Evidence map›Paper›PMID 41651817›Full record

ArticleNature communications2026

Immune-mediated protection and enhancement of dengue drives patterns of infant cases in Brazil.

Matt D T Hitchings, Angkana T Huang, Otavio T Ranzani, Bernardo García-Carreras, Mauricio L Nogueira, Albert I Ko, Julio Croda, Henrik Salje, Derek A T Cummings

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Nature communications, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Matt D T HitchingsDepartment of Biostatistics, College of Public Health & Health Professions, University of Florida, Gainesville, FL, USA. mhitchings@ufl.edu.ORCID 0000-0003-2327-3557
Angkana T HuangDepartment of Genetics, University of Cambridge, Cambridge, UK.ORCID 0000-0002-9857-3506
Otavio T RanzaniDataHealth Lab, Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain.ORCID 0000-0002-4677-6862
Bernardo García-CarrerasEmerging Pathogens Institute; University of Florida, Gainesville, FL, USA.ORCID 0000-0002-0714-300X
Mauricio L NogueiraLaboratório de Pesquisas em Virologia, Departamento de Doenças Dermatológicas Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto, SP, Brazil.ORCID 0000-0003-1102-2419
Albert I KoDepartment of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.ORCID 0000-0001-9023-2339
Julio CrodaDepartment of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.
Henrik SaljeDepartment of Genetics, University of Cambridge, Cambridge, UK.ORCID 0000-0003-3626-4254
Derek A T CummingsDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Funding

Dengue ProgramFundação de Amparo à Pesquisa do Estado de São PauloViral Genomic Surveillance and One Health
6 · The paper itself

Abstract

Infants represent a vulnerable population for severe outcomes from infectious diseases. For dengue virus, maternal antibodies can cause severe disease in infants aged 5-12 months through antibody-dependent enhancement, but the role of maternal immunity in neonates aged 0-30 days has not been quantified. Our study leverages the re-emerging setting of Brazil, where the proportion of mothers with anti-dengue antibodies varies across space and time. Infant dengue burden has risen 11-fold from 2000-2024, in line with expansion in the general population. We fit mechanistic models to infant dengue and severe dengue cases reported through surveillance to disentangle the competing roles of maternal immunity, transmission, and age on the risk of dengue and severe dengue in infants across the first year of life. We observed peaks in severe dengue risk in neonates and at 7-8 months of age. These two peaks were explained by competing mechanisms. Infants born to seropositive mothers had lower overall risk of dengue, but increased risk of severe disease from 5-12 months, than those born to seronegative mothers. As dengue incidence increases, and vaccination becomes available, maternal antibodies may decrease infant burden but increase the risk of severe disease.

Indexed as

DengueDengue VirusImmunity, Maternally-AcquiredAntibodies, ViralAntibody-Dependent EnhancementBrazilFemaleHumansIncidenceInfant, NewbornMaleRisk AssessmentSevere DengueAntibodies, Viral

Identifiers

PMID41651817
PMCPMC12996452

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.