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Epidemiology of Infant Dengue Cases Illuminates Serotype-Specificity in the Interaction between Immunity and Disease, and Changes in Transmission Dynamics.
PLoS Negl Trop Dis. 2015 Dec; 9(12):e0004262.PN

Abstract

BACKGROUND

Infants born to dengue immune mothers acquire maternal antibodies to dengue. These antibodies, though initially protective, decline during the first year of life to levels thought to be disease enhancing, before reaching undetectable levels. Infants have long been studied to understand the interaction between infection and disease on an individual level.

METHODS/FINDINGS

Considering infants (cases <1 year old) as a unique group, we analyzed serotype specific dengue case data from patients admitted to a pediatric hospital in Bangkok, Thailand. We show differences in the propensity of serotypes to cause disease in individuals with dengue antibodies (infants and post-primary cases) and in individuals without dengue antibodies (primary cases). The mean age of infant cases differed among serotypes, consistent with previously observed differential waning of maternal antibody titers by serotype. We show that trends over time in epidemiology of infant cases are consistent with those observed in the whole population, and therefore with trends in the force of infection.

CONCLUSIONS/SIGNIFICANCE

Infants with dengue are informative about the interaction between antibody and the dengue serotypes, confirming that in this population DENV-2 and DENV-4 almost exclusively cause disease in the presence of dengue antibody despite infections occurring in others. We also observe differences between the serotypes in the mean age in infant cases, informative about the interaction between waning immunity and disease for the different serotypes in infants. In addition, we show that the mean age of infant cases over time is informative about transmission in the whole population. Therefore, ongoing surveillance for dengue in infants could provide useful insights into dengue epidemiology, particularly after the introduction of a dengue vaccine targeting adults and older children.

Authors+Show Affiliations

Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America.Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America. Department of Biology, University of Florida, Gainesville, Florida, United States of America.Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.Queen Sirikit National Institute of Child Health, Bangkok, Thailand.Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America.Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America.Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.Dengue Vaccine Initiative, International Vaccine Institute, Seoul, Korea.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26658730

Citation

Clapham, Hannah, et al. "Epidemiology of Infant Dengue Cases Illuminates Serotype-Specificity in the Interaction Between Immunity and Disease, and Changes in Transmission Dynamics." PLoS Neglected Tropical Diseases, vol. 9, no. 12, 2015, pp. e0004262.
Clapham H, Cummings DA, Nisalak A, et al. Epidemiology of Infant Dengue Cases Illuminates Serotype-Specificity in the Interaction between Immunity and Disease, and Changes in Transmission Dynamics. PLoS Negl Trop Dis. 2015;9(12):e0004262.
Clapham, H., Cummings, D. A., Nisalak, A., Kalayanarooj, S., Thaisomboonsuk, B., Klungthong, C., Fernandez, S., Srikiatkhachorn, A., Macareo, L. R., Lessler, J., Reiser, J., & Yoon, I. K. (2015). Epidemiology of Infant Dengue Cases Illuminates Serotype-Specificity in the Interaction between Immunity and Disease, and Changes in Transmission Dynamics. PLoS Neglected Tropical Diseases, 9(12), e0004262. https://doi.org/10.1371/journal.pntd.0004262
Clapham H, et al. Epidemiology of Infant Dengue Cases Illuminates Serotype-Specificity in the Interaction Between Immunity and Disease, and Changes in Transmission Dynamics. PLoS Negl Trop Dis. 2015;9(12):e0004262. PubMed PMID: 26658730.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Epidemiology of Infant Dengue Cases Illuminates Serotype-Specificity in the Interaction between Immunity and Disease, and Changes in Transmission Dynamics. AU - Clapham,Hannah, AU - Cummings,Derek A T, AU - Nisalak,Ananda, AU - Kalayanarooj,Siripen, AU - Thaisomboonsuk,Butsaya, AU - Klungthong,Chonticha, AU - Fernandez,Stefan, AU - Srikiatkhachorn,Anon, AU - Macareo,Louis R, AU - Lessler,Justin, AU - Reiser,Julia, AU - Yoon,In-Kyu, Y1 - 2015/12/11/ PY - 2015/07/21/received PY - 2015/11/03/accepted PY - 2015/12/15/entrez PY - 2015/12/15/pubmed PY - 2016/4/7/medline SP - e0004262 EP - e0004262 JF - PLoS neglected tropical diseases JO - PLoS Negl Trop Dis VL - 9 IS - 12 N2 - BACKGROUND: Infants born to dengue immune mothers acquire maternal antibodies to dengue. These antibodies, though initially protective, decline during the first year of life to levels thought to be disease enhancing, before reaching undetectable levels. Infants have long been studied to understand the interaction between infection and disease on an individual level. METHODS/FINDINGS: Considering infants (cases <1 year old) as a unique group, we analyzed serotype specific dengue case data from patients admitted to a pediatric hospital in Bangkok, Thailand. We show differences in the propensity of serotypes to cause disease in individuals with dengue antibodies (infants and post-primary cases) and in individuals without dengue antibodies (primary cases). The mean age of infant cases differed among serotypes, consistent with previously observed differential waning of maternal antibody titers by serotype. We show that trends over time in epidemiology of infant cases are consistent with those observed in the whole population, and therefore with trends in the force of infection. CONCLUSIONS/SIGNIFICANCE: Infants with dengue are informative about the interaction between antibody and the dengue serotypes, confirming that in this population DENV-2 and DENV-4 almost exclusively cause disease in the presence of dengue antibody despite infections occurring in others. We also observe differences between the serotypes in the mean age in infant cases, informative about the interaction between waning immunity and disease for the different serotypes in infants. In addition, we show that the mean age of infant cases over time is informative about transmission in the whole population. Therefore, ongoing surveillance for dengue in infants could provide useful insights into dengue epidemiology, particularly after the introduction of a dengue vaccine targeting adults and older children. SN - 1935-2735 UR - https://www.unboundmedicine.com/medline/citation/26658730/Epidemiology_of_Infant_Dengue_Cases_Illuminates_Serotype_Specificity_in_the_Interaction_between_Immunity_and_Disease_and_Changes_in_Transmission_Dynamics_ L2 - https://dx.plos.org/10.1371/journal.pntd.0004262 DB - PRIME DP - Unbound Medicine ER -