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DOI	10.1073/pnas.2013941118
	Boosting can explain patterns of fluctuations of ratios of inapparent to symptomatic dengue virus infections
	Alexander L.W.; Ben-Shachar R.; Katzelnick L.C.; Kuan G.; Balmaseda A.; Harris E.; Boots M.
发表日期	2021
ISSN	00278424
卷号	118 期号:14
英文摘要	Dengue is the most prevalent arboviral disease worldwide, and the four dengue virus (DENV) serotypes circulate endemically in many tropical and subtropical regions. Numerous studies have shown that the majority of DENV infections are inapparent, and that the ratio of inapparent to symptomatic infections (I/S) fluctuates substantially year-to-year. For example, in the ongoing Pediatric Dengue Cohort Study (PDCS) in Nicaragua, which was established in 2004, the I/S ratio has varied from 16.5:1 in 2006- 2007 to 1.2:1 in 2009-2010. However, the mechanisms explaining these large fluctuations are not well understood. We hypothesized that in dengue-endemic areas, frequent boosting (i.e., exposures to DENV that do not lead to extensive viremia and result in a less than fourfold rise in antibody titers) of the immune response can be protective against symptomatic disease, and this can explain fluctuating I/S ratios. We formulate mechanistic epidemiologic models to examine the epidemiologic effects of protective homologous and heterologous boosting of the antibody response in preventing subsequent symptomatic DENV infection. We show that models that include frequent boosts that protect against symptomatic disease can recover the fluctuations in the I/S ratio that we observe, whereas a classic model without boosting cannot. Furthermore, we show that a boosting model can recover the inverse relationship between the number of symptomatic cases and the I/S ratio observed in the PDCS. These results highlight the importance of robust dengue control efforts, as intermediate dengue control may have the potential to decrease the protective effects of boosting. © 2021 National Academy of Sciences. All rights reserved.
英文关键词	Asymptomatic; Dynamics; Epidemiology; Immunity; Modeling
语种	英语
来源期刊	Proceedings of the National Academy of Sciences of the United States of America
文献类型	期刊论文
条目标识符	http://gcip.llas.ac.cn/handle/2XKMVOVA/179955
作者单位	Integrative Biology, University of California, Berkeley, CA 94720, United States; Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, CA 94720, United States; Centro de Salud Socrates Flores Vivas, Ministry of Health, Managua, 12014, Nicaragua; Sustainable Sciences Institute, Managua, 14007, Nicaragua; Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, 16064, Nicaragua; Biosciences, University of Exeter, Penryn, TR10 9EZ, United Kingdom
推荐引用方式 GB/T 7714	Alexander L.W.,Ben-Shachar R.,Katzelnick L.C.,et al. Boosting can explain patterns of fluctuations of ratios of inapparent to symptomatic dengue virus infections[J],2021,118(14).
APA	Alexander L.W..,Ben-Shachar R..,Katzelnick L.C..,Kuan G..,Balmaseda A..,...&Boots M..(2021).Boosting can explain patterns of fluctuations of ratios of inapparent to symptomatic dengue virus infections.Proceedings of the National Academy of Sciences of the United States of America,118(14).
MLA	Alexander L.W.,et al."Boosting can explain patterns of fluctuations of ratios of inapparent to symptomatic dengue virus infections".Proceedings of the National Academy of Sciences of the United States of America 118.14(2021).