Dengue is the most important mosquito-borne viral disease affecting humans, and dengue fever and dengue hemorrhagic fever/dengue shock syndrome have emerged as major public health problems, particularly in Southeast Asia and Latin America. An effective, tetravalent vaccine could dramatically improve the fate of millions of people who are affected by this disease. Recent studies indicate that by age 10, 90-95% of children in Managua have been infected with one or more of the four dengue virus serotypes, and up to one in four children is infected with dengue virus each year. This study follows a cohort of 3700 children aged 2-9 at high risk for dengue in Managua’s densely-populated, low to mid-socioeconomic status District II near the Lago de Managua.

The landmark study, a collaboration between the Division of Infectious Diseases at the University of California, Berkeley and the Ministry of Health of Nicaragua and supported by the Gates-funded Pediatric Dengue Vaccine Initiative (PDVI), brings together the Nicaraguan laboratory, epidemiology, and clinical sectors in an unprecedented collaboration, building scientific capability and infrastructure to a level previously out of reach. Designed initially for three years, the study should provide detailed and well-documented epidemiological data linked with biologic specimens from a pediatric population in a highly dengue-endemic Latin American setting that will enable numerous questions about the pathogenesis and epidemiology of dengue to be addressed.

Year two of the study began in July with the annual sample collection from the cohort population of nearly 4000 children, this time integrating new technologies such as PDAs, bar codes, and geographic information systems. It was a heroic effort that, thanks to an outstanding team there, went off without a hitch.