Estimating the Risk of Vertical Transmission of Dengue: A Prospective Study

Célia Basurko Centre d’Investigation Clinique Antilles Guyane, Inserm CIC1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana, France;
Equipe EA3593, Ecosystèmes amazoniens et Pathologie Tropicale, Université de la Guyane, Cayenne, French Guiana, France;

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Séverine Matheus Laboratoire de virologie, Centre National de Référence des Arbovirus, Institut Pasteur de la Guyane Cayenne, French Guiana, France;

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Hélène Hildéral Centre d’Investigation Clinique Antilles Guyane, Inserm CIC1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana, France;

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Sibille Everhard Centre d’Investigation Clinique Antilles Guyane, Inserm CIC1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana, France;

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Marion Restrepo Centre d’Investigation Clinique Antilles Guyane, Inserm CIC1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana, France;
Service de gynécologie et d’obstétrique, Centre Hospitalier de l’Ouest Guyanais, Saint Laurent du Maroni, French Guiana, France;
Pôle de santé publique, Centre Hospitalier de l’Ouest Guyanais, Saint Laurent du Maroni, French Guiana, France;

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Emma Cuadro-Alvarez Service de pédiatrie, Centre Hospitalier de Cayenne, Cayenne, French Guiana, France;

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Véronique Lambert Service de gynécologie et d’obstétrique, Centre Hospitalier de l’Ouest Guyanais, Saint Laurent du Maroni, French Guiana, France;

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Rachida Boukhari Service d’analyses médicales, Centre Hospitalier de l’Ouest Guyanais, Saint Laurent du Maroni, French Guiana, France;

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Jean-Pierre Duvernois Service de gynécologie et d’obstétrique, Centre médico-chirurgical de Kourou, Croix Rouge Française, Kourou, French Guiana, France;

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Anne Favre Réseau périnat de Guyane, Cayenne, French Guiana, France

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Mathieu Nacher Centre d’Investigation Clinique Antilles Guyane, Inserm CIC1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana, France;
Equipe EA3593, Ecosystèmes amazoniens et Pathologie Tropicale, Université de la Guyane, Cayenne, French Guiana, France;

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Gabriel Carles Service de gynécologie et d’obstétrique, Centre Hospitalier de l’Ouest Guyanais, Saint Laurent du Maroni, French Guiana, France;

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The incidence of dengue worldwide is increasing rapidly. A better understanding of dengue transmission may help improve interventions against this major public health problem. The virus is mostly transmitted by vectors. There are, however, other modes of transmission, notably mother-to-child transmission or vertical transmission. We studied a prospective cohort of 54 women who had dengue while pregnant during the 2012–2013 epidemic in French Guiana to estimate the mother-to-child transmission rate and assess the clinical and biological presentation of neonatal dengue. The rate of vertical transmission was between 18.5% (95% confidence interval [CI]: 9.25–31.4) and 22.7% (95% CI: 11.5–37.8), depending on the calculation method used. Mother-to-child transmission occurred both in early and late pregnancy. There were 52 births, including three newborns who presented neonatal dengue with warning signs requiring platelet transfusion. This quantification of the mother-to-child transmission of dengue highlights three points: first, vertical transmission of dengue is not negligible; second, it is more frequent when maternal dengue occurs late during pregnancy near delivery; and third, reliable diagnostic tests must be used to allow the diagnosis of vertical transmission. Our findings indicate that if there is a known history of maternal dengue during pregnancy, or if there is fever during the 15 days before term, cord blood and placenta should be sampled after delivery and tested for the virus, and the newborn should be closely monitored during the postpartum period.

Author Notes

Address correspondence to Célia Basurko or Mathieu Nacher, Centre d’Investigation Clinique Antilles Guyane, Inserm CIC1424, Centre Hospitalier de Cayenne, avenue des Flamboyants, 97300 Cayenne, French Guiana. E-mails: cbasurko@gmail.com or mathieu.nacher@ch-cayenne.fr

Financial support: This study was funded by European public funds (PO-FEDER 2007-2013 program; presage number 31257), by the Pasteur Institute, and by Cayenne General Hospital.

Authors’ addresses: Célia Basurko and Mathieu Nacher, Centre d’Investigation Clinique Antilles Guyane, Inserm CIC1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana, France and Equipe EA3593, Ecosystèmes amazoniens et Pathologie Tropicale, Université de la Guyane, Cayenne, French Guiana, France, E-mails: cbasurko@gmail.com and mathieu.nacher@ch-cayenne.fr. Séverine Matheus, Laboratoire de virologie, Centre National de Référence des Arbovirus, Institut Pasteur de la Guyane Cayenne, French Guiana, France, E-mail: smatheus@pasteur-cayenne.fr. Hélène Hildéral and Sibille Everhard, Centre d’Investigation Clinique Antilles Guyane, Inserm CIC1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana, France, E-mails: helene.hilderal@ch-cayenne.fr and sibille.everhard@gmail.com. Marion Restrepo, Centre d’Investigation Clinique Antilles Guyane, Inserm CIC1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana, France, Service de gynécologie et d’obstétrique, Centre Hospitalier de l’Ouest Guyanais, Saint Laurent du Maroni, French Guiana, France, and Pôle de santé publique, Centre Hospitalier de l’Ouest Guyanais, Saint Laurent du Maroni, French Guiana, France, E-mail: marionrestrepo85@gmail.com. Emma Cuadro-Alvarez, Service de pédiatrie, Centre Hospitalier de Cayenne, Cayenne, French Guiana, France, E-mail: emma.cuadro@ch-cayenne.fr. Véronique Lambert and Gabriel Carles, Service de gynécologie et d’obstétrique, Centre Hospitalier de l’Ouest Guyanais, Saint Laurent du Maroni, French Guiana, France, E-mails: vlambert2@orange.fr and gabriel.carles@wanadoo.fr. Rachida Boukhari, Service d’analyses médicales, Centre Hospitalier de l’Ouest Guyanais, Saint Laurent du Maroni, French Guiana, France, E-mail: r.boukhari@ch-ouestguyane.fr. Jean-Pierre Duvernois, Service de gynécologie et d’obstétrique, Centre médico-chirurgical de Kourou, Croix Rouge Française, Kourou, French Guiana, France, E-mail: sjpduvernois@orange.fr. Anne Favre, Réseau périnat de Guyane, Cayenne, French Guiana, France, E-mail: anne.favre@ch-cayenne.fr.

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