Nguyet Minh Nguyen1, Duong Thi Hue Kien1, Trung Vu Tuan1, Nguyen Than Ha Quyen1, Chau Nguyen Tran1, Long Vo Thi1, Dui Le Thi1, Hoa L. Nguyen1, Jeremy Farrar2,3, Edward C. Holmes4,5, Maia A. Rabaa1, Juliet E. Bryant2,3, Truong Thanh Nguyen6, Nguyen Thi Cam Huong6, Lan Thi Hong Nguyen6, Phạm Phương6, Hung The Nguyen6, Tai Thi Hue Luong6, Bridget Wills2,3, Nguyễn Văn Vĩnh Châu6, Marcel Wolbers2,3, Cameron P. Simmons2,7,3
1aOxford University Clinical Research Unit, District 5, Ho Chi Minh City, Vietnam;
2Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford OX1 2JD, United Kingdom;
3bCentre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford OX1 2JD, United Kingdom;
4cSydney Emerging Infections and Biosecurity Institute, School of Biological Sciences and Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia;
5dFogarty International Center, National Institutes of Health, Bethesda, MD 20892;
6eHospital for Tropical Diseases, District 5, Ho Chi Minh City, Vietnam; and
7Nossal Institute for Global Health, University of Melbourne, VIC 3010, Australia
Tóm tắt
Dengue is the most prevalent arboviral disease of humans. The host and virus variables associated with dengue virus (DENV) transmission from symptomatic dengue cases (
n
= 208) to
Aedes aegypti
mosquitoes during 407 independent exposure events was defined. The 50% mosquito infectious dose for each of DENV-1–4 ranged from 6.29 to 7.52 log10 RNA copies/mL of plasma. Increasing day of illness, declining viremia, and rising antibody titers were independently associated with reduced risk of DENV transmission. High early DENV plasma viremia levels in patients were a marker of the duration of human infectiousness, and blood meals containing high concentrations of DENV were positively associated with the prevalence of infectious mosquitoes 14 d after blood feeding. Ambulatory dengue cases had lower viremia levels compared with hospitalized dengue cases but nonetheless at levels predicted to be infectious to mosquitoes. These data define serotype-specific viremia levels that vaccines or drugs must inhibit to prevent DENV transmission.
