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Original site: www.cdc.gov/mmwr/volumes/72/wr/mm7211a4.htm | RestoredCDC.org is an independent project, not affiliated with CDC or any federal entity. Visit CDC.gov for free official information. Due to archival on January 6, 2025, recent outbreak data is unavailable. Videos are not restored. Access data.restoredcdc.org for restored data. Use of this site implies acceptance of this disclaimer.[More]About Us Report Bug Compare ContentSkip directly to searchEspañol | Other LanguagesHere's how you knowAn official website of the United States government Here's how you knowMorbidity and Mortality Weekly Report (MMWR)Morbidity and Mortality Weekly Report (MMWR)Centers for Disease Control and Prevention. CDC twenty four seven. Saving Lives, Protecting People Morbidity and Mortality Weekly Report (MMWR)SearchSearch Menu Navigation MenuSubmitMorbidity and Mortality Weekly Report (MMWR)* MMWR* Reports by Topic* Publications+ BACKPublications+ Weekly Reporto BACKWeekly Reporto BACKPublications Weekly Reporto Past Volumes (1982-2023)o Past Volumes (1982-2024)o Morbidity and Mortality Weekly Report (MMWR) Home+ Recommendations and Reportso BACKRecommendations and Reportso BACKPublications Recommendations and Reportso Past Volumes (1990-2022)o Past Volumes (1990-2024)o Morbidity and Mortality Weekly Report (MMWR) Home+ Surveillance Summarieso BACKSurveillance Summarieso BACKPublications Surveillance Summarieso Past Volumes (1983-2023)o Past Volumes (1983-2024)o Morbidity and Mortality Weekly Report (MMWR) Home+ Supplementso BACKSupplementso BACKPublications Supplementso Past Volumes (1985-2023)o Morbidity and Mortality Weekly Report (MMWR) Home+ Archive (1952-1981)+ Notifiable Infectious Diseases+ Notifiable Noninfectious Conditions+ Morbidity and Mortality Weekly Report (MMWR) Home* Vital Signs* Visual Abstracts* Podcasts* Continuing Education* MMWR Clinical Pearls* Metrics* For Authors* About+ BACKAbout+ Staff+ Editorial Board+ Morbidity and Mortality Weekly Report (MMWR) Home* Subscribe+ BACKSubscribe+ RSS Feed+ Morbidity and Mortality Weekly Report (MMWR) Home* Morbidity and Mortality Weekly Report (MMWR) HomeMorbidity and Mortality Weekly Report (MMWR)Morbidity and Mortality Weekly Report (MMWR) HomeNotes From the Field: Prevalence of Previous Dengue Virus Infection Among Children and Adolescents — U.S. Virgin Islands, 2022Weekly / March 17, 2023 / 72(11);288–289Related PagesValerie V. Mac, PhD1,2,*; Joshua M. Wong, MD1,3,*; Hannah R. Volkman, PhD3; Janice Perez-Padilla, MPH3; Brian Wakeman, PhD4; Mark Delorey, PhD3; Brad J. Biggerstaff, PhD3; Anna Fagre, DVM, PhD1,3; Annellie Gumbs2; Aubrey Drummond2; Brenae Zimmerman, MPH2; Briana Lettsome, MPH2; Freddy A. Medina, PhD3; Gabriela Paz-Bailey, MD, PhD3; Marlon Lawrence, PhD2; Brett Ellis, PhD2; Hannah G. Rosenblum, MD1; Jamaal Carroll2; Joseph Roth, DrPH2; Janelle Rossington2; Jessica R. Meeker, PhD1; Joy Joseph2; Julia Janssen, MD1; Lisa Laplace Ekpo, DrPH2; Monifa Carrillo2; Niurka Hernandez2; Patricia Charles2; Rafael Tosado, PhD3; Raymond Soto, PhD1,3; Shanice Battle, PhD1; Stephen M. Bart, PhD1; Valentine Wanga, PhD1; Wilfredo Valentin2; Winifred Powell2; Zula Battiste2; Esther M. Ellis, PhD2; Laura E. Adams, DVM3 (View author affiliations)View suggested citationArticle MetricsAltmetric:See more detailsNews (4)Policy documents (1)X (6)Facebook (1)Mendeley (15)Citations: 3Views: 4,415Views: 2,523Views equals page views plus PDF downloadsMetric DetailsTableRelated Materials* Article PDF* Full Issue PDFIn May 2019, the Food and Drug Administration issued approval for Dengvaxia (Sanofi Pasteur), a live-attenuated, chimeric tetravalent dengue vaccine (1). In June 2021, the Advisory Committee on Immunization Practices (ACIP) recommended vaccination with Dengvaxia for children and adolescents aged 9–16 years with laboratory confirmation of previous dengue virus infection and who live in areas with endemic dengue transmission, such as the U.S. Virgin Islands (USVI)† (2). Confirming previous dengue virus infection before vaccine administration (prevaccination screening) is important because 1) although Dengvaxia decreases hospitalization and severe disease from dengue among persons with a previous infection, it increases the risk for these outcomes among persons without a previous infection; 2) many dengue virus infections are asymptomatic; and 3) many patients with symptomatic infections do not seek medical attention or receive appropriate testing (3). Sufficient laboratory evidence of previous dengue virus infection includes a history of laboratory-confirmed dengue§ or a positive serologic test result that meets ACIP-recommended performance standards for prevaccination screening, defined as high specificity (≥98%) and sensitivity (≥75%). A seroprevalence of 20% in the vaccine-eligible population (corresponding to a positive predictive value of ≥90% for a test with minimum sensitivity of 75% and minimum specificity of 98%) is recommended to maximize vaccine safety and minimize the risk for vaccinating persons without a previous dengue virus infection (2).The USVI Department of Health (VIDOH) requested assistance from CDC to determine the prevalence of previous dengue virus infection in children and adolescents within the age range eligible for dengue vaccination. During April–May 2022, a serosurvey was conducted that included children and adolescents in grades 3–7 enrolled in 15 schools. Schools were selected either through a one-stage cluster sampling design (10 schools) stratified by the two health districts in USVI (St. Thomas/St. John or St. Croix) with inclusion probabilities proportional to the size of third grade enrollment or through direct selection by VIDOH (five schools). All children and adolescents in the eligible grade levels at the selected schools were invited to participate. Children and adolescents with parental permission received testing for previous dengue virus infection using a dengue immunoglobin G rapid diagnostic test with 89.6% sensitivity and 95.7% specificity from approximately 5 μL of whole blood obtained by fingerstick (CDC, unpublished data, 2022). Design weights were computed from 10,000 simulations of the inclusion methodology, and then adjusted by raking to the two districts’ estimated population age and sex distributions from the 2022 U.S. Census Bureau population estimates. Weighted estimates of seroprevalence and 95% CIs were adjusted to reflect screening test performance. This activity was reviewed by CDC and was conducted consistent with applicable federal law and CDC policy.¶Among 372 children and adolescents who received testing, 218 (59%) received a negative result, 152 (41%) received a positive result, and two received an indeterminate result (Table). Estimated seroprevalence was similar for males and females. The estimated seroprevalence was lowest in children aged 8 years (27%), and highest in those aged 12 years (69%). Seroprevalence was estimated to be higher in St. Thomas/St. John than in St. Croix. Among children and adolescents aged 9–13 years, the age group eligible for the dengue vaccine, estimated seroprevalence was 51%.Dengue seroprevalence in USVI among age groups eligible for vaccination exceeds the 20% threshold that corresponds to a positive predictive value of ≥90% when implementing prevaccination screening with a test meeting ACIP-recommended performance standards. Dengue vaccination with prevaccination screening should be considered as part of a comprehensive dengue control and prevention strategy in USVI (3). Other U.S. jurisdictions with endemic transmission of dengue virus should evaluate the risks, benefits, and feasibility of incorporating the dengue vaccine into their local vaccine schedule and consider serosurveys to guide this evaluation.TopAcknowledgmentsGinjah Battiste, Janney Ferrol-Hawley, Cosme Harrison, Jordan Lake, Andra Prosper; staff members, families, and students of the U.S. Virgin Islands Department of Education and participating private schools.TopCorresponding author: Joshua M. Wong, nof9@cdc.gov.Top1Epidemic Intelligence Service, CDC; 2U.S. Virgin Islands Department of Health; 3Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC; 4Laboratory Leadership Service, CDC.TopAll authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.Top* These authors contributed equally to this report.† https://www.cdc.gov/dengue/areaswithrisk/around-the-world.html§ https://ndc.services.cdc.gov/case-definitions/dengue-virus-infections-2015/¶ 45 C.F.R. part 46, 21 C.F.R. part 56; 42 U.S.C. Sect. 241(d); 5 U.S.C. Sect. 552a; 44 U.S.C. Sect. 3501 et seq.TopReferences1. Food and Drug Administration. Vaccines, blood & biologics: Dengvaxia. Silver Spring, MD: US Department of Health and Human Services: Food and Drug Administration; 2019. Accessed March 10, 2023. https://www.fda.gov/vaccines-blood-biologics/dengvaxia2. Paz-Bailey G, Adams L, Wong JM, et al. Dengue vaccine: recommendations of the Advisory Committee on Immunization Practices, United States, 2021. MMWR Recomm Rep 2021;70(No. RR-6):1–16. https://doi.org/10.15585/mmwr.rr7006a1 PMID:349785473. Wong JM, Adams LE, Durbin AP, et al. Dengue: a growing problem with new interventions. Pediatrics 2022;149:e2021055522 https://doi.org/10.1542/peds.2021-055522 PMID:35543085TopTABLE. Estimated seroprevalence of dengue virus immunoglobin G antibodies among children and adolescents aged 8–13 years, by sex, age, and health district — U.S. Virgin Islands, April–May 2022Characteristic Children and adolescents Estimated seroprevalence,* % (95% CI)No. who received testing No. with positive test resultsTotal 372 152 47 (29–68)SexFemale 204 87 50 (22–80)Male 168 65 45 (31–59)Age, yrs8 56† 14 27 (17–39)9 76 28 41 (16–71)10 100 39 42 (26–60)11 52 20 50 (24–77)12 58 36 69 (45–88)13 30 15 54 (18–89)Health districtSt. Croix 192 64 34 (21–50)St. Thomas/St. John 180 88 59 (30–86)* Percentage estimates were weighted and standardized to the age and sex of the 2022 U.S. Census Bureau population estimated distribution across the two districts.† Test results were indeterminate for two children.TopSuggested citation for this article: Mac VV, Wong JM, Volkman HR, et al. Notes From the Field: Prevalence of Previous Dengue Virus Infection Among Children and Adolescents — U.S. Virgin Islands, 2022. MMWR Morb Mortal Wkly Rep 2023;72:288–289. DOI: http://dx.doi.org/10.15585/mmwr.mm7211a4.MMWR and Morbidity and Mortality Weekly Report are service marks of the U.S. Department of Health and Human Services.Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of Health and Human Services.References to non-CDC sites on the Internet are provided as a service to MMWR readers and do not constitute or imply endorsement of these organizations or their programs by CDC or the U.S. Department of Health and Human Services. CDC is not responsible for the content of pages found at these sites. URL addresses listed in MMWR were current as of the date of publication.All HTML versions of MMWR articles are generated from final proofs through an automated process. This conversion might result in character translation or format errors in the HTML version. Users are referred to the electronic PDF version (https://www.cdc.gov/mmwr) and/or the original MMWR paper copy for printable versions of official text, figures, and tables.Questions or messages regarding errors in formatting should be addressed to mmwrq@cdc.gov.View Page In: Article PDF Full Issue PDFLast Reviewed: March 16, 2023Source: Centers for Disease Control and Prevention* Syndicate* MMWR* Reports by Topic* Publications plus icon+ Weekly Report plus icono Past Volumes (1982-2023)o Past Volumes (1982-2024)+ Recommendations and Reports plus icono Past Volumes (1990-2022)o Past Volumes (1990-2024)+ Surveillance Summaries plus icono Past Volumes (1983-2023)o Past Volumes (1983-2024)+ Supplements plus icono Past Volumes (1985-2023)+ Archive (1952-1981)+ Notifiable Infectious Diseases+ Notifiable Noninfectious Conditions* Vital Signs* Visual Abstracts* Podcasts* Continuing Education* MMWR Clinical Pearls* Metrics* For Authors* About plus icon+ Staff+ Editorial Board* Subscribe plus icon+ RSS FeedMetric DetailsCloseViewsView data is collected and posted time period. Page views include both html and pdf views of an article.Views since publication* Page Views: 4,285* Page Views: 2,392* Page Downloads: 130* Page Downloads: 131* Total Views: 4,415* Total Views: 2,523View ActivityFirst 30 Days Total ViewsCitations: 3AltmetricsClick a source for Altmetric detailsWhat is the Altmetric Attention Score?The Altmetric Attention Score for a research output provides an indicator of the amount of attention that it has received. 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