• 1.

    World Health Organization, 2009. Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control. Geneva, Switzerland: World Health Organization.

    • Search Google Scholar
    • Export Citation
  • 2.

    Bhatt S, Gething PW, Brady OJ, Messina JP, Farlow AW, Moyes CL, Drake JM, Brownstein JS, Hoen AG, Sankoh O, Myers MF, George DB, Jaenisch T, William Wint GR, Simmons CP, Scott TW, Farrar JJ, Hay SI, 2013. The global distribution and burden of dengue. Nature 120: 504507.

    • Search Google Scholar
    • Export Citation
  • 3.

    Sangkawibha N, Rojanasuphot S, Ahandrik S, Viriyapongse S, Jatanasen S, Salitul V, Phanthumachinda B, Halstead SB, 1984. Risk factors in dengue shock syndrome: a prospective epidemiologic study in Rayong, Thailand I. The 1980 outbreak. Am J Epidemiol 120: 653669.

    • Search Google Scholar
    • Export Citation
  • 4.

    Wilder-Smith A, Schwartz E, 2005. Dengue in travelers. N Engl J Med 353: 924932.

  • 5.

    Mohammed HP, Ramos MM, Rivera A, Johansson M, Munoz-Jordan JL, Sun W, Tomashek KM, 2010. Travel-associated dengue infections in the United States, 1996 to 2005. J Travel Med 17: 814.

    • Search Google Scholar
    • Export Citation
  • 6.

    Centers for Disease Control and Prevention (CDC), 2010. Travel-associated dengue surveillance: United States, 2006–2008. MMWR 59: 715719.

    • Search Google Scholar
    • Export Citation
  • 7.

    Potasman I, Srugo I, Schwartz E, 1999. Dengue seroconversion among Israeli travelers to tropical countries. Emerg Infect Dis 5: 824827.

  • 8.

    Cobelens FGJ, Groen J, Osterhaus ADME, Leentvaar-Kuipers A, Wertheim-van Dillen PME, Kager PA, 2002. Incidence and risk factors of probable dengue virus infection among Dutch travelers to Asia. Trop Med Int Health 7: 331338.

    • Search Google Scholar
    • Export Citation
  • 9.

    Baaten GGG, Gerard JB, Zaaijer HL, van Gool T, King JAPC, van den Hoek A, 2011. Travel-related dengue virus infection, the Netherlands, 2006–2007. Emerg Infect Dis 17: 821828.

    • Search Google Scholar
    • Export Citation
  • 10.

    Leder K, Mutsch M, Schlagenhauf P, Luxemburger C, Torresi J, 2013. Seroepidemiology of dengue in travelers: a paired sera analysis. Travel Med Infect Dis 11: 210213.

    • Search Google Scholar
    • Export Citation
  • 11.

    Ratnam I, Black J, Leder K, Biggs BA, Matchett E, Padiglione A, Woolley I, Panagiotidis T, Gherardin T, Pollissard L, Demont C, Luxemburger C, Torresi J, 2012. Incidence and seroprevalence of dengue virus infections in Australian travelers to Asia. Eur J Clin Microbiol Infect Dis 31: 12031210.

    • Search Google Scholar
    • Export Citation
  • 12.

    Wong SJ, Boyle RH, Demarest VL, Woodmansee AN, Kramer LD, Hongmin L, Drebot M, Koski RA, Fikrig E, Martin DA, Shi PY, 2003. Immunoassay targeting nonstructural protein 5 to differentiate West Nile Virus infection from dengue and St. Louis encephalitis virus infections and from flavivirus infection. J Clin Microbiol 41: 42174223.

    • Search Google Scholar
    • Export Citation
  • 13.

    Johnson AJ, Martin DA, Karabatsos N, Roehrig JT, 2000. Detection of anti-arboviral immunoglobuoin G by using a monoclonal antibody-based caputre enzyme-linnked immunsorbent assay. J Clin Microbiol 38: 18271831.

    • Search Google Scholar
    • Export Citation
  • 14.

    Marrero-Santos KM, Beltran M, Carrio-Lebron J, Sanchez-Vegas C, Hamer DH, Barnett ED, Santiago LM, Hunsperger EA, 2013. Optimization of the cut-off value for a commercial anti-dengue virus IgG immunoassay. Clin Vaccine Immunol 20: 358362.

    • Search Google Scholar
    • Export Citation
  • 15.

    Allwinn R, Doerr HW, Emmerich P, Schmitz H, Preiser W, 2002. Cross-reactivity in flavivirus serology: new implications of an old finding? Med Microbiol Immunol (Berl) 190: 199202.

    • Search Google Scholar
    • Export Citation
  • 16.

    Hertz JT, Munishi OM, Ooi EE, Howe S, Lim WY, Chow A, Morrissey AB, Bartlett JA, Onyango JJ, Maro VP, Kinabo GD, Saganda W, Gubler DJ, Crump JA, 2012. Chikungunya and dengue fever among hospitalized febrile patients in northern Tanzania. Am J Trop Med Hyg 86: 171177.

    • Search Google Scholar
    • Export Citation
  • 17.

    Amarasinghe A, Kuritsky JN, Letson GW, Margolis HS, 2011. Dengue virus infections in Africa. Emerg Infect Dis 17: 13491354.

  • 18.

    Mease LE, Coldren RL, Musila LA, Prosser T, Ogolla F, Ofula VO, Schoepp RJ, Rossi CA, Adungo N, 2011. Seroprevalence and distribution of arboviral infections among rural Kenyan adults: a cross-sectional study. Virol J 8: 371.

    • Search Google Scholar
    • Export Citation
  • 19.

    Bhatt S, Gething PW, Brady OJ, Messina JP, Farlow AW, Moyes CL, Drake JM, Brownstein JS, Hoen AG, Sankoh O, Myers MF, George DB, Jaenisch T, Wint GR, Simmons CP, Scott TW, Farrar JJ, Hay SI, 2013. The global distribution and burden of dengue. Nature 496: 504507.

    • Search Google Scholar
    • Export Citation
  • 20.

    World Health Organization, (eds.) 2009. Chapter 8: Dengue vectors. Comprehensive Guidelines for Prevention and Control of Dengue and Dengue Haemorrhagic Fever. Geneva, Switzerland: World Health Organization.

    • Search Google Scholar
    • Export Citation
  • 21.

    Reiter P, Lathrop S, Bunning ML, Biggersaff BJ, Singer D, Tiwari T, Baber L, Amador M, Thirion J, Hayes J, Seca C, Mendez J, Ramirez B, Robinson J, Rawlings J, Vorndam V, Waterman S, Gubler D, Clark G, Hayes E, 2003. Texas lifestyle limits transmission of dengue virus. Emerg Infect Dis 9: 8689.

    • Search Google Scholar
    • Export Citation
  • 22.

    Chadee DD, Martinez R, 2000. Landing periodicity of Aedes aegypti with implications for dengue transmission in Trinidad, West Indies. J Vector Ecol 25: 158163.

    • Search Google Scholar
    • Export Citation
  • 23.

    Benoit CM, MacLeod WB, Hamer DH, Sanchez-Vegas C, Chen LH, Wilson ME, Karchmer AW, Yanni E, Hochberg NS, Ooi WW, Kogelman L, Barnett ED, 2013. Acceptability of hypothetical dengue vaccines among travelers. J Travel Med 20: 346351.

    • Search Google Scholar
    • Export Citation
  • 24.

    New York Times, 2015. First Dengue Vaccine Approved by Mexico. Available at: http://www.nytimes.com/2015/12/10/business/first-dengue-fever-vaccine-approved-by-mexico.html.

    • Search Google Scholar
    • Export Citation
  • 25.

    Durbin AP, Whitehead SS, 2011. Next generation dengue vaccines: novel strategies currently under development. Viruses 3: 18001814.

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Dengue Virus Seroconversion in Travelers to Dengue-Endemic Areas

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  • 1 Section of Pediatric Infectious Diseases, Boston Medical Center, Boston, Massachusetts.
  • | 2 Center for Global Health and Development, Boston University School of Public Health (BUSPH), Boston, Massachusetts.
  • | 3 Department of Global Health, Boston University School of Public Health (BUSPH), Boston, Massachusetts.
  • | 4 Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.
  • | 5 Division of Pediatric Infectious Diseases, Miami Children's Hospital, Miami, Florida.
  • | 6 Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia.
  • | 7 Travel Medicine Center, Mount Auburn Hospital, Cambridge, Massachusetts.
  • | 8 Harvard Medical School, Boston, Massachusetts.
  • | 9 Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
  • | 10 Department of Infectious Disease, Lahey Clinic Medical Center, Burlington, Massachusetts.
  • | 11 Division of Infectious Disease, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
  • | 12 Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts.
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We conducted a prospective study to measure dengue virus (DENV) antibody seroconversion in travelers to dengue-endemic areas. Travelers seen in the Boston Area Travel Medicine Network planning to visit dengue-endemic countries for ≥ 2 weeks were enrolled from 2009 to 2010. Pre- and post-travel blood samples and questionnaires were collected. Post-travel sera were tested for anti-DENV IgG by indirect IgG enzyme-linked immunosorbent assay (ELISA) and anti-DENV IgM by capture IgM ELISA. Participants with positive post-travel anti-DENV IgG or IgM were tested for pre-travel anti-DENV IgG and IgM; they were excluded from the seroconversion calculation if either pre-travel anti-DENV IgG or IgM were positive. Paired sera and questionnaires were collected for 62% (589/955) of enrolled travelers. Most participants were 19–64 years of age, female, and white. The most common purposes of travel were tourism and visiting friends and relatives; most trips were to Asia or Africa. Median length of travel was 21 days. DENV antibody seroconversion by either anti-DENV IgM or IgG ELISA was 2.9–6.8%; lower range percent excluded potential false-positive anti-DENV IgG due to receipt of yellow fever or Japanese encephalitis vaccines at enrollment; upper range percent excluded proven false-positive anti-DENV IgM. Eighteen percent of those with seroconversion reported dengue-like symptoms. Seroconversion was documented for travel to Africa as well as countries and regions known to be highly dengue endemic (India, Brazil, southeast Asia). Given widespread risk of dengue, travel medicine counseling should include information on risk of dengue in endemic areas and advice on preventing insect bites and seeking prompt medical attention for febrile illness.

Author Notes

* Address correspondence to Elizabeth D. Barnett, Maxwell Finland Laboratory for Infectious Diseases, Boston Medical Center, 670 Albany Street, Boston, MA 02118. E-mail: ebarnett@bu.edu

Authors' addresses: Rosemary M. Olivero, Section of Pediatric Infectious Diseases, Helen DeVos Children's Hospital of Spectrum Health, Grand Rapids, MI, E-mail: rosemary.olivero@gmail.com. Christine M. Benoit, Department of Research and Sponsored Programs, Children's Hospitals and Clinics of Minnesota, St. Paul, MN, E-mail: christine.benoit@childrensmn.org. Elizabeth D. Barnett, Section of Pediatric Infectious Disease, Boston Medical Center, Boston, MA, E-mail: elizabeth.barnett@bmc.org. Davidson H. Hamer and William B. MacLeod, Department of International Health, Center for International Health and Development, Boston University School of Public Health, Boston, MA, E-mails: dhamer@bu.edu and wmacleod@bu.edu. Carolina Sanchez-Vegas, Division of Pediatric Infectious Diseases, Miami Children's Health System, Miami, FL, E-mail: carosvb@yahoo.com. Emily S. Jentes and Nina Marano, Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: efj8@cdc.gov and nbm8@cdc.gov. Emad A. Yanni, GSK Vaccines, emad.a.yanni@gsk.com. Lin H. Chen, Travel Medicine Center, Mount Auburn Cambridge, MA, E-mail: lchen@hms.harvard.edu. Mary E. Wilson, Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, E-mail: mewilson@hsph.harvard.edu. Winnie W. Ooi, Travel and Tropical Medicine Clinic, Lahey Clinic Medical Centre, Burlington, MA, E-mail: winnie.w.ooi@lahey.org. Adolf W. Karchmer, Division of Infectious Diseases, Beth Israel Deaconess Hospital, Boston, MA, E-mail: akarchme@bidmc.harvard.edu. Laura Kogelman, Division of Infectious Diseases, Tufts Medical Center, Boston, MA, E-mail: lkogelman@tuftsmedicalcenter.org.

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