[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]
Volume 25, Number 8—August 2019 / Research
Cross-Protection of Dengue Virus Infection against Congenital Zika Syndrome, Northeastern Brazil
Celia Pedroso1, Carlo Fischer1, Marie Feldmann1, Manoel Sarno, Estela Luz, Andrés Moreira-Soto, Renata Cabral, Eduardo Martins Netto, Carlos Brites, Beate M. Kümmerer, and Jan Felix Drexler
Author affiliations: Universidade Federal de Bahia, Salvador, Brazil (C. Pedroso, M. Sarno, E. Luz, R. Cabral, E. Martins Netto, C. Brites); Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humbolt-Universität zu Berlin and Berlin Institute of Health, Institute of Virology, Berlin, Germany (C. Fischer, A. Moreira-Soto, J.F. Drexler); University of Bonn Medical Centre, Bonn, Germany (M. Feldmann, B.M. Kümmerer); German Centre for Infection Research (B.M. Kümmerer, J.F. Drexler)
The Zika virus outbreak in Latin America resulted in congenital malformations, called congenital Zika syndrome (CZS). For unknown reasons, CZS incidence was highest in northeastern Brazil; one potential explanation is that dengue virus (DENV)–mediated immune enhancement may promote CZS development. In contrast, our analyses of historical DENV genomic data refuted the hypothesis that unique genome signatures for northeastern Brazil explain the uneven dispersion of CZS cases. To confirm our findings, we performed serotype-specific DENV neutralization tests in a case–control framework in northeastern Brazil among 29 Zika virus–seropositive mothers of neonates with CZS and 108 Zika virus–seropositive control mothers. Neutralization titers did not differ significantly between groups. In contrast, DENV seroprevalence and median number of neutralized serotypes were significantly lower among the mothers of neonates with CZS. Supported by model analyses, our results suggest that exposure to multitypic DENV infection may protect from, rather than enhance, development of CZS.
Keywords: Flavivirus; Dengue Fever; Zika Virus; A.D.E.; Congenital Zika Syndrome; Pregnancy; Brazil; Seroprevalence.