Dengue Prevention and 35 Years of Vector Control in Singapore

Ooi, Eng Eong; Goh, Kee Tai; Gubler, Duane J.

doi:10.3201/10.3201/eid1206.051210

Cited by 294 publications

(264 citation statements)

References 16 publications

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“…After two decades of successful management in Singapore that relied primarily on an integrated vector-control program, 25 , 26 there has been a resurgence of dengue disease 27 . The recent epidemiology of the disease in Singapore is characterized by a 5–6-y cycle; incidence rates increase within each cycle before declining for 1 or 2 y 28 .…”

Section: Introductionmentioning

confidence: 99%

Immunogenicity and safety of recombinant tetravalent dengue vaccine (CYD-TDV) in individuals aged 2–45 years

Leo

Wilder-Smith

Archuleta

et al. 2012

Human Vaccines & Immunotherapeutics

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This was a multicenter, blinded, Phase II study (NCT00880893) conducted in Singapore. The primary objectives were to evaluate the safety of a tetravalent dengue vaccine (TDV) comprising four recombinant, live, attenuated viruses (CYD-TDV) and the dengue virus serotype-specific antibody responses before and 28 d after each vaccination. Participants were randomized 3:1 to receive three doses of CYD-TDV or a control vaccine at 0, 6 and 12 mo. Control vaccine was placebo for the first dose (all ages) and for subsequent doses, licensed hepatitis-A for children (aged 2–11 years) or influenza vaccine for adolescents (12–17 years) and adults (18–45 years). Between April and October 2009, 317 children, 187 adolescents and 696 adults were enrolled. In all age groups, reactogenicity was higher after the first injection of CYD-TDV than after placebo control. Reactogenicity after subsequent CYD-TDV doses was no higher than after the first dose, and tended to be lower or similar to that seen after active control vaccination. Seropositivity rates and geometric mean neutralizing antibody titers (GMTs; 1/dil) against all four dengue virus serotypes increased in all age groups after each of the three CYD-TDV doses. Post-dose 3, 66.5% of all participants were seropositive to all four serotypes, and 87.2% were seropositive to ≥ 3 serotypes; GMTs for all participants ranged from 43.0 against dengue virus serotype 1 to 100 against dengue virus serotype 4. GMTs were higher in children than in adolescents. These results support the continued development of CYD-TDV for the prevention of dengue disease.

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Section: Introductionmentioning

confidence: 99%

Immunogenicity and safety of recombinant tetravalent dengue vaccine (CYD-TDV) in individuals aged 2–45 years

Leo

Wilder-Smith

Archuleta

et al. 2012

Human Vaccines & Immunotherapeutics

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“…These efforts started in the 1970s and had been shown to be successful for a period of time in Singapore and Cuba (7). However, such efforts were proven to be unsustainable (8) by the explosion of dengue fever cases in recent years (4). A long-term solution to fully eradicate the disease can be achieved by making a safe and effective vaccine, which can simultaneously stimulate protection against all four serotypes.…”

mentioning

confidence: 99%

Near-Atomic Resolution Cryo-Electron Microscopic Structure of Dengue Serotype 4 Virus

Kostyuchenko

Chew

et al. 2014

J Virol

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Dengue virus (DENV), a mosquito-borne virus, is responsible for millions of cases of infections worldwide. There are four DENV serotypes (DENV1 to -4). After a primary DENV infection, the antibodies elicited confer lifetime protection against that DENV serotype. However, in a secondary infection with another serotype, the preexisting antibodies may cause antibody-dependent enhancement (ADE) of infection of macrophage cells, leading to the development of the more severe form of disease, dengue hemorrhagic fever. Thus, a safe vaccine should stimulate protection against all dengue serotypes simultaneously. To facilitate the development of a vaccine, good knowledge of different DENV serotype structures is crucial. Structures of DENV1 and DENV2 had been solved previously. Here we present a near-atomic resolution cryo-electron microscopy (cryo-EM) structure of mature DENV4. Comparison of the DENV4 structure with similar-resolution cryo-EM structures of DENV1 and DENV2 showed differences in surface charge distribution, which may explain their differences in binding to cellular receptors, such as heparin. Also, observed variations in amino acid residues involved in interactions between envelope and membrane proteins on the virus surface correlate with their ability to undergo structural changes at higher temperatures.

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“…Dengue became hyperendemic in the 1960s, and DHF was a major contributor to childhood deaths. This drove the establishment of an effective vector control program that drastically reduced the Aedes aegypti population from 16% to under 2%, bringing about a 15-year period of low dengue incidence from 1975 to 1990 [23]. When dengue made a resurgence in the 1990s, there was a steady decline in the proportion of patients under 15 years of age and an increase in the proportion of patients above 25 years of age over the years, as well as a trend toward the acquisition of dengue outside the home.…”

Section: Changing Epidemiologymentioning

confidence: 99%

“…A seroprevalence study of adults aged 18-79 years in Singapore comparing the prevalence of anti-dengue IgG antibodies in the population in 2004 and 2010 showed that the age-standardized rates of seroprevalence was significantly lower in 2010 (54 · 4%) compared to 2004 (63 · 1%) [24], implying that a growing proportion of the adult population remained susceptible to dengue virus infections. These findings led the authors to propose that the successful vector control and surveillance program resulted in lowered seroprevalence and herd immunity in the adult population, while the shift in acquisition patterns toward one that was outside of the home (due to better vector elimination in residential versus non-residential sites), resulted in the acquisition of disease at a later stage in life [23].…”

Section: Changing Epidemiologymentioning

confidence: 99%

Dengue in the elderly: a review

Lin

Lee

Leo

2017

Expert Review of Anti-infective Therapy

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Dengue Prevention and 35 Years of Vector Control in Singapore

Abstract: A vector control program must be based on epidemiologic and entomologic data.

Cited by 294 publications

References 16 publications

Immunogenicity and safety of recombinant tetravalent dengue vaccine (CYD-TDV) in individuals aged 2–45 years

Immunogenicity and safety of recombinant tetravalent dengue vaccine (CYD-TDV) in individuals aged 2–45 years

Near-Atomic Resolution Cryo-Electron Microscopic Structure of Dengue Serotype 4 Virus

Dengue in the elderly: a review

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