Over 105 million dengue infections are estimated to occur annually. Understanding the disease dynamics of dengue is often difficult due to multiple strains circulating within a population. Interactions between dengue serotype dynamics may result in complex cross-immunity dynamics at the population level and create difficulties in terms of formulating intervention strategies for the disease. In this study, a nationally representative 16-year time series with over 43 000 serotyped dengue infections was used to infer the long-run effects of between and within strain interactions and their impacts on past outbreaks. We used a novel identification strategy incorporating sign-identified Bayesian vector autoregressions, using structural impulse responses, historical decompositions and counterfactual analysis to conduct inference on dengue dynamics post-estimation. We found that on the population level: (i) across-serotype interactions on the population level were highly persistent, with a one time increase in any other serotype associated with long run decreases in the serotype of interest (range: 0.5–2.5 years) and (ii) over 38.7% of dengue cases of any serotype were associated with across-serotype interactions. The findings in this paper will substantially impact public health policy interventions with respect to dengue.

估计每年发生超过 1.05 亿登革热感染。由于多种菌株在人群中传播，因此了解登革热的疾病动态通常很困难。登革热血清型动力学之间的相互作用可能会导致人口层面复杂的交叉免疫动力学，并在制定疾病干预策略方面造成困难。在这项研究中，一个具有全国代表性的 16 年时间序列以及超过 43 000 例血清型登革热感染被用于推断菌株之间和菌株内部相互作用的长期影响及其对过去爆发的影响。我们使用了一种新的识别策略，结合了符号识别的贝叶斯向量自回归，使用结构脉冲响应，历史分解和反事实分析，以对登革热动态后估计进行推断。我们发现，在人群水平上：(i) 人群水平上的跨血清型相互作用是高度持久的，任何其他血清型的一次增加与感兴趣的血清型的长期下降有关（范围：0.5-2.5 年） (ii) 超过 38.7% 的任何血清型登革热病例与跨血清型相互作用有关。本文的研究结果将对有关登革热的公共卫生政策干预产生重大影响。7% 的任何血清型登革热病例与跨血清型相互作用有关。本文的研究结果将对有关登革热的公共卫生政策干预产生重大影响。7% 的任何血清型登革热病例与跨血清型相互作用有关。本文的研究结果将对有关登革热的公共卫生政策干预产生重大影响。