medRxiv PreprintsInternational10 November 2026
Impact of DENV-ZIKV cross-reactivity in Southeast Asia: A modelling study in Thailand
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Dengue virus (DENV) is endemic across Southeast Asia (SEA), where a large proportion of adults have been infected. Zika virus (ZIKV) has circulated in the region for decades but the extent of transmission remains unclear. Prior infection with one virus can protect against or enhance infection with the other, but the population-level consequences are unknown. We developed an age-structured DENV-ZIKV model with nine cross-reactivity assumptions combining cross-protection and subsequent enhancement, and simulated sustained co-circulation under changing Thai demography. Through cross-reactivity, D
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