Use of seroprevalence to guide dengue vaccination plans for older adults in a dengue non-endemic country

Yi-Hua Pan, Mei-Ying Liao, Yu-Wen Chien, Tzong-Shiann Ho, Hui-Ying Ko, Chin-Rur Yang, Shu-Fen Chang, Chia-Yi Yu, Shu-Yu Lin, Pin-Wei Shih, Pei-Yun Shu, Day-Yu Chao, Chao-Ying Pan, Hong-Ming Chen, Guey-Chuen Perng, Chia-Chi Ku, Chwan-Chuen King

Research output: Contribution to journalA1: Web of Science-articlepeer-review


A shift in dengue cases toward the adult population, accompanied by an increased risk of severe cases of dengue in the elderly, has created an important emerging issue in the past decade. To understand the level of past DENV infection among older adults after a large dengue outbreak occurred in southern Taiwan in 2015, we screened 1498 and 2603 serum samples from healthy residents aged ≥ 40 years in Kaohsiung City and Tainan City, respectively, to assess the seroprevalence of anti-DENV IgG in 2016. Seropositive samples were verified to exclude cross-reaction from Japanese encephalitis virus (JEV), using DENV/JEV-NS1 indirect IgG ELISA. We further identified viral serotypes and secondary DENV infections among positive samples in the two cities. The overall age-standardized seroprevalence of DENV-IgG among participants was 25.77% in Kaohsiung and 11.40% in Tainan, and the seroprevalence was significantly higher in older age groups of both cities. Although the percentages of secondary DENV infection in Kaohsiung and Tainan were very similar (43.09% and 44.76%, respectively), DENV-1 and DENV-2 spanned a wider age range in Kaohsiung, whereas DENV-2 was dominant in Tainan. As very few studies have obtained the serostatus of DENV infection in older adults and the elderly, this study highlights the need for further investigation into antibody status, as well as the safety and efficacy of dengue vaccination in these older populations.

Original languageEnglish
JournalPLoS Neglected Tropical Diseases
Issue number4
Pages (from-to)e0009312
Publication statusPublished - Apr-2021


  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antibodies, Viral/blood
  • Dengue/epidemiology
  • Dengue Virus/genetics
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Immunoglobulin G/blood
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Seroepidemiologic Studies
  • Taiwan/epidemiology


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