Coinfection, Altered Vector Infectivity, and Antibody-Dependent Enhancement: The Dengue-Zika Interplay

Although dengue and Zika cocirculation has increased within the past 5 years, very little is known about its epidemiological consequences. To investigate the effect of dengue and Zika cocirculation on the spread of both pathogens, we create a deterministic dengue and Zika coinfection model, the first to incorporate altered infectivity of mosquitoes (due to coinfection). The model also addresses increased infectivity due to antibody-dependent enhancement (ADE) within the human population. Central to our analysis is the derivation and interpretation of the basic reproductive number and invasion reproductive number of both pathogens. In addition, we investigate how model parameters impact the persistence of each disease. Our results identify threshold conditions under which one disease facilitates the spread of the other and show that ADE has a greater impact on disease persistence than altered vector infectivity. This work highlights the importance of ADE and illustrates that while the endemic presence of dengue facilitates the spread of Zika, it is possible for high Zika prevalence to prevent the establishment of dengue.