Impact of DENV-ZIKV cross-reactivity in Southeast Asia: A modelling study in Thailand

In Thailand, DENV cross-reactivity strongly shapes ZIKV transmission in an age-structured model, while ZIKV has little effect on DENV transmission.

• Why it matters: Prior DENV or ZIKV infection can protect or enhance subsequent infection, but the population-level impact on co-circulation and ZIKV burden in SEA is unclear.
• What they did: The study built an age-structured DENV–ZIKV model with nine cross-reactivity assumptions (cross-protection and enhancement) and simulated sustained co-circulation under changing Thai demography.
• The result: With DENV-driven enhancement of both ZIKV infection and symptomatic risk, the long-term ZIKV burden roughly doubled; population ageing increased mean case ages by over 20 years, and over half of 15–49-year-olds stayed ZIKV-naive under all assumptions.

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