Sequential dengue virus infections detected in active and passive surveillance programs in Thailand, 1994-2010
Authors
Bhoomiboonchoo, PirayaNisalak, Ananda
Chansatiporn, Natkamol
Yoon, In-Kyu
Kalayanarooj, Siripen
Thipayamongkolgul, Mathuros
Endy, Timothy
Rothman, Alan L.
Green, Sharone
Srikiatkhachorn, Anon
Buddhari, Darunee
Mammen, Mammen P.
Gibbons, Robert V.
UMass Chan Affiliations
Department of Medicine, Division of Infectious Diseases and ImmunologyDocument Type
Journal ArticlePublication Date
2015-03-14Keywords
Immunology and Infectious DiseaseInfectious Disease
International Public Health
Public Health
Virus Diseases
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BACKGROUND: The effect of prior dengue virus (DENV) exposure on subsequent heterologous infection can be beneficial or detrimental depending on many factors including timing of infection. We sought to evaluate this effect by examining a large database of DENV infections captured by both active and passive surveillance encompassing a wide clinical spectrum of disease. METHODS: We evaluated datasets from 17 years of hospital-based passive surveillance and nine years of cohort studies, including clinical and subclinical DENV infections, to assess the outcomes of sequential heterologous infections. Chi square or Fisher's exact test was used to compare proportions of infection outcomes such as disease severity; ANOVA was used for continuous variables. Multivariate logistic regression was used to assess risk factors for infection outcomes. RESULTS: Of 38,740 DENV infections, two or more infections were detected in 502 individuals; 14 had three infections. The mean ages at the time of the first and second detected infections were 7.6 +/- 3.0 and 11.2 +/- 3.0 years. The shortest time between sequential infections was 66 days. A longer time interval between sequential infections was associated with dengue hemorrhagic fever (DHF) in the second detected infection (OR 1.3, 95% CI 1.2-1.4). All possible sequential serotype pairs were observed among 201 subjects with DHF at the second detected infection, except DENV-4 followed by DENV-3. Among DENV infections detected in cohort subjects by active study surveillance and subsequent non-study hospital-based passive surveillance, hospitalization at the first detected infection increased the likelihood of hospitalization at the second detected infection. CONCLUSIONS: Increasing time between sequential DENV infections was associated with greater severity of the second detected infection, supporting the role of heterotypic immunity in both protection and enhancement. Hospitalization was positively associated between the first and second detected infections, suggesting a possible predisposition in some individuals to more severe dengue disease.Source
BMC Public Health. 2015 Mar 14;15:250. doi: 10.1186/s12889-015-1590-z. Link to article on publisher's siteDOI
10.1186/s12889-015-1590-zPermanent Link to this Item
http://hdl.handle.net/20.500.14038/39701PubMed ID
25886528Related Resources
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
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10.1186/s12889-015-1590-z
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Except where otherwise noted, this item's license is described as <p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<a href="http://creativecommons.org/licenses/by/4.0">http://creativecommons.org/licenses/by/4.0</a>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.</p>