Seroprevalence of Dengue, Chikungunya and Zika at the epicenter of the congenital microcephaly epidemic in Northeast Brazil: A population-based survey

Abstract

Background The four Dengue viruses (DENV) serotypes were re-introduced in Brazil’s Northeast region in a couple of decades, between 1980’s and 2010’s, where the DENV1 was the first detected serotype and DENV4 the latest. Zika (ZIKV) and Chikungunya (CHIKV) viruses were introduced in Recife around 2014 and led to large outbreaks in 2015 and 2016, respectively. However, the true extent of the ZIKV and CHIKV outbreaks, as well as the risk factors associated with exposure to these viruses remain vague. Methods We conducted a stratified multistage household serosurvey among residents aged between 5 and 65 years in the city of Recife, Northeast Brazil, from August 2018 to February 2019. The city neighborhoods were stratified and divided into high, intermediate, and low socioeconomic strata (SES). Previous ZIKV, DENV and CHIKV infections were detected by IgG-based enzyme linked immunosorbent assays (ELISA). Recent ZIKV and CHIKV infections were assessed through IgG3 and IgM ELISA, respectively. Design-adjusted seroprevalence were estimated by age group, sex, and SES. The ZIKV seroprevalence was adjusted to account for the cross-reactivity with dengue. Individual and household-related risk factors were analyzed through regression models to calculate the force of infection. Odds Ratio (OR) were estimated as measure of effect. Principal findings A total of 2,070 residents’ samples were collected and analyzed. The force of viral infection for high SES were lower as compared to low and intermediate SES. DENV seroprevalence was 88.7% (CI95%:87.0–90.4), and ranged from 81.2% (CI95%:76.9–85.6) in the high SES to 90.7% (CI95%:88.3–93.2) in the low SES. The overall adjusted ZIKV seroprevalence was 34.6% (CI95%:20.0–50.9), and ranged from 47.4% (CI95%:31.8–61.5) in the low SES to 23.4% (CI95%:12.2–33.8) in the high SES. The overall CHIKV seroprevalence was 35.7% (CI95%:32.6–38.9), and ranged from 38.6% (CI95%:33.6–43.6) in the low SES to 22.3% (CI95%:15.8–28.8) in the high SES. Surprisingly, ZIKV seroprevalence rapidly increased with age in the low and intermediate SES, while exhibited only a small increase with age in high SES. CHIKV seroprevalence according to age was stable in all SES. The prevalence of serological markers of ZIKV and CHIKV recent infections were 1.5% (CI95%:0.1–3.7) and 3.5% (CI95%:2.7–4.2), respectively. Conclusions Our results confirmed continued DENV transmission and intense ZIKV and CHIKV transmission during the 2015/2016 epidemics followed by ongoing low-level transmission. The study also highlights that a significant proportion of the population is still susceptible to be infected by ZIKV and CHIKV. The reasons underlying a ceasing of the ZIKV epidemic in 2017/18 and the impact of antibody decay in susceptibility to future DENV and ZIKV infections may be related to the interplay between disease transmission mechanism and actual exposure in the different SES.

Enhanced immunogenicity and protective efficacy in mice following a Zika DNA vaccine designed by modulation of membrane-anchoring regions and its association to adjuvants

“…Despite the progress in the development of vaccine candidates against ZIKV since the last outbreak in 2015, there are no licensed prophylactic vaccines. In addition, pregnant women represent the main risk group for ZIKV infection, as current literature shows evidence for ongoing virus circulation in the human population ( 8 ).…”

The Antiviral Potential of AdipoRon, an Adiponectin Receptor Agonist, Reveals the Ability of Zika Virus to Deregulate Adiponectin Receptor Expression

“…This search for safe, bio-active molecules capable of protecting the developing CNS of the fetus is indeed a necessity, especially since vertical transmission from mother to child is possible and deleterious at various stages of pregnancy [ 60 ], including the possibility of an early contamination via the father’s semen [ 61 ]. This research is also needed to anticipate the possibility of the reemergence of the ZIKV Asian strains that still circulate silently in several world spots [ 62 , 63 , 64 , 65 ], but also in response to the threat of emergence of contemporary African strains whose teratogenic capacities are under the spotlight [ 66 ]. Unfortunately, and even if the literature on the discovery of antivirals selected from high-throughput screening of compound libraries; from observation of the traditional pharmacopoeia usages, notably based on plant and marine biodiversity [ 46 , 67 ] or from de novo design, is plethoric, it has to be admitted that, to date, few therapeutic strategies have resulted in conclusive clinical phases [ 68 , 69 ].…”

Clinical spectrum of congenital Zika virus infection in Brazil: Update and issues for research development

“…The ongoing dengue epidemic in 2024 presents a current public health crisis 21 . Since 2015, the co-circulation of dengue, Zika, and Chikungunya, all transmitted by the same Aedes aegypti vector, suggests the persistent risk of these arboviruses within the country 21 , 22 . Therefore, Zika remains an epidemic threat, given its high vector density and large susceptible population nationwide.…”