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SHIFTING PATTERNS OF DENGUE THREE YEARS AFTER ZIKA VIRUS EMERGENCE IN BRAZIL
https://www.arca.fiocruz.br/handle/icict/60281
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Department of Biology. University of Oxford. Oxford. United Kingdom.
Department of Biology. University of Oxford. Oxford. United Kingdom.
Fundação Oswaldo Cruz. Instituto Rene Rachou. Belo Horizonte, MG, Brazil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Flavivírus. Rio de Janeiro, RJ, Brazil.
Sciences and Technologies for Sustainable Development and One Health. University of Campus Bio-Medico di Roma. Rome, Italy / Fundação Oswaldo Cruz. Instituto Rene Rachou. Belo Horizonte, MG, Brazil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Flavivírus. Rio de Janeiro, RJ, Brazil.
Universidade Estadual de Feira de Santana. Feira de Santana, BA, Brazil.
Universidade Estadual de Feira de Santana. Feira de Santana, BA, Brazil.
Centre for Ecology and Conservation. University of Exeter. Penryn, United Kingdom.
Católica Biomedical Research. Católica Medical School. Universidade Católica Portuguesa. Lisbon, Portugal
Department of Biology. University of Oxford. Oxford. United Kingdom.
Fundação Oswaldo Cruz. Instituto Rene Rachou. Belo Horizonte, MG, Brazil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Flavivírus. Rio de Janeiro, RJ, Brazil.
Sciences and Technologies for Sustainable Development and One Health. University of Campus Bio-Medico di Roma. Rome, Italy / Fundação Oswaldo Cruz. Instituto Rene Rachou. Belo Horizonte, MG, Brazil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Flavivírus. Rio de Janeiro, RJ, Brazil.
Universidade Estadual de Feira de Santana. Feira de Santana, BA, Brazil.
Universidade Estadual de Feira de Santana. Feira de Santana, BA, Brazil.
Centre for Ecology and Conservation. University of Exeter. Penryn, United Kingdom.
Católica Biomedical Research. Católica Medical School. Universidade Católica Portuguesa. Lisbon, Portugal
Abstract
In 2015, the Zika virus (ZIKV) emerged in Brazil, leading to widespread outbreaks in Latin America. Following this, many countries in these regions reported a significant drop in the circulation of dengue virus (DENV), which resurged in 2018-2019. We examine age-specific incidence data to investigate changes in DENV epidemiology before and after the emergence of ZIKV. We observe that incidence of DENV was concentrated in younger individuals during resurgence compared to 2013-2015. This trend was more pronounced in Brazilian states that had experienced larger ZIKV outbreaks. Using a mathematical model, we show that ZIKV-induced cross-protection alone, often invoked to explain DENV decline across Latin America, cannot explain the observed age-shift without also assuming some form of disease enhancement. Our results suggest that a sudden accumulation of population-level immunity to ZIKV could suppress DENV and reduce the mean age of DENV incidence via both protective and disease-enhancing interactions.
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