Changes in the dynamics of dengue incidence in South and Central America are possibly due to cross-population immunity after Zika virus epidemics.

Autor: Mugabe VA; Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BA, Brazil.; Universidade Licungo, Quelimane, Zambézia, Mozambique., Borja LS; Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, BA, Brazil., Cardoso CW; Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, BA, Brazil.; Secretaria Municipal de Saúde de Salvador, Salvador, BA, Brazil., Weaver SC; University of Texas Medical Branch, Galveston, TX, USA., Reis MG; Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, BA, Brazil.; Faculdade de Medicina, Universidade Federal da Bahia, Salvador, BA, Brazil.; Yale School of Public Health, New Haven, CT, USA., Kitron U; Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, BA, Brazil.; Emory University, Atlanta, GA, USA., Ribeiro GS; Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, BA, Brazil.; Faculdade de Medicina, Universidade Federal da Bahia, Salvador, BA, Brazil.
Jazyk: angličtina
Zdroj: Tropical medicine & international health : TM & IH [Trop Med Int Health] 2021 Mar; Vol. 26 (3), pp. 272-280. Date of Electronic Publication: 2020 Nov 30.
DOI: 10.1111/tmi.13526
Abstrakt: Objective: We tested the hypothesis that Zika virus (ZIKV) immunity may protect against dengue virus (DENV) infection, disease severity or human amplification, based on analysis of epidemiological data from our long-term surveillance study (2009-2016) in the city of Salvador, Brazil, that indicated a substantial reduction in the frequency of laboratory-confirmed dengue cases following the Zika outbreak. To assess whether similar patterns were observed across the Americas, we did a broader explorative investigation of historical series (2004 to 2019) of suspected cases of dengue fever, covering 20 DENV-endemic South and Central American countries.
Methods: We used segmented linear regressions of single group interrupted time series (ITS) analysis to evaluate whether the Zika epidemic had a statistical effect on the trends of annual dengue incidence.
Results: We observed in our 16-year historical series that in all countries, the incidence of dengue exhibited periodic oscillations over time, with a general trend of statistically significant increase during the pre-Zika period overall and for 11 of the 20 countries. Following the peak of the first population exposure to ZIKV in the Americas, in 2016, the overall rate of reported dengue cases in 2017 and 2018 in the countries under study sharply dropped (P < 0.05) and was the lowest reported since 2005. Individually in each country, a statistically significant reduction in the annual dengue incidence beginning in 2016 or in 2017-2018 occurred in 13 of the 20 studied countries. However, in 2019, reports of suspected dengue cases increased across the Americas. In Brazil, Dominican Republic, Guatemala and Honduras, dengue incidence was >5 times higher in 2019 than in 2017 and 2018, and, in 2019, they had the greater dengue incidence than in all previous years throughout the historical series.
Conclusions: The widespread decline in suspected dengue cases recorded in 2017 and 2018 lends further support to our previous epidemiological hypothesis of ZIKV-induced cross-species immunity to DENV. However, the cross-protection appears to be transient (around 2 years). Long-term, prospective follow-ups of dengue reports are needed to confirm (or refute) these findings, which could have significant public health implications, in particular regarding DENV vaccine development and application.
(© 2020 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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