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Here, we found aging of the population and its effect on the hazard of transmission to be the dominant contributors, with temporal changes in surveillance practices playing a lesser role. With ongoing population aging, we expect a continuing shift of DHF toward older individuals, heightening the chance of clinical complications with comorbidities. With most other highly endemic countries facing similar shifts in age structure, the pattern is expected to appear elsewhere. Awareness is needed to improve diagnosis and treatment.<\/jats:p>","DOI":"10.1073\/pnas.2115790119","type":"journal-article","created":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T15:03:16Z","timestamp":1652108596000},"update-policy":"https:\/\/doi.org\/10.1073\/pnas.cm10313","source":"Crossref","is-referenced-by-count":45,"title":["Assessing the role of multiple mechanisms increasing the age of dengue cases in Thailand"],"prefix":"10.1073","volume":"119","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9857-3506","authenticated-orcid":false,"given":"Angkana T.","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Biology, University of Florida, Gainesville, FL 32611"},{"name":"Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand 10400"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5413-5507","authenticated-orcid":false,"given":"Saki","family":"Takahashi","sequence":"additional","affiliation":[{"name":"School of Medicine, University of California, San Francisco, CA 94143"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3626-4254","authenticated-orcid":false,"given":"Henrik","family":"Salje","sequence":"additional","affiliation":[{"name":"Department of Genetics, University of Cambridge, Cambridge, United Kingdom CB23EH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5371-2138","authenticated-orcid":false,"given":"Lin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Genetics, University of Cambridge, Cambridge, United Kingdom CB23EH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernardo","family":"Garcia-Carreras","sequence":"additional","affiliation":[{"name":"Department of Biology, University of Florida, Gainesville, FL 32611"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Anderson","sequence":"additional","affiliation":[{"name":"Microbiology and Immunology, State University of New York Upstate Medical University, Syracuse, NY 13210"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Endy","sequence":"additional","affiliation":[{"name":"Microbiology and Immunology, State University of New York Upstate Medical University, Syracuse, NY 13210"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8368-7682","authenticated-orcid":false,"given":"Stephen","family":"Thomas","sequence":"additional","affiliation":[{"name":"Microbiology and Immunology, State University of New York Upstate Medical University, Syracuse, NY 13210"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4064-6848","authenticated-orcid":false,"given":"Alan L.","family":"Rothman","sequence":"additional","affiliation":[{"name":"Laboratory of Viral Immunity and Pathogenesis, University of Rhode Island, Kingston, RI 02881"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chonticha","family":"Klungthong","sequence":"additional","affiliation":[{"name":"Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand 10400"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony R.","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand 10400"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand 10400"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sopon","family":"Iamsirithaworn","sequence":"additional","affiliation":[{"name":"Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand 11000"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1154-4527","authenticated-orcid":false,"given":"Pawinee","family":"Doung-Ngern","sequence":"additional","affiliation":[{"name":"Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand 11000"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6784-1021","authenticated-orcid":false,"given":"Isabel","family":"Rodriguez-Barraquer","sequence":"additional","affiliation":[{"name":"School of Medicine, University of California, San Francisco, CA 94143"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9437-1907","authenticated-orcid":false,"given":"Derek A. 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