From Re-Emergence to Hyperendemicity The Natural History of the Dengue Epidemic in Brazil 英文参考文献.docVIP

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From Re-Emergence to Hyperendemicity The Natural History of the Dengue Epidemic in Brazil 英文参考文献.doc

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From Re-Emergence to Hyperendemicity The Natural History of the Dengue Epidemic in Brazil 英文参考文献

FromRe-EmergencetoHyperendemicity:TheNatural HistoryoftheDengueEpidemicinBrazil IsabelRodriguez-Barraquer1*,MarliT.Cordeiro2,3,CynthiaBraga2,WaynerV.deSouza2,ErnestoT. Marques2,4,DerekA.T.Cummings1 1Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America, 2Centro de Pesquisas Aggeu Magalha?es, Fundac?a?o Oswaldo Cruz, Recife, Pernambuco, Brazil, 3Central Laboratory of Public Health, Secretaria de Sau′de do Estado de Pernambuco, Recife, Pernambuco,Brazil,4DepartmentofInfectiousDiseasesandMicrobiology,CenterforVaccineResearch,UniversityofPittsburgh,Pittsburgh,Pennsylvania,UnitedStates ofAmerica Abstract Background:Denguevirus(DENV)wasreintroducedintoBrazilin1986andby1995ithadspreadthroughoutthecountry. In2007thenumberofdenguehemorrhagicfever(DHF)casesmorethandoubledandashiftintheagedistributionwas reported. While previously the majority of DHF cases occurred among adults, in 2007 53% of cases occurred in children under15yearsold.Thereasonsforthisshifthavenotbeendetermined. Methods and Findings: Age stratified cross-sectional seroepidemiologic survey conducted in Recife, Brazil in 2006. SerostatuswasdeterminedbyELISAbaseddetectionofDengueIgG.Weestimatedtime-constantandtime-varyingforces ofinfectionofDENVbetween1986and2006.Weuseddiscrete-timesimulationtoestimatetheaccumulationofmonotypic and multitypic immunity over time in a population previously completely susceptible to DENV. We projected the age distributionofpopulationimmunitytodengueassumingsimilarhazardsofinfectioninfutureyears.Theoverallprevalence of DENV IgG was0.80 (n=1427). The time-constant force of infectionfor the period was estimated to be 0.052 (95% CI 0.041,0.063),correspondingto5.2%ofsusceptibleindividualsbecominginfectedeachyearbyeachserotype.Simulations showthatastimesincere-emergenceofdenguegoesby,multitypicimmunityaccumulatesinadultswhileanincreasing proportionofsusceptibleindividualsandthosewithmonotypicimmunityareamongyoungagegr