Previous Dengue Infection among Children in Puerto Rico and Implications for Dengue Vaccine Implementation

Am J Trop Med Hyg. 2023 Jun 12;109(2):413-419. doi: 10.4269/ajtmh.23-0091. Print 2023 Aug 2.

Abstract

Limited dengue virus (DENV) seroprevalence estimates are available for Puerto Rico, which are needed to inform the potential use and cost-effectiveness of DENV vaccines. The Communities Organized to Prevent Arboviruses (COPA) is a cohort study initiated in 2018 in Ponce, Puerto Rico, to assess arboviral disease risk and provide a platform to evaluate interventions. We recruited participants from households in 38 study clusters, who were interviewed and provided a serum specimen. Specimens from 713 children aged 1 to 16 years during the first year of COPA were tested for the four DENV serotypes and ZIKV using a focus reduction neutralization assay. We assessed the seroprevalence of DENV and ZIKV by age and developed a catalytic model from seroprevalence and dengue surveillance data to estimate the force of infection for DENV during 2003-2018. Overall, 37% (n = 267) were seropositive for DENV; seroprevalence was 9% (11/128) among children aged 1 to 8 years and 44% (256/585) among children aged 9 to 16 years, exceeding the threshold over which DENV vaccination is deemed cost-effective. A total of 33% were seropositive for ZIKV, including 15% among children aged 0 to 8 years and 37% among children aged 9 to 16 years. The highest force of infection occurred in 2007, 2010, and 2012-2013, with low levels of transmission from 2016 to 2018. A higher proportion of children had evidence of multitypic DENV infection than expected, suggesting high heterogeneity in DENV risk in this setting.

Publication types

  • Research Support, N.I.H., Intramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Antibodies, Viral
  • Child
  • Cohort Studies
  • Dengue Vaccines*
  • Dengue Virus*
  • Dengue* / epidemiology
  • Dengue* / prevention & control
  • Humans
  • Puerto Rico / epidemiology
  • Seroepidemiologic Studies
  • Zika Virus Infection*
  • Zika Virus*

Substances

  • Dengue Vaccines
  • Antibodies, Viral