Dengue Infection Spectrum in Guangzhou: A Cross-Sectional Seroepidemiology Study among Community Residents between 2013 and 2015

The majority of dengue virus infections are asymptomatic, which could potentially facilitate the transmission of dengue fever and increase the percentage of sever dengue fever manifestations. This cross-sectional study explored the sero-prevalence of dengue virus infection in Guangzhou to clarify the infection spectrum. In total, 2085 serum samples were collected from residents of 34 communities. All samples were selected from a 200,000-sample database holding serum collected from community residents living in Liwan and Yuexiu districts of Guangzhou between September 2013 and August 2015, and 17 to 28 individuals of each age group were chosen per month. Dengue immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies were tested by enzyme-linked immunosorbent assay. Symptomatic infected individuals were identified via follow-up questionnaires. Among 2085 serum samples, anti-dengue IgG and IgM positive rates were 11.80% and 3.98%, respectively. The IgG antibody positive rate increased with age and was higher in poorly educated people than in highly educated people and in married individuals than in single individuals. Approximately 96.71% of dengue virus infections and an estimated 13.68% of the whole population were asymptomatic. Such high asymptomatic-infection rates have an impact on the local spread of dengue fever. Stricter surveillance, such as a network of rapid diagnostic laboratories, screening of residents in the epidemic season, and other integrated control measures are necessary.