Index cluster study of dengue virus infection in Nicaragua.

Am J Trop Med Hyg
Authors
Keywords
Abstract

Traditional study designs do not identify acute asymptomatic or pre-symptomatic dengue virus (DENV) infections, thus limiting our understanding of immunologic and viral factors that modulate infection outcome. In the 2006 and 2007 dengue seasons, we conducted a pilot index cluster study in Managua, Nicaragua, in which 442 persons living within 50 meters of 22 index cases identified through an ongoing pediatric cohort study were evaluated for DENV infection. Post-enrollment and pre-enrollment DENV infections were confirmed in 12 (2.7%) and 19 (4.3%) contacts, respectively. Five (42%) post-enrollment infections were asymptomatic, and DENV-2 was identified in 9 (75%) infections. Phylogenetic analysis with full-length DENV genomic sequence from contacts, index cases, and cohort dengue cases indicated focal transmission and infection outside the local area. We demonstrate the feasibility of identification of acute asymptomatic and pre-symptomatic cases in urban Latin America, the first report of such a study in the Americas, and identify age and concomitant immunity to DENV of contacts as a key factor in index cluster study design.

Year of Publication
2010
Journal
Am J Trop Med Hyg
Volume
83
Issue
3
Pages
683-9
Date Published
2010 Sep
ISSN
1476-1645
URL
DOI
10.4269/ajtmh.2010.10-0023
PubMed ID
20810839
PubMed Central ID
PMC2929070
Links
Grant list
HHSN266200400001C / AO / NIAID NIH HHS / United States
HHSN272200900006C / AI / NIAID NIH HHS / United States