The effects of tertiary and quaternary infections on the epidemiology of dengue.

The effects of tertiary and quaternary infections on the epidemiology of dengue.
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DOI:
10.1371/journal.pone.0012347
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发表时间:
2010-08-23
期刊:
影响因子:
3.7
通讯作者:
Recker M
Recker M
中科院分区:
综合性期刊3区
文献类型:
--
作者:
Wikramaratna PS;Simmons CP;Gupta S;Recker M

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登革热的流行病学特征是不规则的流行病爆发和四种共循环病毒血清型的非传染性动态。虽然一种血清型感染似乎对同源感染具有终身保护作用,但由于抗体依赖性增强(ADE)现象,认为其是继发性异源感染后严重疾病表现的风险因素。随后的临床感染很少报告,由于大多数登革热感染通常无症状,目前尚不清楚三级或四级感染是否以及在多大程度上有助于登革热流行病学。在这里,我们调查的影响,第三次和随后的感染登革热的传播动力学,并表明,虽然定性模式在很大程度上是等效的,系统更容易表现出desertifised血清型振荡和多年度的流行病爆发后,他们的列入。更重要的是,允许第三次和第四次感染大大增加了感染的力量,而不诉诸高的基本生殖数字。因此,如果允许两次以上的感染,现实的年龄流行模式和血清转换率更容易与登革热传播潜力的低值相协调;这应该对登革热控制和干预措施产生重要影响。
The epidemiology of dengue is characterised by irregular epidemic outbreaks and desynchronised dynamics of its four co-circulating virus serotypes. Whilst infection by one serotype appears to convey life-long protection to homologous infection, it is believed to be a risk factor for severe disease manifestations upon secondary, heterologous infection due to the phenomenon of Antibody-Dependent Enhancement (ADE). Subsequent clinical infections are rarely reported and, since the majority of dengue infections are generally asymptomatic, it is not clear if and to what degree tertiary or quaternary infections contribute to dengue epidemiology. Here we investigate the effect of third and subsequent infections on the transmission dynamics of dengue and show that although the qualitative patterns are largely equivalent, the system more readily exhibits the desynchronised serotype oscillations and multi-annual epidemic outbreaks upon their inclusion. More importantly, permitting third and fourth infections significantly increases the force of infection without resorting to high basic reproductive numbers. Realistic age-prevalent patterns and seroconversion rates are therefore easier reconciled with a low value of dengue's transmission potential if allowing for more than two infections; this should have important consequences for dengue control and intervention measures.
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期刊: PLoS medicine
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发表时间: 1988-01-01
影响因子: 3.3
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发表时间: 2005-10-18
影响因子: 11.1
作者:
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