Immunological serotype interactions and their effect on the epidemiological pattern of dengue

Abstract

Long-term epidemiological data reveal multi-annual fluctuations in the incidence of dengue fever and dengue haemorrhagic fever, as well as complex cyclical behaviour in the dynamics of the four serotypes of the dengue virus. It has previously been proposed that these patterns are due to the phenomenon of the so-called antibody-dependent enhancement (ADE) among dengue serotypes, whereby viral replication is increased during secondary infection with a heterologous serotype; however, recent studies have implied that this positive reinforcement cannot account for the temporal patterns of dengue and that some form of cross-immunity or external forcing is necessary. Here, we show that ADE alone can produce the observed periodicities and desynchronized oscillations of individual serotypes if its effects are decomposed into its two possible manifestations: enhancement of susceptibility to secondary infections and increased transmissibility from individuals suffering from secondary infections. This decomposition not only lowers the level of enhancement necessary for realistic disease patterns but also reduces the risk of stochastic extinction. Furthermore, our analyses reveal a time-lagged correlation between serotype dynamics and disease incidence rates, which could have important implications for understanding the irregular pattern of dengue epidemics.

Cross-immunity between strains explains the dynamical pattern of paramyxoviruses

“…Using statistical likelihoods, we compare two hypothetical mechanisms of interaction between diseases: cross-immunity (immune-mediated interaction) (37)(38)(39)(40)(41)(42) and convalescence (ecological interaction) (43,44). Accurate assessment of the nature of interaction among these viruses has important potential public health consequences for prediction of outbreaks and control of disease by targeting and timing of control strategies.…”

Phase control of resonant systems: Interference, chaos and high periodicity

“…An example of this occurs in the modelling of dengue. Recker et al [30] constructed a model that takes into account antibody-dependent enhancement, increasing both susceptibility and infection transmission during secondary infection. In this model high period fluctuations can happen without external forcing.…”

“…Increasing the enhancement parameters leads to system instability. Whether dengue epidemics are driven exogenously [19] or endogenously [30] remains a matter for further discussion.…”

On the dynamics of simultaneous spreading of two-strain dengue serotypes

“…It is an important public health problem since this disease is endemic in more than 100 countries affecting more than 2.5 billion people living in tropical areas (Gluber, 2002;Feng and Velasco-Hernandez, 1997;Recker et al, 2009;Adams et al, 2006). The main transmitting agent are the mosquitoes Aedes aegypti and Aedes albopictus.…”

“…Once a person is infected by one of the serotypes will never be reinfected by the same serotype again but will remain susceptible to the heterologous strain after a period of cross-immunity. Moreover and additional immunological response to reinfection known as antibody-dependent enhancement (ADE) which influences the susceptibility of the hosts to an heterologous serotype has also been pointed as an important aspect for reinfection patterns studies (Gluber, 2002;Recker et al, 2009;Wearing and Rohani, 2006).…”