Interactions between serotypes of dengue highlight epidemiological impact of cross-immunity

Nicholas G. Reich, Sourya Shrestha, Aaron A. King, Pejman Rohani, Justin Lessler, Siripen Kalayanarooj, In Kyu Yoon, Robert V. Gibbons, Donald S Burke, Derek A.T. Cummings

Research output: Contribution to journalArticlepeer-review

149 Scopus citations


Dengue, a mosquito-borne virus of humans, infects over 50 million people annually. Infection with any of the four dengue serotypes induces protective immunity to that serotype, but does not confer long-term protection against infection by other serotypes. The immunological interactions between serotypes are of central importance in understanding epidemiological dynamics and anticipating the impact of dengue vaccines. We analysed a 38-year time series with 12 197 serotyped dengue infections from a hospital in Bangkok, Thailand. Using novel mechanistic models to represent different hypothesized immune interactions between serotypes, we found strong evidence that infection with dengue provides substantial short-term cross-protection against other serotypes (approx. 1-3 years). This is the first quantitative evidence that short-term cross-protection exists since human experimental infection studies performed in the 1950s. These findings will impact strategies for designing dengue vaccine studies, future multi-strain modelling efforts, and our understanding of evolutionary pressures in multi-strain disease systems.

Original languageEnglish (US)
Article number0414
JournalJournal of the Royal Society Interface
Issue number86
StatePublished - Sep 6 2013


  • Cross-protection
  • Dengue
  • Infectious disease modelling
  • Time-series models

ASJC Scopus subject areas

  • Biotechnology
  • Biophysics
  • Bioengineering
  • Biomaterials
  • Biochemistry
  • Biomedical Engineering


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