Incidence of Dengue Virus Infection in School-Aged Children in Puerto Rico: A Prospective Seroepidemiologic Study

D. Fermín Argüello National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico; Office of the Director, National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; University of Puerto Rico School of Medicine, San Juan, Puerto Rico; Food and Drug Administration, Silver Spring, Maryland; Sanofi Aventis, Paris, France; Sanofi Pasteur, Lyon, France

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Kay M. Tomashek National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico; Office of the Director, National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; University of Puerto Rico School of Medicine, San Juan, Puerto Rico; Food and Drug Administration, Silver Spring, Maryland; Sanofi Aventis, Paris, France; Sanofi Pasteur, Lyon, France

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Luz Quiñones National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico; Office of the Director, National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; University of Puerto Rico School of Medicine, San Juan, Puerto Rico; Food and Drug Administration, Silver Spring, Maryland; Sanofi Aventis, Paris, France; Sanofi Pasteur, Lyon, France

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Manuela Beltran National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico; Office of the Director, National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; University of Puerto Rico School of Medicine, San Juan, Puerto Rico; Food and Drug Administration, Silver Spring, Maryland; Sanofi Aventis, Paris, France; Sanofi Pasteur, Lyon, France

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Luz Acosta National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico; Office of the Director, National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; University of Puerto Rico School of Medicine, San Juan, Puerto Rico; Food and Drug Administration, Silver Spring, Maryland; Sanofi Aventis, Paris, France; Sanofi Pasteur, Lyon, France

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Luis M. Santiago National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico; Office of the Director, National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; University of Puerto Rico School of Medicine, San Juan, Puerto Rico; Food and Drug Administration, Silver Spring, Maryland; Sanofi Aventis, Paris, France; Sanofi Pasteur, Lyon, France

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Brad J. Biggerstaff National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico; Office of the Director, National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; University of Puerto Rico School of Medicine, San Juan, Puerto Rico; Food and Drug Administration, Silver Spring, Maryland; Sanofi Aventis, Paris, France; Sanofi Pasteur, Lyon, France

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Enid J. Garcia-Rivera National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico; Office of the Director, National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; University of Puerto Rico School of Medicine, San Juan, Puerto Rico; Food and Drug Administration, Silver Spring, Maryland; Sanofi Aventis, Paris, France; Sanofi Pasteur, Lyon, France

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Wellington Sun National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico; Office of the Director, National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; University of Puerto Rico School of Medicine, San Juan, Puerto Rico; Food and Drug Administration, Silver Spring, Maryland; Sanofi Aventis, Paris, France; Sanofi Pasteur, Lyon, France

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Laurence Pollissard-Gadroy National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico; Office of the Director, National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; University of Puerto Rico School of Medicine, San Juan, Puerto Rico; Food and Drug Administration, Silver Spring, Maryland; Sanofi Aventis, Paris, France; Sanofi Pasteur, Lyon, France

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Christine Luxemburger National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico; Office of the Director, National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; University of Puerto Rico School of Medicine, San Juan, Puerto Rico; Food and Drug Administration, Silver Spring, Maryland; Sanofi Aventis, Paris, France; Sanofi Pasteur, Lyon, France

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Elizabeth Hunsperger National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico; Office of the Director, National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; University of Puerto Rico School of Medicine, San Juan, Puerto Rico; Food and Drug Administration, Silver Spring, Maryland; Sanofi Aventis, Paris, France; Sanofi Pasteur, Lyon, France

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DOI:
https://doi.org/10.4269/ajtmh.14-0231
Volume/Issue:
Volume 92: Issue 3
Page(s):
486–491
Restricted access
Get Permissions

Dengue is a potentially fatal acute febrile illness caused by the mosquito-borne dengue viruses (DENV-1 to -4). To estimate DENV seroincidence in school-aged children, a 1-year prospective cohort study was conducted in Patillas, Puerto Rico; 10- to 18-year-olds (N = 345) were randomly selected from 13 public schools. At enrollment, 49.8% of the entire cohort had DENV immunoglobulin G (IgG) anti-DENV antibodies, and there were individuals with neutralizing antibodies specific to each of the four DENV. The mean age of participants with incident DENV infection was 13.4 years. The 1-year seroincidence rate was 5.6%, and 61.1% of infections were inapparent. Having IgG anti-DENV at enrollment was associated with seroincidence (risk ratio = 6.8). Acute febrile illnesses during the study period were captured by a fever diary and an enhanced and passive surveillance system in the municipios of Patillas and Guayama. In summary, at enrollment, nearly one-half of the participants had a prior DENV infection, with the highest incidence in the 10- to 11-year-olds, of which most were inapparent infections, and symptomatic infections were considered mild.

Author Notes

* Address correspondence to Elizabeth Hunsperger, CDC Dengue Branch, 1324 Calle Cañada, San Juan, PR 00920-3860. E-mail: enh4@cdc.gov

Financial support: This work was supported, in part, under Cooperative Research and Development Agreement (CRDA) CID-01-138-02 with Sanofi Pasteur, Inc.

Authors' addresses: D. Fermín Argüello, Kay M. Tomashek, Luz Quiñones, Manuela Beltran, Luz Acosta, Luis M. Santiago, and Elizabeth Hunsperger, National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico, E-mails: dfmanito@gmail.com, kay.tomashek@nih.gov, luzquinones@hotmail.com, mvb6@cdc.gov, lda9@cdc.gov, and enh4@cdc.gov. Brad J. Biggerstaff, Office of the Director, National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, E-mail: bkb5@cdc.gov. Enid J. Garcia-Rivera, University of Puerto Rico School of Medicine, San Juan, Puerto Rico, E-mail: enid.garcia3@upr.edu. Wellington Sun, Food and Drug Administration, Silver Spring, MD, E-mail: Wellington.Sun@fda.hhs.gov. Laurence Pollissard-Gadroy, Sanofi Aventis, Paris, France, E-mail: laurencehmp@gmail.com. Christine Luxemburger, Sanofi Pasteur, Lyon, France, E-mail: Christine.Luxemburger@sanofipasteur.com.

Copyright:
© The American Society of Tropical Medicine and Hygiene 2015
Received:
14 Apr 2014
|
Accepted:
20 Nov 2014
|
Published Online:
04 Mar 2015
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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