{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T23:47:13Z","timestamp":1788824833447,"version":"build-2803163510"},"reference-count":48,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T00:00:00Z","timestamp":1748304000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The geographic range of flaviviruses is expanding, as evidenced by the increase in dengue virus (DENV) cases and the recent emergence of Zika virus (ZIKV) in the Americas. Studying seroprevalence of flaviviruses in (hyper)endemic regions is challenging due to extensive antibody cross-reactivity. Over the past decade, Aruba and Cura\u00e7ao have experienced DENV and ZIKV outbreaks, of which the magnitude and impact remain unclear due to the challenges of disentangling DENV from ZIKV (past) infection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Here, we study the potential utility of blood donors for monitoring the extent of circulation, on 2 Caribbean islands. We report a longitudinal cross-sectional study using randomly selected blood donor sera (n = 715) during the ZIKV outbreaks on Aruba and Cura\u00e7ao (January 2016\u2013July 2017). Flavivirus seroprevalence was estimated using a validated multiplex protein microarray containing NS1 proteins for 11 flaviviruses, in combination with confirmation virus neutralization tests on a selection of sera.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>It was possible to disentangle ZIKV exposure from exposure to other flaviviruses. In Cura\u00e7ao, the seroprevalence of ZIKV antibodies was 25% and significantly higher than the prevalence of antibodies attributable to ZIKV exposure in Aruba (8%). Flavivirus immunoglobulin G antibody (IgG) titers increased with age (P &amp;lt; .05),<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This methodology allows estimation of ZIKV seroprevalence during and after the ZIKV outbreaks. This study shows the importance of including age in the interpretation of serology data. Furthermore, it gives insights into the complex antibody (background) patterns of flaviviruses over time, and highlights the utility of an existing voluntary blood donor program to monitor and respond to (flavivirus) outbreaks.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiaf281","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T04:13:56Z","timestamp":1748319236000},"page":"e507-e517","source":"Crossref","is-referenced-by-count":4,"title":["Estimating Zika Virus Seroprevalence in a Dengue Virus\u2013Endemic Population: The Use of Blood Donors and Multiplex Serology to Monitor Arbovirus Outbreaks in the Dutch Caribbean"],"prefix":"10.1093","volume":"232","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5860-3582","authenticated-orcid":false,"given":"Louella M R","family":"Kasbergen","sequence":"first","affiliation":[{"name":"Department of Viroscience, Erasmus University Medical Center , Rotterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reina S","family":"Sikkema","sequence":"additional","affiliation":[{"name":"Department of Viroscience, Erasmus University Medical Center , Rotterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3465-6409","authenticated-orcid":false,"given":"Felicity","family":"Chandler","sequence":"additional","affiliation":[{"name":"Department of Viroscience, Erasmus University Medical Center , Rotterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janko H G","family":"van Beek","sequence":"additional","affiliation":[{"name":"Department of Viroscience, Erasmus University Medical Center , Rotterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaskara","family":"Halabi","sequence":"additional","affiliation":[{"name":"Epidemiology and Research, Ministry of Health, Environment and Nature , Willemstad ,","place":["Cura\u00e7ao"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nor\u00e9diz","family":"Lourents","sequence":"additional","affiliation":[{"name":"Epidemiology and Research, Ministry of Health, Environment and Nature , Willemstad ,","place":["Cura\u00e7ao"]},{"name":"Cura\u00e7ao Public Health Service (GGD), Ministry of Health , Willemstad ,","place":["Cura\u00e7ao"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene G","family":"Maduro","sequence":"additional","affiliation":[{"name":"Epidemiology and Research Unit, Department of Public Health Aruba , Oranjestad ,","place":["Aruba"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Izzy","family":"Gerstenbluth","sequence":"additional","affiliation":[{"name":"Epidemiology and Research, Ministry of Health, Environment and Nature , Willemstad ,","place":["Cura\u00e7ao"]},{"name":"Cura\u00e7ao Public Health Service (GGD), Ministry of Health , Willemstad ,","place":["Cura\u00e7ao"]},{"name":"Department of Epidemiology and Immunology, Cura\u00e7ao Biomedical and Health Research Institute , Willemstad ,","place":["Cura\u00e7ao"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6368-8266","authenticated-orcid":false,"given":"Ashley","family":"Duits","sequence":"additional","affiliation":[{"name":"Department of Immunohematology, Red Cross Blood Bank Foundation Cura\u00e7ao , Willemstad ,","place":["Cura\u00e7ao"]},{"name":"Institute for Medical Education, University Medical Center Groningen , Groningen ,","place":["The Netherlands"]},{"name":"Department of Epidemiology and Immunology, Cura\u00e7ao Biomedical and Health Research Institute , Willemstad ,","place":["Cura\u00e7ao"]},{"name":"Department of Immunohematology, Horacio Oduber Hospital Blood Bank , Oranjestad ,","place":["Aruba"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion P G","family":"Koopmans","sequence":"additional","affiliation":[{"name":"Department of Viroscience, Erasmus University Medical Center , Rotterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,5,27]]},"reference":[{"key":"2025092306180910500_jiaf281-B1","first-page":"1","volume-title":"One Health","author":"Gould","year":"2017"},{"key":"2025092306180910500_jiaf281-B2","doi-asserted-by":"crossref","first-page":"675","DOI":"10.2471\/BLT.16.171082","article-title":"Zika: the origin and spread of a mosquito-borne virus","volume":"94","author":"Kindhauser","year":"2016","journal-title":"Bull World Health Organ"},{"key":"2025092306180910500_jiaf281-B3","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1590\/0074-02760150192","article-title":"First report of autochthonous transmission of Zika virus in Brazil","volume":"110","author":"Zanluca","year":"2015","journal-title":"Mem Inst Oswaldo 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