Serologic Imprint of Dengue Virus in Urban Haiti: Characterization of Humoral Immunity to Dengue in Infants and Young Children

Abstract

Dengue is endemic to Haiti but not recognized as an important illness in the autochthonous population. To evaluate the prevalence of antibodies to dengue virus (DENV), serum samples from infants and young children 7–36 months of age (n = 166) were assayed by plaque reduction neutralization assays to each DENV serotype. Dengue virus serotype 1 had infected 40% of this study population, followed by serotype 2 (12%), serotype 3 (11%), and serotype 4 (2%). Fifty-three percent of infants and young children less than 12 months of age had already experienced DENV infection, and the seroprevalence of antibody to DENV increased to 65% by 36 months. Heterotypic antibody responses were an important component of the total dengue immunity profile.

Infectious Diseases Seen in a Primary Care Clinic in Leogane, Haiti

“…Three additional cases were identified in foreigners. Because all serotypes of the virus are endemic in Haiti and because the recently published seroprevalence of dengue in Haiti is high, 18 it is likely that this finding represents a gross underestimation. Several explanations can be provided for the seemingly low occurrence of dengue fever.…”

“…Third, the high seroprevalence of dengue fever in a recent survey might indicate that large parts of the local population are immune to dengue. 18,19 One of the most important vector-borne diseases in Haiti is lymphatic filariasis caused by Wuchereria bancrofti . Although filariasis is a non-febrile and non-life-threatening disease, it is highly debilitating.…”

A Cluster of Dengue Cases in American Missionaries Returning from Haiti, 2010

“…35 Moreover, the findings from this report along with documented dengue cases among native Haitians, [16][17][18][19] travelers to Haiti, [11][12][13][14][15] and known dengue endemicity in the neighboring Dominican Republic [36][37][38] indicate that Haitians and travelers to Haiti are at risk for DENV infection.…”

“…8,9 Although no consistent surveillance for dengue exists in Haiti, mosquito vectors for dengue are present in Haiti, 10 and dengue has been documented in visitors to Haiti, including travelers, 11,12 military personnel, 13 and relief workers. 14,15 These observations, along with reports of dengue in native Haitians, [16][17][18][19] suggest that DENV transmission is endemic in Haiti.…”

Characteristics and Spectrum of Disease Among Ill Returned Travelers from Pre- and Post-Earthquake Haiti: The GeoSentinel Experience

“…5,6 In addition, all four serotypes of dengue virus are endemic in that country; one recent study indicates a 40% prevalence of dengue serotype 1 infection among Haitian children. 7 Besides these infectious diseases, other health risks to travelers are magnified by the effects of Haiti's sociopolitical and economic reality. Limited basic utilities (water, sanitation, and electricity), weak transportation and communication networks, an underdeveloped healthcare and public health infrastructure, and security issues [8][9][10][11] likely contribute to elevated risk of acute and chronic diseases and injuries among foreign travelers.…”