Infection history may hold the key to designing better dengue vaccines

May 13, 2019

A recent paper examined how a child’s first dengue virus infection (DENV) impacts the risk of future infection and found that, compared to children never infected with the dengue virus, children with one prior infection had a lower risk of new infection while children with two or more infections experienced a higher risk of new infection. 

The study utilizes data from a pediatric cohort in Nicaragua to modulate the risks of DENV infection and subsequent clinical disease.

Researchers have known for some time that being infected with one of the four dengue serotypes provides long-term immunity against that particular strain, and short-term immunity against the other three.  But precisely how previous infection affects the risk of subsequent infection was not clear.

M. Elizabeth Halloran, a professor of biostatistics at the University of Washington, co-authored this study which introduces a new statistical method to infer full infection history.  Halloran played a key role in the development of these methodologies.

“The significance of the study is two-fold,” said Halloran. “First, this is a new statistical methodology for inferring infection history for dengue when some of the data on dengue history are missing.

“Second, we found that among children with one or more prior infections, intermediate titers increase, whereas high titers decrease, the risk of subsequent infection.” Titers measure the amount of antibodies in a person’s blood.

Halloran says next steps include analyzing more years of data, and the study notes that using high-quality surveillance data in future dengue vaccine trials will enable more reliable assessment of a vaccine’s safety and efficacy on individual-level infection.

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