TY - JOUR AU - Pedroso, Celia AU - Fischer, Carlo AU - Feldmann, Marie AU - Sarno, Manoel AU - Luz, Estela AU - Moreira-Soto, Andrés AU - Cabral, Renata AU - Netto, Eduardo Martins AU - Brites, Carlos AU - Kümmerer, Beate AU - Drexler, Jan Felix T1 - Cross-Protection of Dengue Virus Infection against Congenital Zika Syndrome, Northeastern Brazil T2 - Emerging Infectious Disease journal PY - 2019 VL - 25 IS - 8 SP - 1485 SN - 1080-6059 AB - 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 multitypic DENV infection may protect from, rather than enhance, development of CZS. KW - Zika virus KW - dengue virus KW - cross protection KW - antibody-dependent enhancement KW - flaviviridae KW - Brazil KW - viral plaque assay KW - T-cell specificity KW - viruses KW - congenital Zika syndrome DO - 10.3201/eid2508.190113 UR - https://wwwnc.cdc.gov/eid/article/25/8/19-0113_article ER - End of Reference