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Incidence and seroprevalence of dengue virus infections in Australian travellers to Asia

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Abstract

The purpose of this study was to estimate the incidence density and prevalence of dengue virus infection in Australian travellers to Asia. We conducted a multi-centre prospective cohort study of Australian travellers over a 32-month period. We recruited 467 travellers (≥16 years of age) from three travel clinics who intended to travel Asia, and 387 (82.9%) of those travellers completed questionnaires and provide samples pre- and post-travel for serological testing for dengue virus infection. Demographic data, destination countries and history of vaccinations and flavivirus infections were obtained. Serological testing for dengue IgG and IgM by enzyme-linked immunosorbent assay (ELISA) (PanBio assay) was performed. Acute seroconversion for dengue infection was demonstrated in 1.0% of travellers, representing an incidence of 3.4 infections per 10,000 days of travel (95% confidence interval [CI]: 0.9–8.7). The seroprevalence of dengue infection was 4.4% and a greater number of prior trips to Asia was a predictor for dengue seroprevalence (p = 0.019). All travellers experienced subclinical dengue infections and had travelled to India (n = 3) and China (n = 1). This significant attack rate of dengue infection can be used to advise prospective travellers to dengue-endemic countries.

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References

  1. Brandt WE (1990) From the World Health Organization. Development of dengue and Japanese encephalitis vaccines. J Infect Dis 162(3):577–583

    Article  PubMed  CAS  Google Scholar 

  2. Whitehead SS, Blaney JE, Durbin AP, Murphy BR (2007) Prospects for a dengue virus vaccine. Nat Rev Microbiol 5(7):518–528

    Article  PubMed  CAS  Google Scholar 

  3. Schwartz E, Mendelson E, Sidi Y (1996) Dengue fever among travelers. Am J Med 101(5):516–520

    Article  PubMed  CAS  Google Scholar 

  4. Schwartz E, Moskovitz A, Potasman I, Peri G, Grossman Z, Alkan ML (2000) Changing epidemiology of dengue fever in travelers to Thailand. Eur J Clin Microbiol Infect Dis 19(10):784–786

    Article  PubMed  CAS  Google Scholar 

  5. Jelinek T (2000) Dengue fever in international travelers. Clin Infect Dis 31(1):144–147

    Article  PubMed  CAS  Google Scholar 

  6. Jelinek T, Dobler G, Hölscher M, Löscher T, Nothdurft HD (1997) Prevalence of infection with dengue virus among international travelers. Arch Intern Med 157(20):2367–2370

    Article  PubMed  CAS  Google Scholar 

  7. O’Brien D, Tobin S, Brown GV, Torresi J (2001) Fever in returned travelers: review of hospital admissions for a 3-year period. Clin Infect Dis 33(5):603–609

    Article  PubMed  Google Scholar 

  8. Freedman DO, Weld LH, Kozarsky PE, Fisk T, Robins R, von Sonnenburg F, Keystone JS, Pandey P, Cetron MS; GeoSentinel Surveillance Network (2006) Spectrum of disease and relation to place of exposure among ill returned travelers. N Engl J Med 354(2):119–130

    Article  PubMed  CAS  Google Scholar 

  9. Sung V, O’Brien DP, Matchett E, Brown GV, Torresi J (2003) Dengue Fever in travelers returning from southeast Asia. J Travel Med 10(4):208–213

    Article  PubMed  Google Scholar 

  10. López-Vélez R, Pérez-Casas C, Vorndam AV, Rigau J (1996) Dengue in Spanish travelers returning from the tropics. Eur J Clin Microbiol Infect Dis 15(10):823–826

    Article  PubMed  Google Scholar 

  11. Wichmann O, Gascon J, Schunk M, Puente S, Siikamaki H, Gjørup I, López-Vélez R, Clerinx J, Peyerl-Hoffmann G, Sundøy A, Genton B, Kern P, Calleri G, de Górgolas M, Mühlberger N, Jelinek T; European Network on Surveillance of Imported Infectious Diseases (2007) Severe dengue virus infection in travelers: risk factors and laboratory indicators. J Infect Dis 195(8):1089–1096

    Article  PubMed  CAS  Google Scholar 

  12. Potasman I, Srugo I, Schwartz E (1999) Dengue seroconversion among Israeli travelers to tropical countries. Emerg Infect Dis 5(6):824–827

    Article  PubMed  CAS  Google Scholar 

  13. Cobelens FG, Groen J, Osterhaus AD, Leentvaar-Kuipers A, Wertheim-van Dillen PM, Kager PA (2002) Incidence and risk factors of probable dengue virus infection among Dutch travellers to Asia. Trop Med Int Health 7(4):331–338

    Article  PubMed  Google Scholar 

  14. Rigau-Pérez JG, Clark GG, Gubler DJ, Reiter P, Sanders EJ, Vorndam AV (1998) Dengue and dengue haemorrhagic fever. Lancet 352(9132):971–977

    Article  PubMed  Google Scholar 

  15. Guzmán MG, Alvarez M, Rodriguez-Roche R, Bernardo L, Montes T, Vazquez S, Morier L, Alvarez A, Gould EA, Kourí G, Halstead SB (2007) Neutralizing antibodies after infection with dengue 1 virus. Emerg Infect Dis 13(2):282–286

    Article  PubMed  Google Scholar 

  16. Guzmán MG, Kourí G (2002) Dengue: an update. Lancet Infect Dis 2(1):33–42

    Article  PubMed  Google Scholar 

  17. Goncalvez AP, Engle RE, St Claire M, Purcell RH, Lai CJ (2007) Monoclonal antibody-mediated enhancement of dengue virus infection in vitro and in vivo and strategies for prevention. Proc Natl Acad Sci U S A 104(22):9422–9427

    Article  PubMed  CAS  Google Scholar 

  18. Vaughn DW, Green S, Kalayanarooj S, Innis BL, Nimmannitya S, Suntayakorn S, Endy TP, Raengsakulrach B, Rothman AL, Ennis FA, Nisalak A (2000) Dengue viremia titer, antibody response pattern, and virus serotype correlate with disease severity. J Infect Dis 181(1):2–9

    Article  PubMed  CAS  Google Scholar 

  19. Wichmann O, Hongsiriwon S, Bowonwatanuwong C, Chotivanich K, Sukthana Y, Pukrittayakamee S (2004) Risk factors and clinical features associated with severe dengue infection in adults and children during the 2001 epidemic in Chonburi, Thailand. Trop Med Int Health 9(9):1022–1029

    Article  PubMed  Google Scholar 

  20. Ratnam I, Torresi J, Matchett E, Pollissard L, Luxemburg C, Lemoh CN, Black JF (2011) Development and validation of an instrument to assess the risk of developing viral infections in Australian travelers during international travel. J Travel Med 18(4):262–270

    Article  PubMed  Google Scholar 

  21. Vaughn DW, Nisalak A, Solomon T, Kalayanarooj S, Nguyen MD, Kneen R, Cuzzubbo A, Devine PL (1999) Rapid serologic diagnosis of dengue virus infection using a commercial capture ELISA that distinguishes primary and secondary infections. Am J Trop Med Hyg 60(4):693–698

    PubMed  CAS  Google Scholar 

  22. Wilder-Smith A, Schwartz E (2005) Dengue in travelers. N Engl J Med 353(9):924–932

    Article  PubMed  CAS  Google Scholar 

  23. Schwartz E, Weld LH, Wilder-Smith A, von Sonnenburg F, Keystone JS, Kain KC, Torresi J, Freedman DO; GeoSentinel Surveillance Network (2008) Seasonality, annual trends, and characteristics of dengue among ill returned travelers, 1997–2006. Emerg Infect Dis 14(7):1081–1088

    Article  PubMed  Google Scholar 

  24. Papadimitropoulos V, Vergidis PI, Bliziotis I, Falagas ME (2004) Vaccination against typhoid fever in travellers: a cost-effectiveness approach. Clin Microbiol Infect 10(8):681–683

    Article  PubMed  CAS  Google Scholar 

  25. Ekdahl K, de Jong B, Andersson Y (2005) Risk of travel-associated typhoid and paratyphoid fevers in various regions. J Travel Med 12(4):197–204

    Article  PubMed  Google Scholar 

  26. Mutsch M, Spicher VM, Gut C, Steffen R (2006) Hepatitis A virus infections in travelers, 1988–2004. Clin Infect Dis 42(4):490–497

    Article  PubMed  Google Scholar 

  27. Löscher T, Keystone JS, Steffen R (1999) Vaccination of travelers against hepatitis A and B. J Travel Med 6(2):107–114

    Article  PubMed  Google Scholar 

  28. Teitelbaum P (2004) An estimate of the incidence of hepatitis A in unimmunized Canadian travelers to developing countries. J Travel Med 11(2):102–106

    Article  PubMed  Google Scholar 

  29. Askling HH, Rombo L, Andersson Y, Martin S, Ekdahl K (2009) Hepatitis A risk in travelers. J Travel Med 16(4):233–238

    Article  PubMed  Google Scholar 

  30. McBride WJ, Mullner H, LaBrooy JT, Wronski I (1998) The 1993 dengue 2 epidemic in Charters Towers, North Queensland: clinical features and public health impact. Epidemiol Infect 121(1):151–156

    Article  PubMed  CAS  Google Scholar 

  31. Waterman SH, Novak RJ, Sather GE, Bailey RE, Rios I, Gubler DJ (1985) Dengue transmission in two Puerto Rican communities in 1982. Am J Trop Med Hyg 34(3):625–632

    PubMed  CAS  Google Scholar 

  32. Burke DS, Nisalak A, Johnson DE, Scott RM (1988) A prospective study of dengue infections in Bangkok. Am J Trop Med Hyg 38(1):172–180

    PubMed  CAS  Google Scholar 

  33. Allwinn R, Hofknecht N, Doerr HW (2008) Dengue in travellers is still underestimated. Intervirology 51(2):96–100

    Article  PubMed  Google Scholar 

  34. Jelinek T, Mühlberger N, Harms G, Corachán M, Grobusch MP, Knobloch J, Bronner U, Laferl H, Kapaun A, Bisoffi Z, Clerinx J, Puente S, Fry G, Schulze M, Hellgren U, Gjørup I, Chalupa P, Hatz C, Matteelli A, Schmid M, Nielsen LN, da Cunha S, Atouguia J, Myrvang B, Fleischer K; European Network on Imported Infectious Disease Surveillance (2002) Epidemiology and clinical features of imported dengue fever in Europe: sentinel surveillance data from TropNetEurop. Clin Infect Dis 35(9):1047–1052

    Article  PubMed  CAS  Google Scholar 

  35. Itoda I, Masuda G, Suganuma A, Imamura A, Ajisawa A, Yamada K, Yabe S, Takasaki T, Kurane I, Totsuka K, Negishi M (2006) Clinical features of 62 imported cases of dengue fever in Japan. Am J Trop Med Hyg 75(3):470–474

    PubMed  Google Scholar 

  36. Cuzzubbo AJ, Vaughn DW, Nisalak A, Solomon T, Kalayanarooj S, Aaskov J, Dung NM, Devine PL (1999) Comparison of PanBio dengue duo enzyme-linked immunosorbent assay (ELISA) and MRL dengue fever virus immunoglobulin M capture ELISA for diagnosis of dengue virus infections in Southeast Asia. Clin Diagn Lab Immunol 6(5):705–712

    PubMed  CAS  Google Scholar 

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Acknowledgements

We would like to thank Ian Gordon for his statistical contribution, Jennie Layden and other laboratory staff, and the travel clinic staff involved in the study. Most of all, we are indebted to the participating travellers.

Conflicts of interest

This study was funded by an investigator-initiated unrestricted grant from Sanofi-Pasteur. The authors Laurence Pollissard, Clarisse Demont and Christine Luxemburger are employees of Sanofi-Pasteur. Joseph Torresi has received a speaking honoraria from Sanofi-Pasteur.

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Authors and Affiliations

  1. The Royal Melbourne Hospital, Parkville, VIC, Australia

    I. Ratnam, K. Leder, B.-A. Biggs & E. Matchett

  2. The University of Melbourne, Parkville, VIC, Australia

    I. Ratnam, J. Black & B.-A. Biggs

  3. Monash University, Clayton, VIC, Australia

    K. Leder

  4. Monash Medical Centre, Clayton, VIC, Australia

    A. Padiglione & I. Woolley

  5. Victorian Infectious Diseases Reference Laboratory, North Melbourne, VIC, Australia

    T. Panagiotidis

  6. The Travel Doctor, Travellers Medication and Vaccination Centre (TMVC), Melbourne, VIC, Australia

    T. Gherardin

  7. Sanofi-Pasteur, Lyon, France

    L. Pollissard, C. Demont & C. Luxemburger

  8. The Austin Hospital, Heidelberg, VIC, Australia

    J. Torresi

  9. The University of Melbourne, Parkville, VIC, Australia

    J. Torresi

  10. Department of Infectious Diseases, Austin Hospital, The University of Melbourne, 145 Studley Road, Heidelberg, VIC, 3084, Australia

    J. Torresi

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  1. I. Ratnam
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  2. J. Black
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  3. K. Leder
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  10. L. Pollissard
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  11. C. Demont
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  12. C. Luxemburger
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  13. J. Torresi
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Corresponding author

Correspondence to J. Torresi.

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Ratnam, I., Black, J., Leder, K. et al. Incidence and seroprevalence of dengue virus infections in Australian travellers to Asia. Eur J Clin Microbiol Infect Dis 31, 1203–1210 (2012). https://doi.org/10.1007/s10096-011-1429-1

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  • DOI: https://doi.org/10.1007/s10096-011-1429-1

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