{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T10:27:00Z","timestamp":1791973620907,"version":"4.4.0"},"reference-count":40,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2021,7,23]],"date-time":"2021-07-23T00:00:00Z","timestamp":1626998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Royal Society to JCRH","award":["CHG\\R1\\170061"],"award-info":[{"award-number":["CHG\\R1\\170061"]}]},{"name":"Newton Fund\u2019s Institutional Links","award":["216416089"],"award-info":[{"award-number":["216416089"]}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["206471\/Z\/17\/Z"],"award-info":[{"award-number":["206471\/Z\/17\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Zika virus (ZIKV) exposure across flavivirus-endemic countries, including the Philippines, remains largely unknown despite sporadic case reporting and environmental suitability for transmission. Using laboratory surveillance data from 2016, 997 serum samples were randomly selected from suspected dengue (DENV) case reports across the Philippines and assayed for serological markers of short-term (IgM) and long-term (IgG) ZIKV exposure. Using mixture models, we re-evaluated ZIKV IgM\/G seroprevalence thresholds and used catalytic models to quantify the force of infection (attack rate, AR) from age-accumulated ZIKV exposure. While we observed extensive ZIKV\/DENV IgG cross-reactivity, not all individuals with active DENV presented with elevated ZIKV IgG, and a proportion of dengue-negative cases (DENV IgG-) were ZIKV IgG-positive (14.3%, 9\/63). We identified evidence of long-term, yet not short-term, ZIKV exposure across Philippine regions (ZIKV IgG+: 31.5%, 314\/997) which was geographically uncorrelated with DENV exposure. In contrast to the DENV AR (12.7% (95%CI: 9.1\u201317.4%)), the ZIKV AR was lower (5.7% (95%CI: 3\u201311%)) across the country. Our results provide evidence of widespread ZIKV exposure across the Philippines and suggest the need for studies to identify ZIKV infection risk factors over time to better prepare for potential future outbreaks.<\/jats:p>","DOI":"10.3390\/v13081441","type":"journal-article","created":{"date-parts":[[2021,7,25]],"date-time":"2021-07-25T22:07:00Z","timestamp":1627250820000},"page":"1441","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Serological Evidence of Widespread Zika Transmission across the Philippines"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7273-874X","authenticated-orcid":false,"given":"Joseph R.","family":"Biggs","sequence":"first","affiliation":[{"name":"Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ava Kristy","family":"Sy","sequence":"additional","affiliation":[{"name":"Department of Virology, Research Institute for Tropical Medicine, Manila 1781, Philippines"},{"name":"Dengue Study Group, Research Institute for Tropical Medicine, Manila 1781, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3235-2129","authenticated-orcid":false,"given":"Oliver J.","family":"Brady","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"},{"name":"Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam J.","family":"Kucharski","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"},{"name":"Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Funk","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"},{"name":"Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun-Hung","family":"Tu","sequence":"additional","affiliation":[{"name":"Department of Molecular Parasitology and Tropical Diseases, Graduate Institute of Medical Sciences, Taipei Medical University, Taipei 11031, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Anne Joy","family":"Reyes","sequence":"additional","affiliation":[{"name":"Department of Virology, Research Institute for Tropical Medicine, Manila 1781, Philippines"},{"name":"Dengue Study Group, Research Institute for Tropical Medicine, Manila 1781, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Ann","family":"Quinones","sequence":"additional","affiliation":[{"name":"Department of Virology, Research Institute for Tropical Medicine, Manila 1781, Philippines"},{"name":"Dengue Study Group, Research Institute for Tropical Medicine, Manila 1781, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Jones-Warner","sequence":"additional","affiliation":[{"name":"Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Ashall","sequence":"additional","affiliation":[{"name":"Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferchito L.","family":"Avelino","sequence":"additional","affiliation":[{"name":"Department of Health, Philippine Epidemiology Bureau, Manila 1003, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nemia L.","family":"Sucaldito","sequence":"additional","affiliation":[{"name":"Department of Health, Philippine Epidemiology Bureau, Manila 1003, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2186-4989","authenticated-orcid":false,"given":"Amado O.","family":"Tandoc","sequence":"additional","affiliation":[{"name":"Department of Virology, Research Institute for Tropical Medicine, Manila 1781, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Cutiongco-de la Paz","sequence":"additional","affiliation":[{"name":"Institute of Human Genetics, University of the Philippines, Manila 1000, Philippines"},{"name":"Philippine Genome Centre, University of the Philippines, Manila 1101, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Rosario Z.","family":"Capeding","sequence":"additional","affiliation":[{"name":"Dengue Study Group, Research Institute for Tropical Medicine, Manila 1781, Philippines"},{"name":"Institute of Human Genetics, University of the Philippines, Manila 1000, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmencita D.","family":"Padilla","sequence":"additional","affiliation":[{"name":"Institute of Human Genetics, University of the Philippines, Manila 1000, Philippines"},{"name":"Philippine Genome Centre, University of the Philippines, Manila 1101, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8587-1849","authenticated-orcid":false,"given":"Martin L.","family":"Hibberd","sequence":"additional","affiliation":[{"name":"Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"},{"name":"Institute of Human Genetics, University of the Philippines, Manila 1000, Philippines"},{"name":"Philippine Genome Centre, University of the Philippines, Manila 1101, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julius Clemence R.","family":"Hafalla","sequence":"additional","affiliation":[{"name":"Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, 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