ArticleBMC infectious diseases2021
A fatal case report of antibody-dependent enhancement of dengue virus type 1 following remote Zika virus infection.
Article in BMC infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 23 citations in OpenAlex.
- Impact of previous SARS-CoV-2 infection on the severity of respiratory syncytial virus infection in hospitalized children.Scientific reports · 2025Article
- High seroprevalence of antibodies to Dengue, Chikungunya, and Zika viruses in Dire Dawa, Ethiopia: A cross-sectional survey in 2024.PLoS neglected tropical diseases · 2025Article
- Review
- Estimating per-infection cost and burden for dengue and Zika as a function of antibody-dependent enhancement.PLoS neglected tropical diseases · 2025Article
- Influence of previous Zika virus infection on acute dengue episode.PLoS neglected tropical diseases · 2023Article
- Mechanisms of Zika astrocyte infection and neuronal toxicity.NeuroImmune pharmacology and therapeutics · 2023Article
- Epidemiological profile of arboviruses in two different scenarios: dengue circulation vs. dengue, chikungunya and Zika co-circulation.BMC infectious diseases · 2023Article
- Zika Virus from the Perspective of Observational Studies: a Review.Journal of arthropod-borne diseases · 2022Review
- Evaluation of Antibody-Dependent Fc-Mediated Viral Entry, as Compared With Neutralization, in SARS-CoV-2 Infection.Frontiers in immunology · 2022Article
- Self-Assembling Nanovaccine Confers Complete Protection Against Zika Virus Without Causing Antibody-Dependent Enhancement.Frontiers in immunology · 2022Article
- Article
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15 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundDengue virus (DENV) is endemic in many parts of the world. Antibody dependent enhancement (ADE) in DENV infections occurs when a person with primary immunity is infected by a second, different DENV strain. Antibodies to Zika virus (ZIKV), which emerged in the Western Hemisphere in 2015, are cross reactive with DENV and theoretically could provoke ADE in a DENV naïve individual. CASE PRESENTATION: DENV infection was suspected in a child who had recently returned from a one-month stay in the Dominican Republic. The child presented with fever, vomiting, abdominal pain, and in hypovolemic shock. Volume and pressor resuscitation were unsuccessful, and the child died less than 24 h after hospitalization. Laboratory results suggested an early acute first DENV infection since serum, plasma, and spinal fluid had DENV1 detected by polymerase chain reaction (PCR), yet the serum lacked IgG antibodies to DENV nonstructural protein 1 (NS1) of all four DENV serotypes. This acute DENV infection occurred in the presence of a remote ZIKV infection as determined by antibodies to ZIKV NS1 envelope by multiplex microsphere immunoassay and an exceptionally high plaque reduction neutralization titer to ZIKV. ZIKV IgG avidity index was high, confirming a past infection. DENV1 RNA was detected in all ten organs and tissues examined by PCR. The severe and fatal complications reported here suggest that a remote ZIKV infection may provoke an exaggerated immune response leading to hypovolemic shock when primarily infected by DENV1.
conclusionWe report the first known patient in the United States with a rapidly progressive and fatal case of travel-associated DENV in which prior exposure to ZIKV likely played a role in triggering an ADE phenomenon. This association of prior ZIKV immunity and subsequent new dengue infection is a worrisome phenomenon and an important contribution to the body of knowledge on immunity to flaviviruses.
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