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Transmission dynamics of Oropouche virus in Latin America and the Caribbean

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Abstract

Oropouche virus (OROV) is an arbovirus endemic to the Amazon region since the 1950s that re-emerged in late 2023, causing a major epidemic across Central and South America. Here we investigated the transmission dynamics of the 2023–2024 epidemic in Manaus City (Amazonas state, Brazil), a major metropolitan hub in the Amazon, and estimated OROV infections across Latin America and the Caribbean. OROV re-emergence in Manaus resulted in an increase of IgG seroprevalence from 11.4% in November 2023 to 25.7% in November 2024. The neutralizing capacity of OROV-specific IgG antibodies from individuals collected before and after the re-emergence demonstrated a median plaque reduction neutralization test 50% titer of 640 against both the historical and contemporary OROV isolates. A historical reconstruction of OROV circulation in Manaus indicated a continuous low-level transmission with two major outbreaks of comparable seasonality and magnitude in 1980–1981 and 2023–2024. We estimate approximately 336,000 OROV infections in the Amazon region under a scenario of continuous endemic transmission without major outbreaks and over 9.4 million OROV infections during major outbreaks from 1960 to 2025. Collectively, our findings provide a comprehensive assessment of OROV transmission in Manaus and contribute to a better understanding of the OROV burden.

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Fig. 1: Oropouche fever outbreak in Manaus, 2023–2024.
Fig. 2: Detection of OROV-specific antibodies in Manaus between 2023 and 2024.
Fig. 3: OROV antibody response before and after the 2023–2024 outbreak in Manaus.
Fig. 4: Reconstruction of Oropouche fever outbreaks in Manaus.
Fig. 5: Estimated number of OROV infections in Latin America and the Caribbean.
Fig. 6: Surveillance capacity and healthcare accessibility in OROV-affected regions.

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Data availability

All codes and data used to generate the figures in this article are publicly available via GitHub at https://github.com/wmarciel/Oropouche-LAC. We obtained shapefiles from the Brazilian Institute of Geography and Statistics and the Centers for Disease Control and Prevention, respectively. De-identified individual-level data from the Brazilian Ministry of Health can be provided for research purposes after approval by a committee on human experimentation (if applicable). These data can be obtained upon request to the corresponding authors. The estimated response time from the corresponding authors may be up to 3 weeks.

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Acknowledgements

W.M.d.S. and N.R.F. were supported by Wellcome Trust Digital Technology Development Award in Climate Sensitive Infectious Disease Modelling (no. 226075/Z/22/Z) and the Wellcome Trust Dengue and Zika Immunology and Genomics Multi-Country Network (DeZi Network; no. 316633/Z/24/Z). J.L.P.-M. is supported by São Paulo Research Foundation (no. 2022/10442-0), National Council for Scientific and Technological Development (CNPq, no. 309971/2023-3). E.R.M. is affiliated with the Wellcome Trust-funded Centres for Antimicrobial Optimization Network (no. 226693/Z/22/Z). V.S.S. was supported by a CNPq fellowship. We acknowledge funding from the MRC Centre for Global Infectious Disease Analysis (no. MR/R015600/1), jointly funded by the UK Medical Research Council and the UK Foreign, Commonwealth and Development Office, under the MRC/FCDO Concordat agreement, and also part of the EDCTP2 program supported by the European Union. A.I.B. was supported by Cornell Atkinson Center seed funding. We thank J. A. Tida (www.plotmyscience.com) for figure editing.

Author information

Author notes

  1. These authors contributed equally: Erika R. Manuli, Xinyi Hua, Gabriel C. Scachetti, Julia Forato

  2. These authors jointly supervised this work: José Luiz Proenca-Modena, Ester C. Sabino, William M. de Souza.

Authors and Affiliations

  1. Programa de Pós-Graduação em Doenças Infecciosas e Saúde Global, Departamento de Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil

    Erika R. Manuli & Ester C. Sabino

  2. Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil

    Erika R. Manuli, Geovana M. Pereira, Ligia Capuani & Nuno R. Faria

  3. Departamento de Pesquisa Clínica e Inovação em Saúde, Universidade Municipal de São Caetano do Sul, São Paulo, Brazil

    Erika R. Manuli

  4. Department of Microbiology, Immunology, and Molecular Genetics, College of Medicine, University of Kentucky, Lexington, KY, USA

    Xinyi Hua  (华心怡), Julia Forato, Ingra M. Claro, Shirlene T. S. de Lima & William M. de Souza

  5. Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas, Brazil

    Gabriel C. Scachetti, Julia Forato, Livia Sacchetto, Shirlene T. S. de Lima, Marielton P. Cunha & José Luiz Proenca-Modena

  6. Department of Genetics, University of Cambridge, Cambridge, UK

    Oscar Cortes-Azuero & Henrik Salje

  7. EUROInstitute, EUROIMMUN Brasil, São Caetano do Sul, Brazil

    Ana Carolina Bernardo, Cláudia F. Resende & Natália B. S. Bacarov

  8. Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil

    Ronaldo de Jesus & Rodrigo B. Kato

  9. Instituto Leônidas e Maria Deane, Fiocruz Amazônia, Manaus, Brazil

    Bárbara B. Salgado, Carolina M. L. Singh, Nadielle C. Pereira & Pritesh J. Lalwani

  10. Instituto de Saúde e Biotecnologia, Universidade Federal do Amazonas, Coari, Brazil

    Renato S. Reis

  11. Instituto de Ciências Biológicas, Universidade Federal do Amazonas, Manaus, Brazil e Diretoria de Ensino e Pesquisa, Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas, Manaus, Brazil

    Sérgio R. L. Albuquerque & Allyson G. Costa

  12. Division of Infection and Immunity, Cardiff University School of Medicine, University Hospital of Wales, Cardiff, UK

    Richard Stanton

  13. Instituto Todos Pela Saúde, São Paulo, Brazil

    Vanderson S. Sampaio

  14. Department of Public and Ecosystem Health, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA

    Ana I. Bento

  15. Department of Mathematics, Imperial College London, London, UK

    Oliver Ratmann

  16. MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK

    Nuno R. Faria

  17. Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, USA

    Scott C. Weaver

  18. Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil

    Ester C. Sabino

Authors
  1. Erika R. Manuli
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  2. Xinyi Hua  (华心怡)
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  3. Gabriel C. Scachetti
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  4. Julia Forato
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  5. Ingra M. Claro
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  6. Geovana M. Pereira
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  7. Livia Sacchetto
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  8. Oscar Cortes-Azuero
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  9. Ana Carolina Bernardo
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  10. Cláudia F. Resende
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  11. Natália B. S. Bacarov
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  12. Ligia Capuani
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  13. Shirlene T. S. de Lima
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  14. Ronaldo de Jesus
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  15. Rodrigo B. Kato
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  16. Bárbara B. Salgado
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  17. Carolina M. L. Singh
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  18. Nadielle C. Pereira
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  19. Renato S. Reis
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  20. Sérgio R. L. Albuquerque
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  21. Richard Stanton
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  22. Vanderson S. Sampaio
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  23. Ana I. Bento
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  24. Marielton P. Cunha
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  25. Oliver Ratmann
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  26. Nuno R. Faria
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  27. Scott C. Weaver
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  28. Pritesh J. Lalwani
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  29. Henrik Salje
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  30. Allyson G. Costa
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  31. José Luiz Proenca-Modena
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  32. Ester C. Sabino
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  33. William M. de Souza
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Contributions

W.M.d.S., J.L.P.-M. and E.C.S. conceptualized the study. E.R.M., X.H., G.C.S., J.F., I.M.C., G.M.P., L.S., A.C.B., C.F.R., N.B.S.B., S.T.S.d.L., R.d.J., R.B.K., B.B.S., C.M.L.S., N.C.P., V.S.S., R.S.R., P.J.L., A.G.C., J.L.P.-M., E.C.S. and W.M.d.S. contributed to the acquisition of data. X.H., G.C.S., O.C.-A., O.R. and W.M.d.S. contributed to the data analysis. X.H., G.C.S., N.R.F., S.C.W., H.S., J.L.P.-M., E.C.S. and W.M.d.S. contributed to data interpretation. W.M.d.S. and X.H. drafted the paper. X.H., G.C.S., L.S., M.P.C., R.S., O.R., A.I.B., N.R.F., S.C.W., H.S., A.G.C., J.L.P.-M., E.C.S. and W.M.d.S. revised the paper. A.G.C., J.L.P.-M., E.C.S. and W.M.d.S. acquired funding for the study. All authors read and approved the final version of the paper and the submission. X.H. and W.M.d.S. accessed and verified all the data reported in the study.

Corresponding authors

Correspondence to José Luiz Proenca-Modena, Ester C. Sabino or William M. de Souza.

Ethics declarations

Competing interests

A.C.B., C.F.R. and N.B.S.B. are employees of EUROIMMUN Brasil. The other authors declare no competing interests.

Peer review

Peer review information

Nature Medicine thanks Jonas Schmidt-Chanasit, Joseph Wu and the other, anonymous, reviewer(s) for their contribution to the peer review of this work. Peer reviewer reports are available. Primary Handling Editor: Lia Parkin, in collaboration with the Nature Medicine team.

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Extended data

Extended Data Fig. 1 Testing positivity rates and healthcare access in Manaus, Amazonas, and Brazil.

A) Testing positivity rates of Oropouche virus (OROV) for collected samples in 2023 and 2024. Observed rates are shown as dots, and 95% confidence intervals are shown as bars. Data are presented for Manaus (n = 9,345), Amazonas (n = 24,614), and Brazil (n = 187,320). B) Model-predicted relative surveillance capacity index for emerging acute viral infectious diseases. The index ranges from 0 (lowest) to 1 (highest). Data are represented as medians (dots) with interquartile ranges (bars). C) Optimal travel time to healthcare facilities in hours via motorized transport. Data are represented as medians (dots) with interquartile ranges (bars).

Extended Data Fig. 2 Spatiotemporal variation in OROV transmission suitability in Amazonas state, Brazil.

Mean monthly OROV transmission suitability (Index P) for Culicoides paraensis from 2014 to 2024 at the municipality level in Amazonas state. Index P values of ≥1 indicate suitable climate conditions for transmission, and values of <1 indicate unsuitable conditions.

Extended Data Fig. 3 OROV transmission suitability in Manaus City, Brazil.

A) Time series of average weekly index P from 2014 to 2025 in Manaus city, Brazil. The dashed line shows that Index P ≥ 1, which indicates a suitable climate for OROV transmission by C. paraensis. B) The number of days suitable for OROV transmission by C. paraensis per year from 2014 to 2024. The dashed line indicates 6 months of suitable climate for OROV transmission by C. paraensis for the year.

Extended Data Table 1 Prior distributions used in the MVSE package for estimating the OROV transmission potential via the vector Clicoides paraensis midges. N/A
Full size table
Extended Data Table 2 Seroprevalence by age group for serosurveys conducted in Manaus during 2015 and 2016, November 2023, June, and November 2024
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Extended Data Table 3 PRNT50 titers in OROV antibody-positive samples against OROV AM0088 isolate
Full size table
Extended Data Table 4 Major OROV outbreaks documented from 1961 to 2021
Full size table

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Manuli, E.R., Hua, X., Scachetti, G.C. et al. Transmission dynamics of Oropouche virus in Latin America and the Caribbean. Nat Med (2026). https://doi.org/10.1038/s41591-026-04221-z

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