title: Spatial and temporal circulation of dengue virus serotypes: a prospective study of primary school children in Kamphaeng Phet, Thailand.
abstract: Dengue virus occurs as four distinct serotypes, each of which causes epidemics throughout the tropical and subtropical regions of the world. Few studies have examined co-circulation of multiple dengue virus serotypes in a well-defined cohort population over time and their capacity to produce severe dengue disease. In this paper, the authors report the details and findings of the first 3 years (1998-2000) of an ongoing prospective study of dengue virus transmission and disease severity in a cohort of children in northern Thailand. A total of 108 dengue virus isolates were obtained from 167 acute dengue virus infections; 23% were DEN-1, 35% were DEN-2, 41% were DEN-3, and 1% were DEN-4. Despite the proximity of the schools, there was marked spatial and temporal clustering of transmission of each dengue serotype. Serotype-specific antibody levels prior to the dengue transmission season were not predictive of the incidence of dengue virus infections or the predominant serotype transmitted at individual schools. All dengue serotypes produced severe dengue illness, although DEN-3 produced more severe symptoms than the other dengue serotypes. The authors' findings emphasize the complexity of dengue serotype-specific virus transmission and severe dengue disease and have important implications for dengue control and vaccine development.
authors.affiliation: Department of Virology, United States Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand. Timothy.Endy@det.amedd.army.mil
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Endy
authors.forename: Ananda
authors.initials: A
authors.lastname: Nisalak
authors.forename: Supamit
authors.initials: S
authors.lastname: Chunsuttiwat
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Libraty
authors.forename: Sharone
authors.initials: S
authors.lastname: Green
authors.forename: Alan L
authors.initials: AL
authors.lastname: Rothman
authors.forename: David W
authors.initials: DW
authors.lastname: Vaughn
authors.forename: Francis A
authors.initials: FA
authors.lastname: Ennis
mesh_terms: D000208:Acute Disease; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D002648:Child; D003715:Dengue / Q000453:epidemiology / Q000635:transmission / Q000821:virology*; D003716:Dengue Virus / Q000145:classification* / Q000302:isolation & purification; D005260:Female; D006386:Hemagglutination Tests; D006801:Humans; D007124:Immunoenzyme Techniques; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D012044:Regression Analysis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013785:Thailand / Q000453:epidemiology