Research Article

Impact of preexisting dengue immunity on Zika virus emergence in a dengue endemic region

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Science  08 Feb 2019:
Vol. 363, Issue 6427, pp. 607-610
DOI: 10.1126/science.aav6618
  • Fig. 1 Location of the study.

    (A) Location of the city of Salvador within the state of Bahía and within Brazil. (B) Satellite image of the Pau da Lima community study site in Salvador. (C) Spatial heterogeneity in the proportion of the samples that were found to be ZIKV IgG3–positive (indicated by colors) in October 2015. The smoothed surface was generated using a generalized additive model that included latitude, longitude, and altitude as predictors. Study areas A and B are indicated. Black dots denote locations of study households.

  • Fig. 2 Results of serological testing conducted before and after the ZIKV outbreak among Pau da Lima cohort participants.

    (A) Each dot shows the result of an individual participant sample using our ZIKV IgG3 assay (see supplementary materials). (B) ZIKV PRNT was performed on a random subset of samples collected in March 2015 (orange) and October 2015 (green). (C) ROC curve showing the performance of the ZIKV IgG3 assay. Dashed line indicates the cutoff established, using the PRNT results as the gold standard, to achieve a sensitivity of 85% and a specificity of 97%.

  • Fig. 3 Age-stratified seropositivity to ZIKV and DENV measured in October 2015 (post–Zika outbreak) and March 2015 (pre–Zika outbreak), respectively.

    (A) ZIKV seropositivity. The red line shows the mean seropositivity in this population. (B) DENV seropositivity. The blue line shows the fit of the best model estimating the historical DENV force of infection in this population (see supplementary materials). Error bars denote 95% confidence intervals.

  • Fig. 4 Results of generalized additive models looking at two metrics of ZIKV infection as a function of age and prior DENV exposure.

    DENV NS1 IgG titer and DENV NS1 IgG3 levels were measured in March 2015. (A) Proportion ZIKV-positive in October 2015 according to our ZIKV IgG3 assay. (B) Ratio of IgG3 levels in October 2015 versus March 2015. Shaded areas denote 95% confidence intervals.

Supplementary Materials

  • Impact of preexisting dengue immunity on Zika virus emergence in a dengue endemic region

    Isabel Rodriguez-Barraquer, Federico Costa, Eduardo J. M. Nascimento, Nivison Nery Júnior, Priscila M. S. Castanha, Gielson Almeida Sacramento, Jaqueline Cruz, Mayara Carvalho, Daiana De Olivera, José E. Hagan, Haritha Adhikarla, Elsio A. Wunder Jr., Danilo F. Coêlho, Sasha R. Azar, Shannan L. Rossi, Nikos Vasilakis, Scott C. Weaver, Guilherme S. Ribeiro, Angel Balmaseda, Eva Harris, Maurício L. Nogueira, Mitermayer G. Reis, Ernesto T. A. Marques, Derek A. T. Cummings, Albert I. Ko

    Materials/Methods, Supplementary Text, Tables, Figures, and/or References

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    • Materials and Methods 
    • Figs. S1 to S3
    • Tables S1 to S9
    • References 

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