1921
Volume 103, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Dengue is endemic in Brazil. The dengue surveillance system’s reliance on passive reporting may underestimate disease incidence and cannot detect asymptomatic/pauci-symptomatic cases. In this 3-year prospective cohort study (NCT01391819) in 5- to 13-year-old children from nine schools in Fortaleza ( = 2,117), we assessed dengue virus (DENV) infection seroprevalence by IgG indirect ELISA at yearly visits and disease incidence through active and enhanced passive surveillance. Real-time quantitative polymerase chain reaction (RT-qPCR) and DENV IgM/IgG capture ELISA were used for diagnosis. We further characterized confirmed and probable cases with a plaque reduction neutralization test. At enrollment, 54.1% (95% CI: 46.6, 61.4) of children were DENV IgG positive. The annual incidence of laboratory-confirmed symptomatic dengue cases was 11.0 (95% CI: 7.3, 14.7), 18.1 (10.4, 25.7), and 10.2 (0.7, 19.7), and of laboratory-confirmed or probable dengue cases with neutralizing antibody profile evocative of dengue exposure was 13.2 (6.6, 19.9), 18.7 (5.3, 32.2), and 8.4 (2.4, 19.2) per 1,000 child-years in 2012, 2013, and 2014, respectively. By RT-qPCR, we identified 14 DENV-4 cases in 2012–2013 and seven DENV-1 cases in 2014. During the course of the study, 32.8% of dengue-naive children experienced a primary infection. Primary inapparent dengue infection was detected in 20.3% (95% CI: 13.6, 29.1) of dengue-naive children in 2012, 8.7% (6.9, 10.9) in 2013, and 5.1% (4.4, 6.0) in 2014. Our results confirmed the high dengue endemicity in Fortaleza, with active and enhanced passive surveillance detecting three to five times more cases than the National System of Disease Notification.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution (CC-BY) License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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References

  1. Bos S, Gadea G, Despres P, 2018. Dengue: a growing threat requiring vaccine development for disease prevention. Pathog Glob Health 112: 294305.
    [Google Scholar]
  2. Brady OJ, Gething PW, Bhatt S, Messina JP, Brownstein JS, Hoen AG, Moyes CL, Farlow AW, Scott TW, Hay SI, 2012. Refining the global spatial limits of dengue virus transmission by evidence-based consensus. PLoS Negl Trop Dis 6: e1760.
    [Google Scholar]
  3. Bhatt S et al., 2013. The global distribution and burden of dengue. Nature 496: 504507.
    [Google Scholar]
  4. Deen JL, Harris E, Wills B, Balmaseda A, Hammond SN, Rocha C, Dung NM, Hung NT, Hien TT, Farrar JJ, 2006. The WHO dengue classification and case definitions: time for a reassessment. Lancet 368: 170173.
    [Google Scholar]
  5. PAHO, 2011–2017. Dengue: Reported Cases 2010–2017. Available at: http://www.paho.org/hq/index.php?option=com_topics&view=rdmore&cid=6290&Itemid=40734 Accessed June 7, 2018.
    [Google Scholar]
  6. Wunderlich J, Acuna-Soto R, Alonso WJ, 2018. Dengue hospitalisations in Brazil: annual wave from west to east and recent increase among children. Epidemiol Infect 146: 236245.
    [Google Scholar]
  7. Rajapakse S, Rodrigo C, Rajapakse A, 2012. Treatment of dengue fever. Infect Drug Resist 5: 103112.
    [Google Scholar]
  8. Dayan G et al., 2015. Prospective cohort study with active surveillance for fever in four dengue endemic countries in Latin America. Am J Trop Med Hyg 93: 1823.
    [Google Scholar]
  9. WHO, 2017. Updated Questions and Answers Related to Information Presented in the Sanofi Pasteur Press Release on 30 November 2017 with Regards to the Dengue Vaccine Dengvaxia®. Available at: http://www.who.int/immunization/diseases/dengue/q_and_a_dengue_vaccine_dengvaxia/en/. Accessed June 7, 2018.
    [Google Scholar]
  10. WHO, 2018. Dengue Vaccine: WHO Position Paper – September 2018. Available at: https://www.who.int/wer/2018/wer9336/en/. Accessed October 8, 2019.
    [Google Scholar]
  11. Magalhaes T et al., 2017. Zika virus displacement by a chikungunya outbreak in Recife, Brazil. PLoS Negl Trop Dis 11: e0006055.
    [Google Scholar]
  12. PAHO, 2017. Zika Epidemiological Report - Brazil. Available at: http://www.paho.org/hq/index.php?option=com_docman&task=doc_view&gid=35221&&Itemid=270&lang=en. Accessed June 7, 2018.
    [Google Scholar]
  13. Paixao ES, Teixeira MG, Rodrigues LC, 2018. Zika, chikungunya and dengue: the causes and threats of new and re-emerging arboviral diseases. BMJ Glob Health 3: e000530.
    [Google Scholar]
  14. Coelho GE, Leal PL, Cerroni Mde P, Simplicio AC, Siqueira JB Jr., 2016. Sensitivity of the dengue surveillance system in Brazil for detecting hospitalized cases. PLoS Negl Trop Dis 10: e0004705.
    [Google Scholar]
  15. Siqueira JB Jr., Martelli CM, Coelho GE, Simplicio AC, Hatch DL, 2005. Dengue and dengue hemorrhagic fever, Brazil, 1981–2002. Emerg Infect Dis 11: 4853.
    [Google Scholar]
  16. Silva MM et al., 2016. Accuracy of dengue reporting by national surveillance system, Brazil. Emerg Infect Dis 22: 336339.
    [Google Scholar]
  17. Toan NT, Rossi S, Prisco G, Nante N, Viviani S, 2015. Dengue epidemiology in selected endemic countries: factors influencing expansion factors as estimates of underreporting. Trop Med Int Health 20: 840863.
    [Google Scholar]
  18. Undurraga EA, Edillo FE, Erasmo JNV, Alera MTP, Yoon IK, Largo FM, Shepard DS, 2017. Disease burden of dengue in the Philippines: adjusting for underreporting by comparing active and passive dengue surveillance in punta princesa, Cebu city. Am J Trop Med Hyg 96: 887898.
    [Google Scholar]
  19. Ten Bosch QA et al., 2018. Contributions from the silent majority dominate dengue virus transmission. PLoS Pathog 14: e1006965.
    [Google Scholar]
  20. Duong V et al., 2015. Asymptomatic humans transmit dengue virus to mosquitoes. Proc Natl Acad Sci USA 112: 1468814693.
    [Google Scholar]
  21. Gordon A, Kuan G, Mercado JC, Gresh L, Aviles W, Balmaseda A, Harris E, 2013. The Nicaraguan pediatric dengue cohort study: incidence of inapparent and symptomatic dengue virus infections, 2004–2010. PLoS Negl Trop Dis 7: e2462.
    [Google Scholar]
  22. 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 190: 199202.
    [Google Scholar]
  23. IBGE, 2010. Census in Brazil. Available at: https://censo2010.ibge.gov.br/painel/?nivel=mn. Accessed December 13, 2018.
    [Google Scholar]
  24. Sadon N, Delers A, Jarman RG, Klungthong C, Nisalak A, Gibbons RV, Vassilev V, 2008. A new quantitative RT-PCR method for sensitive detection of dengue virus in serum samples. J Virol Methods 153: 16.
    [Google Scholar]
  25. World Health Organization, 2007. Guidelines for Plaque Reduction Neutralization Testing of Human Antibodies to Dengue Virus. WHO/IVB/07.07. Geneva, Switzerland: WHO Press. Available at: http://apps.who.int/iris/bitstream/handle/10665/69687/who_ivb_07.07_eng.pdf;jsessionid=132268832C281B2D84D1C359287D6C02?sequence=1. Accessed August 28, 2018.
    [Google Scholar]
  26. Endy TP, 2014. Human immune responses to dengue virus infection: lessons learned from prospective cohort studies. Front Immunol 5: 183.
    [Google Scholar]
  27. Katzelnick LC, Harris E, 2018. The use of longitudinal cohorts for studies of dengue viral pathogenesis and protection. Curr Opin Virol 29: 5161.
    [Google Scholar]
  28. Arguello DF et al., 2015. Incidence of dengue virus infection in school-aged children in Puerto Rico: a prospective seroepidemiologic study. Am J Trop Med Hyg 92: 486491.
    [Google Scholar]
  29. Balmaseda A et al., 2006. High seroprevalence of antibodies against dengue virus in a prospective study of schoolchildren in Managua, Nicaragua. Trop Med Int Health 11: 935942.
    [Google Scholar]
  30. Standish K, Kuan G, Aviles W, Balmaseda A, Harris E, 2010. High dengue case capture rate in four years of a cohort study in Nicaragua compared to national surveillance data. PLoS Negl Trop Dis 4: e633.
    [Google Scholar]
  31. Possas C et al., 2017. Zika puzzle in Brazil: peculiar conditions of viral introduction and dissemination - a review. Mem Inst Oswaldo Cruz 112: 319327.
    [Google Scholar]
  32. Temporao JG, Penna GO, Carmo EH, Coelho GE, do Socorro Silva Azevedo R, Teixeira Nunes MR, da Costa Vasconcelos PF, 2011. Dengue virus serotype 4, Roraima state, Brazil. Emerg Infect Dis 17: 938940.
    [Google Scholar]
  33. Government of Cera State, 2016. Weekly Surveillance Bulletin in Ceara 2015 (01/08/2016). Available at http://www.saude.ce.gov.br/index.php/boletins/. Accessed December 1, 2016.
    [Google Scholar]
  34. Rocha BAM, Guilarde AO, Argolo AFLT, Tassara MP, da Silveira LA, Junqueira IC, Turchi MD, Féres VCR, Martelli CMT, 2017. Dengue-specific serotype related to clinical severity during the 2012/2013 epidemic in centre of Brazil. Infect Dis Poverty 6: 116.
    [Google Scholar]
  35. da Costa Faria NR et al., 2017. Analysis of clinical and laboratory alterations related to dengue case severity: comparison between serotypes 2 and 4 in Brazil. Am J Trop Med Hyg 97: 137145.
    [Google Scholar]
  36. Heringer M, Souza TMA, Lima M, Nunes PCG, Faria N, de Bruycker-Nogueira F, Chouin-Carneiro T, Nogueira RMR, Dos Santos FB, 2017. Dengue type 4 in Rio de Janeiro, Brazil: case characterization following its introduction in an endemic region. BMC Infect Dis 17: 410.
    [Google Scholar]
  37. Ramos MM, Tomashek KM, Arguello DF, Luxemburger C, Quinones L, Lang J, Munoz-Jordan JL, 2009. Early clinical features of dengue infection in Puerto Rico. Trans R Soc Trop Med Hyg 103: 878884.
    [Google Scholar]
  38. Sirivichayakul C, Limkittikul K, Chanthavanich P, Jiwariyavej V, Chokejindachai W, Pengsaa K, Suvannadabba S, Dulyachai W, Letson GW, Sabchareon A, 2012. Dengue infection in children in Ratchaburi, Thailand: a cohort study. II. Clinical manifestations. PLoS Negl Trop Dis 6: e1520.
    [Google Scholar]
  39. Katzelnick LC, Coloma J, Harris E, 2017. Dengue: knowledge gaps, unmet needs, and research priorities. Lancet Infect Dis 17: e88e100.
    [Google Scholar]
  40. Tomashek KM et al., 2017. Clinical and epidemiologic characteristics of dengue and other etiologic agents among patients with acute febrile illness, Puerto Rico, 2012–2015. PLoS Negl Trop Dis 11: e0005859.
    [Google Scholar]
  41. Daumas RP, Passos SR, Oliveira RV, Nogueira RM, Georg I, Marzochi KB, Brasil P, 2013. Clinical and laboratory features that discriminate dengue from other febrile illnesses: a diagnostic accuracy study in Rio de Janeiro, Brazil. BMC Infect Dis 13: 77.
    [Google Scholar]
  42. Gibbons CL et al., 2014. Measuring underreporting and under-ascertainment in infectious disease datasets: a comparison of methods. BMC Public Health 14: 147.
    [Google Scholar]
  43. Heringer M, Souza TMA, Lima M, Nunes PCG, Faria N, de Bruycker-Nogueira F, Chouin-Carneiro T, Nogueira RMR, Dos Santos FB, 2017. Dengue type 4 in Rio de Janeiro, Brazil: case characterization following its introduction in an endemic region. BMC Infect Dis 17: 410.
    [Google Scholar]
  44. Ramos MM, Tomashek KM, Arguello DF, Luxemburger C, Quinones L, Lang J, Munoz-Jordan JL, 2009. Early clinical features of dengue infection in Puerto Rico. Trans R Soc Trop Med Hyg 103: 878884.
    [Google Scholar]
  45. Sirivichayakul C, Limkittikul K, Chanthavanich P, Jiwariyavej V, Chokejindachai W, Pengsaa K, Suvannadabba S, Dulyachai W, Letson GW, Sabchareon A, 2012. Dengue infection in children in Ratchaburi, Thailand: a cohort study. II. Clinical manifestations. PLoS Negl Trop Dis 6: e1520.
    [Google Scholar]
  46. Katzelnick LC, Coloma J, Harris E, 2017. Dengue: knowledge gaps, unmet needs, and research priorities. Lancet Infect Dis 17: e88e100.
    [Google Scholar]
  47. Tomashek KM et al., 2017. Clinical and epidemiologic characteristics of dengue and other etiologic agents among patients with acute febrile illness, Puerto Rico, 2012–2015. PLoS Negl Trop Dis 11: e0005859.
    [Google Scholar]
  48. Daumas RP, Passos SR, Oliveira RV, Nogueira RM, Georg I, Marzochi KB, Brasil P, 2013. Clinical and laboratory features that discriminate dengue from other febrile illnesses: a diagnostic accuracy study in Rio de Janeiro, Brazil. BMC Infect Dis 13: 77.
    [Google Scholar]
  49. Gibbons CL et al., 2014. Measuring underreporting and under-ascertainment in infectious disease datasets: a comparison of methods. BMC Public Health 14: 147.
    [Google Scholar]
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  • Received : 12 Jul 2019
  • Accepted : 25 Mar 2020
  • Published online : 27 Apr 2020
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