Dengue Underestimation in Guangzhou, China: Evidence of Seroprevalence in Communities With No Reported Cases Before a Large Outbreak in 2014.

Dengue transmission in the study communities had occurred prior to the 2014 massive outbreak, possibly for many years, but went undiagnosed and unreported. A proportion of the study population experienced secondary infection as different serotypes of DENV increased the risk for severe diseases. Active surveillance and education of both healthcare providers and the general population should be conducted in areas at risk for dengue emergence in order to better reduce disease burden.