transmission. To assess the true dengue infection rate and disease control efforts in Singapore, we conducted age-stratified serosurveys among residents after a 2013 outbreak that was the largest dengue outbreak on record. The age-weighted prevalence of dengue immunoglobulin G among residents was 49.8% (95% confidence interval: 48.4, 51.1) in 2013 and 48.6% (95% confidence interval: 47.0, 50.0) in 2017; prevalence increased with age. Combining these data with those from previous serosurveys, the year-on-year estimates of the dengue force of infection from 1930 to 2017 revealed a significant decrease from the late 1960s to the mid-1990s, after which the force of infection remained stable at approximately 10 per 1,000 persons per year. The reproduction number (R0) had also declined since the 1960s. The reduction in dengue transmission may be attributed to the sustained national vector program and partly to a change in the age structure of the population. The improved estimated ratio of notified cases to true infections, from 1:14 in 2005–2009 to 1:6 in 2014–2017, signifies that the national notification system, which relies on diagnosed cases, has improved over time. The data also suggest that the magnitudes of dengue epidemics cannot be fairly compared across calendar years and that the current disease control program remains applicable.
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Affiliation(s)
- Li Kiang Tan
- Environmental Health Institute, National Environment Agency, Singapore
| | - Swee Ling Low
- Environmental Health Institute, National Environment Agency, Singapore
| | - Haoyang Sun
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Yuan Shi
- Environmental Health Institute, National Environment Agency, Singapore
| | - Lilac Liu
- Environmental Health Institute, National Environment Agency, Singapore
| | - Sally Lam
- Blood Services Group, Health Sciences Authority, Singapore
| | - Hwee Huang Tan
- Blood Services Group, Health Sciences Authority, Singapore
| | - Li Wei Ang
- Epidemiology and Disease Control Division, Ministry of Health, Singapore
| | - Wing Yan Wong
- Environmental Health Institute, National Environment Agency, Singapore
| | - Rachel Chua
- Environmental Health Institute, National Environment Agency, Singapore
| | - Diana Teo
- Blood Services Group, Health Sciences Authority, Singapore
| | - Lee Ching Ng
- Environmental Health Institute, National Environment Agency, Singapore
- School of Biological Sciences, Nanyang Technological University, Singapore
| | - Alex R Cook
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
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