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Pandya K, Bhatti V, Ghosh S, Singh H, Kulhari K, Bhai Patel B, Khan I. Community-based study to describe the epidemiology of dengue infection in a large cantonment during one transmission season. Med J Armed Forces India 2024; 80:276-280. [PMID: 38799995 PMCID: PMC11116983 DOI: 10.1016/j.mjafi.2023.04.008] [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: 11/01/2022] [Accepted: 04/25/2023] [Indexed: 05/29/2024] Open
Abstract
Background Dengue is one of the most important vector-borne disease in India. It has been linked to monsoons when Aedes aegypti mosquitoes breed profusely in containers. No study exists in Armed Forces wherein a community-based sero-survey has described the epidemiology of dengue. The present study tries to fill this knowledge gap. Methods A total of 422 participants were studied for one transmission season of July-December. Blood samples were collected for testing dengue IgG and IgM at the beginning and at end of the study period. The study participants were interviewed at least twice within this period of 6 months to assess clinical condition and follow-up. Point prevalence and incidence were measured. Distribution of presence or absence of symptoms was noted for positive as well as negative cases. Results All participants were males. Average age was 31.75 years. Point prevalence at the beginning of transmission season was 11.6% (95% CI: 8.4%-14.6%) and 15.6% (95% CI: 12.1%-19.1%) towards the end. Incidence was found to be 147.4 per 1000 for 6 months. Forty percent of incident cases were asymptomatic. Conclusion Healthcare planners and hospital commanders in stations across Armed Forces can use the prevalence and incidence figures obtained in this study as a general guide while planning for prevention and control of dengue. Also, this study points to the fact that dengue transmission in Delhi may have shifted earlier to months of April/May than the conventionally accepted season of July-December.
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Affiliation(s)
- Kapil Pandya
- Classified Specialist (Community Medicine), Indian Level 3 Hospital, MONUSCO, C/o 56, APO, India
| | - V.K. Bhatti
- Professor & Head, Department of Community Medicine, Armed Forces Medical College, Pune, India
| | - Subhadeep Ghosh
- Associate Professor, Department of Community Medicine, Armed Forces Medical College, Pune, India
| | | | - Kanchan Kulhari
- Associate Professor, Department of Biochemistry, Armed Forces Medical College, Pune, India
| | | | - I.D. Khan
- Classified Specialist (Microbiology), Base Hospital, Delhi Cantt, India
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2
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Kiener M, Shayegh N, Nyathi SV, Ndenga BA, Mutuku FM, LaBeaud AD. Low Rate of Asymptomatic Dengue Infection Detected in Coastal Kenya Using Pooled Polymerase Chain Reaction Testing. Am J Trop Med Hyg 2024; 110:738-740. [PMID: 38471167 PMCID: PMC10993852 DOI: 10.4269/ajtmh.23-0650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 12/24/2023] [Indexed: 03/14/2024] Open
Abstract
Asymptomatic dengue virus (DENV) infections have important public health implications but are challenging to identify. We performed a cross-sectional study of reverse transcription quantitative polymerase chain reaction on pooled sera of asymptomatic individuals from the south coast of Kenya at two time periods to identify cases of asymptomatic viremia. Among 2,460 samples tested in pools of 9 or 10, we found only one positive case (0.04% incidence). Although pooling of samples has the potential to be a cost-effective and time-efficient method for asymptomatic DENV detection, mass cross-sectional pooled testing may not provide accurate data on rates of asymptomatic infection, likely owing to a decrease in the sensitivity with pooling of samples, a short period of viremia, or testing in the absence of an outbreak.
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Affiliation(s)
- Melanie Kiener
- Department of Medicine, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, California
| | - Nader Shayegh
- Howard University College of Medicine, Washington, District of Columbia
| | - Sindiso Victor Nyathi
- Department of Medicine, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, California
| | | | | | - Angelle Desiree LaBeaud
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Stanford University School of Medicine, Stanford, California
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3
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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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4
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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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5
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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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6
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Peñataro Yori P, Paredes Olórtegui M, Schiaffino F, Colston JM, Pinedo Vasquez T, Garcia Bardales PF, Shapiama Lopez V, Zegarra Paredes LF, Perez K, Curico G, Flynn T, Zhang J, Ramal Asayag C, Meza Sanchez G, Silva Delgado H, Casapia Morales M, Casanova W, Jiu B, Oberhelman R, Munayco Escate C, Silver R, Henao O, Cooper KK, Liu J, Houpt ER, Kosek MN. Etiology of acute febrile illness in the peruvian amazon as determined by modular formatted quantitative PCR: a protocol for RIVERA, a health facility-based case-control study. BMC Public Health 2023; 23:674. [PMID: 37041550 PMCID: PMC10088183 DOI: 10.1186/s12889-023-15619-6] [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: 02/27/2023] [Accepted: 04/06/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND The study of the etiology of acute febrile illness (AFI) has historically been designed as a prevalence of pathogens detected from a case series. This strategy has an inherent unrealistic assumption that all pathogen detection allows for causal attribution, despite known asymptomatic carriage of the principal causes of acute febrile illness in most low- and middle-income countries (LMICs). We designed a semi-quantitative PCR in a modular format to detect bloodborne agents of acute febrile illness that encompassed common etiologies of AFI in the region, etiologies of recent epidemics, etiologies that require an immediate public health response and additional pathogens of unknown endemicity. We then designed a study that would delineate background levels of transmission in the community in the absence of symptoms to provide corrected estimates of attribution for the principal determinants of AFI. METHODS A case-control study of acute febrile illness in patients ten years or older seeking health care in Iquitos, Loreto, Peru, was planned. Upon enrollment, we will obtain blood, saliva, and mid-turbinate nasal swabs at enrollment with a follow-up visit on day 21-28 following enrollment to attain vital status and convalescent saliva and blood samples, as well as a questionnaire including clinical, socio-demographic, occupational, travel, and animal contact information for each participant. Whole blood samples are to be simultaneously tested for 32 pathogens using TaqMan array cards. Mid-turbinate samples will be tested for SARS-CoV-2, Influenza A and Influenza B. Conditional logistic regression models will be fitted treating case/control status as the outcome and with pathogen-specific sample positivity as predictors to attain estimates of attributable pathogen fractions for AFI. DISCUSSION The modular PCR platforms will allow for reporting of all primary results of respiratory samples within 72 h and blood samples within one week, allowing for results to influence local medical practice and enable timely public health responses. The inclusion of controls will allow for a more accurate estimate of the importance of specific prevalent pathogens as a cause of acute illness. STUDY REGISTRATION Project 1791, Registro de Proyectos de Investigación en Salud Pública (PRISA), Instituto Nacional de Salud, Perú.
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Affiliation(s)
- Pablo Peñataro Yori
- Division of Infectious Disease and International Health, School of Medicine, University of Virginia, Charlottesville, VA, USA
- Asociación Benefica PRISMA, Iquitos, Loreto, Peru
| | | | - Francesca Schiaffino
- Division of Infectious Disease and International Health, School of Medicine, University of Virginia, Charlottesville, VA, USA
- Faculty of Veterinary Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Josh M Colston
- Division of Infectious Disease and International Health, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | | | | | | | | | - Karin Perez
- Asociación Benefica PRISMA, Iquitos, Loreto, Peru
| | | | - Thomas Flynn
- Division of Infectious Disease and International Health, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Jixian Zhang
- Division of Infectious Disease and International Health, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Cesar Ramal Asayag
- Universidad Nacional de La Amazonia Peruana, Loreto, Peru
- Hospital Regional de Loreto, Iquitos, Loreto, Peru
| | - Graciela Meza Sanchez
- Universidad Nacional de La Amazonia Peruana, Loreto, Peru
- Direccion Regional de Salud, Loreto, Peru
| | | | - Martin Casapia Morales
- Universidad Nacional de La Amazonia Peruana, Loreto, Peru
- Hospital Regional de Loreto, Iquitos, Loreto, Peru
| | - Wilma Casanova
- Universidad Nacional de La Amazonia Peruana, Loreto, Peru
| | - Bruce Jiu
- Laboratorio de Referencia en Salud Publica de la Direccion Regional de Salud- Diresa, Loreto, Peru
| | - Richard Oberhelman
- Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Cesar Munayco Escate
- Centro Nacional de Epidemiologia, Prevencion, y Control de Enfermedades, Ministerio de Salud de Peru, Jesus Maria, Peru
| | - Rachel Silver
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Olga Henao
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kerry K Cooper
- School of Animal and Comparative Biomedical Sciences, University of Arizona, Tucson, AZ, USA
| | - Jie Liu
- School of Public Health, Qingdao University, Qingdao, China
| | - Eric R Houpt
- Division of Infectious Disease and International Health, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Margaret N Kosek
- Division of Infectious Disease and International Health, School of Medicine, University of Virginia, Charlottesville, VA, USA.
- Asociación Benefica PRISMA, Iquitos, Loreto, Peru.
- Division of Infectious Diseases and International Health, Public Health Sciences, 345 Crispell Dr, Rm 2525, Charlottesville, USA.
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7
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Peñataro Yori P, Paredes Olórtegui M, Schiaffino F, Perez K, Curico Huansi G, Flynn T, Zhang J, Ramal Asayag C, Meza Sanchez G, Silva Delgado H, Casapia Morales M, Casanova W, Jiu B, Munayco Escate C, Silver R, Henao O, Cooper KK, Liu J, Houpt E, Kosek MN, Colston JM, Oberhelman R, Pinedo Vasquez T, Garcia Bardales PF, Shapiama Lopez WV, Zegarra Paredes LF. Etiology of Acute Febrile Illness in the Peruvian Amazon as determined by modular formatted quantitative PCR: A Protocol for RIVERA, a Health Facility-Based Case-Control Study. RESEARCH SQUARE 2023:rs.3.rs-2635774. [PMID: 37034707 PMCID: PMC10081374 DOI: 10.21203/rs.3.rs-2635774/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Background The study of the etiology of acute febrile illness (AFI) has historically been designed as a prevalence of pathogens detected from a case series. This strategy has an inherent unrealistic assumption that all pathogen detection allows for causal attribution, despite known asymptomatic carriage of the principal causes of acute febrile illness in most low- and middle-income countries (LMICs). We designed a semi-quantitative PCR in a modular format to detect bloodborne agents of acute febrile illness that encompassed common etiologies of AFI in the region, etiologies of recent epidemics, etiologies that require an immediate public health response and additional pathogens of unknown endemicity. We then designed a study that would delineate background levels of transmission in the community in the absence of symptoms to provide corrected estimates of attribution for the principal determinants of AFI. Methods A case-control study of acute febrile illness in patients ten years or older seeking health care in Iquitos, Loreto, Peru, was planned. Upon enrollment, we will obtain blood, saliva, and mid-turbinate nasal swabs at enrollment with a follow-up visit on day 21-28 following enrollment to attain vital status and convalescent saliva and blood samples, as well as a questionnaire including clinical, socio-demographic, occupational, travel, and animal contact information for each participant. Whole blood samples are to be simultaneously tested for 32 pathogens using TaqMan array cards. Mid-turbinate samples will be tested for SARS-CoV-2, Influenza A and Influenza B. Conditional logistic regression models will be fitted treating case/control status as the outcome and with pathogen-specific sample positivity as predictors to attain estimates of attributable pathogen fractions for AFI. Discussion The modular PCR platforms will allow for reporting of all primary results of respiratory samples within 72 hours and blood samples within one week, allowing for results to influence local medical practice and enable timely public health responses. The inclusion of controls will allow for a more accurate estimate of the importance of specific, prevalent pathogens as a cause of acute illness. Study Registration Project 1791, Registro de Proyectos de Investigación en Salud Pública (PRISA), Instituto Nacional de Salud, Perú.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Cesar Munayco Escate
- Centro de Epidemiologia, Prevencion, y Control de Enfermedades, Ministerio de Salud
| | | | - Olga Henao
- Centers for Disease Control and Prevention
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De Santis O, Pothin E, Bouscaren N, Irish SR, Jaffar-Bandjee MC, Menudier L, Ramis J, Schultz C, Lamaurt F, Wisniak A, Bertolotti A, Hafsia S, Dussart P, Baril L, Mavingui P, Flahault A. Investigation of Dengue Infection in Asymptomatic Individuals during a Recent Outbreak in La Réunion. Viruses 2023; 15:v15030742. [PMID: 36992451 PMCID: PMC10058293 DOI: 10.3390/v15030742] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/15/2023] [Accepted: 03/10/2023] [Indexed: 03/17/2023] Open
Abstract
The number of dengue cases has increased dramatically over the past 20 years and is an important concern, particularly as the trends toward urbanization continue. While the majority of dengue cases are thought to be asymptomatic, it is unknown to what extent these contribute to transmission. A better understanding of their importance would help to guide control efforts. In 2019, a dengue outbreak in La Reunion resulted in more than 18,000 confirmed cases. Between October 2019 and August 2020, 19 clusters were investigated in the south, west, and east of the island, enabling the recruitment of 605 participants from 368 households within a 200 m radius of the home of the index cases (ICs). No active asymptomatic infections confirmed by RT-PCR were detected. Only 15% were possible asymptomatic dengue infections detected by the presence of anti-dengue IgM antibodies. Only 5.3% of the participants had a recent dengue infection confirmed by RT-PCR. Although the resurgence of dengue in La Réunion is very recent (2016), the rate of anti-dengue IgG positivity, a marker of past infections, was already high at 43% in this study. Dengue transmission was focal in time and space, as most cases were detected within a 100-m radius of the ICs, and within a time interval of less than 7 days between infections detected in a same cluster. No particular demographic or socio-cultural characteristics were associated with dengue infections. On the other hand, environmental risk factors such as type of housing or presence of rubbish in the streets were associated with dengue infections.
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Affiliation(s)
- Olga De Santis
- Inserm CIC1410, CHU de La Réunion, 97410 Saint Pierre, France
- Global Health Institute, University of Geneva, 1209 Geneva, Switzerland
- Correspondence:
| | - Emilie Pothin
- Swiss Tropical and Public Health Institute, 4002 Basel, Switzerland
- Department of Public Health, Faculty of Medicine, University of Basel, 4051 Basel, Switzerland
| | | | - Seth R. Irish
- Swiss Tropical and Public Health Institute, 4002 Basel, Switzerland
- Department of Public Health, Faculty of Medicine, University of Basel, 4051 Basel, Switzerland
| | | | | | - Julie Ramis
- UMR Processus Infectieux en Milieu Insulaire et Tropical, Cyroi, 97400 Saint Denis, France
| | - Cédric Schultz
- Inserm CIC1410, CHU de La Réunion, 97410 Saint Pierre, France
| | - Florence Lamaurt
- Inserm CIC1410, CHU de La Réunion, 97410 Saint Pierre, France
- Institut de santé publique, d’épidémiologie et de développement (ISPED), Université de Bordeaux, 33000 Bordeaux, France
| | - Ania Wisniak
- Global Health Institute, University of Geneva, 1209 Geneva, Switzerland
| | - Antoine Bertolotti
- Inserm CIC1410, CHU de La Réunion, 97410 Saint Pierre, France
- Service des Maladies Infectieuses—Dermatologie, CHU de La Réunion, 97410 Saint Pierre, France
| | - Sarah Hafsia
- UMR Processus Infectieux en Milieu Insulaire et Tropical, Cyroi, 97400 Saint Denis, France
| | - Philippe Dussart
- Unité de Virologie, Institut Pasteur de Madagascar, Antananarivo 101, Madagascar
| | - Laurence Baril
- Unité d’épidémiologie, Institut Pasteur de Madagascar, Antananarivo 101, Madagascar
| | - Patrick Mavingui
- UMR Processus Infectieux en Milieu Insulaire et Tropical, Cyroi, 97400 Saint Denis, France
| | - Antoine Flahault
- Global Health Institute, University of Geneva, 1209 Geneva, Switzerland
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9
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Vo HTM, Upasani V, Auerswald H, Lay S, Sann S, Vanderlinden A, Ken S, Sorn S, Ly S, Duong V, Dussart P, Cantaert T. Temporal patterns of functional anti-dengue antibodies in dengue infected individuals with different disease outcome or infection history. Sci Rep 2022; 12:17863. [PMID: 36284116 PMCID: PMC9596418 DOI: 10.1038/s41598-022-21722-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 09/30/2022] [Indexed: 01/20/2023] Open
Abstract
Heterotypic secondary dengue virus (DENV) infection is a risk factor for the development of severe disease. To assess the contribution of the developing polyclonal humoral immune response to the course of acute infection, we have determined anti-DENV IgG titers, neutralizing antibodies, percentages of antibodies binding to DENV-infected cells and antibody‑dependent enhancement (ADE) to the infecting serotype in DENV-infected Cambodian children (n = 58), ranging from asymptomatic dengue to severe disease. The results showed that ADE titers are highest against the infecting serotype during heterotypic secondary DENV-2 infection. Moreover, IgG titers, neutralizing antibodies and ADE titers against the infecting serotype peak at D10 and are maintained until D60 after laboratory-confirmed secondary DENV infection. Anti-DENV IgG titers and the magnitude of the functional antibody response were higher in secondary DENV-infected patients compared to primary infected patients. No differences in antibody titers, neutralizing or enhancing antibodies could be observed between asymptomatic or hospitalized patients between 6 and 8 days after laboratory-confirmed DENV-1 infection. However, at this time point, the level of IgG bound to DENV-infected cells was associated with disease severity in hospitalized patients. Taken together, our data offer insights for more comprehensive interpretation of antibody response profile to natural infection and its correlation to disease outcome.
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Affiliation(s)
- Hoa Thi My Vo
- Immunology Unit, Institut Pasteur du Cambodge, The Pasteur Network, Phnom Penh, Cambodia
- Centre for Tropical Medicine, Oxford University Clinical Research Unit, Ho Chi Minh, Vietnam
| | - Vinit Upasani
- Immunology Unit, Institut Pasteur du Cambodge, The Pasteur Network, Phnom Penh, Cambodia
| | - Heidi Auerswald
- Virology Unit, Institut Pasteur du Cambodge, The Pasteur Network, Phnom Penh, Cambodia
| | - Sokchea Lay
- Immunology Unit, Institut Pasteur du Cambodge, The Pasteur Network, Phnom Penh, Cambodia
| | - Sotheary Sann
- Immunology Unit, Institut Pasteur du Cambodge, The Pasteur Network, Phnom Penh, Cambodia
| | - Axelle Vanderlinden
- Immunology Unit, Institut Pasteur du Cambodge, The Pasteur Network, Phnom Penh, Cambodia
| | - Sreymom Ken
- Virology Unit, Institut Pasteur du Cambodge, The Pasteur Network, Phnom Penh, Cambodia
| | - Sopheak Sorn
- Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, The Pasteur Network, Phnom Penh, Cambodia
| | - Sowath Ly
- Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, The Pasteur Network, Phnom Penh, Cambodia
| | - Veasna Duong
- Virology Unit, Institut Pasteur du Cambodge, The Pasteur Network, Phnom Penh, Cambodia
| | - Philippe Dussart
- Virology Unit, Institut Pasteur du Cambodge, The Pasteur Network, Phnom Penh, Cambodia
- The Pasteur Network, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Tineke Cantaert
- Immunology Unit, Institut Pasteur du Cambodge, The Pasteur Network, Phnom Penh, Cambodia.
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10
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Pasharawipas T. Perspectives Concerning Various Symptoms of SARS-CoV-2 Detected Individuals. Open Microbiol J 2021. [DOI: 10.2174/1874285802115010152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
After exposure to SARS-CoV-2, varying symptoms of COVID-19 ranging from asymptomatic symptoms to morbidity and mortality have been exhibited in each individual. SARS-CoV-2 requires various cellular molecules for penetration into a target host cell. Angiotensin-converting enzyme2 (ACE2) acts as the viral receptor molecule. After attachment, SARS-CoV-2 also requires the transmembrane protease serine-2 (TMPRSS-2) and furin molecules, which serve as co-receptors for penetration into the target cell and for subsequent replication. In the meantime, a major histocompatibility complex (MHC) is required for the induction of adaptive immune cells, especially cytotoxic T cells and helper T cells, to clear the virally infected cells. This perspective review article proposes different aspects to explain the varying symptoms of the individuals who have been exposed to SARS-CoV-2, which relates to the polymorphisms of these involved molecules.
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Bournazos S, Vo HTM, Duong V, Auerswald H, Ly S, Sakuntabhai A, Dussart P, Cantaert T, Ravetch JV. Antibody fucosylation predicts disease severity in secondary dengue infection. Science 2021; 372:1102-1105. [PMID: 34083490 DOI: 10.1126/science.abc7303] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 01/19/2021] [Accepted: 04/14/2021] [Indexed: 12/13/2022]
Abstract
Although antiviral antibodies generally confer protective functions, antibodies against dengue virus (DENV) are associated with enhanced disease susceptibility. Antibodies can mediate DENV infection of leukocytes via Fcγ receptors, likely contributing to dengue disease pathogenesis. To determine if this mechanism accounts for variable disease severity, we examined Fab and Fc structures of anti-DENV antibodies from patients before and after infection and with variable disease outcomes. Neither antibody titers nor neutralizing activity correlated with disease severity in DENV-infected populations. Rather, DENV infection induced a specific increase in immunoglobulin G1 (IgG1) afucosylation, and the levels of afucosylated IgG1 were predictive of dengue disease severity. Thus, the IgG1 fucosylation status represents a robust prognostic tool for dengue disease, highlighting the key role of the Fc glycan structure in dengue pathogenesis.
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Affiliation(s)
- Stylianos Bournazos
- Laboratory of Molecular Genetics and Immunology, The Rockefeller University, New York, NY, USA
| | - Hoa Thi My Vo
- Immunology Unit, Institut Pasteur du Cambodge, Institut Pasteur International Network, Phnom Penh, Cambodia
| | - Veasna Duong
- Virology Unit, Institut Pasteur du Cambodge, Institut Pasteur International Network, Phnom Penh, Cambodia
| | - Heidi Auerswald
- Virology Unit, Institut Pasteur du Cambodge, Institut Pasteur International Network, Phnom Penh, Cambodia
| | - Sowath Ly
- Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, Institut Pasteur International Network, Phnom Penh, Cambodia
| | - Anavaj Sakuntabhai
- Functional Genetics of Infectious Diseases Unit, Department of Global Health, Institut Pasteur, Paris Cedex 15, France.,Centre National de la Recherche Scientifique (CNRS), UMR2000, Paris Cedex 15, France
| | - Philippe Dussart
- Virology Unit, Institut Pasteur du Cambodge, Institut Pasteur International Network, Phnom Penh, Cambodia
| | - Tineke Cantaert
- Immunology Unit, Institut Pasteur du Cambodge, Institut Pasteur International Network, Phnom Penh, Cambodia.
| | - Jeffrey V Ravetch
- Laboratory of Molecular Genetics and Immunology, The Rockefeller University, New York, NY, USA.
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Ligsay A, Telle O, Paul R. Challenges to Mitigating the Urban Health Burden of Mosquito-Borne Diseases in the Face of Climate Change. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5035. [PMID: 34068688 PMCID: PMC8126106 DOI: 10.3390/ijerph18095035] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/22/2021] [Accepted: 05/06/2021] [Indexed: 11/17/2022]
Abstract
Cities worldwide are facing ever-increasing pressure to develop mitigation strategies for all sectors to deal with the impacts of climate change. Cities are expected to house 70% of the world's population by 2050, and developing related resilient health systems is a significant challenge. Because of their physical nature, cities' surface temperatures are often substantially higher than that of the surrounding rural areas, generating the so-called Urban Heat Island (UHI) effect. Whilst considerable emphasis has been placed on strategies to mitigate against the UHI-associated negative health effects of heat and pollution in cities, mosquito-borne diseases have largely been ignored. However, the World Health Organization estimates that one of the main consequences of global warming will be an increased burden of mosquito-borne diseases, many of which have an urban facet to their epidemiology and thus the global population exposed to these pathogens will steadily increase. Current health mitigation strategies for heat and pollution, for example, may, however, be detrimental for mosquito-borne diseases. Implementation of multi-sectoral strategies that can benefit many sectors (such as water, labor, and health) do exist or can be envisaged and would enable optimal use of the meagre resources available. Discussion among multi-sectoral stakeholders should be actively encouraged.
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Affiliation(s)
- Antonio Ligsay
- The Graduate School, University of Santo Tomas, Manila 1008, Philippines;
- Clinical and Health-Related Research, St. Luke’s Medical Center WHQM College of Medicine, Quezon City 1112, Philippines
| | - Olivier Telle
- CNRS, Géographie-Cités, Paris 1 Université Paris-Sorbonne, 75006 Paris, France;
| | - Richard Paul
- Functional Genetics of Infectious Diseases Unit, Institut Pasteur, UMR 2000 (CNRS), 75015 Paris, France
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13
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Dengue outbreaks in Bangladesh: Historic epidemic patterns suggest earlier mosquito control intervention in the transmission season could reduce the monthly growth factor and extent of epidemics. CURRENT RESEARCH IN PARASITOLOGY & VECTOR-BORNE DISEASES 2021; 1:100063. [PMID: 35284868 PMCID: PMC8906128 DOI: 10.1016/j.crpvbd.2021.100063] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 11/16/2021] [Accepted: 11/20/2021] [Indexed: 11/21/2022]
Abstract
Dengue is endemic in Bangladesh and is an important cause of morbidity and mortality. Suppressing the mosquito vector activity at the optimal time annually is a practical strategy to control dengue outbreaks. The objective of this study was to estimate the monthly growth factor (GF) of dengue cases over the past 12 years as a means to identify the optimal time for a vector-control programme in Bangladesh. We reviewed the monthly cases reported by the Institute of Epidemiology, Disease Control and Research of Bangladesh during the period of January 2008–December 2019. We calculated the GF of dengue cases between successive months during this period and report means and 95% confidence intervals (CI). The median number of patients admitted to the hospital with dengue fever per year was 1554 (range: 375–101,354). The mean monthly GF of dengue cases was 1.2 (95% CI: 0.4–2.4). The monthly GF lower CI between April and July was > 1, whereas from September to November and January the upper CI was <1. The highest GF of dengue was recorded in June (mean: 2.4; 95% CI: 1.7–3.5) and lowest in October (mean: 0.43; 95% CI: 0.24–0.73). More than 81% (39/48) months between April and July for the period 2008–2019 had monthly GF > 1 compared to 20% (19/96) months between August and March of the same period. The monthly GF was significantly correlated with monthly rainfall (r = 0.39) and monthly mean temperature (r = 0.30). The growth factor of the dengue cases over the last 12 years appeared to follow a marked periodicity linked to regional rainfall patterns. The increased transmission rate during the months of April–July, a seasonally determined peak suggests the need for strengthening a range of public health interventions, including targeted vector control efforts and community education campaigns. The monthly reported dengue cases from January 2008 to December 2019 were analysed to estimate monthly growth factor. The monthly growth factor lower 95% confidence interval between April and July was > 1. More than 81% (39/48) months between April and July of the period 2008–2019 had monthly GF > 1. Only 20% (19/96) of the months between August and March of the period 2008–2019 had monthly GF > 1. Controlling the mosquitoes earlier might be more efficient in limiting the dengue outbreaks in Bangladesh.
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14
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Hussen MO, Sayed ASM, Abushahba MFN. Sero-epidemiological study on Dengue fever virus in humans and camels at Upper Egypt. Vet World 2020; 13:2618-2624. [PMID: 33487979 PMCID: PMC7811540 DOI: 10.14202/vetworld.2020.2618-2624] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 11/02/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND AND AIM Dengue fever (DF) is an important mosquito-borne viral zoonosis affecting over 100 countries worldwide and putting about 3.9 billion people at risk of infection. The disease has re-emerged in Egypt since 2011; however, there is a paucity of recent epidemiological data available. Therefore, in this study, we employed a cross-sectional study to determine DF prevalence in humans and camels in Asyut and Sohag Governorates, Egypt, during 2019. MATERIALS AND METHODS A total of 91 humans and a similar number of dromedary camels were utilized in this study. Sera were obtained and analyzed for the presence of specific antibodies against DF virus using enzyme-linked immunosorbent assay. Related epidemiological data affecting the disease spread in humans and camels were recorded and statistically analyzed. RESULTS The seroprevalence of DF in humans and camels was 12.09% and 3.3%, respectively. The disease varied significantly by the species examined as humans were found to be at a higher risk of acquiring the infection compared to camels. Nearly equal odds of exposure (odds ratio [OR]) were seen in the individuals with close contact with camels compared to those without; however, individuals exposed to mosquitoes were at approximately 3 times higher risk of infection (OR=2.95 [95% confidence interval [CI], 0.73-11.93]) compared to individuals who were not exposed to mosquitoes (OR=0.033 [95% CI, 0.084-1.37]). Interestingly, DF seropositivity in camels was significantly related to the presence or absence of symptoms within 2 weeks before sampling (p=0.02) where symptomatic animals had higher odds of exposure (OR=19.51 [95%, 0.97-392.3]) compared to asymptomatic ones (OR=0.05 [95%, 0.002-1.03]). CONCLUSION The current study reports the presence of specific antibodies against dengue virus (DENV) in humans residing within Asyut and Sohag Governorates, Egypt. Furthermore, it provides the first serological evidence of DENV circulation in camels which is alarming. A more comprehensive study is needed; however, this baseline investigation underscores the urgent need for increasing awareness among people residing in the area as well as application of the appropriate mosquito control measures to avoid further spread of the disease.
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Affiliation(s)
| | - Amal S. M. Sayed
- Department of Zoonoses, Faculty of Veterinary Medicine, Assiut University, Asyut 71526, Egypt
| | - Mostafa F. N. Abushahba
- Department of Zoonoses, Faculty of Veterinary Medicine, Assiut University, Asyut 71526, Egypt
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15
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Vishvakarma VK, Chandra R, Singh P. An Experimental and Theoretical Approach to Understand Fever, DENF & its Cure. Infect Disord Drug Targets 2020; 21:495-513. [PMID: 32888275 DOI: 10.2174/1871526520999200905122052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/21/2020] [Accepted: 07/17/2020] [Indexed: 11/22/2022]
Abstract
Fever is a response of a human body, due to an increase in the temperature, against certain stimuli. It may be associated with several reasons and one of the major causes of fever is a mosquito bite. Fever due to dengue virus (DENV) infection is being paid most attention out of several other fever types because of a large number of deaths reported worldwide. Dengue virus is transmitted by biting of the mosquitoes, Aedes aegypti and Aedes albopictus. DENV1, DENV2, DENV3 and DENV4 are the four serotypes of dengue virus and these serotypes have 65% similarities in their genomic structure. The genome of DENV is composed of single-stranded RNA and it encodes for the polyprotein. Structural and non-structural proteins (nsP) are the two major parts of polyprotein. Researchers have paid high attention to the non-structural protease (nsP) of DENV like nsP1, nsP2A, nsP2B, nsP3, nsP4A, nsP4B and nsP5. The NS2B-NS3 protease of DENV is the prime target of the researchers as it is responsible for the catalytic activity. In the present time, Dengvaxia (vaccine) is being recommended to patients suffering severely from DENV infection in few countries only. Till date, neither a vaccine nor an effective medicine is available to combat all four serotypes. This review describes the fever, its causes, and studies to cure the infection due to DENV using theoretical and experimental approaches.
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Affiliation(s)
- Vijay Kumar Vishvakarma
- Department of Chemistry, Atma Ram Sanatan Dharma College, University of Delhi, New Delhi, India
| | - Ramesh Chandra
- Drug Discovery & Development Laboratory, Department of Chemistry, University of Delhi, Delhi, India
| | - Prashant Singh
- Department of Chemistry, Atma Ram Sanatan Dharma College, University of Delhi, New Delhi, India
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Ladreyt H, Auerswald H, Tum S, Ken S, Heng L, In S, Lay S, Top C, Ly S, Duong V, Dussart P, Durand B, Chevalier V. Comparison of Japanese Encephalitis Force of Infection in Pigs, Poultry and Dogs in Cambodian Villages. Pathogens 2020; 9:pathogens9090719. [PMID: 32882890 PMCID: PMC7558861 DOI: 10.3390/pathogens9090719] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/25/2020] [Accepted: 08/28/2020] [Indexed: 12/22/2022] Open
Abstract
Japanese encephalitis virus (JEV) is the main cause of human viral encephalitis in Asia, with a mortality rate reaching 30%, mostly affecting children. The traditionally described cycle involving wild birds as reservoirs, pigs as amplifying hosts and Culex mosquitoes as vectors is questioned, with increasing evidence of a more complex multi-host system involved in areas where densities of pigs are low, such as in Cambodia. In 2018, we examined pigs, chickens, ducks and dogs from Kandal province, Cambodia, for antibody response against JEV by hemagglutination inhibition and virus neutralization assays. Forces of infection (FOI) for flaviviruses and JEV were estimated per species and per unit of body surface area (BSA). JEV seroprevalence reached 31% (95% CI: 23-41%) in pigs, 1% (95% CI: 0.1-3%) in chickens, 12% (95% CI: 7-19%) in ducks and 35% (95% CI: 28-42%) in dogs. Pigs were most likely to be infected (FOI: 0.09 per month), but the FOI was higher in ducks than in pigs for a given BSA (ratio of 0.13). Dogs had a lower FOI than ducks but a higher FOI than chickens (0.01 per month). For a given BSA, dogs were less likely to be infected than pigs (ratio of 1.9). In Cambodia, the virus may be circulating between multiple hosts. Dogs live in close contact with humans, and estimating their exposure to JEV infection could be a relevant indicator of the risk for humans to get infected, which is poorly known due to underdiagnosis. Understanding the JEV cycle and developing tools to quantify the exposure of humans is essential to adapt and support control measures for this vaccine-preventable disease.
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Affiliation(s)
- Héléna Ladreyt
- Epidemiology Unit, Laboratory for Animal Health, French Agency for Food, Environmental and Occupational Health and Safety (ANSES), University Paris-Est, 14 rue Pierre et Marie Curie, 94700 Maisons-Alfort, France; (H.L.); (B.D.)
- International Center of Research in Agriculture for Development (CIRAD), UMR ASTRE, F-34090 Montpellier, France
| | - Heidi Auerswald
- Virology Unit, Institut Pasteur du Cambodge, Institut Pasteur International Network, 5 Monivong Boulevard, P.O Box. 983, Phnom Penh 12201, Cambodia; (H.A.); (S.K.); (L.H.); (S.I.); (C.T.); (V.D.); (P.D.)
| | - Sothyra Tum
- National Animal Health and Production Research Institute, General Directorate for Animal Health and Production, Ministry of Agriculture, Forestry and Fisheries, Phnom Penh 12201, Cambodia;
| | - Sreymom Ken
- Virology Unit, Institut Pasteur du Cambodge, Institut Pasteur International Network, 5 Monivong Boulevard, P.O Box. 983, Phnom Penh 12201, Cambodia; (H.A.); (S.K.); (L.H.); (S.I.); (C.T.); (V.D.); (P.D.)
| | - Leangyi Heng
- Virology Unit, Institut Pasteur du Cambodge, Institut Pasteur International Network, 5 Monivong Boulevard, P.O Box. 983, Phnom Penh 12201, Cambodia; (H.A.); (S.K.); (L.H.); (S.I.); (C.T.); (V.D.); (P.D.)
| | - Saraden In
- Virology Unit, Institut Pasteur du Cambodge, Institut Pasteur International Network, 5 Monivong Boulevard, P.O Box. 983, Phnom Penh 12201, Cambodia; (H.A.); (S.K.); (L.H.); (S.I.); (C.T.); (V.D.); (P.D.)
| | - Sokchea Lay
- Immunology Unit, Institut Pasteur du Cambodge, Institut Pasteur International Network, 5 Monivong Boulevard, P.O Box. 983, Phnom Penh 12201, Cambodia;
| | - Chakriyouth Top
- Virology Unit, Institut Pasteur du Cambodge, Institut Pasteur International Network, 5 Monivong Boulevard, P.O Box. 983, Phnom Penh 12201, Cambodia; (H.A.); (S.K.); (L.H.); (S.I.); (C.T.); (V.D.); (P.D.)
| | - Sowath Ly
- Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, Institut Pasteur International Network, 5 Monivong Boulevard, PO Box 983, Phnom Penh 12201, Cambodia;
| | - Veasna Duong
- Virology Unit, Institut Pasteur du Cambodge, Institut Pasteur International Network, 5 Monivong Boulevard, P.O Box. 983, Phnom Penh 12201, Cambodia; (H.A.); (S.K.); (L.H.); (S.I.); (C.T.); (V.D.); (P.D.)
| | - Philippe Dussart
- Virology Unit, Institut Pasteur du Cambodge, Institut Pasteur International Network, 5 Monivong Boulevard, P.O Box. 983, Phnom Penh 12201, Cambodia; (H.A.); (S.K.); (L.H.); (S.I.); (C.T.); (V.D.); (P.D.)
| | - Benoit Durand
- Epidemiology Unit, Laboratory for Animal Health, French Agency for Food, Environmental and Occupational Health and Safety (ANSES), University Paris-Est, 14 rue Pierre et Marie Curie, 94700 Maisons-Alfort, France; (H.L.); (B.D.)
| | - Véronique Chevalier
- International Center of Research in Agriculture for Development (CIRAD), UMR ASTRE, F-34090 Montpellier, France
- Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, Institut Pasteur International Network, 5 Monivong Boulevard, PO Box 983, Phnom Penh 12201, Cambodia;
- International Center of Research in Agriculture for Development (CIRAD), UMR ASTRE, Phnom Penh 12201, Cambodia
- Correspondence:
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17
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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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