Dengue Transmission in Two Puerto Rican Communities in 1982

Sh, Waterman; Rj, Novak; Ge, Sather; Re, Bailey; Rios, Isabela; Dj, Gubler

doi:10.4269/ajtmh.1985.34.625

Cited by 88 publications

(78 citation statements)

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“…9 Our estimate was considerably lower than the estimates from two prior prospective seroincidence studies conducted in Puerto Rico during the 1969 and 1982 epidemics. 6,11 These studies found child and adolescent seroincidence rates of 60-70% 6 and 37%. 11 The higher seroincidence rates in these studies might be explained by the introduction of new DENV serotypes into a largely non-immune population.…”

Section: Discussionmentioning

confidence: 98%

“…6,11 These studies found child and adolescent seroincidence rates of 60-70% 6 and 37%. 11 The higher seroincidence rates in these studies might be explained by the introduction of new DENV serotypes into a largely non-immune population. For example, in 1969, Puerto Rico experienced an epidemic of predominantly DENV-2, a DENV serotype that had not been detected previously in Puerto Rico.…”

Section: Discussionmentioning

confidence: 98%

“…The majority of information has come from data obtained through the Puerto Rico passive dengue surveillance system (PDSS) and several seroepidemiologic studies. [6][7][8][9][10][11][12][13][14][15] These studies have shown that the highest incidence of disease is among 10-to 19-year-olds and that disease incidence varies by year and municipality. However, PDSS is not capable of detecting inapparent DENV infection, and none of the previous seroepidemiologic studies described seroincidence of inapparent DENV infections among school-aged children and adolescents.…”

Section: Introductionmentioning

confidence: 99%

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Incidence of Dengue Virus Infection in School-Aged Children in Puerto Rico: A Prospective Seroepidemiologic Study

Argüello¹,

Tomashek²,

Quiñones³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. Dengue is a potentially fatal acute febrile illness caused by the mosquito-borne dengue viruses (DENV-1 to -4). To estimate DENV seroincidence in school-aged children, a 1-year prospective cohort study was conducted in Patillas, Puerto Rico; 10-to 18-year-olds (N = 345) were randomly selected from 13 public schools. At enrollment, 49.8% of the entire cohort had DENV immunoglobulin G (IgG) anti-DENV antibodies, and there were individuals with neutralizing antibodies specific to each of the four DENV. The mean age of participants with incident DENV infection was 13.4 years. The 1-year seroincidence rate was 5.6%, and 61.1% of infections were inapparent. Having IgG anti-DENV at enrollment was associated with seroincidence (risk ratio = 6.8). Acute febrile illnesses during the study period were captured by a fever diary and an enhanced and passive surveillance system in the municipios of Patillas and Guayama. In summary, at enrollment, nearly one-half of the participants had a prior DENV infection, with the highest incidence in the 10-to 11-year-olds, of which most were inapparent infections, and symptomatic infections were considered mild.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Incidence of Dengue Virus Infection in School-Aged Children in Puerto Rico: A Prospective Seroepidemiologic Study

Argüello¹,

Tomashek²,

Quiñones³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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“…6,7 Infection with any of the four dengue serotypes can be asymptomatic in 65-90% of cases. [8][9][10] However, when such infections result in clinically apparent disease, symptoms can range from mild undifferentiated febrile illness to severe dengue, which can include fatal complications such as major bleeding and shock caused by abnormal capillary permeability with plasma leakage. 3,11 Recent reports have shown that the incidence of dengue is increasing in the Americas.…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with Dengue Mortality in Latin America and the Caribbean, 1995–2009: An Ecological Study

Díaz-Quijano

Waldman²

2012

The American Society of Tropical Medicine and Hygiene

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Abstract. In this study, we aimed to estimate the effect that environmental, demographic, and socioeconomic factors have on dengue mortality in Latin America and the Caribbean. To that end, we conducted an observational ecological study, analyzing data collected between 1995 and 2009. Dengue mortality rates were highest in the Caribbean (Spanishspeaking and non-Spanish-speaking). Multivariate analysis through Poisson regression revealed that the following factors were independently associated with dengue mortality: time since identification of endemicity (adjusted rate ratio ; population density (aRR = 2.1 and 3.2 for 20-120 inhabitants/km 2 and > 120 inhabitants/km 2 , respectively); Human Development Index > 0.83 (aRR = 0.4); and circulation of the dengue 2 serotype (aRR = 1.7). These results highlight the important role that environmental, demographic, socioeconomic, and biological factors have played in increasing the severity of dengue in recent decades.

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“…A serosurvey conducted in 1982 in the municipality of Florida, Puerto Rico, indicated that 68 to 80% of individuals had past exposure to dengue; however, recent unpublished CDC data indicate that these levels are now much higher, demonstrating a high prevalence of dengue in Puerto Rico (22). In the case of multiple arboviral infections over time, the sequence of infecting viral species can be an important determinant in the resulting serological responses detected by immunological assays.…”

Section: Discussionmentioning

confidence: 99%

Serological Evaluation of Suspected West Nile Virus Human Cases following Its Introduction during a Dengue Outbreak in Puerto Rico in 2007

Hunsperger¹,

Beltrán²,

Acosta³

et al. 2011

Clin. Vaccine Immunol.

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A laboratory testing algorithm was evaluated to confirm West Nile virus (WNV) infection in human serum following the introduction of the virus in Puerto Rico in 2007. This testing algorithm used two standard diagnostic assays, the IgM antibody capture enzyme-linked immunosorbent assay (MAC ELISA) and real-time reverse transcriptase PCR (RT-PCR), along with two nonconventional assays, the nonstructural protein 1 (NS1) ELISA and a 90%-plaque-reduction neutralization test (PRNT 90 ) with IgG depletion for dengue virus (DENV) and WNV. A total of 2,321 serum samples from suspected WNV human cases were submitted for testing. Approximately one-third (867, 37%) were cross-reactive for DENV and WNV by MAC ELISA and had negative RT-PCR results for both viruses. Of a subset of 43 samples tested, 31 (72%) of these cases were identified as positive for DENV in the PRNT 90 with IgG depletion and 8 (19%) were positive in the DENV NS1 antigen ELISA. These two assays combined differentiated 36 (84%) of the samples that could not be diagnosed using the standard diagnostic testing methods.The introduction of West Nile virus (WNV) into the northeastern United States in 1999 and its subsequent rapid spread throughout the United States raised concerns about the potential for the introduction and spread of the virus in the Caribbean (4, 6, 7, 16). Since 1999, evidence of WNV transmission has been reported throughout the Caribbean, where diagnosis has been complicated by the cocirculation of other flaviviruses, including the dengue virus (DENV) (12). The continued spread of WNV through North America, Latin America, and the Caribbean has highlighted the need for disease-specific diagnostic tests for flaviviruses. Until recently, DENV has been the only circulating flavivirus in Puerto Rico; therefore, the surveillance system testing algorithm was not designed to detect other arboviruses. The first serological evidence of WNV in Puerto Rico was reported in wild birds in 2003. The first WNV isolate was obtained in mosquitoes in June 2007 in the municipalities of Ceiba and Naguabo along the northeastern coast of the island and coincided with the largest outbreaks of dengue since 1998 (Fig. 1) (1). The epidemic curve indicated that the dengue outbreak began May 2007, 1 week prior to the serological detection of WNV in sentinel chickens.The Centers for Disease Control and Prevention (CDC) and the Puerto Rico Health Department have jointly managed an island-wide WNV surveillance system for humans since 2003. The data presented in this study are an evaluation of the samples obtained from the WNV surveillance from July through December 2007 following the detection of WNV in sentinel chickens (1). The purpose of this study was to evaluate a new testing algorithm to differentiate between WNV and DENV cases in IgM-cross-reactive samples. A new testing algorithm was developed to evaluate suspected WNV-positive serum samples using a 90%-plaque-reduction neutralization test (PRNT 90 ) with IgG depletion. Further differentiation was achieved using the ...

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Dengue Transmission in Two Puerto Rican Communities in 1982

Cited by 88 publications

References 0 publications

Incidence of Dengue Virus Infection in School-Aged Children in Puerto Rico: A Prospective Seroepidemiologic Study

Incidence of Dengue Virus Infection in School-Aged Children in Puerto Rico: A Prospective Seroepidemiologic Study

Factors Associated with Dengue Mortality in Latin America and the Caribbean, 1995–2009: An Ecological Study

Serological Evaluation of Suspected West Nile Virus Human Cases following Its Introduction during a Dengue Outbreak in Puerto Rico in 2007

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