title: Asymptomatic humans transmit dengue virus to mosquitoes.
abstract: Three-quarters of the estimated 390 million dengue virus (DENV) infections each year are clinically inapparent. People with inapparent dengue virus infections are generally considered dead-end hosts for transmission because they do not reach sufficiently high viremia levels to infect mosquitoes. Here, we show that, despite their lower average level of viremia, asymptomatic people can be infectious to mosquitoes. Moreover, at a given level of viremia, DENV-infected people with no detectable symptoms or before the onset of symptoms are significantly more infectious to mosquitoes than people with symptomatic infections. Because DENV viremic people without clinical symptoms may be exposed to more mosquitoes through their undisrupted daily routines than sick people and represent the bulk of DENV infections, our data indicate that they have the potential to contribute significantly more to virus transmission to mosquitoes than previously recognized.
authors.affiliation: Virology Unit, Institut Pasteur in Cambodia, International Network of Pasteur Institutes, 12201 Phnom Penh, Cambodia;
authors.forename: Veasna
authors.initials: V
authors.lastname: Duong
authors.affiliation: Insect-Virus Interactions Group, Department of Genomes and Genetics, Institut Pasteur, 75015 Paris, France; Centre National de la Recherche Scientifique, Unité de Recherche Associée 3012, 75015 Paris, France;
authors.forename: Louis
authors.initials: L
authors.lastname: Lambrechts
authors.affiliation: Centre National de la Recherche Scientifique, Unité de Recherche Associée 3012, 75015 Paris, France; Functional Genetics of Infectious Diseases Unit, Department of Genomes and Genetics, Institut Pasteur, 75015 Paris, France;
authors.forename: Richard E
authors.initials: RE
authors.lastname: Paul
authors.affiliation: Epidemiology and Public Health Unit, Institut Pasteur in Cambodia, International Network of Pasteur Institutes, 12201 Phnom Penh, Cambodia;
authors.forename: Sowath
authors.initials: S
authors.lastname: Ly
authors.affiliation: Virology Unit, Institut Pasteur in Cambodia, International Network of Pasteur Institutes, 12201 Phnom Penh, Cambodia;
authors.forename: Rath Srey
authors.initials: RS
authors.lastname: Lay
authors.affiliation: Department of Entomology and Nematology, University of California, Davis, CA 95616;
authors.forename: Kanya C
authors.initials: KC
authors.lastname: Long
authors.affiliation: National Center for Malariology, Ministry of Health, 12302 Phnom Penh, Cambodia;
authors.forename: Rekol
authors.initials: R
authors.lastname: Huy
authors.affiliation: Epidemiology and Public Health Unit, Institut Pasteur in Cambodia, International Network of Pasteur Institutes, 12201 Phnom Penh, Cambodia;
authors.forename: Arnaud
authors.initials: A
authors.lastname: Tarantola
authors.affiliation: Department of Entomology and Nematology, University of California, Davis, CA 95616; Fogarty International Center, National Institutes of Health, Bethesda, MD 20892;
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Scott
authors.affiliation: Centre National de la Recherche Scientifique, Unité de Recherche Associée 3012, 75015 Paris, France; Functional Genetics of Infectious Diseases Unit, Department of Genomes and Genetics, Institut Pasteur, 75015 Paris, France;
authors.forename: Anavaj
authors.initials: A
authors.lastname: Sakuntabhai
authors.affiliation: Virology Unit, Institut Pasteur in Cambodia, International Network of Pasteur Institutes, 12201 Phnom Penh, Cambodia; GlaxoSmithKline, Vaccines Value Health Sciences, Singapore 189720 buchyphilippe@hotmail.com.
authors.forename: Philippe
authors.initials: P
authors.lastname: Buchy
mesh_terms: D000293:Adolescent; D000330:Aedes / Q000821:virology; D000818:Animals; D002648:Child; D003715:Dengue / Q000097:blood / Q000635:transmission* / Q000821:virology*; D003716:Dengue Virus / Q000502:physiology*; D004306:Dose-Response Relationship, Immunologic; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D012044:Regression Analysis; D014766:Viremia / Q000097:blood / Q000821:virology
keywords: Aedes aegypti; Cambodia; dengue; human-to-mosquito transmission; mosquito experimental infection