{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T05:17:41Z","timestamp":1775107061762,"version":"3.50.1"},"reference-count":33,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,2]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Limited dengue virus (DENV) seroprevalence estimates are available for Puerto Rico, which are needed to inform the potential use and cost-effectiveness of DENV vaccines. The Communities Organized to Prevent Arboviruses (COPA) is a cohort study initiated in 2018 in Ponce, Puerto Rico, to assess arboviral disease risk and provide a platform to evaluate interventions. We recruited participants from households in 38 study clusters, who were interviewed and provided a serum specimen. Specimens from 713 children aged 1 to 16 years during the first year of COPA were tested for the four DENV serotypes and ZIKV using a focus reduction neutralization assay. We assessed the seroprevalence of DENV and ZIKV by age and developed a catalytic model from seroprevalence and dengue surveillance data to estimate the force of infection for DENV during 2003\u20132018. Overall, 37% (<jats:italic>n<\/jats:italic> = 267) were seropositive for DENV; seroprevalence was 9% (11\/128) among children aged 1 to 8 years and 44% (256\/585) among children aged 9 to 16 years, exceeding the threshold over which DENV vaccination is deemed cost-effective. A total of 33% were seropositive for ZIKV, including 15% among children aged 0 to 8 years and 37% among children aged 9 to 16 years. The highest force of infection occurred in 2007, 2010, and 2012\u20132013, with low levels of transmission from 2016 to 2018. A higher proportion of children had evidence of multitypic DENV infection than expected, suggesting high heterogeneity in DENV risk in this setting.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0091","type":"journal-article","created":{"date-parts":[[2023,6,12]],"date-time":"2023-06-12T14:57:53Z","timestamp":1686581873000},"page":"413-419","source":"Crossref","is-referenced-by-count":6,"title":["Previous Dengue Infection among Children in Puerto Rico and Implications for Dengue Vaccine Implementation"],"prefix":"10.4269","volume":"109","author":[{"given":"Laura E.","family":"Adams","sequence":"first","affiliation":[{"name":"Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matt D. T.","family":"Hitchings","sequence":"additional","affiliation":[{"name":"University of Florida, Gainesville, Florida;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Freddy A.","family":"Medina","sequence":"additional","affiliation":[{"name":"Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dania M.","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liliana","family":"S\u00e1nchez-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"Moore","sequence":"additional","affiliation":[{"name":"University of Georgia, Athens, Georgia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen S.","family":"Whitehead","sequence":"additional","affiliation":[{"name":"Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge L.","family":"Mu\u00f1oz-Jord\u00e1n","sequence":"additional","affiliation":[{"name":"Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa","family":"Rivera-Amill","sequence":"additional","affiliation":[{"name":"Ponce Health Sciences University\/Ponce Research Institute, Ponce, Puerto Rico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriela","family":"Paz-Bailey","sequence":"additional","affiliation":[{"name":"Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Nature","first-page":"504","article-title":"The global distribution and burden of dengue","volume":"496","author":"Bhatt","year":"2013"},{"key":"b2","series-title":"Science","first-page":"929","article-title":"Antibody-dependent enhancement of severe dengue disease in humans","volume":"358","author":"Katzelnick","year":"2017"},{"key":"b3","series-title":"MMWR Recomm Rep","first-page":"1","article-title":"Dengue vaccine: recommendations of the advisory committee on immunization practices, United States, 2021","volume":"70","author":"Paz-Bailey","year":"2021"},{"key":"b4","series-title":"N Engl J Med","first-page":"327","article-title":"Effect of dengue serostatus on dengue vaccine safety and efficacy","volume":"379","author":"Sridhar","year":"2018"},{"key":"b5","series-title":"N Engl J Med","first-page":"1195","article-title":"Efficacy and long-term safety of a dengue vaccine in regions of endemic disease","volume":"373","author":"Hadinegoro","year":"2015"},{"key":"b6","series-title":"PLoS Med","first-page":"e1002181","article-title":"The long-term safety, public health impact, and cost-effectiveness of routine vaccination with a recombinant, live-attenuated dengue vaccine (Dengvaxia): a model comparison study","volume":"13","author":"Flasche","year":"2016"},{"key":"b7","series-title":"PLoS Negl Trop Dis","first-page":"e0007482","article-title":"Model-based assessment of public health impact and cost-effectiveness of dengue vaccination following screening for prior exposure","volume":"13","author":"Espa\u00f1a","year":"2019"},{"key":"b8","series-title":"Emerg Infect Dis","first-page":"1522","article-title":"Lessons learned from dengue surveillance and research, Puerto Rico, 1899\u20132013","volume":"25","author":"Sharp","year":"2019"},{"key":"b9","series-title":"PLoS Negl Trop Dis","first-page":"e0008532","article-title":"Epidemiologic and spatiotemporal trends of Zika Virus disease during the 2016 epidemic in Puerto Rico","volume":"14","author":"Sharp","year":"2020"},{"key":"b10","series-title":"Emerg Infect Dis","first-page":"1221","article-title":"High incidence of chikungunya virus and frequency of viremic blood donations during epidemic, Puerto Rico, USA, 2014","volume":"22","author":"Simmons","year":"2016"},{"key":"b11","year":"2022"},{"key":"b12","series-title":"Am J Trop Med Hyg","first-page":"486","article-title":"Incidence of dengue virus infection in school-aged children in Puerto Rico: a prospective seroepidemiologic study","volume":"92","author":"Arg\u00fcello","year":"2015"},{"key":"b13","series-title":"Trans R Soc Trop Med Hyg","first-page":"158","article-title":"Dengue seroprevalence: data from the clinical development of a tetravalent dengue vaccine in 14 countries (2005\u20132014)","volume":"112","author":"L\u2019Azou","year":"2018"},{"key":"b14","series-title":"PLoS Negl Trop Dis","first-page":"e0009966","article-title":"Assessment of community support for Wolbachia-mediated population suppression as a control method for Aedes aegypti mosquitoes in a community cohort in Puerto Rico","volume":"15","author":"S\u00e1nchez-Gonz\u00e1lez","year":"2021"},{"key":"b15","series-title":"PLoS Negl Trop Dis","first-page":"e0010416","article-title":"Risk factors for infection with chikungunya and Zika viruses in southern Puerto Rico: a community-based cross-sectional seroprevalence survey","volume":"16","author":"Adams","year":"2022"},{"key":"b16","series-title":"J Stat Softw","first-page":"1","article-title":"mice: Multivariate Imputation by Chained Equations in R","volume":"45","author":"Van Buuren","year":"2011"},{"key":"b17","series-title":"PLoS Negl Trop Dis","first-page":"e0005859","article-title":"Clinical and epidemiologic characteristics of dengue and other etiologic agents among patients with acute febrile illness, Puerto Rico, 2012\u20132015","volume":"11","author":"Tomashek","year":"2017"},{"key":"b18","year":"2019"},{"key":"b19","series-title":"eLife","first-page":"e45474","article-title":"Opportunities for improved surveillance and control of dengue from age-specific case data","volume":"8","author":"Rodriguez-Barraquer","year":"2019"},{"key":"b20","series-title":"PLoS Negl Trop Dis","first-page":"e0004833","article-title":"Estimating dengue transmission intensity from case-notification data from multiple countries","volume":"10","author":"Imai","year":"2016"},{"key":"b21","series-title":"PLoS Negl Trop Dis","first-page":"e0003719","article-title":"Estimating dengue transmission intensity from sero-prevalence surveys in multiple countries","volume":"9","author":"Imai","year":"2015"},{"key":"b22","series-title":"PLoS Med","first-page":"e1000139","article-title":"The impact of the demographic transition on dengue in Thailand: insights from a statistical analysis and mathematical modeling","volume":"6","author":"Cummings","year":"2009"},{"key":"b23","series-title":"Philos Trans R Soc Lond B Biol Sci","first-page":"757","article-title":"Transmission dynamics and epidemiology of dengue: insights from age-stratified sero-prevalence surveys","volume":"354","author":"Ferguson","year":"1999"},{"key":"b24","year":"2020"},{"key":"b25","author":"Vehtari","year":"2023"},{"key":"b26","series-title":"J Stat Distrib Appl","first-page":"1","article-title":"Mean and variance of ratios of proportions from categories of a multinomial distribution","volume":"5","author":"Duris","year":"2018"},{"key":"b27","series-title":"J Infect Dis","first-page":"536","article-title":"Longitudinal analysis of antibody cross-neutralization following Zika virus and dengue virus infection in Asia and the Americas","volume":"218","author":"Montoya","year":"2018"},{"key":"b28","series-title":"Acta Trop","first-page":"234","article-title":"Seroprevalence and risk factors for dengue infection in socio-economically distinct areas of Recife, Brazil","volume":"113","author":"Braga","year":"2010"},{"key":"b29","series-title":"Am J Trop Med Hyg","first-page":"625","article-title":"Dengue transmission in two Puerto Rican Communities in 1982","volume":"34","author":"Waterman","year":"1985"},{"key":"b30","series-title":"Pathog Glob Health","first-page":"10","article-title":"Is dengue a disease of poverty? 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