Estimating Zika Virus Seroprevalence in a Dengue Virus–Endemic Population: The Use of Blood Donors and Multiplex Serology to Monitor Arbovirus Outbreaks in the Dutch Caribbean - Report - MDSpire
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Assessing Seroprevalence of Zika Virus in a Dengue-Endemic Community: Utilizing Blood Donor Samples and Multiplex Serology for Arbovirus Surveillance in the Dutch Caribbean
Seroprevalence of Zika Virus in Dengue-Endemic Caribbean Islands Using Blood Donor Samples
Overview
This study assessed Zika virus (ZIKV) seroprevalence in Aruba and Curaçao during 2016–2017 using blood donor sera and multiplex serology combined with virus neutralization tests. Results showed a higher ZIKV antibody prevalence in Curaçao (25%) compared to Aruba (8%), with flavivirus IgG titers increasing significantly with age.
Background
Flaviviruses such as dengue virus (DENV) and ZIKV are expanding geographically, with ZIKV causing outbreaks in the Americas including the Caribbean. Both Aruba and Curaçao experienced DENV and ZIKV outbreaks between 2016 and 2017, but the true extent of ZIKV exposure remains unclear due to asymptomatic infections and antibody cross-reactivity. Serological differentiation between flaviviruses is challenging, especially in endemic regions, due to cross-reactive antibodies and original antigenic sin. Virus neutralization tests are the gold standard but are resource-intensive, whereas NS1 protein-based multiplex assays offer a more feasible alternative for large-scale surveillance.
Data Highlights
Island
Number of Samples
ZIKV Seroprevalence (%)
Curaçao
395
25
Aruba
320
8
Key Findings
ZIKV seroprevalence was significantly higher in Curaçao (25%) than in Aruba (8%) during the 2016–2017 outbreaks.
Flavivirus IgG antibody titers increased with donor age, indicating cumulative exposure over time.
Multiplex NS1 protein microarray combined with virus neutralization tests effectively distinguished ZIKV exposure from other flavivirus infections despite antibody cross-reactivity.
Blood donor samples provide a valuable resource for longitudinal arbovirus surveillance in endemic regions.
The study highlights the importance of including age as a factor when interpreting flavivirus serology data.
Clinical Implications
Utilizing blood donor sera with multiplex serology and confirmatory neutralization tests enables more accurate estimation of ZIKV exposure in areas with co-circulating flaviviruses. This approach can improve outbreak monitoring and guide public health responses in dengue-endemic regions. Clinicians should consider age-related antibody patterns when interpreting flavivirus serology results.
Conclusion
This study demonstrates that blood donor-based multiplex serology combined with virus neutralization testing is a practical and effective method to assess ZIKV seroprevalence in dengue-endemic Caribbean islands. The findings provide important insights into flavivirus exposure dynamics and support enhanced arbovirus surveillance strategies.
References
Original Article 2024 -- Assessing Seroprevalence of Zika Virus in a Dengue-Endemic Community
by Louella M R Kasbergen, Reina S Sikkema, Felicity Chandler, Janko H G van Beek, Yaskara Halabi, Norédiz Lourents, Eugene G Maduro, Izzy Gerstenbluth, Ashley Duits, Marion P G Koopmans
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