Applying a multi-strain dengue model to epidemics data.

Dengue disease transmission is a complex vector-borne disease, mainly due to the co-circulation of four serotypes of the virus. Mathematical models have proved to be a useful tool to understand the complexity of this disease. In this work, we extend the model studied by Esteva et al., 2003, originally proposed for two serotypes, to four circulating serotypes. Using epidemic data of dengue fever in Iquitos (Peru) and San Juan (Puerto Rico), we estimate numerically the co-circulation parameter values for selected outbreaks using a bootstrap method, and we also obtained the Basic Reproduction Number, R0, for each serotype, using both analytical calculations and numerical simulations. Our results indicate that the impact of co-circulation of serotypes in population dynamics of dengue infection is such that there is a reduced effect from DENV-3 to DENV-4 in comparison to no-cross effect for epidemics in Iquitos. Concerning San Juan epidemics, also comparing to no-cross effect, we also observed a reduced effect from the predominant serotype DENV-3 to both DENV-2 and DENV-1 epidemics neglecting the very small number of cases of DENV-4.

Heterogeneities in dengue spatial-temporal transmission in Brazilian cities and its influence on the optimal age of vaccination.

BACKGROUND: The development of a safe and effective vaccine is considered crucial for dengue transmission control since vetor control has been failed; some potential candidates are currently in test, and in this context theoretical studies are necessary to evaluate vaccination strategies such as the age groups that should be vaccinated, the percentage of the population at risk, and the target geographic regions to make dengue control feasible and optimal. METHODS: A partial differential model is used to mimics dengue transmission in human population in order to estimate the optimal vaccination age, using data collected from dengue reported cases in ten cities of Brazil from 2001 to 2014. For this purpose, the basic reproduction number of the disease was minimized assuming a single-dose vaccination strategy, equal vaccine efficacy for all circulating serotypes, and no vaccine failure. Numerical methods were used to assess the optimal vaccination age and its confidence age range. RESULTS: The results reveal complex spatial-temporal patterns associated to the disease transmission, highlighting the heterogeneity in defining the target population for dengue vaccination. However, the values obtained for the optimal age of vaccination, as targeting individuals under 13 years old, are compatible with the ones reported in similar studies in Brazil. The results also show that the optimal age for vaccination in general does not match with the age of the highest number of cases. CONCLUSIONS: The variation of the optimal age for vaccination across the country reflects heterogeneities in dengue spatial-temporal transmission in Brazilian cities, and can be used to define the target population and cities to optimize vaccination strategies in a context of high cost and low quantity of available vaccine.