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Background.  Infection with any of the 4 related dengue virus serotypes (DENV-1–4) is thought to result in lifelong immunity to homotypic reinfection (ie, reinfection with the same serotype).

Methods.  Archived serum samples collected as part of an ongoing pediatric dengue cohort study in Nicaragua were tested for DENV by real-time reverse transcription polymerase chain reaction. Samples were collected from 2892 children who presented with an acute febrile illness clinically attributed to a non-DENV cause (hereafter, “C cases”). Test results were added to a database of previously identified symptomatic dengue cases in the cohort to identify repeat infections.

Results.  Four patients with homotypic DENV reinfections were identified and confirmed among 29 repeat DENV infections (13.8%) with serotype confirmation. Homotypic reinfections …