Use of seroprevalence to guide dengue vaccination plans for older adults in a dengue non-endemic country

Yi Hua Pan; Mei Ying Liao; Yu Wen Chien; Tzong Shiann Ho; Hui Ying Ko; Chin Rur Yang; Shu Fen Chang; Chia Yi Yu; Shu Yu Lin; Pin Wei Shih; Pei Yun Shu; Day Yu Chao; Chao Ying Pan; Hong Ming Chen; Guey Chuen Perng; Chia Chi Ku; Chwan Chuen King

doi:10.1371/journal.pntd.0009312

Use of seroprevalence to guide dengue vaccination plans for older adults in a dengue non-endemic country

Yi Hua Pan, Mei Ying Liao, Yu Wen Chien, Tzong Shiann Ho, Hui Ying Ko, Chin Rur Yang, Shu Fen Chang, Chia Yi Yu, Shu Yu Lin, Pin Wei Shih, Pei Yun Shu, Day Yu Chao, Chao Ying Pan, Hong Ming Chen, Guey Chuen Perng, Chia Chi Ku, Chwan Chuen King

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Abstract

A shift in dengue cases toward the adult population, accompanied by an increased risk of severe cases of dengue in the elderly, has created an important emerging issue in the past decade. To understand the level of past DENV infection among older adults after a large dengue outbreak occurred in southern Taiwan in 2015, we screened 1498 and 2603 serum samples from healthy residents aged ≥ 40 years in Kaohsiung City and Tainan City, respectively, to assess the seroprevalence of anti-DENV IgG in 2016. Seropositive samples were verified to exclude cross-reaction from Japanese encephalitis virus (JEV), using DENV/ JEV-NS1 indirect IgG ELISA. We further identified viral serotypes and secondary DENV infections among positive samples in the two cities. The overall age-standardized seroprevalence of DENV-IgG among participants was 25.77% in Kaohsiung and 11.40% in Tainan, and the seroprevalence was significantly higher in older age groups of both cities. Although the percentages of secondary DENV infection in Kaohsiung and Tainan were very similar (43.09% and 44.76%, respectively), DENV-1 and DENV-2 spanned a wider age range in Kaohsiung, whereas DENV-2 was dominant in Tainan. As very few studies have obtained the serostatus of DENV infection in older adults and the elderly, this study highlights the need for further investigation into antibody status, as well as the safety and efficacy of dengue vaccination in these older populations.

Original language	English
Article number	e0009312
Journal	PLoS neglected tropical diseases
Volume	15
Issue number	4
DOIs	https://doi.org/10.1371/journal.pntd.0009312
Publication status	Published - 2021 Apr

All Science Journal Classification (ASJC) codes

Public Health, Environmental and Occupational Health
Infectious Diseases

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Pan, Y. H., Liao, M. Y., Chien, Y. W., Ho, T. S., Ko, H. Y., Yang, C. R., Chang, S. F., Yu, C. Y., Lin, S. Y., Shih, P. W., Shu, P. Y., Chao, D. Y., Pan, C. Y., Chen, H. M., Perng, G. C., Ku, C. C., & King, C. C. (2021). Use of seroprevalence to guide dengue vaccination plans for older adults in a dengue non-endemic country. PLoS neglected tropical diseases, 15(4), Article e0009312. https://doi.org/10.1371/journal.pntd.0009312

@article{b27a9057bb034c14b84a1974452f0c7f,

title = "Use of seroprevalence to guide dengue vaccination plans for older adults in a dengue non-endemic country",

abstract = "A shift in dengue cases toward the adult population, accompanied by an increased risk of severe cases of dengue in the elderly, has created an important emerging issue in the past decade. To understand the level of past DENV infection among older adults after a large dengue outbreak occurred in southern Taiwan in 2015, we screened 1498 and 2603 serum samples from healthy residents aged ≥ 40 years in Kaohsiung City and Tainan City, respectively, to assess the seroprevalence of anti-DENV IgG in 2016. Seropositive samples were verified to exclude cross-reaction from Japanese encephalitis virus (JEV), using DENV/ JEV-NS1 indirect IgG ELISA. We further identified viral serotypes and secondary DENV infections among positive samples in the two cities. The overall age-standardized seroprevalence of DENV-IgG among participants was 25.77% in Kaohsiung and 11.40% in Tainan, and the seroprevalence was significantly higher in older age groups of both cities. Although the percentages of secondary DENV infection in Kaohsiung and Tainan were very similar (43.09% and 44.76%, respectively), DENV-1 and DENV-2 spanned a wider age range in Kaohsiung, whereas DENV-2 was dominant in Tainan. As very few studies have obtained the serostatus of DENV infection in older adults and the elderly, this study highlights the need for further investigation into antibody status, as well as the safety and efficacy of dengue vaccination in these older populations.",

author = "Pan, {Yi Hua} and Liao, {Mei Ying} and Chien, {Yu Wen} and Ho, {Tzong Shiann} and Ko, {Hui Ying} and Yang, {Chin Rur} and Chang, {Shu Fen} and Yu, {Chia Yi} and Lin, {Shu Yu} and Shih, {Pin Wei} and Shu, {Pei Yun} and Chao, {Day Yu} and Pan, {Chao Ying} and Chen, {Hong Ming} and Perng, {Guey Chuen} and Ku, {Chia Chi} and King, {Chwan Chuen}",

note = "Funding Information: The authors sincerely appreciate the financial support from the research grants of NHRI (MR-106-CO-34 to CCK, MR-107-PP-27 to CCK, and MR-108-GP-14 and MR-109-GP-14 to CCK), Taiwan, which made this investigation possible. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: {\textcopyright} 2021 Pan et al.",

year = "2021",

month = apr,

doi = "10.1371/journal.pntd.0009312",

language = "English",

volume = "15",

journal = "PLoS neglected tropical diseases",

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Pan, YH, Liao, MY, Chien, YW , Ho, TS, Ko, HY, Yang, CR, Chang, SF, Yu, CY, Lin, SY, Shih, PW, Shu, PY, Chao, DY, Pan, CY, Chen, HM, Perng, GC, Ku, CC & King, CC 2021, 'Use of seroprevalence to guide dengue vaccination plans for older adults in a dengue non-endemic country', PLoS neglected tropical diseases, vol. 15, no. 4, e0009312. https://doi.org/10.1371/journal.pntd.0009312

TY - JOUR

T1 - Use of seroprevalence to guide dengue vaccination plans for older adults in a dengue non-endemic country

AU - Pan, Yi Hua

AU - Liao, Mei Ying

AU - Chien, Yu Wen

AU - Ho, Tzong Shiann

AU - Ko, Hui Ying

AU - Yang, Chin Rur

AU - Chang, Shu Fen

AU - Yu, Chia Yi

AU - Lin, Shu Yu

AU - Shih, Pin Wei

AU - Shu, Pei Yun

AU - Chao, Day Yu

AU - Pan, Chao Ying

AU - Chen, Hong Ming

AU - Perng, Guey Chuen

AU - Ku, Chia Chi

AU - King, Chwan Chuen

N1 - Funding Information: The authors sincerely appreciate the financial support from the research grants of NHRI (MR-106-CO-34 to CCK, MR-107-PP-27 to CCK, and MR-108-GP-14 and MR-109-GP-14 to CCK), Taiwan, which made this investigation possible. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: © 2021 Pan et al.

PY - 2021/4

Y1 - 2021/4

N2 - A shift in dengue cases toward the adult population, accompanied by an increased risk of severe cases of dengue in the elderly, has created an important emerging issue in the past decade. To understand the level of past DENV infection among older adults after a large dengue outbreak occurred in southern Taiwan in 2015, we screened 1498 and 2603 serum samples from healthy residents aged ≥ 40 years in Kaohsiung City and Tainan City, respectively, to assess the seroprevalence of anti-DENV IgG in 2016. Seropositive samples were verified to exclude cross-reaction from Japanese encephalitis virus (JEV), using DENV/ JEV-NS1 indirect IgG ELISA. We further identified viral serotypes and secondary DENV infections among positive samples in the two cities. The overall age-standardized seroprevalence of DENV-IgG among participants was 25.77% in Kaohsiung and 11.40% in Tainan, and the seroprevalence was significantly higher in older age groups of both cities. Although the percentages of secondary DENV infection in Kaohsiung and Tainan were very similar (43.09% and 44.76%, respectively), DENV-1 and DENV-2 spanned a wider age range in Kaohsiung, whereas DENV-2 was dominant in Tainan. As very few studies have obtained the serostatus of DENV infection in older adults and the elderly, this study highlights the need for further investigation into antibody status, as well as the safety and efficacy of dengue vaccination in these older populations.

AB - A shift in dengue cases toward the adult population, accompanied by an increased risk of severe cases of dengue in the elderly, has created an important emerging issue in the past decade. To understand the level of past DENV infection among older adults after a large dengue outbreak occurred in southern Taiwan in 2015, we screened 1498 and 2603 serum samples from healthy residents aged ≥ 40 years in Kaohsiung City and Tainan City, respectively, to assess the seroprevalence of anti-DENV IgG in 2016. Seropositive samples were verified to exclude cross-reaction from Japanese encephalitis virus (JEV), using DENV/ JEV-NS1 indirect IgG ELISA. We further identified viral serotypes and secondary DENV infections among positive samples in the two cities. The overall age-standardized seroprevalence of DENV-IgG among participants was 25.77% in Kaohsiung and 11.40% in Tainan, and the seroprevalence was significantly higher in older age groups of both cities. Although the percentages of secondary DENV infection in Kaohsiung and Tainan were very similar (43.09% and 44.76%, respectively), DENV-1 and DENV-2 spanned a wider age range in Kaohsiung, whereas DENV-2 was dominant in Tainan. As very few studies have obtained the serostatus of DENV infection in older adults and the elderly, this study highlights the need for further investigation into antibody status, as well as the safety and efficacy of dengue vaccination in these older populations.

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ER -

Use of seroprevalence to guide dengue vaccination plans for older adults in a dengue non-endemic country

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