Underrecognized mildly symptomatic viremic dengue virus infections in rural Thai schools and villages

I.K. Yoon, A.L. Rothman, D. Tannitisupawong, A. Srikiatkhachorn, R.G. Jarman, J. Aldstadt, A. Nisalak, M.P. Mammen Jr., S. Thammapalo, S. Green, D.H. Libraty, R.V. Gibbons, A. Getis, T. Endy, J.W. Jones, C.J.M. Koenraadt, A.C. Morrison, T. Fansiri, C. Pimgate, T.W. Scott

Research output: Contribution to journalArticleAcademicpeer-review

82 Citations (Scopus)

Abstract

BACKGROUND: The understanding of dengue virus (DENV) transmission dynamics and the clinical spectrum of infection are critical to informing surveillance and control measures. Geographic cluster studies can elucidate these features in greater detail than cohort studies alone. METHODS: A 4-year longitudinal cohort and geographic cluster study was undertaken in rural Thailand. Cohort children underwent pre-/postseason serology and active school absence-based surveillance to detect inapparent and symptomatic dengue. Cluster investigations were triggered by cohort dengue and non-dengue febrile illnesses (positive and negative clusters, respectively). RESULTS: The annual cohort incidence of symptomatic dengue ranged from 1.3% to 4.4%. DENV-4 predominated in the first 2 years, DENV-1 in the second 2 years. The inapparent-to-symptomatic infection ratio ranged from 1.1:1 to 2.9:1. Positive clusters had a 16.0% infection rate, negative clusters 1.1%. Of 119 infections in positive clusters, 59.7% were febrile, 20.2% were afebrile with other symptoms, and 20.2% were asymptomatic. Of 16 febrile children detected during cluster investigations who continued to attend school, 9 had detectable viremia. CONCLUSIONS: Dengue transmission risk was high near viremic children in both high- and low-incidence years. Inapparent infections in the cohort overestimated the rate of asymptomatic infections. Ambulatory children with mild febrile viremic infections could represent an important component of dengue transmission.
Original languageEnglish
Pages (from-to)389-398
JournalThe Journal of Infectious Diseases
Volume206
Issue number3
DOIs
Publication statusPublished - 2012

Keywords

  • kamphaeng phet
  • aedes-aegypti
  • transmission
  • children
  • epidemiology
  • blood
  • surveillance
  • inapparent
  • indonesia
  • patterns

Fingerprint

Dive into the research topics of 'Underrecognized mildly symptomatic viremic dengue virus infections in rural Thai schools and villages'. Together they form a unique fingerprint.

Cite this