Science.gov

Sample records for prevent dengue outbreaks

  1. Impact of a dengue outbreak experience in the preventive perceptions of the community from a temperate region: Madeira Island, Portugal.

    PubMed

    Nazareth, Teresa; Sousa, Carla Alexandra; Porto, Graça; Gonçalves, Luzia; Seixas, Gonçalo; Antunes, Luís; Silva, Ana Clara; Teodósio, Rosa

    2015-03-01

    The ability to effectively modify behaviours is increasingly relevant to attain and maintain a good health status. Current behaviour-change models and theories present two main approaches for (healthier) decision-making: one analytical/logical, and one experiential/emotional/intuitive. Therefore, to achieve an integral and dynamic understanding of the public perceptions both approaches should be considered: community surveys should measure cognitive understanding of health-risk contexts, and also explore how past experiences affect this understanding. In 2011, community perceptions regarding domestic source reduction were assessed in Madeira Island͘. After Madeira's first dengue outbreak (2012) a unique opportunity to compare perceptions before and after the outbreak-experience occurred. This was the aim of this study, which constituted the first report on the effect of an outbreak experience on community perceptions regarding a specific vector-borne disease. A cross-sectional survey was performed within female residents at the most aegypti-infested areas. Perceptions regarding domestic source reduction were assessed according to the Essential Perception (EP)-analysis tool. A matching process paired individuals from studies performed before and after the outbreak, ensuring homogeneity in six determinant variables. After the outbreak, there were more female residents who assimilated the concepts considered to be essential to understand the proposed behaviour. Nevertheless, no significant difference was observed in the number of female residents who achieved the defined 'minimal understanding''. Moreover, most of the population (95.5%) still believed at least in one of the identified myths. After the outbreak some myths disappeared and others appeared. The present study quantified and explored how the experience of an outbreak influenced the perception regarding a dengue-preventive behaviour. The outbreak experience surprisingly led to the appearance of new myths

  2. Effects of a Five-Year Citywide Intervention Program To Control Aedes aegypti and Prevent Dengue Outbreaks in Northern Argentina

    PubMed Central

    Gürtler, Ricardo E.; Garelli, Fernando M.; Coto, Héctor D.

    2009-01-01

    Background Dengue has propagated widely through the Americas. Most countries have not been able to maintain permanent larval mosquito control programs, and the long-term effects of control actions have rarely been documented. Methodology The study design was based on a before-and-after citywide assessment of Aedes aegypti larval indices and the reported incidence of dengue in Clorinda, northeastern Argentina, over 2003–2007. Interventions were mainly based on focal treatment with larvicides of every mosquito developmental site every four months (14 cycles), combined with limited source reduction efforts and ultra-low-volume insecticide spraying during emergency operations. The program conducted 120,000 house searches for mosquito developmental sites and 37,000 larvicide applications. Principal Findings Random-effects regression models showed that Breteau indices declined significantly in nearly all focal cycles compared to pre-intervention indices clustered by neighborhood, after allowing for lagged effects of temperature and rainfall, baseline Breteau index, and surveillance coverage. Significant heterogeneity between neighborhoods was revealed. Larval indices seldom fell to 0 shortly after interventions at the same blocks. Large water-storage containers were the most abundant and likely to be infested. The reported incidence of dengue cases declined from 10.4 per 10,000 in 2000 (by DEN-1) to 0 from 2001 to 2006, and then rose to 4.5 cases per 10,000 in 2007 (by DEN-3). In neighboring Paraguay, the reported incidence of dengue in 2007 was 30.6 times higher than that in Clorinda. Conclusions Control interventions exerted significant impacts on larval indices but failed to keep them below target levels during every summer, achieved sustained community acceptance, most likely prevented new dengue outbreaks over 2003–2006, and limited to a large degree the 2007 outbreak. For further improvement, a shift is needed towards a multifaceted program with intensified

  3. Prevention of dengue outbreaks through Aedes aegypti oviposition activity forecasting method.

    PubMed

    Estallo, Elizabet L; Ludueña-Almeida, Francisco F; Visintin, Andrés M; Scavuzzo, Carlos M; Introini, María V; Zaidenberg, Mario; Almirón, Walter R

    2011-05-01

    Dengue has affected the north provinces of Argentina, mainly Salta province. The 2009 outbreak, with 5 deaths and >27,000 infected, was the most important, and the first to extend into the central area of the country. This article includes research on seasonal Aedes aegypti abundance variation in Orán City (Salta province), and determination of the date of mosquito population increase and an estimation of the date of maximum rate of increase as well as the intrinsic rate of natural increase (r), to detect the optimal time to apply vector control measures. Between September 2005 and March 2007, ovitraps were randomly distributed in the city to collect Ae. aegypti eggs. The variation observed in the number of collected eggs was described by fitting a third-degree polynomial by the least square method, allowing to determine the time when population increase began (week 1), after the temperate and dry season. Eggs were collected throughout the year, with the highest variation in abundance during the warm and rainy season, and the maximum value registered in February 2007. The rate of increase of the number of eggs laid per week peaked between weeks 9 and 10 after the beginning of the population increase (week 1). Week 1 depends on temperature, it occurs after getting over the thermal threshold and the needed accumulation of 160 degree-day is reached. Consequently, week 1 changes depending on temperature. Peak abundance of eggs during 2005-2006 was recorded on week 15 (after week 1); during 2006-2007, the peak was observed on week 22. Estimation of the intrinsic rate of natural increase (r) of Ae. aegypti is useful not only to determine optimal time to apply vector control measures with better cost-benefit, but also to add an insecticide control strategy against the vector to diminish the possibility of resistance.

  4. Dissecting Japan's Dengue Outbreak in 2014

    PubMed Central

    Quam, Mikkel B.; Sessions, October; Kamaraj, Uma Sangumathi; Rocklöv, Joacim; Wilder-Smith, Annelies

    2016-01-01

    Despite Japan's temperate climate, a dengue outbreak occurred in Tokyo for the first time in over 70 years in 2014. We dissected this dengue outbreak based on phylogenetic analysis, travel interconnectivity, and environmental drivers for dengue epidemics. Comparing the available dengue virus 1 (DENV1) E gene sequence from this outbreak with 3,282 unique DENV1 sequences in National Center for Biotechnology Information suggested that the DENV might have been imported from China, Indonesia, Singapore, or Vietnam. With travelers arriving into Japan, Guangzhou (China) may have been the source of DENV introduction, given that Guangzhou also reported a large-scale dengue outbreak in 2014. Coinciding with the 2014 outbreak, Tokyo's climate conditions permitted the amplification of Aedes vectors and the annual peak of vectorial capacity. Given suitable vectors and climate conditions in addition to increasing interconnectivity with endemic areas of Asia, Tokyo's 2014 outbreak did not come as a surprise and may foretell more to come. PMID:26711518

  5. Randomness of Dengue Outbreaks on the Equator.

    PubMed

    Chen, Yirong; Cook, Alex R; Lim, Alisa X L

    2015-09-01

    A simple mathematical model without seasonality indicated that the apparently chaotic dengue epidemics in Singapore have characteristics similar to epidemics resulting from chance. Randomness as a sufficient condition for patterns of dengue epidemics in equatorial regions calls into question existing explanations for dengue outbreaks there.

  6. Severe Dengue Fever Outbreak in Taiwan

    PubMed Central

    Wang, Sheng-Fan; Wang, Wen-Hung; Chang, Ko; Chen, Yen-Hsu; Tseng, Sung-Pin; Yen, Chia-Hung; Wu, Deng-Chyang; Chen, Yi-Ming Arthur

    2016-01-01

    Dengue fever (DF) is a vector-borne disease caused by dengue viruses (DENVs). Epidemic dengue occurs intermittently in Taiwan. In 2014, Taiwan experienced its largest DF outbreak. There were 15,732 DF cases reported. There were a total of 136 dengue hemorrhagic fever (DHF) cases, of which 20 resulted in death. Most DF cases were reported in southern Taiwan. A total of 15,043 (96%) cases were from Kaohsiung, a modern city in southern Taiwan. This report reviews DF epidemics in Taiwan during 2005–2014. The correlation between DF and DHF along with temperature and precipitation were conjointly examined. We conclude that most dengue epidemics in Taiwan resulted from imported DF cases. Results indicate three main factors that may have been associated with this DF outbreak in Kaohsiung: an underground pipeline explosion combined with subsequent rainfall and higher temperature. These factors may have enhanced mosquito breeding activity, facilitating DENV transmission. PMID:26572871

  7. Community Involvement in Dengue Outbreak Control: An Integrated Rigorous Intervention Strategy

    PubMed Central

    Lin, Hualiang; Liu, Tao; Song, Tie; Lin, Lifeng; Xiao, Jianpeng; Lin, Jinyan; He, Jianfeng; Zhong, Haojie; Hu, Wenbiao; Deng, Aiping; Peng, Zhiqiang; Ma, Wenjun; Zhang, Yonghui

    2016-01-01

    Background An explosive outbreak of dengue fever occurred in Guangdong Province, China in 2014. A community-based integrated intervention was applied to control this outbreak in the capital city Guangzhou, where dengue epidemic was mainly caused by imported cases. Methodology/Principal Findings We used a time series generalized additive model based on meteorological factors to assess the effectiveness of this intervention. The results showed that there was significant reduction in mosquito density following the intervention, and there was a 70.47% (95% confidence interval: 66.07%, 74.88%) reduction in the reported dengue cases compared with the predicted cases after 12 days since the beginning of the intervention, we estimated that a total of 23,302 dengue cases were prevented. Conclusions This study suggests that an integrated dengue intervention program has significant effects to control a dengue outbreak in areas where dengue epidemic was mainly caused by imported dengue cases. PMID:27548481

  8. The Driving Force for 2014 Dengue Outbreak in Guangdong, China

    PubMed Central

    Yakob, Laith; Zhu, Huai-Ping; Jin, Zhen; Zhang, Wen-Yi

    2016-01-01

    Dengue fever has rapidly spread in recent decades to become the most globally expansive viral vector-borne disease. In mainland China, a number of dengue outbreaks have been reported since 1978, but the worst epidemic in decades, involving 45230 cases and 76 imported cases, resulting in six deaths in Guangdong province, emerged in 2014. Reasons for this ongoing surge in dengue, both imported and autochthonous, are currently unclear and demand urgent investigation. Here, a seasonally-driven dynamic epidemiological model was used to simulate dengue transmission data recorded from the unprecedented outbreak. Sensitivity analysis demonstrate that delayed mosquito control, the continuous importations between the end of April to the early of July, the transmission of asymptomatic dengue infections, and the abnormally high precipitation from May to August might be the causal factors for the unprecedented outbreak. Our results suggested that the earlier and more frequent control measures in targeting immature and adult mosquitoes were effective in preventing larger outbreaks, and enhanced frontier health and quarantine from the end of April to the early of July for international communications and travelers. PMID:27861514

  9. Repetitive dengue outbreaks in East Africa: A proposed phased mitigation approach may reduce its impact.

    PubMed

    Baba, Marycelin; Villinger, Jandouwe; Masiga, Daniel K

    2016-05-01

    Dengue outbreaks have persistently occurred in eastern African countries for several decades. We assessed each outbreak to identify risk factors and propose a framework for prevention and impact mitigation. Seven out of ten countries in eastern Africa and three islands in the Indian Ocean have experienced dengue outbreaks between 1823 and 2014. Major risk factors associated with past dengue outbreaks include climate, virus and vector genetics and human practices. Appropriate use of dengue diagnostic tools and their interpretation are necessary for both outbreak investigations and sero-epidemiological studies. Serosurvey findings during inter-epidemic periods have not been adequately utilised to prevent re-occurrence of dengue outbreaks. Local weather variables may be used to predict dengue outbreaks, while entomological surveillance can complement other disease-mitigation efforts during outbreaks and identify risk-prone areas during inter-epidemic periods. The limitations of past dengue outbreak responses and the enormous socio-economic impacts of the disease on human health are highlighted. Its repeated occurrence in East Africa refutes previous observations that susceptibility may depend on race. Alternate hypotheses on heterotypic protection among flaviviruses may not be applied to all ecologies. Prevention and mitigation of severe dengue outbreaks should necessarily consider the diverse factors associated with their occurrence. Implementation of phased dengue mitigation activities can enforce timely and judicious use of scarce resources, promote environmental sanitation, and drive behavioural change, hygienic practices and community-based vector control. Understanding dengue epidemiology and clinical symptoms, as determined by its evolution, are significant to preventing future dengue epidemics.

  10. Societal impact of dengue outbreaks: Stakeholder perceptions and related implications. A qualitative study in Brazil, 2015

    PubMed Central

    Rodrigues, Mariana; Davis, Ben; Besson, Marie-Hélène; Audureau, Etienne; Saba, Joseph

    2017-01-01

    Background The growing burden of dengue in many countries worldwide and the difficulty of preventing outbreaks have increased the urgency to identify alternative public health management strategies and effective approaches to control and prevent dengue outbreaks. The objectives of this study were to understand the impact of dengue outbreak on different stakeholders in Brazil, to explore their perceptions of approaches used by governmental authorities to control and prevent dengue outbreaks and to define the challenges and implications of preventing future outbreaks. Methods In 2015, a qualitative study was conducted in two urban states in Brazil: São Paulo, which was experiencing an outbreak in 2015, and Rio de Janeiro, which experienced outbreaks in 2011 and 2012. Face-to-face interviews using a semi-structured questionnaire were conducted with nine different categories of stakeholders: health workers (physicians, nurses), hospital administrators, municipal government representatives, community members and leaders, school administrators, business leaders and vector control managers. Interviews were focused on the following areas: impact of the dengue outbreak, perceptions of control measures implemented by governmental authorities during outbreaks and challenges in preventing future dengue outbreaks. Results A total of 40 stakeholders were included in the study. Health workers and community members reported longer waiting times at hospitals due to the increased number of patients receiving care for dengue-related symptoms. Health workers and hospital administrators reported that there were no major interruptions in access to care. Overall financial impact of dengue outbreaks on households was greatest for low-income families. Despite prevention and control campaigns implemented between outbreak periods, various stakeholders reported that dengue prevention and control efforts performed by municipal authorities remained insufficient, suggesting that efforts should

  11. First documented outbreak of dengue in the Peruvian Amazon region.

    PubMed

    Phillips, I; Need, J; Escamilla, J; Colán, E; Sánchez, S; Rodríguez, M; Vásquez, L; Seminario, J; Betz, T; da Rosa, A T

    1992-01-01

    This article describes a classical dengue outbreak caused by dengue serotypes 1 and 4 that occurred from March to July 1990 in the city of Iquitos and surrounding areas of Loreto Department in the Peruvian Amazon. Epidemiologic data indicate that more than 150,000 persons may have been affected in Iquitos alone. Another dengue outbreak occurred in Tarapoto, a city in the neighboring department of San Martín. Laboratory data indicate that the same dengue serotypes were involved in both outbreaks. No cases of dengue hemorrhagic fever/shock syndrome appear to have occurred. Prior to this outbreak, no indigenous dengue cases had been documented in Peru.

  12. Dengue-1 virus isolation during first dengue fever outbreak on Easter Island, Chile.

    PubMed

    Perret, Cecilia; Abarca, Katia; Ovalle, Jimena; Ferrer, Pablo; Godoy, Paula; Olea, Andrea; Aguilera, Ximena; Ferrés, Marcela

    2003-11-01

    Dengue virus was detected for the first time in Chile, in an outbreak of dengue fever on Easter Island. The virus was isolated in tissue culture and characterized by reverse transcription-polymerase chain reaction as being dengue type 1.

  13. A potential risk assessment of a dengue outbreak in north central Texas, USA. (Part 2 of 2): Development of a practical prevention strategy.

    PubMed

    Lee, Joon-Hak; Stahl, Matt; Sawlis, Scott; Suzuki, Sumi

    2009-06-01

    In response to three dengue cases in north central Texas in 2005, the authors assessed the potential risk of a dengue outbreak in Dallas County in 2006. As a part of the assessment, habitat factors for dengue vector mosquitoes were quantified and associated with their abundances. In addition, percent population originated from endemic countries (Hispanic origin in the Census data) was associated with vector abundances and habitat factors of the vectors. Percent population data were obtained from publicly accessible databases. The areas with higher Hispanic populations had more Aedes aegypti and container numbers and also appeared to have more shade, which is attractive to this species. The methodology of this study may help to devise a practical strategy to reduce the risk of dengue outbreak in areas where dengue vector activity is present and a potential source of infection.

  14. Cost of dengue outbreaks: literature review and country case studies

    PubMed Central

    2013-01-01

    Background Dengue disease surveillance and vector surveillance are presumed to detect dengue outbreaks at an early stage and to save – through early response activities – resources, and reduce the social and economic impact of outbreaks on individuals, health systems and economies. The aim of this study is to unveil evidence on the cost of dengue outbreaks. Methods Economic evidence on dengue outbreaks was gathered by conducting a literature review and collecting information on the costs of recent dengue outbreaks in 4 countries: Peru, Dominican Republic, Vietnam, and Indonesia. The literature review distinguished between costs of dengue illness including cost of dengue outbreaks, cost of interventions and cost-effectiveness of interventions. Results Seventeen publications on cost of dengue showed a large range of costs from 0.2 Million US$ in Venezuela to 135.2 Million US$ in Brazil. However, these figures were not standardized to make them comparable. Furthermore, dengue outbreak costs are calculated differently across the publications, and cost of dengue illness is used interchangeably with cost of dengue outbreaks. Only one paper from Australia analysed the resources saved through active dengue surveillance. Costs of vector control interventions have been reported in 4 studies, indicating that the costs of such interventions are lower than those of actual outbreaks. Nine papers focussed on the cost-effectiveness of dengue vaccines or dengue vector control; they do not provide any direct information on cost of dengue outbreaks, but their modelling methodologies could guide future research on cost-effectiveness of national surveillance systems. The country case studies – conducted in very different geographic and health system settings - unveiled rough estimates for 2011 outbreak costs of: 12 million US$ in Vietnam, 6.75 million US$ in Indonesia, 4.5 million US$ in Peru and 2.8 million US$ in Dominican Republic (all in 2012 US$). The proportions of the

  15. The History of Dengue Outbreaks in the Americas

    PubMed Central

    Brathwaite Dick, Olivia; San Martín, José L.; Montoya, Romeo H.; del Diego, Jorge; Zambrano, Betzana; Dayan, Gustavo H.

    2012-01-01

    Dengue is a viral disease usually transmitted by Aedes aegypti mosquitoes. Dengue outbreaks in the Americas reported in medical literature and to the Pan American Health Organization are described. The outbreak history from 1600 to 2010 was categorized into four phases: Introduction of dengue in the Americas (1600–1946); Continental plan for the eradication of the Ae. aegypti (1947–1970) marked by a successful eradication of the mosquito in 18 continental countries by 1962; Ae. aegypti reinfestation (1971–1999) caused by the failure of the mosquito eradication program; Increased dispersion of Ae. aegypti and dengue virus circulation (2000–2010) characterized by a marked increase in the number of outbreaks. During 2010 > 1.7 million dengue cases were reported, with 50,235 severe cases and 1,185 deaths. A dramatic increase in the number of outbreaks has been reported in recent years. Urgent global action is needed to avoid further disease spread. PMID:23042846

  16. The history of dengue outbreaks in the Americas.

    PubMed

    Brathwaite Dick, Olivia; San Martín, José L; Montoya, Romeo H; del Diego, Jorge; Zambrano, Betzana; Dayan, Gustavo H

    2012-10-01

    Dengue is a viral disease usually transmitted by Aedes aegypti mosquitoes. Dengue outbreaks in the Americas reported in medical literature and to the Pan American Health Organization are described. The outbreak history from 1600 to 2010 was categorized into four phases: Introduction of dengue in the Americas (1600-1946); Continental plan for the eradication of the Ae. aegypti (1947-1970) marked by a successful eradication of the mosquito in 18 continental countries by 1962; Ae. aegypti reinfestation (1971-1999) caused by the failure of the mosquito eradication program; Increased dispersion of Ae. aegypti and dengue virus circulation (2000-2010) characterized by a marked increase in the number of outbreaks. During 2010 > 1.7 million dengue cases were reported, with 50,235 severe cases and 1,185 deaths. A dramatic increase in the number of outbreaks has been reported in recent years. Urgent global action is needed to avoid further disease spread.

  17. An entomological study on the dengue vectors during outbreak of dengue in Tiruppur town and its surroundings, Tamil Nadu, India.

    PubMed

    Balakrishnan, N; Venkatesh, S; Lal, Shiv

    2006-03-01

    Tiruppur town and its surroundings of Tamil Nadu state had reported the rise in dengue cases and some deaths during July, 2005. A team from NICD branch, Coonoor investigated the outbreak of dengue during August, 2005. Due to acute scarcity of water, people in Tiruppur town and surrounding rural areas store water in cement tanks and other containers which facilitated the prolific breeding of the dengue vector mosquitoes. The Aedes aegypti adult and larval survey conducted in randomly selected areas and the larval breeding indices and adult mosquito density were found to be above the critical levels. The state health and municipal authorities had initiated the control measures in urban areas. However in rural areas, these measures needed to be sustained and surveillance for dengue cases to be strengthened for timely control and prevention of the future outbreaks of this disease.

  18. Factors associated with larval control practices in a dengue outbreak prone area.

    PubMed

    Mohamad, Mariam; Selamat, Mohamad Ikhsan; Ismail, Zaliha

    2014-01-01

    In order to reduce the risk of dengue outbreak recurrence in a dengue outbreak prone area, the members of the community need to sustain certain behavior to prevent mosquito from breeding. Our study aims to identify the factors associated with larval control practices in this particular community. A cross-sectional study involves 322 respondents living in a dengue outbreak prone area who were interviewed using a pretested questionnaire. The level of knowledge about Aedes mosquitoes, dengue transmission, its symptoms, and personal preventive measures ranges from fair to good. The level of attitude towards preventive measures was high. However, reported level of personal larval control practices was low (33.2%). Our multiple logistic regression analysis showed that only those with a good level of attitude towards personal preventive measure and frequent attendance to health campaigns were significantly associated with the good larval control practices. We conclude that, in a dengue outbreak prone area, having a good attitude towards preventive measures and frequent participation in health campaigns are important factors to sustain practices on larval control.

  19. The prevention and control of dengue after Typhoon Haiyan

    PubMed Central

    Aumentado, Charito; Cerro, Boyd Roderick; Olobia, Leonido; Suy, Lyndon Lee; Reyes, Aldrin; Kusumawathie, Pahalagedera HD; Sagrado, Maria; Hall, Julie Lyn; Abeyasinghe, Rabindra; Foxwell, Alice Ruth

    2015-01-01

    Objective Many of the areas in the Philippines affected by Typhoon Haiyan are endemic for dengue; therefore, dengue prevention was a priority in the initial post-disaster risk assessment. We describe the dengue prevention and response strategies applied after Haiyan. Methods The dengue response was implemented by a wide range of national and international stakeholders. Priorities included the rapid re-establishment of an effective surveillance system to quickly identify new dengue cases, monitor trends and determine the geographical distribution of cases. Dengue rapid diagnostic tests (RDTs) were distributed to sentinel health facilities, and comprehensive vector control activities and entomological surveys were implemented. Several training sessions for key stakeholders and awareness campaigns for communities were organized. Results There were RDT-positive dengue cases reported from urban and semi-urban areas where entomological surveys also confirmed a high density of Aedes aegypti mosquitoes. Although there was an increase in dengue cases in January 2014, the number of cases remained below the epidemic threshold throughout the remaining months of 2014. Discussion There was no large outbreak of dengue after Haiyan, possibly due to the targeted, multifaceted and rapid response for dengue after Haiyan. However, surveillance differed after Typhoon Haiyan, making comparisons with previous years difficult. Multiple players contributed to the response that was also facilitated by close communication and coordination within the Health Cluster. PMID:26767138

  20. What caused the 2012 dengue outbreak in Pucallpa, Peru? A socio-ecological autopsy.

    PubMed

    Charette, Margot; Berrang-Ford, Lea; Llanos-Cuentas, Elmer Alejandro; Cárcamo, César; Kulkarni, Manisha

    2017-02-01

    Dengue is highly endemic in Peru, with increases in transmission particularly since vector re-infestation of the country in the 1980s. Pucallpa, the second largest city in the Peruvian Amazon, experienced a large outbreak in 2012 that caused more than 10,000 cases and 13 deaths. To date, there has been limited research on dengue in the Peruvian Amazon outside of Iquitos, and no published review or critical analysis of the 2012 Pucallpa dengue outbreak. This study describes the incidence, surveillance, and control of dengue in Ucayali to understand the factors that contributed to the 2012 Pucallpa outbreak. We employed a socio-ecological autopsy approach to consider distal and proximal contributing factors, drawing on existing literature and interviews with key personnel involved in dengue control, surveillance and treatment in Ucayali. Spatio-temporal analysis showed that relative risk of dengue was higher in the northern districts of Calleria (RR = 2.18), Manantay (RR = 1.49) and Yarinacocha (RR = 1.25) compared to all other districts between 2004 and 2014. The seasonal occurrence of the 2012 outbreak is consistent with typical seasonal patterns for dengue incidence in the region. Our assessment suggests that the outbreak was proximally triggered by the introduction of a new virus serotype (DENV-2 Asian/America) to the region. Increased travel, rapid urbanization, and inadequate water management facilitated the potential for virus spread and transmission, both within Pucallpa and regionally. These triggers occurred within the context of failures in surveillance and control programming, including underfunded and ad hoc vector control. These findings have implications for future prevention and control of dengue in Ucayali as new diseases such as chikungunya and Zika threaten the region.

  1. Post Outbreak Review: Dengue Preparedness and Response in Key West, Florida

    PubMed Central

    Hayden, Mary H.; Cavanaugh, Jamie L.; Tittel, Christopher; Butterworth, Melinda; Haenchen, Steven; Dickinson, Katherine; Monaghan, Andrew J.; Ernst, Kacey C.

    2015-01-01

    Dengue is the most prevalent mosquito-borne viral infection. Recent outbreaks in the southern United States illustrate the risk of reemergence. The first autochthonous cases since 1934 in Key West, FL, occurred in 2009–2010. We conducted a survey in 2012 with decision makers instrumental to the control of the outbreak to 1) determine their awareness of the multiple strategies used to control the outbreak and 2) assess their perceptions of the relative effectiveness of these strategies. An online survey was delivered to a predefined list of decision makers from multiple sectors to better understand dengue preparedness and response. Thirty-six out of 45 surveys were returned for an 80% response rate. Results indicate the need to focus prevention strategies on educational campaigns designed to increase population awareness of transmission risk. Respondents remain concerned about future dengue transmission risk in Key West and lack of resources to respond. PMID:26078319

  2. Post Outbreak Review: Dengue Preparedness and Response in Key West, Florida.

    PubMed

    Hayden, Mary H; Cavanaugh, Jamie L; Tittel, Christopher; Butterworth, Melinda; Haenchen, Steven; Dickinson, Katherine; Monaghan, Andrew J; Ernst, Kacey C

    2015-08-01

    Dengue is the most prevalent mosquito-borne viral infection. Recent outbreaks in the southern United States illustrate the risk of reemergence. The first autochthonous cases since 1934 in Key West, FL, occurred in 2009-2010. We conducted a survey in 2012 with decision makers instrumental to the control of the outbreak to 1) determine their awareness of the multiple strategies used to control the outbreak and 2) assess their perceptions of the relative effectiveness of these strategies. An online survey was delivered to a predefined list of decision makers from multiple sectors to better understand dengue preparedness and response. Thirty-six out of 45 surveys were returned for an 80% response rate. Results indicate the need to focus prevention strategies on educational campaigns designed to increase population awareness of transmission risk. Respondents remain concerned about future dengue transmission risk in Key West and lack of resources to respond.

  3. Dengue outbreak--Federated States of Micronesia, 2012-2013.

    PubMed

    2013-07-19

    On September 26, 2012, a woman aged 35 years from Kosrae in the Federated States of Micronesia (FSM) was hospitalized with fever, headache, muscle pain, vomiting, leukopenia, and thrombocytopenia. A rapid diagnostic test (RDT) (Dengue Duo, Standard Diagnostics Inc.) was positive for dengue virus (DENV) nonstructural protein-1 (NS1). During the next week, seven more persons with suspected dengue were tested with the RDT, of whom three were RDT-positive for NS1 or anti-DENV immunoglobulin M (IgM). During October, the Kosrae State Department of Health Services, with support from the FSM Department of Health and Social Affairs and the World Health Organization (WHO), responded to the outbreak with enhanced surveillance, training in clinical management, analysis of hospital surge capacity, a rapid mosquito survey to identify species and distributions, and control measures. By March 14, 2013, approximately 3.7% of Kosrae State residents had been hospitalized with suspected dengue. The outbreak consumed scarce medical and public health services, including outpatient, inpatient, and laboratory services, resulting in redirection of human and material resources from other important medical and public health activities. Because the health consequences of dengue can be substantial in resource-limited settings, Pacific Island nations might wish to consider preparedness measures for dengue outbreaks such as developing and testing outbreak response plans and ensuring adequate capacity for epidemiologic surveillance and laboratory testing.

  4. Clinical Profiles of Dengue Infection during an Outbreak in Northern India

    PubMed Central

    Merugumala, Vamsi; Pathak, Ravi

    2016-01-01

    Introduction. Dengue fever is an arboviral disease, which is transmitted by mosquito vector and presents as varied clinical spectrum of dengue fever (DF), dengue hemorrhagic fever (DHF), dengue shock syndrome (DSS), and expanded dengue syndrome (EDS) with atypical presentations, thus posing a diagnostic dilemma. Unless we are aware of these presentations, diagnosis as well as early initiation of treatment becomes difficult. We studied the various clinical presentations of dengue infection during an outbreak of disease in 2015. Materials and Methods. A total of 115 confirmed cases of dengue infection from Department of Medicine of Deen Dayal Upadhyay Hospital, New Delhi, were enrolled in this observational study. Results. The common signs and symptoms of dengue infection were fever, headache, body ache, backache, retro-orbital pain, bleeding manifestations, and rash in 100%, 87%, 86%, 58%, 41%, 21%, and 21%, respectively. Nonspecific or warning signs and symptoms included vomiting, weakness, abdominal pain, breathlessness, vertigo, sweating, and syncope. Other possible signs and symptoms of coinfections, comorbidities, or complications included diarrhea, sore throat, and neurological manifestations. There were seven patients with coinfections and four with comorbidities. The final diagnosis of these patients was DF (73%), DHF (16.5%), DSS (1.7%), and EDS (4.3%). Among EDS patients, the atypical presentations included encephalopathy, lateral rectus nerve palsy, acalculous cholecystitis, and myocarditis. Four patients required ICU care and there was no death in this study. Conclusion. Knowledge of atypical presentations is a must for early diagnosis and timely intervention to prevent life-threatening complications. PMID:28025597

  5. Dengue

    MedlinePlus

    Dengue is an infection caused by a virus. You can get it if an infected mosquito bites you. Dengue does not spread from person to person. It ... the world. Outbreaks occur in the rainy season. Dengue is rare in the United States. Symptoms include ...

  6. An outbreak of dengue fever in St. Croix (U. S. Virgin Islands), 2005.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In the summer of 2005, an outbreak of dengue virus serotype-2 with cases of dengue hemorrhagic fever (DHF) occurred in St. Croix, US Virgin Islands. The medical records of all dengue laboratory-positive patients either seen in the Emergency Department of or admitted to the Governor Juan F. Luis Hosp...

  7. Vaccines and immunization strategies for dengue prevention

    PubMed Central

    Liu, Yang; Liu, Jianying; Cheng, Gong

    2016-01-01

    Dengue is currently the most significant arboviral disease afflicting tropical and sub-tropical countries worldwide. Dengue vaccines, such as the multivalent attenuated, chimeric, DNA and inactivated vaccines, have been developed to prevent dengue infection in humans, and they function predominantly by stimulating immune responses against the dengue virus (DENV) envelope (E) and nonstructural-1 proteins (NS1). Of these vaccines, a live attenuated chimeric tetravalent DENV vaccine developed by Sanofi Pasteur has been licensed in several countries. However, this vaccine renders only partial protection against the DENV2 infection and is associated with an unexplained increased incidence of hospitalization for severe dengue disease among children younger than nine years old. In addition to the virus-based vaccines, several mosquito-based dengue immunization strategies have been developed to interrupt the vector competence and effectively reduce the number of infected mosquito vectors, thus controlling the transmission of DENV in nature. Here we summarize the recent progress in the development of dengue vaccines and novel immunization strategies and propose some prospective vaccine strategies for disease prevention in the future. PMID:27436365

  8. Vaccines and immunization strategies for dengue prevention.

    PubMed

    Liu, Yang; Liu, Jianying; Cheng, Gong

    2016-07-20

    Dengue is currently the most significant arboviral disease afflicting tropical and sub-tropical countries worldwide. Dengue vaccines, such as the multivalent attenuated, chimeric, DNA and inactivated vaccines, have been developed to prevent dengue infection in humans, and they function predominantly by stimulating immune responses against the dengue virus (DENV) envelope (E) and nonstructural-1 proteins (NS1). Of these vaccines, a live attenuated chimeric tetravalent DENV vaccine developed by Sanofi Pasteur has been licensed in several countries. However, this vaccine renders only partial protection against the DENV2 infection and is associated with an unexplained increased incidence of hospitalization for severe dengue disease among children younger than nine years old. In addition to the virus-based vaccines, several mosquito-based dengue immunization strategies have been developed to interrupt the vector competence and effectively reduce the number of infected mosquito vectors, thus controlling the transmission of DENV in nature. Here we summarize the recent progress in the development of dengue vaccines and novel immunization strategies and propose some prospective vaccine strategies for disease prevention in the future.

  9. Using Baidu Search Index to Predict Dengue Outbreak in China

    NASA Astrophysics Data System (ADS)

    Liu, Kangkang; Wang, Tao; Yang, Zhicong; Huang, Xiaodong; Milinovich, Gabriel J.; Lu, Yi; Jing, Qinlong; Xia, Yao; Zhao, Zhengyang; Yang, Yang; Tong, Shilu; Hu, Wenbiao; Lu, Jiahai

    2016-12-01

    This study identified the possible threshold to predict dengue fever (DF) outbreaks using Baidu Search Index (BSI). Time-series classification and regression tree models based on BSI were used to develop a predictive model for DF outbreak in Guangzhou and Zhongshan, China. In the regression tree models, the mean autochthonous DF incidence rate increased approximately 30-fold in Guangzhou when the weekly BSI for DF at the lagged moving average of 1–3 weeks was more than 382. When the weekly BSI for DF at the lagged moving average of 1–5 weeks was more than 91.8, there was approximately 9-fold increase of the mean autochthonous DF incidence rate in Zhongshan. In the classification tree models, the results showed that when the weekly BSI for DF at the lagged moving average of 1–3 weeks was more than 99.3, there was 89.28% chance of DF outbreak in Guangzhou, while, in Zhongshan, when the weekly BSI for DF at the lagged moving average of 1–5 weeks was more than 68.1, the chance of DF outbreak rose up to 100%. The study indicated that less cost internet-based surveillance systems can be the valuable complement to traditional DF surveillance in China.

  10. Using Baidu Search Index to Predict Dengue Outbreak in China

    PubMed Central

    Liu, Kangkang; Wang, Tao; Yang, Zhicong; Huang, Xiaodong; Milinovich, Gabriel J; Lu, Yi; Jing, Qinlong; Xia, Yao; Zhao, Zhengyang; Yang, Yang; Tong, Shilu; Hu, Wenbiao; Lu, Jiahai

    2016-01-01

    This study identified the possible threshold to predict dengue fever (DF) outbreaks using Baidu Search Index (BSI). Time-series classification and regression tree models based on BSI were used to develop a predictive model for DF outbreak in Guangzhou and Zhongshan, China. In the regression tree models, the mean autochthonous DF incidence rate increased approximately 30-fold in Guangzhou when the weekly BSI for DF at the lagged moving average of 1–3 weeks was more than 382. When the weekly BSI for DF at the lagged moving average of 1–5 weeks was more than 91.8, there was approximately 9-fold increase of the mean autochthonous DF incidence rate in Zhongshan. In the classification tree models, the results showed that when the weekly BSI for DF at the lagged moving average of 1–3 weeks was more than 99.3, there was 89.28% chance of DF outbreak in Guangzhou, while, in Zhongshan, when the weekly BSI for DF at the lagged moving average of 1–5 weeks was more than 68.1, the chance of DF outbreak rose up to 100%. The study indicated that less cost internet-based surveillance systems can be the valuable complement to traditional DF surveillance in China. PMID:27905501

  11. Investigation Into an Outbreak of Dengue-like Illness in Pernambuco, Brazil, Revealed a Cocirculation of Zika, Chikungunya, and Dengue Virus Type 1.

    PubMed

    Pessôa, Rodrigo; Patriota, João Veras; Lourdes de Souza, Maria de; Felix, Alvina Clara; Mamede, Nubia; Sanabani, Sabri S

    2016-03-01

    In April 2015, an outbreak of dengue-like illness occurred in Tuparetama, a small city in the northeast region of Brazil; this outbreak was characterized by its fast expansion. An investigation was initiated to identify the viral etiologies and advise the health authorities on implementing control measures to contain the outbreak. This is the first report of this outbreak in the northeast, even though a few cases were documented earlier in a neighboring city.Plasma samples were obtained from 77 suspected dengue patients attending the main hospital in the city. Laboratory assays, such as real-time reverse transcription polymerase chain reaction, virus cDNA sequencing, and enzyme-linked immunosorbent assay, were employed to identify the infecting virus and molecular phylogenetic analysis was performed to define the circulating viral genotypes.RNA of Zika virus (ZIKV) and Dengue virus (DENV) or IgM antibodies (Abs) to DENV or chikungunya (CHIKV) were detected in 40 of the 77 plasma samples (51.9%). DENV was found in 9 patients (11.7%), ZIKV was found in 31 patients (40.2%), CHIKV in 1 patient (1.3%), and coinfection of DENV and ZIKV was detected in 2 patients (2.6%). The phylogenetic analysis of 2 available partial DENV and 14 ZIKV sequences revealed the identities of genotype 1 and the Asiatic lineage, respectively.Consistent with recent reports from the same region, our results showed that the ongoing outbreak is caused by ZIKV, DENV, and CHIKV. This emphasizes the need for a routine and differential diagnosis of arboviruses in patients with dengue-like illness. Coordinated efforts are necessary to contain the outbreak. Continued surveillance will be important to assess the effectiveness of current and future prevention strategies.

  12. Investigation Into an Outbreak of Dengue-like Illness in Pernambuco, Brazil, Revealed a Cocirculation of Zika, Chikungunya, and Dengue Virus Type 1

    PubMed Central

    Pessôa, Rodrigo; Patriota, João Veras; de Lourdes de Souza, Maria; Felix, Alvina Clara; Mamede, Nubia; Sanabani, Sabri S.

    2016-01-01

    Abstract In April 2015, an outbreak of dengue-like illness occurred in Tuparetama, a small city in the northeast region of Brazil; this outbreak was characterized by its fast expansion. An investigation was initiated to identify the viral etiologies and advise the health authorities on implementing control measures to contain the outbreak. This is the first report of this outbreak in the northeast, even though a few cases were documented earlier in a neighboring city. Plasma samples were obtained from 77 suspected dengue patients attending the main hospital in the city. Laboratory assays, such as real-time reverse transcription polymerase chain reaction, virus cDNA sequencing, and enzyme-linked immunosorbent assay, were employed to identify the infecting virus and molecular phylogenetic analysis was performed to define the circulating viral genotypes. RNA of Zika virus (ZIKV) and Dengue virus (DENV) or IgM antibodies (Abs) to DENV or chikungunya (CHIKV) were detected in 40 of the 77 plasma samples (51.9%). DENV was found in 9 patients (11.7%), ZIKV was found in 31 patients (40.2%), CHIKV in 1 patient (1.3%), and coinfection of DENV and ZIKV was detected in 2 patients (2.6%). The phylogenetic analysis of 2 available partial DENV and 14 ZIKV sequences revealed the identities of genotype 1 and the Asiatic lineage, respectively. Consistent with recent reports from the same region, our results showed that the ongoing outbreak is caused by ZIKV, DENV, and CHIKV. This emphasizes the need for a routine and differential diagnosis of arboviruses in patients with dengue-like illness. Coordinated efforts are necessary to contain the outbreak. Continued surveillance will be important to assess the effectiveness of current and future prevention strategies. PMID:27015222

  13. Detection of Saint Louis encephalitis virus in dengue-suspected cases during a dengue 3 outbreak.

    PubMed

    Terzian, Ana Carolina Bernardes; Mondini, Adriano; Bronzoni, Roberta Vieira de Moraes; Drumond, Betânia Paiva; Ferro, Bianca Piovezan; Cabrera, Eliana Márcia Sotello; Figueiredo, Luis Tadeu Moraes; Chiaravalloti-Neto, Francisco; Nogueira, Maurício Lacerda

    2011-03-01

    Arboviruses are frequently associated with outbreaks in humans and represent a serious public health problem. Among the Brazilian arboviruses, Mayaro virus, Dengue virus (DENV), Yellow Fever virus, Rocio virus, Saint Louis Encephalitis virus (SLEV), and Oropouche virus are responsible for most of human cases. All these arboviruses usually produce undistinguishable acute febrile illness, especially in the acute phase of infection. In this study we investigated the presence of arboviruses in sera of 519 patients presenting acute febrile illness, during a dengue outbreak in São José do Rio Preto City (São Paulo, Brazil). A multiplex-nested RT-polymerase chain reaction assay was applied to detect and identify the main Brazilian arboviruses (Flavivirus, Alphavirus, and Orthobunyavirus genera). The molecular analysis showed that 365 samples were positive to DENV-3, 5 to DENV-2, and 8 to SLEV. Among the positive samples, one coinfection was detected between DENV-2 and DENV-3. The phylogenetic analysis of the SLEV envelope gene indicated that the virus circulating in city is related to lineage V strains. These results indicated that during that large DENV-3 outbreak in 2006, different arboviruses cocirculated causing human disease. Thus, it is necessary to have an efficient surveillance system to control the dissemination of these arboviruses in the population.

  14. [Integrated strategy for dengue prevention and control in the Region of the Americas].

    PubMed

    San Martín, José Luis; Brathwaite-Dick, Olivia

    2007-01-01

    During the last 22 years, the Region of the Americas has seen an upward trend in dengue incidence, with epidemics peaking ever higher and recurring every 3-5 years, almost regularly. A major factor in the spread of the disease has been the diminished capacity of national programs to respond with dengue prevention and control. This paper evaluates the Integrated Strategy for Dengue Prevention and Control-approved by the 44th Directing Council of the Pan American Health Organization in September 2003- and its preliminary results. The Integrated Strategy for Dengue is a management model designed to strengthen national programs, with a focus on reducing morbidity, mortality, and the societal and economic burdens produced by outbreaks and epidemics. Currently, 11 of the countries in the Region have developed a plan for or implemented a national strategy. In addition, a sub-Regional plan has been developed for Central America and the Dominican Republic. The Integrated Strategy for Dengue is expected to produce a qualitative leap forward in prevention and control through stronger partnerships among the State, its various ministries, and governing bodies, at all levels; private companies; and the range of community and civil groups. Once implemented, this strategy will reduce risk factors for dengue transmission, establish an integrated epidemiological surveillance system, decrease Aedes aegypti mosquito populations, prepare laboratories to better detect and identify the virus, optimize diagnosis and treatment, and, as a result, decrease the frequency, magnitude, and severity of dengue outbreaks and epidemics.

  15. Community Participation, Dengue Fever Prevention and Control Practices in Swat, Pakistan

    PubMed Central

    Zahir, Abdul; Ullah, Asad; Shah, Mussawar; Mussawar, Arsalan

    2016-01-01

    Background: The aim of this study was to determine the role of community participation in prevention of dengue fever in The Swat district located in the Northern area of Khyber Pakhtunkhwa, Pakistan, which experienced a dengue fever outbreak in August, 2013. A total number of 8,963 dengue cases with 0.4% case fatality ratio were registered during the outbreak. Methods: A sample size of 354 respondents were proportionally allocated to each residential colony and then randomly selected. The association of independent variable (Community participation) and dependent variable (practices for control) were tested by using Chi Square test. Results: Results regarding perception of practices for dengue control with community participation showed that: practices for control had significant association with organization of people to eradicate dengue mosquitoes (p=0.00), community leaders (p=0.04), community efforts (p≤0.01), use of insecticides by community people (p=0.00) and involvement of community people in awareness campaign (p=0.00). Similarly, significant associations were found between practices for control and community shared information during dengue outbreak (p=0.00), community link with health department, NGO, Other agencies (p=0.02). Conclusion and Global Health Implications: We conclude that the spread of dengue epidemic was aided by the ignorance, laziness of the community people and government agencies. However, the people, religious scholars, leaders and government agencies were not organized to participate in dengue prevention and eradication, hence, the chances of dengue infection increased in community. The study recommends mobilizing local communities and activating local leadership with active participation of Government and non-government organizations for initiation of preventive strategies. PMID:28058191

  16. Clinical, Virologic, and Epidemiologic Characteristics of Dengue Outbreak, Dar es Salaam, Tanzania, 2014

    PubMed Central

    Mboera, Leonard E.G.; De Nardo, Pasquale; Oriyo, Ndekya M.; Meschi, Silvia; Rumisha, Susan F.; Colavita, Francesca; Mhina, Athanas; Carletti, Fabrizio; Mwakapeje, Elibariki; Capobianchi, Maria Rosaria; Castilletti, Concetta; Di Caro, Antonino; Nicastri, Emanuele; Malecela, Mwelecele N.; Ippolito, Giuseppe

    2016-01-01

    We investigated a dengue outbreak in Dar es Salaam, Tanzania, in 2014, that was caused by dengue virus (DENV) serotype 2. DENV infection was present in 101 (20.9%) of 483 patients. Patient age and location of residence were associated with infection. Seven (4.0%) of 176 patients were co-infected with malaria and DENV. PMID:27088845

  17. Clinical, Virologic, and Epidemiologic Characteristics of Dengue Outbreak, Dar es Salaam, Tanzania, 2014.

    PubMed

    Vairo, Francesco; Mboera, Leonard E G; De Nardo, Pasquale; Oriyo, Ndekya M; Meschi, Silvia; Rumisha, Susan F; Colavita, Francesca; Mhina, Athanas; Carletti, Fabrizio; Mwakapeje, Elibariki; Capobianchi, Maria Rosaria; Castilletti, Concetta; Di Caro, Antonino; Nicastri, Emanuele; Malecela, Mwelecele N; Ippolito, Giuseppe

    2016-05-01

    We investigated a dengue outbreak in Dar es Salaam, Tanzania, in 2014, that was caused by dengue virus (DENV) serotype 2. DENV infection was present in 101 (20.9%) of 483 patients. Patient age and location of residence were associated with infection. Seven (4.0%) of 176 patients were co-infected with malaria and DENV.

  18. On the analysis of effectiveness in mass application of mosquito repellent for dengue disease prevention

    NASA Astrophysics Data System (ADS)

    Aldila, D.; Soewono, E.; Nuraini, N.

    2012-05-01

    Dengue disease has been known as one of dangerous vector-borne diseases and become serious threat in many tropical countries. With no vaccine and antiviral available until nowadays, and frequent appearance of extraordinary dengue outbreaks, many governments are forced to declare national problem for dengue. At this moment, the only method available to prevent dengue disease transmission is to combat the disease-carrying mosquitoes as well as to reduce the contact between human and mosquitoes. The fast growing dengue transmission in many countries in recent years indicates that the mosquito control programs are far from successful. The use of mosquito repellent is one possible instrument which could be used as an effective mass treatment to prevent the dengue outbreak during endemic period. Here in this paper a Susceptible-Infectious-Recovered (S-I-R) dengue transmission model with repellent mass treatment is being applied to portions of children and adult compartments. Analysis of the basic reproductive ratio (Ro) of the model is done. It is shown, with reasonable choices of portions of treated children and adults, in combination with reduction of mosquito population, the basic reproductive ratio can be significantly reduced and occurrence of endemic can be avoided. Numerical simulations are shown for various treatment scenarios.

  19. [Outbreak of Dengue-2 virus in Salta, Argentina, 1988].

    PubMed

    Avilés, G; Rangeon, G; Baroni, P; Paz, V; Monteros, M; Sartini, J L; Enria, D

    2000-01-01

    Dengue (DEN) reemergence was first detected in Salta, Argentina, in 1997. It was confirmed by serology and PCR that DEN-2 virus was responsible for sporadic cases and indigenous transmission. A laboratory-based surveillance system allowed the detection of an outbreak in Salta several months later. In total, 378 DEN cases were laboratory diagnosed out of 646 (58%) studied. The cases were distributed in 10 localities of the province between January 3rd and May 31st, 1998. One DEN-2 viral isolation and 4 PCR products were obtained from patients coming from Orán and Embarcación localities. Male and female cases occurred at a similar rate (1:1), with adult cases (82.5%) nearly five times greater than for children under 15 years-old (17.5%). Clinically, all cases corresponded to classic DEN. This is the first time that a DEN outbreak has been laboratory-diagnosed in Argentina and also the first time that DEN virus has been isolated in this country.

  20. An epidemiological cluster pattern of dengue outbreak amongst close contacts in Selangor, Peninsular Malaysia.

    PubMed

    Ang, K T; Ruhaini, I; Chua, K B

    2006-08-01

    Dengue fever is major public health problem especially among the highly urbanized states of Malaysia, such as, Selangor and Kuala Lumpur Federal Territory. We report an epidemiological cluster pattern of dengue outbreak in the district of Gombak, Selangor that may mimic other acute febrile illnesses in which the transmission mode is via close contact. This dengue outbreak consisted of two waves; an initial cluster of three cases (including the first deceased, JI) which occurred between 20th and 21st of July, followed by a later larger cluster of 11 cases that occurred between 1st and 8th of August 2005. This epidemiological clustering pattern of acute dengue virus infection among close contacts suggests an intense rate of dengue virus transmission within the vicinity of the first deceased's house.

  1. An analysis of a short-lived outbreak of dengue fever in Mauritius.

    PubMed

    Ramchurn, S K; Moheeput, K; Goorah, S S

    2009-08-27

    During the month of June 2009, Mauritius experienced a short-lived outbreak of dengue fever localised in its capital city Port Louis. Aedes albopictus, a secondary vector of dengue viruses, was the probable vector. We introduce a method which combines Google Earth images, stochastic cellular automata and scale free network ideas to map this outbreak. The method could complement other techniques to forecast the evolution of potential localised mosquito-borne viral outbreaks in Mauritius and in at-risk locations elsewhere for public health planning purposes.

  2. DENGUE OUTBREAK IN MATO GROSSO STATE, MIDWESTERN BRAZIL.

    PubMed

    Heinen, Letícia Borges da Silva; Zuchi, Nayara; Cardoso, Belgath Fernandes; Santos, Marcelo Adriano Mendes dos; Nogueira, Mauricio Lacerda; Dezengrini-Slhessarenko, Renata

    2015-12-01

    Dengue virus (DENV) is the most frequent arbovirus worldwide. In this study, we report a large outbreak in Mato Grosso State (MT). Serum samples from 604 patients with acute febrile illness for less than five days were inoculated in C6/36 cells, then infected cells were subjected to an indirect immunofluorescence test for DENV serotypes and yellow fever virus. Serum samples were submitted to a multiplex-semi-nested-RT-PCR for 11 flaviviruses. DENV-4 was isolated in 150/604 (24.8%) and DENV-1 in 19/604 (3.1%) specimens. By RT-PCR, 331 (54.8%) samples tested positive for DENV; 321 had single infections (DENV-4 n = 305; DENV-1 n = 15; DENV-3 n = 1), nine had co-infections of DENV-1/DENV-4, and one of DENV-2/DENV-4. DENV-4 was detected in 315/331 (95.2%) positive patients from 17 municipalities, and DENV-1 in 24/331 (7.2%) patients from five cities in north-central MT and the city of Cuiaba. The incidence of infection was higher in patients aged 20-39 (142/331; 42.9%). The NS5 partial nucleotide sequence of DENV-1 was most similar to that of genotype V, DENV-2 to Southeast Asian/American, DENV-3 to genotype III, and DENV-4 to genotype II strains, considered the most frequent strains in Brazil. This outbreak coincided with the introduction of DENV-4 in the state. Cuiaba was hyperendemic for the four DENV serotypes, highlighting the necessity for arbovirus surveillance in MT.

  3. DENGUE OUTBREAK IN MATO GROSSO STATE, MIDWESTERN BRAZIL

    PubMed Central

    HEINEN, Letícia Borges da Silva; ZUCHI, Nayara; CARDOSO, Belgath Fernandes; dos SANTOS, Marcelo Adriano Mendes; NOGUEIRA, Mauricio Lacerda; DEZENGRINI-SLHESSARENKO, Renata

    2015-01-01

    Dengue virus (DENV) is the most frequent arbovirus worldwide. In this study, we report a large outbreak in Mato Grosso State (MT). Serum samples from 604 patients with acute febrile illness for less than five days were inoculated in C6/36 cells, then infected cells were subjected to an indirect immunofluorescence test for DENV serotypes and yellow fever virus. Serum samples were submitted to a multiplex-semi-nested-RT-PCR for 11 flaviviruses. DENV-4 was isolated in 150/604 (24.8%) and DENV-1 in 19/604 (3.1%) specimens. By RT-PCR, 331 (54.8%) samples tested positive for DENV; 321 had single infections (DENV-4 n = 305; DENV-1 n = 15; DENV-3 n = 1), nine had co-infections of DENV-1/DENV-4, and one of DENV-2/DENV-4. DENV-4 was detected in 315/331 (95.2%) positive patients from 17 municipalities, and DENV-1 in 24/331 (7.2%) patients from five cities in north-central MT and the city of Cuiaba. The incidence of infection was higher in patients aged 20-39 (142/331; 42.9%). The NS5 partial nucleotide sequence of DENV-1 was most similar to that of genotype V, DENV-2 to Southeast Asian/American, DENV-3 to genotype III, and DENV-4 to genotype II strains, considered the most frequent strains in Brazil. This outbreak coincided with the introduction of DENV-4 in the state. Cuiaba was hyperendemic for the four DENV serotypes, highlighting the necessity for arbovirus surveillance in MT. PMID:27049702

  4. Alarm Variables for Dengue Outbreaks: A Multi-Centre Study in Asia and Latin America

    PubMed Central

    Bowman, Leigh R.; Tejeda, Gustavo S.; Coelho, Giovanini E.; Sulaiman, Lokman H.; Gill, Balvinder S.; McCall, Philip J.; Olliaro, Piero L.; Ranzinger, Silvia R.; Quang, Luong C.; Ramm, Ronald S.; Kroeger, Axel; Petzold, Max G.

    2016-01-01

    Background Worldwide, dengue is an unrelenting economic and health burden. Dengue outbreaks have become increasingly common, which place great strain on health infrastructure and services. Early warning models could allow health systems and vector control programmes to respond more cost-effectively and efficiently. Methodology/Principal Findings The Shewhart method and Endemic Channel were used to identify alarm variables that may predict dengue outbreaks. Five country datasets were compiled by epidemiological week over the years 2007–2013. These data were split between the years 2007–2011 (historic period) and 2012–2013 (evaluation period). Associations between alarm/ outbreak variables were analysed using logistic regression during the historic period while alarm and outbreak signals were captured during the evaluation period. These signals were combined to form alarm/ outbreak periods, where 2 signals were equal to 1 period. Alarm periods were quantified and used to predict subsequent outbreak periods. Across Mexico and Dominican Republic, an increase in probable cases predicted outbreaks of hospitalised cases with sensitivities and positive predictive values (PPV) of 93%/ 83% and 97%/ 86% respectively, at a lag of 1–12 weeks. An increase in mean temperature ably predicted outbreaks of hospitalised cases in Mexico and Brazil, with sensitivities and PPVs of 79%/ 73% and 81%/ 46% respectively, also at a lag of 1–12 weeks. Mean age was predictive of hospitalised cases at sensitivities and PPVs of 72%/ 74% and 96%/ 45% in Mexico and Malaysia respectively, at a lag of 4–16 weeks. Conclusions/Significance An increase in probable cases was predictive of outbreaks, while meteorological variables, particularly mean temperature, demonstrated predictive potential in some countries, but not all. While it is difficult to define uniform variables applicable in every country context, the use of probable cases and meteorological variables in tailored early warning

  5. Comparative Analysis of Dengue and Zika Outbreaks Reveals Differences by Setting and Virus

    PubMed Central

    Kucharski, Adam J.; Camacho, Anton; Eggo, Rosalind M.; Yakob, Laith; Murray, Lawrence M.; Edmunds, W. John

    2016-01-01

    The pacific islands of Micronesia have experienced several outbreaks of mosquito-borne diseases over the past decade. In outbreaks on small islands, the susceptible population is usually well defined, and there is no co-circulation of pathogens. Because of this, analysing such outbreaks can be useful for understanding the transmission dynamics of the pathogens involved, and particularly so for yet understudied pathogens such as Zika virus. Here, we compared three outbreaks of dengue and Zika virus in two different island settings in Micronesia, the Yap Main Islands and Fais, using a mathematical model of transmission dynamics and making full use of commonalities in disease and setting between the outbreaks. We found that the estimated reproduction numbers for Zika and dengue were similar when considered in the same setting, but that, conversely, reproduction number for the same disease can vary considerably by setting. On the Yap Main Islands, we estimated a reproduction number of 8.0–16 (95% Credible Interval (CI)) for the dengue outbreak and 4.8–14 (95% CI) for the Zika outbreak, whereas for the dengue outbreak on Fais our estimate was 28–102 (95% CI). We further found that the proportion of cases of Zika reported was smaller (95% CI 1.4%–1.9%) than that of dengue (95% CI: 47%–61%). We confirmed these results in extensive sensitivity analysis. They suggest that models for dengue transmission can be useful for estimating the predicted dynamics of Zika transmission, but care must be taken when extrapolating findings from one setting to another. PMID:27926933

  6. Comparative Analysis of Dengue and Zika Outbreaks Reveals Differences by Setting and Virus.

    PubMed

    Funk, Sebastian; Kucharski, Adam J; Camacho, Anton; Eggo, Rosalind M; Yakob, Laith; Murray, Lawrence M; Edmunds, W John

    2016-12-01

    The pacific islands of Micronesia have experienced several outbreaks of mosquito-borne diseases over the past decade. In outbreaks on small islands, the susceptible population is usually well defined, and there is no co-circulation of pathogens. Because of this, analysing such outbreaks can be useful for understanding the transmission dynamics of the pathogens involved, and particularly so for yet understudied pathogens such as Zika virus. Here, we compared three outbreaks of dengue and Zika virus in two different island settings in Micronesia, the Yap Main Islands and Fais, using a mathematical model of transmission dynamics and making full use of commonalities in disease and setting between the outbreaks. We found that the estimated reproduction numbers for Zika and dengue were similar when considered in the same setting, but that, conversely, reproduction number for the same disease can vary considerably by setting. On the Yap Main Islands, we estimated a reproduction number of 8.0-16 (95% Credible Interval (CI)) for the dengue outbreak and 4.8-14 (95% CI) for the Zika outbreak, whereas for the dengue outbreak on Fais our estimate was 28-102 (95% CI). We further found that the proportion of cases of Zika reported was smaller (95% CI 1.4%-1.9%) than that of dengue (95% CI: 47%-61%). We confirmed these results in extensive sensitivity analysis. They suggest that models for dengue transmission can be useful for estimating the predicted dynamics of Zika transmission, but care must be taken when extrapolating findings from one setting to another.

  7. Zika in Rio de Janeiro: Assessment of basic reproduction number and comparison with dengue outbreaks.

    PubMed

    Villela, D A M; Bastos, L S; DE Carvalho, L M; Cruz, O G; Gomes, M F C; Durovni, B; Lemos, M C; Saraceni, V; Coelho, F C; Codeço, C T

    2017-02-27

    Zika virus infection was declared a public health emergency of international concern in February 2016 in response to the outbreak in Brazil and its suspected link with congenital anomalies. In this study, we use notification data and disease natural history parameters to estimate the basic reproduction number (R 0) of Zika in Rio de Janeiro, Brazil. We also obtain estimates of R 0 of dengue from time series of dengue cases in the outbreaks registered in 2002 and 2012 in the city, when DENV-3 and DENV-4 serotypes, respectively, had just emerged. Our estimates of the basic reproduction number for Zika in Rio de Janeiro based on surveillance notifications (R 0 = 2·33, 95% CI: 1·97-2·97) were higher than those obtained for dengue in the city (year 2002: R 0 = 1·70 [1·50-2·02]; year 2012: R 0 = 1·25 [1·18-1·36]). Given the role of Aedes aegypti as vector of both the Zika and dengue viruses, we also derive R 0 of Zika as a function of both dengue reproduction number and entomological and epidemiological parameters for dengue and Zika. Using the dengue outbreaks from previous years allowed us to estimate the potential R 0 of Zika. Our estimates were closely in agreement with our first Zika's R 0 estimation from notification data. Hence, these results validate deriving the potential risk of Zika transmission in areas with recurring dengue outbreaks. Whether transmission routes other than vector-based can sustain a Zika epidemic still deserves attention, but our results suggest that the Zika outbreak in Rio de Janeiro emerged due to population susceptibility and ubiquitous presence of Ae. aegypti.

  8. Chikungunya: a reemerging infection spreading during 2010 dengue fever outbreak in National Capital Region of India.

    PubMed

    Ramachandran, V G; Das, Shukla; Roy, Priyamvada; Hada, Vivek; Mogha, Narendra Singh

    2016-06-01

    Chikungunya fever is an important reemerging arbovirus illness, which is transmitted by the same vector as of dengue virus. Many cases of concurrent infections with multiple dengue virus serotypes have been reported in many countries. Also, concurrent infection with Chikungunya virus and dengue virus has been reported in the past in Delhi. Therefore, this study was done to detect Chikungunya IgM antibodies in suspected dengue fever patients. In this study, 1666 serum samples suspected of dengue fever and collected during the outbreak period (August 2010-December 2010) were tested for dengue IgM antibodies, of which 736 tested negative. Of the 736 dengue IgM negative sera, 666 were tested for Chikungunya IgM antibodies. The demographic profile and essential laboratory investigations were recorded. Chikungunya IgM was detected in 9.91 % of the patients. During the post-monsoon period though dengue dominated in numbers, the number of Chikungunya fever cases increased gradually followed by an abrupt decrease with the onset of winter. The Chikungunya IgM positive patients were suffering from fever of more than 5 days duration and had thrombocytopenia. Due to similarity in clinical features and vector transmitting dengue and Chikungunya virus, continuous surveillance of both dengue fever and Chikungunya fever is desirable for better management and epidemiological assessment.

  9. The molecular and clinical features of dengue during outbreak in Jambi, Indonesia in 2015.

    PubMed

    Haryanto, Sotianingsih; Hayati, Rahma F; Yohan, Benediktus; Sijabat, Lanceria; Sihite, Ifo F; Fahri, Sukmal; Meutiawati, Febrina; Halim, Jonathan A N; Halim, Stefanie N; Soebandrio, Amin; Sasmono, R Tedjo

    2016-05-01

    Dengue is hyperendemic in Indonesia. In 2015, reported cases of dengue fever doubled those of 2014 in the Jambi municipality of Sumatra. We examined viral aetiology and its relationship with disease outcome in Jambi. Dengue-suspected patients' sera were collected and NS1 detection and IgM/IgG serology were performed. Dengue virus (DENV) serotyping was performed using real-time RT-PCR. Envelope genes were sequenced to determine the genotypes of DENV. Clinical, haematologic, and demographic data were recorded. Of 210 dengue-suspected patients, 107 were confirmed. The disease manifested as Dengue Fever (62%), Dengue Haemorrhagic Fever (36%), and Dengue Shock Syndrome (2%). The serotypes of 94 DENV were determined. All DENV serotypes were detected with DENV-1 as the predominant serotype (66%). Genotypically, the DENV-1 viruses belong to Genotype I, DENV-2 was of Cosmopolitan genotype, DENV-3 as Genotype I, and DENV-4 belonged to Genotype II. Comparison with historical data revealed serotype predominance switched from DENV-3 to DENV-1, and the replacement of Genotype IV of DENV-1 with Genotype I. In summary, DENV-1 predominated during the 2015 dengue outbreak in Jambi. The full spectrum of dengue disease occurred and was characterized by a switch in predominant serotypes.

  10. Spatio-temporal and neighborhood characteristics of two dengue outbreaks in two arid cities of Mexico.

    PubMed

    Reyes-Castro, Pablo A; Harris, Robin B; Brown, Heidi E; Christopherson, Gary L; Ernst, Kacey C

    2017-03-01

    Little is currently known about the spatial-temporal dynamics of dengue epidemics in arid areas. This study assesses dengue outbreaks that occurred in two arid cities of Mexico, Hermosillo and Navojoa, located in northern state of Sonora. Laboratory confirmed dengue cases from Hermosillo (N=2730) and Navojoa (N=493) were geocoded by residence and assigned neighborhood-level characteristics from the 2010 Mexican census. Kernel density and Space-time cluster analysis was performed to detect high density areas and space-time clusters of dengue. Ordinary Least Square regression was used to assess the changing socioeconomic characteristics of cases over the course of the outbreaks. Both cities exhibited contiguous patterns of space-time clustering. Initial areas of dissemination were characterized in both cities by high population density, high percentage of occupied houses, and lack of healthcare. Future research and control efforts in these regions should consider these space-time and socioeconomic patterns.

  11. Characterization of the Myocarditis during the worst outbreak of dengue infection in China.

    PubMed

    Li, Yingying; Hu, Zhongwei; Huang, Yuli; Li, Jianping; Hong, Wenxin; Qin, Zhihui; Tong, Yuwei; Li, Jinglong; Lv, Mingfang; Li, Meiyu; Zheng, Xiaoke; Hu, Jun; Hua, Jinghai; Zhang, Fuchun; Xu, Ding-Li

    2016-07-01

    Myocarditis is a common complication of severe dengue infection. However, data about prevalence and characterization of myocarditis in dengue are still lacking. In 2014, the worst outbreak of dengue in the last two decades in China occurred. In this study, we described the clinical and laboratory diagnostic features of dengue with myocarditis. Totally, 1782 diagnosed dengue patients were admitted from August to October, 2014, all of whom were subjected to electrocardiogram, ultrasound cardiogram, and cardiac enzyme test. About 201 cases of dengue patients were diagnosed with myocarditis and the prevalence of myocarditis in hospitalized dengue was 11.28%. The prevalence of myocarditis in nonsevere dengue with warning signs and severe dengue [NSD(WS+)/SD] and nonsevere dengue without warning signs [NSD(WS-)] was 46.66% and 9.72%, respectively. The NSD(WS+)/SD patients with myocarditis presented with higher incidence of cardiac symptoms, supraventricular tachycardia (14.29% vs. 0%, P < 0.001), atrial fibrillation (25.71% vs. 10.24%, P = 0.019) and heart failure compared with NSD (WS-) patients with myocarditis. About 150 cases of dengue patients without myocarditis in the same period of time in department of Cardiology were recruited as control group. The proportion of NSD(WS+)/SD in dengue patients with and without myocarditis was 17.41% and 2.53%, respectively. Dengue patients with myocarditis experienced longer hospital stay than those without myocarditis (7.17 ± 4.64 vs. 5.98 ± 2.69, P = 0.008). There was no difference between patients with and without myocarditis in the proportion of symptoms, auxiliary methods abnormality, arrhythmia, and heart failure on the discharge day. Our study demonstrates the prevalence of myocarditis in worst outbreak of dengue in China was 11.28% and the incidence of myocarditis increased with the severity of dengue. The NSD(WS+)/SD patients with myocarditis presented with higher incidence of cardiac complication compared

  12. Prediction of Dengue Outbreaks Based on Disease Surveillance and Meteorological Data.

    PubMed

    Ramadona, Aditya Lia; Lazuardi, Lutfan; Hii, Yien Ling; Holmner, Åsa; Kusnanto, Hari; Rocklöv, Joacim

    2016-01-01

    Research is needed to create early warnings of dengue outbreaks to inform stakeholders and control the disease. This analysis composes of a comparative set of prediction models including only meteorological variables; only lag variables of disease surveillance; as well as combinations of meteorological and lag disease surveillance variables. Generalized linear regression models were used to fit relationships between the predictor variables and the dengue surveillance data as outcome variable on the basis of data from 2001 to 2010. Data from 2011 to 2013 were used for external validation purposed of prediction accuracy of the model. Model fit were evaluated based on prediction performance in terms of detecting epidemics, and for number of predicted cases according to RMSE and SRMSE, as well as AIC. An optimal combination of meteorology and autoregressive lag terms of dengue counts in the past were identified best in predicting dengue incidence and the occurrence of dengue epidemics. Past data on disease surveillance, as predictor alone, visually gave reasonably accurate results for outbreak periods, but not for non-outbreaks periods. A combination of surveillance and meteorological data including lag patterns up to a few years in the past showed most predictive of dengue incidence and occurrence in Yogyakarta, Indonesia. The external validation showed poorer results than the internal validation, but still showed skill in detecting outbreaks up to two months ahead. Prior studies support the fact that past meteorology and surveillance data can be predictive of dengue. However, to a less extent has prior research shown how the longer-term past disease incidence data, up to years, can play a role in predicting outbreaks in the coming years, possibly indicating cross-immunity status of the population.

  13. Detection of Mayaro virus infections during a dengue outbreak in Mato Grosso, Brazil.

    PubMed

    Vieira, Carla Julia da Silva Pessoa; Silva, David José Ferreira da; Barreto, Eriana Serpa; Siqueira, Carlos Eduardo Hassegawa; Colombo, Tatiana Elias; Ozanic, Katia; Schmidt, Diane Johnson; Drumond, Betânia Paiva; Mondini, Adriano; Nogueira, Maurício Lacerda; Bronzoni, Roberta Vieira de Morais

    2015-07-01

    Arboviruses are common agents of human febrile illness worldwide. In dengue-endemic areas illness due to other arboviruses have been misdiagnosed as dengue based only on clinical-epidemiological data. In this study we investigated the presence of Brazilian arboviruses in sera of 200 patients presenting acute febrile illness, during a dengue outbreak in Sinop, MT, Brazil. The results showed that 38 samples were positive to Dengue virus (DENV) type 1, two samples to DENV type 4, and six to Mayaro virus. These results indicate that arboviruses others than DENV are circulating in Sinop and the surrounding region, which are going undiagnosed. In addition, molecular and evolutionary analyses indicate that two MAYV genotypes are co-circulating in Mato Grosso, Brazil. Thus, a strong surveillance program must be implemented to evaluate and monitor the distribution and the true importance of non-dengue arboviruses in the etiology of acute febrile illnesses.

  14. [Saint Louis encephalitis virus in Buenos Aires city during the outbreak of dengue in 2009].

    PubMed

    López, Horacio; Neira, Jorge; Morales, María Alejandra; Fabbri, Cintia; D'Agostino, María Laura; Zitto, Teresa

    2011-01-01

    We report the case of a male, 80-year-old resident in the City of Buenos Aires, with a diagnosis of St. Louis encephalitis (SLE) during a countrywide dengue outbreak, from January to May 2009. The patient had a chronic lymphocytic leukemia treated with chlorambucil, prostate cancer (hormone therapy and radiotherapy) and images consistent with bone metastases. Cerebrospinal fluid examination showed pleocytosis with a predominance of mononuclear cells and high protein concentration. Bacteria, fungi and mycobacteria cultures, as well as the PCR for herpes virus, HSV, CMV and EBV, were negative. We confirmed the diagnosis of SLE by detection of IgM antibodies in both CSF and serum sample with IgG seroconversion by neutralization in cell cultures and negative results for other flaviviruses with known circulation in Argentina. We review the evidence for the presence of the St. Louis virus in our country and point to the importance of the diagnosis and the search of other Flavivirus in suspected dengue cases with severe or atypical presentation. This work emphasizes the need to strengthen both the epidemiological surveillance of SLE, and vector control to prevent different infections transmitted by mosquitoes and to understand their true impact on public health in Argentina.

  15. Vaccines for the prevention of dengue: development update.

    PubMed

    Thomas, Stephen J; Endy, Timothy P

    2011-06-01

    The dengue viruses (DENV) are mosquito-borne flaviviruses which cause a spectrum of clinical disease known as "dengue," and have emerged and re-emerged as a significant global health problem. It is estimated more than 120 countries currently have endemic DENV transmission, 55% of the world's population is at risk of infection, and there are between 70-500 million infections of which 2.1 million are clinically severe resulting in 21,000 deaths annually. By all estimates the global dengue problem will continue to worsen due to the increasing mobility of the population, ecological changes, and the inability to effectively sustain vector control. There are no licensed antivirals or vaccines to treat or prevent dengue. The development and widespread use of a safe and efficacious dengue vaccine is required to significantly reduce the global dengue burden. In this review the authors discuss dengue vaccines currently in the pre-clinical and clinical development pipeline.

  16. The 2012 Madeira dengue outbreak: epidemiological determinants and future epidemic potential.

    PubMed

    Lourenço, José; Recker, Mario

    2014-08-01

    Dengue, a vector-borne viral disease of increasing global importance, is classically associated with tropical and sub-tropical regions around the world. Urbanisation, globalisation and climate trends, however, are facilitating the geographic spread of its mosquito vectors, thereby increasing the risk of the virus establishing itself in previously unaffected areas and causing large-scale epidemics. On 3 October 2012, two autochthonous dengue infections were reported within the Autonomous Region of Madeira, Portugal. During the following seven months, this first 'European' dengue outbreak caused more than 2000 local cases and 81 exported cases to mainland Europe. Here, using an ento-epidemiological mathematical framework, we estimate that the introduction of dengue to Madeira occurred around a month before the first official cases, during the period of maximum influx of airline travel, and that the naturally declining temperatures of autumn were the determining factor for the outbreak's demise in early December 2012. Using key estimates, together with local climate data, we further propose that there is little support for dengue endemicity on this island, but a high potential for future epidemic outbreaks when seeded between May and August-a period when detection of imported cases is crucial for Madeira's public health planning.

  17. Dengue and chikungunya: long-distance spread and outbreaks in naïve areas

    PubMed Central

    Rezza, Giovanni

    2014-01-01

    Mosquito-borne virus infections, such as dengue and chikungunya, are continuously expanding their geographical range. The dengue virus, which is known to be a common cause of febrile illness in tropical areas of the Old World, is now widespread in the Americas. In most affected areas, all the four dengue virus serotypes have circulated. Recently, small clusters of dengue have been identified also in Southern Europe during the hot season. The chikungunya virus, initially restricted to Central Africa, where is a common cause of sporadic cases or small outbreaks, and Asia, where it is used to cause large epidemics, has recently invaded new territories. After ravaging Indian Ocean Islands and the Indian subcontinent, CHIKV caused an outbreak in north-eastern Italy. Recently, chikungunya has reached the Caribbean, causing for the first time a large epidemic on the American continent. Although Aedes aegypti is the main vector of both viruses, Aedes albopictus, the Asian ‘Tiger’ mosquito, is now playing an increasingly important role, contributing to their spread in temperate climate areas. Hereby, we focus the attention on outbreaks of dengue and chikungunya occurring in previously disease-free areas and discuss factors associated with the long-distance spread of the vector-borne infections, such as mutations increasing viral fitness, climate change, urbanization, and globalization of humans and vectors. PMID:25491436

  18. The 2012 Madeira Dengue Outbreak: Epidemiological Determinants and Future Epidemic Potential

    PubMed Central

    Lourenço, José; Recker, Mario

    2014-01-01

    Dengue, a vector-borne viral disease of increasing global importance, is classically associated with tropical and sub-tropical regions around the world. Urbanisation, globalisation and climate trends, however, are facilitating the geographic spread of its mosquito vectors, thereby increasing the risk of the virus establishing itself in previously unaffected areas and causing large-scale epidemics. On 3 October 2012, two autochthonous dengue infections were reported within the Autonomous Region of Madeira, Portugal. During the following seven months, this first ‘European’ dengue outbreak caused more than 2000 local cases and 81 exported cases to mainland Europe. Here, using an ento-epidemiological mathematical framework, we estimate that the introduction of dengue to Madeira occurred around a month before the first official cases, during the period of maximum influx of airline travel, and that the naturally declining temperatures of autumn were the determining factor for the outbreak's demise in early December 2012. Using key estimates, together with local climate data, we further propose that there is little support for dengue endemicity on this island, but a high potential for future epidemic outbreaks when seeded between May and August—a period when detection of imported cases is crucial for Madeira's public health planning. PMID:25144749

  19. [Risk factors associated to the epidemic outbreak of dengue virus infection.

    PubMed

    García-Gutiérrez, María Del Rocío; Romero-Zepeda, Hilda; Salvador Romero-Márquez, Rubén

    2013-01-01

    Objective: to identify the risk factors associated to the epidemic of dengue virus infections occurred at Queretaro, Mexico. Methods: a case-control study was carried out on 49 cases and 49 controls. The data included: age, sex, residency, schooling, occupation, clinical data, sources infected with Aedes aegypti, travelling, source of waters, and protection to water recipients. The protection to door and windows was investigated. χ(2) test and odds ratio were estimated. Results: the age group of 20-39 years was the most affected and women predominated. The Satellite area contributed with 38 cases (77.1 %). The absence of mosquito nettings on windows had an OR = 1.8, and ignorance of preventive activities had an OR = 2.8, while the use of insecticides (OR = 0.30) and mosquito repellents (OR = 0.54) were protective factors. Conclusions: the epidemic outbreak in Queretaro confirmed that Aedes aegypti has adapted to greater heights. This fact should alert to the sanitary authorities to face the possibility of an epidemic outbreak with great affectation among population.

  20. Three-Month Real-Time Dengue Forecast Models: An Early Warning System for Outbreak Alerts and Policy Decision Support in Singapore

    PubMed Central

    Shi, Yuan; Liu, Xu; Kok, Suet-Yheng; Rajarethinam, Jayanthi; Liang, Shaohong; Yap, Grace; Chong, Chee-Seng; Lee, Kim-Sung; Tan, Sharon S.Y.; Chin, Christopher Kuan Yew; Lo, Andrew; Kong, Waiming; Ng, Lee Ching; Cook, Alex R.

    2015-01-01

    Background: With its tropical rainforest climate, rapid urbanization, and changing demography and ecology, Singapore experiences endemic dengue; the last large outbreak in 2013 culminated in 22,170 cases. In the absence of a vaccine on the market, vector control is the key approach for prevention. Objectives: We sought to forecast the evolution of dengue epidemics in Singapore to provide early warning of outbreaks and to facilitate the public health response to moderate an impending outbreak. Methods: We developed a set of statistical models using least absolute shrinkage and selection operator (LASSO) methods to forecast the weekly incidence of dengue notifications over a 3-month time horizon. This forecasting tool used a variety of data streams and was updated weekly, including recent case data, meteorological data, vector surveillance data, and population-based national statistics. The forecasting methodology was compared with alternative approaches that have been proposed to model dengue case data (seasonal autoregressive integrated moving average and step-down linear regression) by fielding them on the 2013 dengue epidemic, the largest on record in Singapore. Results: Operationally useful forecasts were obtained at a 3-month lag using the LASSO-derived models. Based on the mean average percentage error, the LASSO approach provided more accurate forecasts than the other methods we assessed. We demonstrate its utility in Singapore’s dengue control program by providing a forecast of the 2013 outbreak for advance preparation of outbreak response. Conclusions: Statistical models built using machine learning methods such as LASSO have the potential to markedly improve forecasting techniques for recurrent infectious disease outbreaks such as dengue. Citation: Shi Y, Liu X, Kok SY, Rajarethinam J, Liang S, Yap G, Chong CS, Lee KS, Tan SS, Chin CK, Lo A, Kong W, Ng LC, Cook AR. 2016. Three-month real-time dengue forecast models: an early warning system for outbreak

  1. Characteristics of a dengue outbreak in a remote pacific island chain--Republic of The Marshall Islands, 2011-2012.

    PubMed

    Sharp, Tyler M; Mackay, Andrew J; Santiago, Gilberto A; Hunsperger, Elizabeth; Nilles, Eric J; Perez-Padilla, Janice; Tikomaidraubuta, Kinisalote S; Colon, Candimar; Amador, Manuel; Chen, Tai-Ho; Lalita, Paul; Muñoz-Jordán, Jorge L; Barrera, Roberto; Langidrik, Justina; Tomashek, Kay M

    2014-01-01

    Dengue is a potentially fatal acute febrile illness caused by four mosquito-transmitted dengue viruses (DENV-1-4). Although dengue outbreaks regularly occur in many regions of the Pacific, little is known about dengue in the Republic of the Marshall Islands (RMI). To better understand dengue in RMI, we investigated an explosive outbreak that began in October 2011. Suspected cases were reported to the Ministry of Health, serum specimens were tested with a dengue rapid diagnostic test (RDT), and confirmatory testing was performed using RT-PCR and IgM ELISA. Laboratory-positive cases were defined by detection of DENV nonstructural protein 1 by RDT, DENV nucleic acid by RT-PCR, or anti-DENV IgM antibody by RDT or ELISA. Secondary infection was defined by detection of anti-DENV IgG antibody by ELISA in a laboratory-positive acute specimen. During the four months of the outbreak, 1,603 suspected dengue cases (3% of the RMI population) were reported. Of 867 (54%) laboratory-positive cases, 209 (24%) had dengue with warning signs, six (0.7%) had severe dengue, and none died. Dengue incidence was highest in residents of Majuro and individuals aged 10-29 years, and ∼95% of dengue cases were experiencing secondary infection. Only DENV-4 was detected by RT-PCR, which phylogenetic analysis demonstrated was most closely related to a virus previously identified in Southeast Asia. Cases of vertical DENV transmission, and DENV/Salmonella Typhi and DENV/Mycobacterium leprae co-infection were identified. Entomological surveys implicated water storage containers and discarded tires as the most important development sites for Aedes aegypti and Ae. albopictus, respectively. Although this is the first documented dengue outbreak in RMI, the age groups of cases and high prevalence of secondary infection demonstrate prior DENV circulation. Dengue surveillance should continue to be strengthened in RMI and throughout the Pacific to identify and rapidly respond to future outbreaks.

  2. Dengue Outbreak in Mombasa City, Kenya, 2013-2014: Entomologic Investigations.

    PubMed

    Lutomiah, Joel; Barrera, Roberto; Makio, Albina; Mutisya, James; Koka, Hellen; Owaka, Samuel; Koskei, Edith; Nyunja, Albert; Eyase, Fredrick; Coldren, Rodney; Sang, Rosemary

    2016-10-01

    Dengue outbreaks were first reported in East Africa in the late 1970s to early 1980s including the 1982 outbreak on the Kenyan coast. In 2011, dengue outbreaks occurred in Mandera in northern Kenya and subsequently in Mombasa city along the Kenyan coast in 2013-2014. Following laboratory confirmation of dengue fever cases, an entomologic investigation was conducted to establish the mosquito species, and densities, causing the outbreak. Affected parts of the city were identified with the help of public health officials. Adult Ae. aegypti mosquitoes were collected using various tools, processed and screened for dengue virus (DENV) by cell culture and RT-PCR. All containers in every accessible house and compound within affected suburbs were inspected for immatures. A total of 2,065 Ae. aegypti adults were collected and 192 houses and 1,676 containers inspected. An overall house index of 22%, container index, 31.0% (indoor = 19; outdoor = 43) and Breteau index, 270.1, were observed, suggesting that the risk of dengue transmission was high. Overall, jerry cans were the most productive containers (18%), followed by drums (17%), buckets (16%), tires (14%) and tanks (10%). However, each site had specific most-productive container-types such as tanks (17%) in Kizingo; Drums in Nyali (30%) and Changamwe (33%), plastic basins (35%) in Nyali-B and plastic buckets (81%) in Ganjoni. We recommend that for effective control of the dengue vector in Mombasa city, all container types would be targeted. Measures would include proper covering of water storage containers and eliminating discarded containers outdoors through a public participatory environmental clean-up exercise. Providing reliable piped water to all households would minimize the need for water storage and reduce aquatic habitats. Isolation of DENV from male Ae. aegypti mosquitoes is a first observation in Kenya and provides further evidence that transovarial transmission may have a role in DENV circulation and

  3. Dengue Outbreak in Mombasa City, Kenya, 2013–2014: Entomologic Investigations

    PubMed Central

    Barrera, Roberto; Makio, Albina; Mutisya, James; Koka, Hellen; Owaka, Samuel; Koskei, Edith; Nyunja, Albert; Eyase, Fredrick; Coldren, Rodney; Sang, Rosemary

    2016-01-01

    Dengue outbreaks were first reported in East Africa in the late 1970s to early 1980s including the 1982 outbreak on the Kenyan coast. In 2011, dengue outbreaks occurred in Mandera in northern Kenya and subsequently in Mombasa city along the Kenyan coast in 2013–2014. Following laboratory confirmation of dengue fever cases, an entomologic investigation was conducted to establish the mosquito species, and densities, causing the outbreak. Affected parts of the city were identified with the help of public health officials. Adult Ae. aegypti mosquitoes were collected using various tools, processed and screened for dengue virus (DENV) by cell culture and RT-PCR. All containers in every accessible house and compound within affected suburbs were inspected for immatures. A total of 2,065 Ae. aegypti adults were collected and 192 houses and 1,676 containers inspected. An overall house index of 22%, container index, 31.0% (indoor = 19; outdoor = 43) and Breteau index, 270.1, were observed, suggesting that the risk of dengue transmission was high. Overall, jerry cans were the most productive containers (18%), followed by drums (17%), buckets (16%), tires (14%) and tanks (10%). However, each site had specific most-productive container-types such as tanks (17%) in Kizingo; Drums in Nyali (30%) and Changamwe (33%), plastic basins (35%) in Nyali-B and plastic buckets (81%) in Ganjoni. We recommend that for effective control of the dengue vector in Mombasa city, all container types would be targeted. Measures would include proper covering of water storage containers and eliminating discarded containers outdoors through a public participatory environmental clean-up exercise. Providing reliable piped water to all households would minimize the need for water storage and reduce aquatic habitats. Isolation of DENV from male Ae. aegypti mosquitoes is a first observation in Kenya and provides further evidence that transovarial transmission may have a role in DENV circulation and

  4. Dengue Antibody and Zika: Friend or Foe?

    PubMed

    Durbin, Anna P

    2016-10-01

    Zika virus is a mosquito-borne Flavivirus related to dengue that is rapidly spreading through the Americas. This outbreak is occurring in dengue-endemic areas where the population has acquired antibodies to dengue. Recent studies reveal that preexisting dengue antibodies may have opposite effects on Zika infection, transmission, and clinical outcome. Discerning these effects is critical to a better understanding of Zika pathogenesis and the prevention of future outbreaks.

  5. E. Coli: Preventing Outbreaks at Camp.

    ERIC Educational Resources Information Center

    McKinney, Mary D.

    1996-01-01

    One strain of E. coli is not usually found in foods, but has been related to consumption of undercooked ground beef. Symptoms are stomach cramps and diarrhea, and 2-7% of infections lead to hemolytic uremic syndrome, which is life threatening. Camps can prevent outbreaks by avoiding uncooked meat on overnight campouts and requiring appropriate…

  6. Vector dynamics and transmission of dengue virus: implications for dengue surveillance and prevention strategies: vector dynamics and dengue prevention.

    PubMed

    Scott, Thomas W; Morrison, Amy C

    2010-01-01

    Accounting for variation in mosquito vector populations will improve dengue surveillance and prevention. Because Aedes aegypti, the principle dengue virus (DENV) vector, transmit the virus with remarkable efficiency, entomological thresholds are especially low. Assessing risk of human infection based on immature mosquito indices has proven difficult. Greater emphasis should be placed on relative abundance of adult vectors in relation to human serotype-specific herd immunity, introduction of unique viruses, mosquito-human contact and weather. The most appropriate spatial scale for assessing entomological risk is the individual household. The scale for measuring DENV transmission risk has yet to be determined but is clearly larger than the household and likely to exceed several city blocks. Because households are expected to be a primary site for human DENV infection, intradomicile vector control strategies should be a priority, especially when the force of transmission is high. The most effective intervention strategy will combine vector control with vaccine delivery for rapid and sustained disease prevention.

  7. Dengue Knowledge and Preventive Practices in Iquitos, Peru.

    PubMed

    Paz-Soldán, Valerie A; Morrison, Amy C; Cordova Lopez, Jhonny J; Lenhart, Audrey; Scott, Thomas W; Elder, John P; Sihuincha, Moises; Kochel, Tadeusz J; Halsey, Eric S; Astete, Helvio; McCall, Philip J

    2015-12-01

    As part of a cluster-randomized trial to evaluate insecticide-treated curtains for dengue prevention in Iquitos, Peru, we surveyed 1,333 study participants to examine knowledge and reported practices associated with dengue and its prevention. Entomological data from 1,133 of these households were linked to the survey. Most participants knew that dengue was transmitted by mosquito bite (85.6%), but only few (18.6%) knew that dengue vectors bite during daytime. Most commonly recognized dengue symptoms were fever (86.6%), headache (76.4%), and muscle/joint pain (67.9%). Most commonly reported correct practices for mosquito control were cleaning homes (61.6%), using insecticide sprays (23%), and avoiding having standing water at home (12.3%). Higher education was associated with higher knowledge about dengue, including transmission and vector control. Higher socioeconomic status was associated with increased reported use of preventive practices requiring money expenditure. We were less likely to find Aedes aegypti eggs, larvae, or pupae in households that had < 5-year-old children at home. Although dengue has been transmitted in Iquitos since the 1990s and the Regional Health Authority routinely fumigates households, treats domestic water containers with larvicide, and issues health education messages through mass media, knowledge of dengue transmission and household practices for prevention could be improved.

  8. Dengue Knowledge and Preventive Practices in Iquitos, Peru

    PubMed Central

    Paz-Soldán, Valerie A.; Morrison, Amy C.; Cordova Lopez, Jhonny J.; Lenhart, Audrey; Scott, Thomas W.; Elder, John P.; Sihuincha, Moises; Kochel, Tadeusz J.; Halsey, Eric S.; Astete, Helvio; McCall, Philip J.

    2015-01-01

    As part of a cluster-randomized trial to evaluate insecticide-treated curtains for dengue prevention in Iquitos, Peru, we surveyed 1,333 study participants to examine knowledge and reported practices associated with dengue and its prevention. Entomological data from 1,133 of these households were linked to the survey. Most participants knew that dengue was transmitted by mosquito bite (85.6%), but only few (18.6%) knew that dengue vectors bite during daytime. Most commonly recognized dengue symptoms were fever (86.6%), headache (76.4%), and muscle/joint pain (67.9%). Most commonly reported correct practices for mosquito control were cleaning homes (61.6%), using insecticide sprays (23%), and avoiding having standing water at home (12.3%). Higher education was associated with higher knowledge about dengue, including transmission and vector control. Higher socioeconomic status was associated with increased reported use of preventive practices requiring money expenditure. We were less likely to find Aedes aegypti eggs, larvae, or pupae in households that had < 5-year-old children at home. Although dengue has been transmitted in Iquitos since the 1990s and the Regional Health Authority routinely fumigates households, treats domestic water containers with larvicide, and issues health education messages through mass media, knowledge of dengue transmission and household practices for prevention could be improved. PMID:26503276

  9. Epidemiological dynamics of an urban Dengue 4 outbreak in São Paulo, Brazil

    PubMed Central

    Villabona-Arenas, Christian Julián; de Oliveira, Jessica Luana; de Sousa-Capra, Carla; Balarini, Karime; Pereira da Fonseca, Celso Ricardo Theoto

    2016-01-01

    Background: Dengue studies at the urban scale are scarce and required for guiding control efforts. In Brazil, the burden of dengue is high and challenges city public health administrations with limited resources. Here we studied the dynamics of a dengue epidemic in a single city. Methods: Serum samples from dengue suspected cases were collected and tested, from December 2012 and July 2013 in Guarujá, Brazil. We use incidence series analysis to provide a detailed view of the reproduction number dynamics and a Bayesian analysis to infer the spread of the serotype using geographic and temporal data. Results: We obtained nucleotide sequences from 354 envelope genes and georeferenced 286 samples during the course of the outbreak. Serotype 4 was responsible for the epidemic. We identified at least two major lineages that overlapped in distribution. We observed high reproduction numbers and high cladogenesis prior to the escalation of clinical case notifications. Three densely populated non-adjacent neighborhoods played a pivotal role during the onset and/or course of the epidemic. Discussion: Our findings point to high dengue virus transmission with a substantial proportion of unapparent cases that led to a late recognition of an outbreak. Usually source reductions initiatives tend to be insufficient once an epidemic has been established. Nevertheless, health authorities in Guarujá prioritized vector control on specific places with clusters of georeferenced viremic patients, which appear to have diminished the epidemic impact. PMID:27069820

  10. Changing pattern of dengue virus serotypes circulating during 2008-2012 and reappearance of dengue serotype 3 may cause outbreak in Kolkata, India.

    PubMed

    Saha, Kallol; Ghosh, Monika; Firdaus, Rushna; Biswas, Aritra; Seth, Bikash; Bhattacharya, Debojyoti; Mukherjee, Kheya; Sadhukhan, Provash Chandra

    2016-10-01

    Dengue virus infection is a major cause of morbidity within the endemic tropical and subtropical regions of the world. Dengue virus has four distinct serotypes with specific clinical manifestations. In this study, we observed the changing pattern of dengue serotypes, age-wise dengue infection and useful sero-detection methods needed in a dengue endemic region. We identified dengue serotypes during a period of 5 years among patients with dengue symptoms visiting one of the largest tertiary care infectious disease hospitals of eastern India in Kolkata. A total of 433 dengue RNA positive samples were isolated from 712 acute dengue suspected cases. Age wise distribution highlighted the susceptible age group being >21 years (24.02%) followed by 11-15 years (21.71%) and 5-10 years (21.02%) of the total infected population. Higher numbers of infected cases were found within females as they are involved in more indoor works. The period of study experienced two dengue outbreaks one in 2008 and another in 2012. For early dengue detection, NS1 was found to be more confirmatory than IgM ELISA regarding sensitivity and specificity. DENV-1, 2, and 4 serotypes were the common circulating strains from 2008 until 2010, after which DENV-3 serotype infections rise and led to a massive dengue outbreak in Kolkata with increased numbers of DHF and DSS cases in 2012. The finding within our study emphasizes the public health importance of such prospective surveillance programs with respect to the changing dengue viral etiology and serotypes. J. Med. Virol. 88:1697-1702, 2016. © 2016 Wiley Periodicals, Inc.

  11. Predicting Unprecedented Dengue Outbreak Using Imported Cases and Climatic Factors in Guangzhou, 2014

    PubMed Central

    Bi, Peng; Yang, Weizhong; Yang, Zhicong; Xu, Lei; Yang, Jun; Liu, Xiaobo; Jiang, Tong; Wu, Haixia; Chu, Cordia; Liu, Qiyong

    2015-01-01

    Introduction Dengue is endemic in more than 100 countries, mainly in tropical and subtropical regions, and the incidence has increased 30-fold in the past 50 years. The situation of dengue in China has become more and more severe, with an unprecedented dengue outbreak hitting south China in 2014. Building a dengue early warning system is therefore urgent and necessary for timely and effective response. Methodology and Principal Findings In the study we developed a time series Poisson multivariate regression model using imported dengue cases, local minimum temperature and accumulative precipitation to predict the dengue occurrence in four districts of Guangzhou, China. The time series data were decomposed into seasonal, trend and remainder components using a seasonal-trend decomposition procedure based on loess (STL). The time lag of climatic factors included in the model was chosen based on Spearman correlation analysis. Autocorrelation, seasonality and long-term trend were controlled in the model. A best model was selected and validated using Generalized Cross Validation (GCV) score and residual test. The data from March 2006 to December 2012 were used to develop the model while the data from January 2013 to September 2014 were employed to validate the model. Time series Poisson model showed that imported cases in the previous month, minimum temperature in the previous month and accumulative precipitation with three month lags could project the dengue outbreaks occurred in 2013 and 2014 after controlling the autocorrelation, seasonality and long-term trend. Conclusions Together with the sole transmission vector Aedes albopictus, imported cases, monthly minimum temperature and monthly accumulative precipitation may be used to develop a low-cost effective early warning system. PMID:26020627

  12. Public Health Responses to a Dengue Outbreak in a Fragile State: A Case Study of Nepal

    PubMed Central

    Griffiths, Karolina; Banjara, Megha Raj; O'Dempsey, T.; Munslow, B.; Kroeger, Axel

    2013-01-01

    Objectives. The number of countries reporting dengue cases is increasing worldwide. Nepal saw its first dengue outbreak in 2010, with 96% of cases reported in three districts. There are numerous policy challenges to providing an effective public health response system in a fragile state. This paper evaluates the dengue case notification, surveillance, laboratory facilities, intersectoral collaboration, and how government and community services responded to the outbreak. Methods. Qualitative data were collected through 20 in-depth interviews, with key stakeholders, and two focus-group discussions, with seven participants. Results. Limitations of case recognition included weak diagnostic facilities and private hospitals not incorporated into the case reporting system. Research on vectors was weak, with no virological surveillance. Limitations of outbreak response included poor coordination and an inadequate budget. There was good community mobilization and emergency response but no routine vector control. Conclusions. A weak state has limited response capabilities. Disease surveillance and response plans need to be country-specific and consider state response capacity and the level of endemicity. Two feasible solutions for Nepal are (1) go upwards to regional collaboration for disease and vector surveillance, laboratory assistance, and staff training; (2) go downwards to expand upon community mobilisation, ensuring that vector control is anticipatory to outbreaks. PMID:23690789

  13. Evaluation of Non-Structural Protein-1(NS1) positive patients of 2013 dengue outbreak in Khyber Pakhtunkhwa, Pakistan

    PubMed Central

    Lutfullah, Ghosia; Ahmed, Jawad; Khan, Aftab; Ihsan, Hina; Ahmad, Jamshed

    2017-01-01

    Background & Objective: Dengue infection is an arthropod borne disease caused by Dengue virus in humans. Dengue virus infection has more potential to produce severe form of the disease with more severe symptoms. Proper diagnosis of dengue fever is very important for its safe management. The objective of this study was to evaluate the non structural protein-1 (NS1) positive parameter for identification of dengue fever by using ELISA from 2013 dengue outbreak in Khyber Pakhtunkhwa. Methods: It was a cross sectional study conducted among 384 patients tested for dengue admitted to different hospitals of Khyber Pakhtunkhwa April to December 2013 with symptoms related to classical dengue fever. Written informed consent was taken from 100 NS1 positive diagnosed patients, and 3 to 5 ml blood sample was collected for confirmation through ELISA testing. ELISA test for dengue IgG and IgM was performed two time in order to confirm the dengue cases. Data was entered and analyzed by using SPSS version 16. Result: The study performed on 100 NS1 positive samples of patients, admitted to hospitals with symptoms related to classical dengue fever, indicated that after performing the IgM and IgG capture ELISA test only 76 samples were actually found positive for dengue. The rest of the 24 samples were found negative for both IgM and IgG capture ELISAs. The study also revealed that 90.8 % patients had primary dengue infection and 35.5% patients had secondary dengue infection. Most patients were between the age of 10-20 years (26%), among them19.7% were having primary dengue infection. Among 10-20 years of age 50% female patients were false dengue patients. Conclusion: About 24 % NSI protein positive samples were found negative for both IgM and IgG capture ELISAs showed that NS1protein positivity does not confirm actual dengue infection. PMID:28367194

  14. Outbreak of viral hemorrhagic fever caused by dengue virus type 3 in Al-Mukalla, Yemen

    PubMed Central

    2013-01-01

    Background Investigations were conducted by the authors to explore an outbreak of viral hemorrhagic fever (VHF) reported in 2010 from Al-Mukalla city, the capital of Hadramout in Yemen. Methods From 15–17 June 2010, the outbreak investigation period, specimens were obtained within 7 days after onset of illness of 18 acutely ill patients hospitalized with VHF and 15 household asymptomatic contacts of 6 acute cases. Additionally, 189 stored sera taken from acutely ill patients with suspected VHF hospitalized in the preceding 12 months were obtained from the Ministry of Health of Yemen. Thus, a total of 222 human specimens were collected; 207 specimens from acute cases and 15 specimens from contacts. All samples were tested with RT-PCR for dengue (DENV), Alkhumra (ALKV), Rift Valley Fever (RVFV), Yellow Fever (YFV), and Chikungunya (CHIKV) viruses. Samples were also tested for DENV IgM, IgG, and NS1-antigen. Medical records of patients were reviewed and demographic, clinical, and laboratory data was collected. Results Of 207 patients tested, 181 (87.4%) patients were confirmed to have acute dengue with positive dengue NS1-antigen (97 patients, 46.9%) and/or IgM (163 patients, 78.7%). Of the 181 patients with confirmed dengue, 100 (55.2%) patients were IgG-positive. DENV RNA was detected in 2 (1%) patients with acute symptoms; both samples were molecularly typed as DENV type 3. No other VHF viruses were detected. For the 15 contacts tested, RT-PCR tests for the five viruses were negative, one contact was dengue IgM positive, and another one was dengue IgG positive. Of the 181 confirmed dengue patients, 120 (66.3%) patients were males and the median age was 24 years. The most common manifestations included fever (100%), headache (94.5%), backache (93.4%), malaise (88.4%), arthralgia (85.1%), myalgia (82.3%), bone pain (77.9%), and leukopenia (76.2%). Two (1.1%) patients died. Conclusions DENV-3 was confirmed to be the cause of an outbreak of VHF in Al

  15. 2013 dengue outbreaks in Singapore and Malaysia caused by different viral strains.

    PubMed

    Ng, Lee-Ching; Chem, Yu-Kie; Koo, Carmen; Mudin, Rose Nani Binti; Amin, Faridah Mohd; Lee, Kim-Sung; Kheong, Chong Chee

    2015-06-01

    Characterization of 14,079 circulating dengue viruses in a cross-border surveillance program, UNITEDengue, revealed that the 2013 outbreaks in Singapore and Malaysia were associated with replacement of predominant serotype. While the predominant virus in Singapore switched from DENV2 to DENV1, DENV2 became predominant in neighboring Malaysia. Dominance of DENV2 was most evident on the southern states where higher fatality rates were observed.

  16. 2013 Dengue Outbreaks in Singapore and Malaysia Caused by Different Viral Strains

    PubMed Central

    Ng, Lee-Ching; Chem, Yu-kie; Koo, Carmen; Mudin, Rose Nani Binti; Amin, Faridah Mohd; Lee, Kim-Sung; Kheong, Chong Chee

    2015-01-01

    Characterization of 14,079 circulating dengue viruses in a cross-border surveillance program, UNITEDengue, revealed that the 2013 outbreaks in Singapore and Malaysia were associated with replacement of predominant serotype. While the predominant virus in Singapore switched from DENV2 to DENV1, DENV2 became predominant in neighboring Malaysia. Dominance of DENV2 was most evident on the southern states where higher fatality rates were observed. PMID:25846296

  17. Minimizing Spatial Variability of Healthcare Spatial Accessibility—The Case of a Dengue Fever Outbreak

    PubMed Central

    Chu, Hone-Jay; Lin, Bo-Cheng; Yu, Ming-Run; Chan, Ta-Chien

    2016-01-01

    Outbreaks of infectious diseases or multi-casualty incidents have the potential to generate a large number of patients. It is a challenge for the healthcare system when demand for care suddenly surges. Traditionally, valuation of heath care spatial accessibility was based on static supply and demand information. In this study, we proposed an optimal model with the three-step floating catchment area (3SFCA) to account for the supply to minimize variability in spatial accessibility. We used empirical dengue fever outbreak data in Tainan City, Taiwan in 2015 to demonstrate the dynamic change in spatial accessibility based on the epidemic trend. The x and y coordinates of dengue-infected patients with precision loss were provided publicly by the Tainan City government, and were used as our model’s demand. The spatial accessibility of heath care during the dengue outbreak from August to October 2015 was analyzed spatially and temporally by producing accessibility maps, and conducting capacity change analysis. This study also utilized the particle swarm optimization (PSO) model to decrease the spatial variation in accessibility and shortage areas of healthcare resources as the epidemic went on. The proposed method in this study can help decision makers reallocate healthcare resources spatially when the ratios of demand and supply surge too quickly and form clusters in some locations. PMID:27983611

  18. Autochthonous dengue outbreak in Nîmes, South of France, July to September 2015.

    PubMed

    Succo, Tiphanie; Leparc-Goffart, Isabelle; Ferré, Jean-Baptiste; Roiz, David; Broche, Béatrice; Maquart, Marianne; Noel, Harold; Catelinois, Olivier; Entezam, Farhad; Caire, Didier; Jourdain, Frédéric; Esteve-Moussion, Isabelle; Cochet, Amandine; Paupy, Christophe; Rousseau, Cyril; Paty, Marie-Claire; Golliot, Franck

    2016-05-26

    In August and September 2015, seven locally acquired cases of dengue virus type 1 (DENV-1) were detected in Nîmes, south of France, where Aedes albopictus has been established since 2011. Epidemiological and entomological investigations allowed to steer vector control measures to contain transmission. An imported case from French Polynesia with onset fever on 4 July was identified as primary case. This outbreak occurred from 8 August to 11 September in a 300 m radius area. Six sprayings to control mosquitos were performed in the affected area. We describe the first considerable dengue outbreak in mainland France where only sporadic cases of autochthonous dengue were recorded previously (2010, 2013 and 2014). The 69 day-period between the primary case and the last autochthonous case suggests multiple episodes of mosquito infections. The absence of notification of autochthonous cases during the month following the primary case's symptoms onset could be explained by the occurrence of inapparent illness. Recurrence of cases every year since 2013, the size of the 2015 outbreak and continuing expansion of areas with presence of Ae. albopictus highlight the threat of arboviral diseases in parts of Europe. Thus, European guidelines should be assessed and adjusted to the current context.

  19. Intra- and interseasonal autoregressive prediction of dengue outbreaks using local weather and regional climate for a tropical environment in Colombia.

    PubMed

    Eastin, Matthew D; Delmelle, Eric; Casas, Irene; Wexler, Joshua; Self, Cameron

    2014-09-01

    Dengue fever transmission results from complex interactions between the virus, human hosts, and mosquito vectors-all of which are influenced by environmental factors. Predictive models of dengue incidence rate, based on local weather and regional climate parameters, could benefit disease mitigation efforts. Time series of epidemiological and meteorological data for the urban environment of Cali, Colombia are analyzed from January of 2000 to December of 2011. Significant dengue outbreaks generally occur during warm-dry periods with extreme daily temperatures confined between 18°C and 32°C--the optimal range for mosquito survival and viral transmission. Two environment-based, multivariate, autoregressive forecast models are developed that allow dengue outbreaks to be anticipated from 2 weeks to 6 months in advance. These models have the potential to enhance existing dengue early warning systems, ultimately supporting public health decisions on the timing and scale of vector control efforts.

  20. Molecular detection of Mayaro virus during a dengue outbreak in the state of Mato Grosso, Central-West Brazil.

    PubMed

    Zuchi, Nayara; Heinen, Letícia Borges da Silva; Santos, Marcelo Adriano Mendes dos; Pereira, Fernanda Carla; Slhessarenko, Renata Dezengrini

    2014-09-01

    Mayaro virus (MAYV) is frequently reported in Pan-Amazonia. The aim of this study was to investigate the circulation of alphaviruses during a dengue outbreak in the state of Mato Grosso, Brazil. Serum samples from dengue-suspected patients were subjected to multiplex semi-nested reverse transcriptase polymerase chain reaction for 11 flaviviruses and five alphaviruses, to nucleotide sequencing and to viral isolation. MAYV was detected in 15 (2.5%) of 604 patients. Twelve were co-infected with dengue virus 4, which was isolated from 10 patients. The molecular detection of MAYV in dengue-suspected patients suggests that other arboviruses may be silently circulating during dengue outbreaks in Brazil.

  1. Molecular detection of Mayaro virus during a dengue outbreak in the state of Mato Grosso, Central-West Brazil

    PubMed Central

    Zuchi, Nayara; Heinen, Letícia Borges da Silva; dos Santos, Marcelo Adriano Mendes; Pereira, Fernanda Carla; Slhessarenko, Renata Dezengrini

    2014-01-01

    Mayaro virus (MAYV) is frequently reported in Pan-Amazonia. The aim of this study was to investigate the circulation of alphaviruses during a dengue outbreak in the state of Mato Grosso, Brazil. Serum samples from dengue-suspected patients were subjected to multiplex semi-nested reverse transcriptase polymerase chain reaction for 11 flaviviruses and five alphaviruses, to nucleotide sequencing and to viral isolation. MAYV was detected in 15 (2.5%) of 604 patients. Twelve were co-infected with dengue virus 4, which was isolated from 10 patients. The molecular detection of MAYV in dengue-suspected patients suggests that other arboviruses may be silently circulating during dengue outbreaks in Brazil. PMID:25141284

  2. Intra- and Interseasonal Autoregressive Prediction of Dengue Outbreaks Using Local Weather and Regional Climate for a Tropical Environment in Colombia

    PubMed Central

    Eastin, Matthew D.; Delmelle, Eric; Casas, Irene; Wexler, Joshua; Self, Cameron

    2014-01-01

    Dengue fever transmission results from complex interactions between the virus, human hosts, and mosquito vectors—all of which are influenced by environmental factors. Predictive models of dengue incidence rate, based on local weather and regional climate parameters, could benefit disease mitigation efforts. Time series of epidemiological and meteorological data for the urban environment of Cali, Colombia are analyzed from January of 2000 to December of 2011. Significant dengue outbreaks generally occur during warm-dry periods with extreme daily temperatures confined between 18°C and 32°C—the optimal range for mosquito survival and viral transmission. Two environment-based, multivariate, autoregressive forecast models are developed that allow dengue outbreaks to be anticipated from 2 weeks to 6 months in advance. These models have the potential to enhance existing dengue early warning systems, ultimately supporting public health decisions on the timing and scale of vector control efforts. PMID:24957546

  3. Dengue and Severe Dengue

    MedlinePlus

    ... can significantly reduce mortality rates from severe dengue. Global Strategy for dengue prevention and control, 2012–2020, Chapter ... vaccine: WHO position paper – July 2016 pdf, 437kb Global Strategy for dengue prevention and control, 2012–2020 Global ...

  4. Sharing experiences: towards an evidence based model of dengue surveillance and outbreak response in Latin America and Asia

    PubMed Central

    2013-01-01

    Background The increasing frequency and intensity of dengue outbreaks in endemic and non-endemic countries requires a rational, evidence based response. To this end, we aimed to collate the experiences of a number of affected countries, identify strengths and limitations in dengue surveillance, outbreak preparedness, detection and response and contribute towards the development of a model contingency plan adaptable to country needs. Methods The study was undertaken in five Latin American (Brazil, Colombia, Dominican Republic, Mexico, Peru) and five in Asian countries (Indonesia, Malaysia, Maldives, Sri Lanka, Vietnam). A mixed-methods approach was used which included document analysis, key informant interviews, focus-group discussions, secondary data analysis and consensus building by an international dengue expert meeting organised by the World Health Organization, Special Program for Research and Training in Tropical Diseases (WHO-TDR). Results Country information on dengue is based on compulsory notification and reporting (“passive surveillance”), with laboratory confirmation (in all participating Latin American countries and some Asian countries) or by using a clinical syndromic definition. Seven countries additionally had sentinel sites with active dengue reporting, some also had virological surveillance. Six had agreed a formal definition of a dengue outbreak separate to seasonal variation in case numbers. Countries collected data on a range of warning signs that may identify outbreaks early, but none had developed a systematic approach to identifying and responding to the early stages of an outbreak. Outbreak response plans varied in quality, particularly regarding the early response. The surge capacity of hospitals with recent dengue outbreaks varied; those that could mobilise additional staff, beds, laboratory support and resources coped best in comparison to those improvising a coping strategy during the outbreak. Hospital outbreak management plans

  5. Advances in the understanding, management, and prevention of dengue.

    PubMed

    Hermann, Laura L; Gupta, Swati B; Manoff, Susan B; Kalayanarooj, Siripen; Gibbons, Robert V; Coller, Beth-Ann G

    2015-03-01

    Dengue causes more human morbidity globally than any other vector-borne viral disease. Recent research has led to improved epidemiological methods that predict disease burden and factors involved in transmission, a better understanding of immune responses in infection, and enhanced animal models. In addition, a number of control measures, including preventative vaccines, are in clinical trials. However, significant gaps remain, including the need for better surveillance in large parts of the world, methods to predict which individuals will develop severe disease, and immunologic correlates of protection against dengue illness. During the next decade, dengue will likely expand its geographic reach and become an increasing burden on health resources in affected areas. Licensed vaccines and antiviral agents are needed in order to effectively control dengue and limit disease.

  6. Preventive transfusion in Dengue shock syndrome-is it necessary?

    PubMed

    Lum, Lucy Chai See; Abdel-Latif, Mohammad El-Amin; Goh, Adrian Yu Teik; Chan, Patrick Wai Keong; Lam, Sai Kit

    2003-11-01

    We compared 53 patients with Dengue shock syndrome (DSS) who received preventive transfusions with 53 who did not. Significant differences in the development of pulmonary edema and length of hospitalization (P<.05) and none in hemorrhage (P=.136) were observed. Preventive transfusions did not produce sustained improvements in the coagulation status in DSS.

  7. Prevention and control of influenza and dengue through vaccine development.

    PubMed

    Greenberg, David P; Robertson, Corwin A; Gordon, Daniel M

    2013-08-01

    Influenza and dengue are viral illnesses of global public health importance, especially among children. Accordingly, these diseases have been the focus of efforts to improve their prevention and control. Influenza vaccination offers the best protection against clinical disease caused by strains contained within the specific year's formulation. It is not uncommon for there to be a mismatch between vaccine strains and circulating strains, particularly with regards to the B lineages. For more than a decade, two distinct lineages of influenza B (Yamagata and Victoria) have co-circulated in the US with varying frequencies, but trivalent influenza vaccines contain only one B-lineage strain and do not offer adequate protection against the alternate B-lineage. Quadrivalent influenza vaccines (QIVs), containing two A strains (H1N1 and H3N2) and two B strains (one from each lineage) have been developed to help protect against the four strains predicted to be the most likely to be circulating. The QIV section of this article discusses epidemiology of pediatric influenza, importance of influenza B in children, potential benefits of QIV, and new quadrivalent vaccines. In contrast to influenza, a vaccine against dengue is not yet available in spite of many decades of research and development. A global increase in reports of dengue fever (DF) and its more severe presentations, dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS), suggest that US physicians will increasingly encounter patients with this disease. Similarities of the early signs and symptoms of influenza and dengue and the differences in disease management necessitates a better understanding of the epidemiology, clinical presentation, management, and prevention of DF by US physicians, including pediatricians. The article also provides a brief overview of dengue and discusses dengue vaccine development.

  8. [Study of epidemiological characteristics and viral sources of dengue fever outbreak in Guangxi Zhuang Autonomous Region, 2014].

    PubMed

    Chen, M M; Tan, Y; Tang, Z Z; Lin, M; Zhou, K J; He, W T; Yang, Y P; Wang, J

    2016-10-10

    Objective: To understand the epidemiological characteristics and viral sources of dengue fever outbreak in Guangxi Zhuang Autonomous Region (Guangxi) in 2014. Methods: A combined analysis of epidemiological characteristics and genetic characteristics were performed in this study. The time, population and area distributions of the cases were analyzed. Serum samples were collected from dengue fever cases to detect NS1 antigen by using commercial ELISA kits according to the guideline of the manufacture. RT-PCR assay was conducted to detect dengue virus in NS1 positive samples. Phylogenetic tree based on E gene sequence of dengue virus were further analyzed. Results: During September-December 2014, an outbreak of dengue fever caused by dengue virus type 1 and 2 occurred in Guangxi, a total of 854 cases were reported without death, including 712 laboratory confirmed cases and 142 clinical diagnosed cases, in which 79.63% (680/854) occurred during 22 September-21 October 2014. All the cases had typical dengue fever symptoms. Most cases occurred in Nanning and Wuzhou, in which 83.61% (714/854) were in age group 15-59 years; 46.60% (398/854) were staff or people engaged in commercial service. A total 526 serum samples were tested for dengue virus serotype by RT-PCR assay. Among 414 positive samples, 345 were positive for dengue virus type 1 (DENV-1) and 69 were positive for dengue virus type 2 (DENV-2), no DENV-3 and DENV-4 were detected. The results of phylogenetic analysis of E gene sequence indicated that the sequences of 99.12%(113/114) of DENV-1 strains in Nanning in China shared 100.00% homology with the isolate (SG EHI D1/529Y13) from Singapore in 2013, which belonged to the genotype Ⅰ; All the DENV-2 isolates from Wuzhou shared 99.80% homology with the isolate (D14005) from Guangdong province, which belonged to genotype Cosmopolitan. Conclusions: The outbreak was caused by DENV-1 from Singapore and DENV-2 from Guangdong province in China. It is necessary to

  9. Diagnosis of Chikungunya dominated co-infection with dengue during an outbreak in south India (2010 and 2012).

    PubMed

    Venkatasubramani, K; Paramasivan, R; Thenmozhi, V; Dhananjeyan, K J; Balaji, T; Leo, S Victor Jerald

    2015-07-01

    Following a report of dengue outbreak from January 2010 to 2012 in the Tirunelveli, Theni, Dharmapuri and Thiruvallur districts of Tamil Nadu state, India, an investigation was carried out. The study was to demonstrate the probable presence of Chikungunya viral antibodies in patients clinically suspected of dengue fever. Out of 331 samples analysed, dengue viral antibodies were observed in 14.8% (n = 49) of patients, while 16.6% (n = 55) were positive for Chikungunya viral specific IgM antibodies. In the four districts surveyed, patients found positive for Chikungunya were found to be higher than dengue. The clinician should consider Chikungunya in the differential diagnosis of dengue-like infection appearing in the community.

  10. Clostridium difficile outbreaks: prevention and treatment strategies

    PubMed Central

    Martinez, Fernando J; Leffler, Daniel A; Kelly, Ciaran P

    2012-01-01

    The incidence and severity of Clostridium difficile infection (CDI) have increased dramatically over the past decade. Its treatment, however, has largely remained the same with the exception of oral vancomycin use as a first-line agent in severe disease. From 1999 to 2004, 20,642 deaths were attributed to CDI in the United States, almost 7 times the rate of all other intestinal infections combined. Worldwide, several major CDI outbreaks have occurred, and many of these were associated with the NAP1 strain. This ‘epidemic’ strain has contributed to the rising incidence and mortality of CDI. The purpose of this article is to review the current management, treatment, infection control, and prevention strategies that are needed to combat this increasingly morbid disease. PMID:22826646

  11. A critical assessment of vector control for dengue prevention.

    PubMed

    Achee, Nicole L; Gould, Fred; Perkins, T Alex; Reiner, Robert C; Morrison, Amy C; Ritchie, Scott A; Gubler, Duane J; Teyssou, Remy; Scott, Thomas W

    2015-05-01

    Recently, the Vaccines to Vaccinate (v2V) initiative was reconfigured into the Partnership for Dengue Control (PDC), a multi-sponsored and independent initiative. This redirection is consistent with the growing consensus among the dengue-prevention community that no single intervention will be sufficient to control dengue disease. The PDC's expectation is that when an effective dengue virus (DENV) vaccine is commercially available, the public health community will continue to rely on vector control because the two strategies complement and enhance one another. Although the concept of integrated intervention for dengue prevention is gaining increasingly broader acceptance, to date, no consensus has been reached regarding the details of how and what combination of approaches can be most effectively implemented to manage disease. To fill that gap, the PDC proposed a three step process: (1) a critical assessment of current vector control tools and those under development, (2) outlining a research agenda for determining, in a definitive way, what existing tools work best, and (3) determining how to combine the best vector control options, which have systematically been defined in this process, with DENV vaccines. To address the first step, the PDC convened a meeting of international experts during November 2013 in Washington, DC, to critically assess existing vector control interventions and tools under development. This report summarizes those deliberations.

  12. A Critical Assessment of Vector Control for Dengue Prevention

    PubMed Central

    Achee, Nicole L.; Gould, Fred; Perkins, T. Alex; Reiner, Robert C.; Morrison, Amy C.; Ritchie, Scott A.; Gubler, Duane J.; Teyssou, Remy; Scott, Thomas W.

    2015-01-01

    Recently, the Vaccines to Vaccinate (v2V) initiative was reconfigured into the Partnership for Dengue Control (PDC), a multi-sponsored and independent initiative. This redirection is consistent with the growing consensus among the dengue-prevention community that no single intervention will be sufficient to control dengue disease. The PDC's expectation is that when an effective dengue virus (DENV) vaccine is commercially available, the public health community will continue to rely on vector control because the two strategies complement and enhance one another. Although the concept of integrated intervention for dengue prevention is gaining increasingly broader acceptance, to date, no consensus has been reached regarding the details of how and what combination of approaches can be most effectively implemented to manage disease. To fill that gap, the PDC proposed a three step process: (1) a critical assessment of current vector control tools and those under development, (2) outlining a research agenda for determining, in a definitive way, what existing tools work best, and (3) determining how to combine the best vector control options, which have systematically been defined in this process, with DENV vaccines. To address the first step, the PDC convened a meeting of international experts during November 2013 in Washington, DC, to critically assess existing vector control interventions and tools under development. This report summarizes those deliberations. PMID:25951103

  13. Dengue in the Americas: challenges for prevention and control.

    PubMed

    Gómez-Dantés, Héctor; Willoquet, Janine Ramsey

    2009-01-01

    Dengue is the most important vector-borne disease in the Americas and threatens the lifes of millions of people in developing countries. Imprecise morbidity and mortality statistics underestimate the magnitude of dengue as a regional health problem. As a result, it is considered a low priority by the health sector with no timely steps for effective control. Dengue is perceived as a problem of 'others' (individually, collectively and institutionally), therefore responsibility for its control is passed on to others (neighbors, the community, municipality, health institutions, or other governmental agencies). With no precise risk indicators available there is little opportunity for timely diagnoses, treatment, health interventions or vector control (poor surveillance). Solutions only targeting the vector reduce the impact of interventions and there is no sustainable control. Without political commitment there are insufficient resources to face the problem. This paper discusses the challenges for prevention and control in the Americas.

  14. Factors Affecting Dengue Prevention Practices: Nationwide Survey of the Malaysian Public

    PubMed Central

    Wong, Li Ping; Shakir, Sharina Mahavera Mohamad; Atefi, Narges; AbuBakar, Sazaly

    2015-01-01

    Background Efforts to stamp dengue in many dengue endemic countries has met little success. There is a need to re-examine and understand how the public at large view the dengue prevention efforts. This study aimed to examine the demographic factors, theoretical constructs of the Health Belief Model and knowledge about dengue and how these influence the practice of dengue prevention. Methods A national telephone survey was carried out with 2,512 individuals of the Malaysian public aged 18–60 years. Results The majority (73%) of the Malaysian public had a total dengue prevention score of 51–100 (of a possible score of 1–100). Multivariate analysis suggests significant correlates of higher dengue prevention practices with demographic background, perception of susceptibility to dengue, perceived density of mosquitoes in the neighbourhood and knowledge about dengue. Households of lower income of which the majority (40.7%) were from the rural areas, were associated with the highest odds [OR = 1.33; 95%CI = 1.09–1.67; p = 0.004] of dengue prevention. Dengue prevention practices were also less likely to be undertaken in neighbourhoods where the responders perceived there is no and/or low density of mosquitoes. Dengue prevention practices are also less likely to be practiced by skilled workers [OR = 0.78; 95%CI = 0.63–0.95; p = 0.029] compared to those unemployed. Higher perceived susceptibility to dengue was associated with higher dengue prevention practices and participants with higher dengue knowledge were found to have a higher level of involvement in dengue prevention practices. Conclusion Results from the study suggest that in formulating approaches to contain dengue, strategies should be developed to cultivate dengue prevention practices among urban population and target areas with low density of mosquitoes where public perceived a less likely chance of getting dengue. Dengue prevention campaigns should focus on messages highlighting the risk of contracting

  15. Climate variation drives dengue dynamics

    PubMed Central

    Xu, Lei; Stige, Leif C.; Chan, Kung-Sik; Zhou, Jie; Yang, Jun; Sang, Shaowei; Wang, Ming; Yang, Zhicong; Yan, Ziqiang; Jiang, Tong; Lu, Liang; Yue, Yujuan; Liu, Xiaobo; Lin, Hualiang; Xu, Jianguo; Liu, Qiyong; Stenseth, Nils Chr.

    2017-01-01

    Dengue, a viral infection transmitted between people by mosquitoes, is one of the most rapidly spreading diseases in the world. Here, we report the analyses covering 11 y (2005–2015) from the city of Guangzhou in southern China. Using the first 8 y of data to develop an ecologically based model for the dengue system, we reliably predict the following 3 y of dengue dynamics—years with exceptionally extensive dengue outbreaks. We demonstrate that climate conditions, through the effects of rainfall and temperature on mosquito abundance and dengue transmission rate, play key roles in explaining the temporal dynamics of dengue incidence in the human population. Our study thus contributes to a better understanding of dengue dynamics and provides a predictive tool for preventive dengue reduction strategies. PMID:27940911

  16. [Integrated prevention and control strategy for dengue in Mesoamerica].

    PubMed

    Gómez-Dantés, Héctor; San Martín, José Luis; Danis-Lozano, Rogelio; Manrique-Saide, Pablo

    2011-01-01

    Dengue in the Americas is a public health problem in ascent. The control strategies have not been effective when sustained in the intensive use of insecticides and poor community participation. The Mesoamerican Initiative for the Prevention and the Integrated Control of Dengue synthesizes the works generated by the Integrated Strategy of the Pan-American Health Organization (PAHO) and the risks stratification strategy designed by the countries of the Mesoamerican region. The objective is to progressively reduce the incidence of dengue cases until a 50% reduction is reached over a five years period. This document describes the elements for the risk stratification, the activities for prevention and control organized by levels of intensity and frequency and the indicators used to pursuit the objectives. To face the dispersion of the problem a concentration of efforts for control in the areas of greater risk is presented; the opportunity in the detection of cases is highlighted to tackle the fast dissemination of the infection; focus on the most productive breeding sites is proposed to battle against the vast dissemination of the breeding sites; and the severity of the infection must be addressed by capable clinical human resources. This strategy was designed along with the national representatives of the control programs to create master plans that provided the basis for the integrated prevention and control of dengue in the Mesoamerican region.

  17. The Self-Regulation Model of Illness: Comparison between Zika and Dengue and Its Application to Predict Mosquito Prevention Behaviours in Malaysia, a Dengue-Endemic Country

    PubMed Central

    Wong, Li Ping; Alias, Haridah; Aghamohammadi, Nasrin; Sam, I-Ching; AbuBakar, Sazaly

    2016-01-01

    Perceptions about illnesses may influence self-care and preventive health behaviours. Illness perceptions of the Zika virus (ZIKV) infection were investigated under the framework of the Self-Regulation Model of Illness. Illness perception differences between ZIKV and dengue fever were also examined. Lastly, associations between illness perceptions of ZIKV with mosquito prevention practices were studied. Samples were drawn from landline telephone numbers using computer-assisted telephone interviewing in Malaysia. A total of 567 respondents completed the survey between February 2015 and May 2016. The median and interquartile range (IQR) for the total six dimensions of illness perceptions score was higher for dengue (23.0 (IQR 17.0–28.0)) than ZIKV (20.0 (IRQ 11.0–28.0)), p < 0.001. Respondents who planned to have children (OR 1.670, 95% CI 1.035–2.694 vs. no intention to have children) and had friends or acquaintances who died of dengue (OR 2.372, 95% CI 1.300–4.327 vs. no friends who died of dengue) were more likely to have a higher total score for six illness perceptions for ZIKV compared to dengue. Multivariate analysis indicated that the best predictors for mosquito control practices after the ZIKV outbreak was declared a Public Health Emergency of International Concern, in descending order, were causes, control, timeline, and consequences dimensions of illness perception. Understanding the context in which a person perceives ZIKV may contribute to developing interventions that influence prevention behaviours. PMID:27929451

  18. Clinical and Epidemiological Characterization of the First Recognized Outbreak of Dengue Virus-Type 2 in Mozambique, 2014

    PubMed Central

    Massangaie, Marilia; Pinto, Gabriela; Padama, Fernando; Chambe, Geraldo; da Silva, Mariana; Mate, Inocêncio; Chirindza, Celia; Ali, Sadia; Agostinho, Sãozinha; Chilaule, Daniel; Weyer, Jacqueline; le Roux, Chantel; Abilio, Ana Paula; Baltazar, Cynthia; Doyle, Timothy J.; Cliff, Julie; Paweska, Janusz; Gudo, Eduardo Samo

    2016-01-01

    Since the first reported epidemic of dengue in Pemba, the capital of Cabo Delgado province, in 1984–1985, no further cases have been reported in Mozambique. In March 2014, the Provincial Health Directorate of Cabo Delgado reported a suspected dengue outbreak in Pemba, associated with a recent increase in the frequency of patients with nonmalarial febrile illness. An investigation conducted between March and June detected a total of 193 clinically suspected dengue patients in Pemba and Nampula, the capital of neighboring Nampula Province. Dengue virus-type 2 (DENV-2) was detected by reverse transcriptase polymerase chain reaction in sera from three patients, and 97 others were classified as probable cases based on the presence of DENV nonstructural protein 1 antigen or anti-DENV immunoglobulin M antibody. Entomological investigations demonstrated the presence of Aedes aegypti mosquitos in both Pemba and Nampula cities. PMID:26643534

  19. Geo-database use to promote dengue infection prevention and control.

    PubMed

    Wongbutdee, Jaruwan; Chaikoolvatana, Anun; Saengnill, Wacharapong; Krasuaythong, Nantaya; Phuphak, Surajit

    2010-07-01

    Dengue infection (DI) is a major health problem in Thailand and is especially prevalent in Ubon Ratchathani Province. The objectives of the project were: (1) to develop a geo-database system for DI prevention and control, (2) to perform an Aedes aegypti larval vector survey for DI prevention and control in Ubon Ratchathani Province, (3) to study the behavior and perceptions regarding DI prevention among the target population in Ubon Ratchathani Province. Ten villages with high incidences of DI over a 3 year period from 2005 to 2007 were selected. The survey was divided into 2 periods, pre-outbreak period (February-April 2008) and outbreak period (June-August 2008). The data were collected in April and June 2008. The households in each village were purposively sampled. Water containers inside and outside of the houses were surveyed using the World Health Organization's house index (HI), container index (CI), and Breteau index (BI). The location of each household was recorded using the global positioning system (GPS). Data regarding people's perceptions and behaviors concerning DI prevention were collected during interviews of 383 families in Mach 2008. A database for DI was developed using ArcView version 9.2. The results showed during the pre-outbreak period, Non Jig, Non Sawang, and Huai Teeneu villages had the highest risk level (BI > or =50). During the outbreak period, Non Jig and Huai Teeneu village had the highest risk level (BI > or =50). Results regarding DI perceptions showed the target population had high levels of DI perceptions. DI preventive behavior was found in 50.9%.

  20. Undesirable Consequences of Insecticide Resistance following Aedes aegypti Control Activities Due to a Dengue Outbreak

    PubMed Central

    Maciel-de-Freitas, Rafael; Avendanho, Fernando Campos; Santos, Rosangela; Sylvestre, Gabriel; Araújo, Simone Costa; Lima, José Bento Pereira; Martins, Ademir Jesus; Coelho, Giovanini Evelim; Valle, Denise

    2014-01-01

    Background During a dengue outbreak with co-circulation of DENV-1 and -2 in the city of Boa Vista, one patient was diagnosed with DENV-4, a serotype supposed absent from Brazil for almost 30 years. The re-emergence of DENV-4 triggered the intensification of mechanical and chemical Aedes aegypti control activities in order to reduce vector density and avoid DENV-4 dissemination throughout the country. Methods/Principal Findings Vector control activities consisted of (a) source reduction, (b) application of diflubenzuron against larvae and (c) vehicle-mounted space spraying of 2% deltamethrin to eliminate adults. Control activity efficacy was monitored by comparing the infestation levels and the number of eggs collected in ovitraps before and after interventions, performed in 22 Boa Vista districts, covering an area of ∼80% of the city and encompassing 56,837 dwellings. A total of 94,325 containers were eliminated or treated with diflubenzuron. The most frequently positive containers were small miscellaneous receptacles, which corresponded to 59% of all positive breeding sites. Insecticide resistance to deltamethrin was assessed before, during and after interventions by dose-response bioassays adopting WHO-based protocols. The intense use of the pyrethroid increased fourfold the resistance ratio of the local Ae. aegypti population only six months after the beginning of vector control. Curiously, this trend was also observed in the districts in which no deltamethrin was applied by the public health services. On the other hand, changes in the resistance ratio to the organophosphate temephos seemed less influenced by insecticide in Boa Vista. Conclusions Despite the intense effort, mosquito infestation levels were only slightly reduced. Besides, the median number of eggs in ovitraps remained unaltered after control activity intensification. The great and rapid increase in pyrethroid resistance levels of natural Ae. aegypti populations is discussed in the context of

  1. [Dengue prevention and control: a review of studies on knowledge, beliefs, and practices].

    PubMed

    Claro, Lenita Barreto Lorena; Tomassini, Hugo Coelho Barbosa; Rosa, Maria Luiza Garcia

    2004-01-01

    This article aims to contribute to dengue control programs through a review of recent studies on knowledge, beliefs, and practices concerning dengue and dengue prevention. The results show that adequate knowledge of dengue and prevention methods are found in close association with high rates of domiciliary infestation by Aedes aegypti. This suggests that traditional education strategies, although efficient in transmitting information, have failed to change population behavior. Qualitative studies reveal two important issues that appear to explain these attitudes: representations of dengue and risks associated with mosquitoes and difficulties in avoiding infestation of household water recipients due to sanitation problems in communities.

  2. Dengue in a changing climate.

    PubMed

    Ebi, Kristie L; Nealon, Joshua

    2016-11-01

    Dengue is the world's most important arboviral disease in terms of number of people affected. Over the past 50 years, incidence increased 30-fold: there were approximately 390 million infections in 2010. Globalization, trade, travel, demographic trends, and warming temperatures are associated with the recent spread of the primary vectors Aedes aegypti and Aedes albopictus and of dengue. Overall, models project that new geographic areas along the fringe of current geographic ranges for Aedes will become environmentally suitable for the mosquito's lifecycle, and for dengue transmission. Many endemic countries where dengue is likely to spread further have underdeveloped health systems, increasing the substantial challenges of disease prevention and control. Control focuses on management of Aedes, although these efforts have typically had limited effectiveness in preventing outbreaks. New prevention and control efforts are needed to counter the potential consequences of climate change on the geographic range and incidence of dengue, including novel methods of vector control and dengue vaccines.

  3. Dengue severity associated with age and a new lineage of dengue virus-type 2 during an outbreak in Rio De Janeiro, Brazil.

    PubMed

    Nunes, Priscila Conrado Guerra; Sampaio, Simone Alves Faria; da Costa, Nieli Rodrigues; de Mendonça, Marcos Cesar Lima; Lima, Monique da Rocha Queiroz; Araujo, Saraiva Eliane M; dos Santos, Flávia Barreto; Simões, Jaqueline Basto Santos; Gonçalves, Bianca de Santis; Nogueira, Rita Maria Ribeiro; de Filippis, Ana Maria Bispo

    2016-07-01

    Dengue virus-type 2 (DENV-2) caused three outbreaks, in the years 1990, 1998, and 2008, in Rio de Janeiro, Brazil. The 2008 outbreak was the most severe in reported cases, hospitalizations, and deaths. To investigate virological and epidemiological factors that may have contributed to the pathogenic profile of 2008 epidemic, 102 patients sera obtained during the epidemic and inter-epidemic periods of three outbreaks were analysed by qRT-PCR to estimate viremia levels and their correlation with the clinical, immunological, and demographic patient characteristics. DENV-2 isolates from the outbreaks were sequenced. Two DENV-2 lineages (I and II) of the American/Asian genotype were confirmed, each exclusive for 1990-2002 and 2007-2011, respectively. The mean viremia level in the 2008 samples was two orders of magnitude higher than that of the 1990-2002 samples. Severe dengue cases increased from 31% in 1990-2002 to 69% in 2007-2011; in patients aged ≤15 years, from 3% in 1990-2002 to 37% in 2007-2011. The DENV-2 lineage II and younger age significantly contributed to the pathogenic profile of 2008 epidemic in Rio de Janeiro.

  4. Binational Dengue Outbreak Along the United States-Mexico Border - Yuma County, Arizona, and Sonora, Mexico, 2014.

    PubMed

    Jones, Jefferson M; Lopez, Benito; Adams, Laura; Gálvez, Francisco Javier Navarro; Núñez, Alfredo Sánchez; Santillán, Nubia Astrid Hernández; Plante, Lydia; Hemme, Ryan R; Casal, Mariana; Hunsperger, Elizabeth A; Muñoz-Jordan, Jorge; Acevedo, Veronica; Ernst, Kacey; Hayden, Mary; Waterman, Steve; Gomez, Diana; Sharp, Tyler M; Komatsu, Kenneth K

    2016-05-20

    Dengue is an acute febrile illness caused by any of four dengue virus types (DENV-1-4). DENVs are transmitted by mosquitos of the genus Aedes (1) and are endemic throughout the tropics (2). In 2010, an estimated 390 million DENV infections occurred worldwide (2). During 2007-2013, a total of three to 10 dengue cases were reported annually in Arizona and all were travel-associated. During September-December 2014, coincident with a dengue outbreak in Sonora, Mexico, 93 travel-associated dengue cases were reported in Arizona residents; 70 (75%) cases were among residents of Yuma County, which borders San Luis Río Colorado, Sonora, Mexico. San Luis Río Colorado reported its first case of locally acquired dengue in September 2014. To investigate the temporal relationship of the dengue outbreaks in Yuma County and San Luis Río Colorado and compare patient characteristics and signs and symptoms, passive surveillance data from both locations were analyzed. In addition, household-based cluster investigations were conducted near the residences of reported dengue cases in Yuma County to identify unreported cases and assess risk for local transmission. Surveillance data identified 52 locally acquired cases (21% hospitalized) in San Luis Río Colorado and 70 travel-associated cases (66% hospitalized) in Yuma County with illness onset during September-December 2014. Among 194 persons who participated in the cluster investigations in Yuma County, 152 (78%) traveled to Mexico at least monthly during the preceding 3 months. Four (2%) of 161 Yuma County residents who provided serum samples for diagnostic testing during cluster investigations had detectable DENV immunoglobulin M (IgM); one reported a recent febrile illness, and all four had traveled to Mexico during the preceding 3 months. Entomologic assessments among 105 households revealed 24 water containers per 100 houses colonized by Ae. aegypti. Frequent travel to Mexico and Ae. aegypti colonization indicate risk for local

  5. Practices of Dengue Fever Prevention and the Associated Factors among the Orang Asli in Peninsular Malaysia

    PubMed Central

    Chandren, Josephine Rebecca; Wong, Li Ping; AbuBakar, Sazaly

    2015-01-01

    Background Dengue is prevalent among Malaysia's indigenous peoples, known as the Orang Asli, and it poses a serious health threat to them. The study aims to look at the socio-demographic factors, health beliefs, and knowledge about dengue and its association to dengue prevention practices among Orang Asli communities in Peninsular Malaysia. Methods A cross-sectional survey was conducted in 16 randomly selected Orang Asli villages from eight states in Peninsular Malaysia from April 2012 until February 2013. Results A total of 560 Orang Asli were interviewed and 505 completed the survey. Slightly above half of the participants (n = 280, 55.4%) had a total dengue prevention score of 51–100 (of a possible score of 0–100). Multivariate analysis findings showed dengue knowledge, perceived barriers to perform dengue prevention, fogging frequency, and perceived susceptibility to dengue fever as significant factors associated to dengue prevention practices. Participants with a lower dengue knowledge score (score 0–18) were less likely (OR = 0.63, 95%CI = 0.44–0.92 vs. score 19–36, P = 0.015) to practice dengue prevention. Participants with low perceived barriers to prevent dengue (score of 1–5) were more likely (OR = 2.06, 95%CI = 1.21–3.53, vs. score of 6–10, P = 0.008) to practice dengue prevention. Villages that were not fogged (OR = 0.49, 95%CI = 0.24–0.99, P = 0.045) or rarely fogged (OR = 0.40, 95%CI = 0.22–0.75, P = 0.004) had lower dengue prevention practices than villages that were fogged often. Participants with low perceived susceptibility of acquiring dengue (score of 1–5) were less likely (OR = 0.54, 95%CI = 0.33–0.89 vs. score of 6–10, P = 0.018) to practice dengue prevention measures. Conclusion Findings imply that educational and health programmes should focus on enhancing dengue knowledge and perceived susceptibility of acquiring dengue and reducing perceived barriers to performing dengue prevention practices among the Orang Asli

  6. Spatio-temporal dynamics of dengue 2009 outbreak in Córdoba City, Argentina.

    PubMed

    Estallo, E L; Carbajo, A E; Grech, M G; Frías-Céspedes, M; López, L; Lanfri, M A; Ludueña-Almeida, F F; Almirón, W R

    2014-08-01

    During 2009 the biggest dengue epidemic to date occurred in Argentina, affecting almost half the country. We studied the spatio-temporal dynamics of the outbreak in the second most populated city of the country, Córdoba city. Confirmed cases and the results of an Aedes aegypti monitoring during the outbreak were geolocated. The imported cases began in January, and the autochthonous in March. Thirty-three percent of the 130 confirmed cases were imported, and occurred mainly at the center of the city. The autochthonous cases were more frequent in the outskirts, specially in the NE and SE. Aedes aegypti infestation showed no difference between neighborhoods with or without autochthonous cases, neither between neighborhoods with autochthonous vs. imported cases. The neighborhoods with imported cases presented higher population densities. The majority of autochthonous cases occurred at ages between 25 and 44 years old. Cases formed a spatio-temporal cluster of up to 20 days and 12km. According to a mathematical model that estimates the required number of days needed for transmission according to daily temperature, the number of cases begun to fall when more than 15.5 days were needed. This may be a coarse estimation of mean mosquito survival in the area, provided that the study area is close to the global distribution limit of the vector, and that cases prevalence was very low.

  7. Seroprevalence of antibodies against Chikungunya, Dengue, and Rift Valley fever viruses after febrile illness outbreak, Madagascar.

    PubMed

    Schwarz, Norbert G; Girmann, Mirko; Randriamampionona, Njary; Bialonski, Alexandra; Maus, Deborah; Krefis, Anne Caroline; Njarasoa, Christine; Rajanalison, Jeanne Fleury; Ramandrisoa, Herly Daniel; Randriarison, Maurice Lucien; May, Jürgen; Schmidt-Chanasit, Jonas; Rakotozandrindrainy, Raphael

    2012-11-01

    In October 2009, two-3 months after an outbreak of a febrile disease with joint pain on the eastern coast of Madagascar, we assessed serologic markers for chikungunya virus (CHIKV), dengue virus (DENV), and Rift Valley fever virus (RVFV) in 1,244 pregnant women at 6 locations. In 2 eastern coast towns, IgG seroprevalence against CHIKV was 45% and 23%; IgM seroprevalence was 28% and 5%. IgG seroprevalence against DENV was 17% and 11%. No anti-DENV IgM was detected. At 4 locations, 450-1,300 m high, IgG seroprevalence against CHIKV was 0%-3%, suggesting CHIKV had not spread to higher inland-altitudes. Four women had IgG against RVFV, probably antibodies from a 2008 epidemic. Most (78%) women from coastal locations with CHIKV-specific IgG reported joint pain and stiffness; 21% reported no symptoms. CHIKV infection was significantly associated with high bodyweight. The outbreak was an isolated CHIKV epidemic without relevant DENV co-transmission.

  8. Seroprevalence of Antibodies against Chikungunya, Dengue, and Rift Valley Fever Viruses after Febrile Illness Outbreak, Madagascar

    PubMed Central

    Girmann, Mirko; Randriamampionona, Njary; Bialonski, Alexandra; Maus, Deborah; Krefis, Anne Caroline; Njarasoa, Christine; Rajanalison, Jeanne Fleury; Ramandrisoa, Herly Daniel; Randriarison, Maurice Lucien; May, Jürgen; Schmidt-Chanasit, Jonas; Rakotozandrindrainy, Raphael

    2012-01-01

    In October 2009, two–3 months after an outbreak of a febrile disease with joint pain on the eastern coast of Madagascar, we assessed serologic markers for chikungunya virus (CHIKV), dengue virus (DENV), and Rift Valley fever virus (RVFV) in 1,244 pregnant women at 6 locations. In 2 eastern coast towns, IgG seroprevalence against CHIKV was 45% and 23%; IgM seroprevalence was 28% and 5%. IgG seroprevalence against DENV was 17% and 11%. No anti-DENV IgM was detected. At 4 locations, 450–1,300 m high, IgG seroprevalence against CHIKV was 0%–3%, suggesting CHIKV had not spread to higher inland-altitudes. Four women had IgG against RVFV, probably antibodies from a 2008 epidemic. Most (78%) women from coastal locations with CHIKV-specific IgG reported joint pain and stiffness; 21% reported no symptoms. CHIKV infection was significantly associated with high bodyweight. The outbreak was an isolated CHIKV epidemic without relevant DENV co-transmission. PMID:23092548

  9. The Basic Reproduction Number ℛ0 and Effectiveness of Reactive Interventions during Dengue Epidemics: The 2002 Dengue Outbreak in Easter Island, Chile

    PubMed Central

    Chowell, G.; Fuentes, R.; Olea, A.; Aguilera, X.; Nesse, H.; Hyman, J. M.

    2015-01-01

    We use a stochastic simulation model to explore the effect of reactive intervention strategies during the 2002 dengue outbreak in the small population of Easter Island, Chile. We quantified the effect of interventions on the transmission dynamics and epidemic size as a function of the simulated control intensity levels and the timing of initiation of control interventions. Because no dengue outbreaks had been reported prior to 2002 in Easter Island, the 2002 epidemic provided a unique opportunity to estimate the basic reproduction number ℛ0 during the initial epidemic phase, prior to the start of control interventions. We estimated ℛ0 at 27.2 (95%CI: 14.8, 49.3). We found that the final epidemic size is highly sensitive to the timing of start of interventions. However, even when the control interventions start several weeks after the epidemic onset, reactive intervention efforts can have a significant impact on the final epidemic size. Our results indicate that the rapid implementation of control interventions can have a significant effect in reducing the epidemic size of dengue epidemics. PMID:24245625

  10. The basic reproduction number R0 and effectiveness of reactive interventions during dengue epidemics: the 2002 dengue outbreak in Easter Island, Chile.

    PubMed

    Chowell, Gerardo; Fuentes, R; Olea, A; Aguilera, X; Nesse, H; Hyman, J M

    2013-01-01

    We use a stochastic simulation model to explore the effect of reactive intervention strategies during the 2002 dengue outbreak in the small population of Easter Island, Chile. We quantified the effect of interventions on the transmission dynamics and epidemic size as a function of the simulated control intensity levels and the timing of initiation of control interventions. Because no dengue outbreaks had been reported prior to 2002 in Easter Island, the 2002 epidemic provided a unique opportunity to estimate the basic reproduction number R0 during the initial epidemic phase, prior to the start of control interventions. We estimated R0 at 27.2 (95%CI: 14.8, 49.3). We found that the final epidemic size is highly sensitive to the timing of start of interventions. However, even when the control interventions start several weeks after the epidemic onset, reactive intervention efforts can have a significant impact on the final epidemic size. Our results indicate that the rapid implementation of control interventions can have a significant effect in reducing the epidemic size of dengue epidemics.

  11. First reported outbreak of classical dengue fever at 1,700 meters above sea level in Guerrero State, Mexico, June 1988.

    PubMed

    Herrera-Basto, E; Prevots, D R; Zarate, M L; Silva, J L; Sepulveda-Amor, J

    1992-06-01

    An outbreak of classical dengue fever occurred from March to August 1988 in the city of Taxco, Guerrero State, Mexico. Taxco is at an elevation of 1,700 meters above sea level, and this study represents the highest altitude at which an outbreak of dengue has been documented. An investigation was conducted to obtain serologic confirmation of dengue infection, determine the extent of the outbreak, and identify risk factors for dengue illness. Toxorhynchites cell lines were used for viral isolation, and hemagglutination inhibition was used to measure anti-dengue antibody titers. The case definition used in the investigation was any person with fever, headache, myalgias, and arthralgias, or rash or retroocular pain. Dengue virus type 1 was isolated from five acute cases. Of 1,686 persons living in the affected area, 42% (715) met the case definition. Large (200-liter) water containers were significantly associated with infection (relative risk = 1.7, 95% confidence interval 1.5-1.9). The effect of altitude on epidemic transmission is most likely modulated by seasonal temperatures. The epidemiologic and serologic confirmation of a dengue outbreak at 1,700 meters above sea level represents the capability of Aedes aegypti to adapt to new environments, and the potential for epidemic spread in cities at comparable altitudes or higher.

  12. Mumps outbreaks in vaccinated populations: are available mumps vaccines effective enough to prevent outbreaks?

    PubMed

    Dayan, Gustavo H; Rubin, Steven

    2008-12-01

    Increased reports of mumps in vaccinated populations prompted a review of the performance of mumps vaccines. The effectiveness of prior vaccination with 1 dose of vaccine ranged from 72.8% to 91% for the Jeryl Lynn strain, from 54.4% to 93% for the Urabe strain, and from 0% to 33% for the Rubini strain. Vaccine effectiveness after 2 doses of mumps vaccine was reported in 3 outbreaks and ranged from 91% to 94.6%. There was evidence of waning immunity, which is a likely factor in mumps outbreaks, aggravated by possible antigenic differences between the vaccine strain and outbreak strains. Inadequate vaccine coverage or use of the Rubini vaccine strain accounted for the majority of outbreaks reviewed; however, some outbreaks could not be prevented, despite high vaccination coverage with 2 doses of the Jeryl Lynn vaccine strain. Our findings indicate the need for more-effective mumps vaccines and/or for review of current vaccination policies to prevent future outbreaks.

  13. Identification of dengue type 2 virus in febrile travellers returning from Burkina Faso to France, related to an ongoing outbreak, October to November 2016

    PubMed Central

    Eldin, Carole; Gautret, Philippe; Nougairede, Antoine; Sentis, Mélanie; Ninove, Laetitia; Saidani, Nadia; Million, Matthieu; Brouqui, Philippe; Charrel, Remi; Parola, Philippe

    2016-01-01

    Dengue fever is rarely reported in travellers returning from Africa. We report two cases of dengue fever in travellers returning from Burkina Faso to France. One of them presented a severe dengue fever with ALT > 1,000 IU/L and pericarditis. Serotype 2 was identified. The cases reflect a large ongoing outbreak with over 1,000 reported cases between August and November in the capital city. Clinicians should consider dengue fever in malaria-negative febrile travellers returning from Africa. PMID:28006651

  14. Effect of Climatic Factors and Population Density on the Distribution of Dengue in Sri Lanka: A GIS Based Evaluation for Prediction of Outbreaks

    PubMed Central

    Sirisena, PDNN; Noordeen, Faseeha; Kurukulasuriya, Harithra; Romesh, Thanuja ALAR; Fernando, LakKumar

    2017-01-01

    Dengue is one of the major hurdles to the public health in Sri Lanka, causing high morbidity and mortality. The present study focuses on the use of geographical information systems (GIS) to map and evaluate the spatial and temporal distribution of dengue in Sri Lanka from 2009 to 2014 and to elucidate the association of climatic factors with dengue incidence. Epidemiological, population and meteorological data were collected from the Epidemiology Unit, Department of Census and Statistics and the Department of Meteorology of Sri Lanka. Data were analyzed using SPSS (Version 20, 2011) and R studio (2012) and the maps were generated using Arc GIS 10.2. The dengue incidence showed a significant positive correlation with rainfall (p<0.0001). No positive correlation was observed between dengue incidence and temperature (p = 0.107) or humidity (p = 0.084). Rainfall prior to 2 and 5 months and a rise in the temperature prior to 9 months positively correlated with dengue incidence as based on the auto-correlation values. A rise in humidity prior to 1 month had a mild positive correlation with dengue incidence. However, a rise in humidity prior to 9 months had a significant negative correlation with dengue incidence based on the auto-correlation values. Remote sensing and GIS technologies give near real time utility of climatic data together with the past dengue incidence for the prediction of dengue outbreaks. In that regard, GIS will be applicable in outbreak predictions including prompt identification of locations with dengue incidence and forecasting future risks and thus direct control measures to minimize major outbreaks. PMID:28068339

  15. Effect of Climatic Factors and Population Density on the Distribution of Dengue in Sri Lanka: A GIS Based Evaluation for Prediction of Outbreaks.

    PubMed

    Sirisena, Pdnn; Noordeen, Faseeha; Kurukulasuriya, Harithra; Romesh, Thanuja Alar; Fernando, LakKumar

    2017-01-01

    Dengue is one of the major hurdles to the public health in Sri Lanka, causing high morbidity and mortality. The present study focuses on the use of geographical information systems (GIS) to map and evaluate the spatial and temporal distribution of dengue in Sri Lanka from 2009 to 2014 and to elucidate the association of climatic factors with dengue incidence. Epidemiological, population and meteorological data were collected from the Epidemiology Unit, Department of Census and Statistics and the Department of Meteorology of Sri Lanka. Data were analyzed using SPSS (Version 20, 2011) and R studio (2012) and the maps were generated using Arc GIS 10.2. The dengue incidence showed a significant positive correlation with rainfall (p<0.0001). No positive correlation was observed between dengue incidence and temperature (p = 0.107) or humidity (p = 0.084). Rainfall prior to 2 and 5 months and a rise in the temperature prior to 9 months positively correlated with dengue incidence as based on the auto-correlation values. A rise in humidity prior to 1 month had a mild positive correlation with dengue incidence. However, a rise in humidity prior to 9 months had a significant negative correlation with dengue incidence based on the auto-correlation values. Remote sensing and GIS technologies give near real time utility of climatic data together with the past dengue incidence for the prediction of dengue outbreaks. In that regard, GIS will be applicable in outbreak predictions including prompt identification of locations with dengue incidence and forecasting future risks and thus direct control measures to minimize major outbreaks.

  16. Dengue Fever Treatment

    MedlinePlus

    ... linkedin Dengue Fever Treatment Dengue Fever Dengue Fever Biology and Transmission Prevention Diagnosis Treatment Featured Research NIAID- ... last reviewed on February 8, 2011 Dengue Fever Biology and Transmission Prevention Diagnosis Treatment Featured Research ^ Return ...

  17. Lineage II of Southeast Asian/American DENV-2 is associated with a severe dengue outbreak in the Peruvian Amazon.

    PubMed

    Williams, Maya; Mayer, Sandra V; Johnson, William L; Chen, Rubing; Volkova, Evgeniya; Vilcarromero, Stalin; Widen, Steven G; Wood, Thomas G; Suarez-Ognio, Luis; Long, Kanya C; Hanley, Kathryn A; Morrison, Amy C; Vasilakis, Nikos; Halsey, Eric S

    2014-09-01

    During 2010 and 2011, the Loreto region of Peru experienced a dengue outbreak of unprecedented magnitude and severity for the region. This outbreak coincided with the reappearance of dengue virus-2 (DENV-2) in Loreto after almost 8 years. Whole-genome sequence indicated that DENV-2 from the outbreak belonged to lineage II of the southeast Asian/American genotype and was most closely related to viruses circulating in Brazil during 2007 and 2008, whereas DENV-2 previously circulating in Loreto grouped with lineage I (DENV-2 strains circulating in South America since 1990). One amino acid substitution (NS5 A811V) in the 2010 and 2011 isolates resulted from positive selection. However, the 2010 and 2011 DENV-2 did not replicate to higher titers in monocyte-derived dendritic cells and did not infect or disseminate in a higher proportion of Aedes aegypti than DENV-2 isolates previously circulating in Loreto. These results suggest that factors other than enhanced viral replication played a role in the severity of this outbreak.

  18. Lineage II of Southeast Asian/American DENV-2 Is Associated with a Severe Dengue Outbreak in the Peruvian Amazon

    PubMed Central

    Williams, Maya; Mayer, Sandra V.; Johnson, William L.; Chen, Rubing; Volkova, Evgeniya; Vilcarromero, Stalin; Widen, Steven G.; Wood, Thomas G.; Suarez-Ognio, Luis; Long, Kanya C.; Hanley, Kathryn A.; Morrison, Amy C.; Vasilakis, Nikos; Halsey, Eric S.

    2014-01-01

    During 2010 and 2011, the Loreto region of Peru experienced a dengue outbreak of unprecedented magnitude and severity for the region. This outbreak coincided with the reappearance of dengue virus-2 (DENV-2) in Loreto after almost 8 years. Whole-genome sequence indicated that DENV-2 from the outbreak belonged to lineage II of the southeast Asian/American genotype and was most closely related to viruses circulating in Brazil during 2007 and 2008, whereas DENV-2 previously circulating in Loreto grouped with lineage I (DENV-2 strains circulating in South America since 1990). One amino acid substitution (NS5 A811V) in the 2010 and 2011 isolates resulted from positive selection. However, the 2010 and 2011 DENV-2 did not replicate to higher titers in monocyte-derived dendritic cells and did not infect or disseminate in a higher proportion of Aedes aegypti than DENV-2 isolates previously circulating in Loreto. These results suggest that factors other than enhanced viral replication played a role in the severity of this outbreak. PMID:25002298

  19. Dengue in Southeast Asia: epidemiological characteristics and strategic challenges in disease prevention.

    PubMed

    Ooi, Eng-Eong; Gubler, Duane J

    2009-01-01

    Dengue emerged as a public health burden in Southeast Asia during and following the Second World War and has become increasingly important, with progressively longer and more frequent cyclical epidemics of dengue fever/dengue hemorrhagic fever. Despite this trend, surveillance for this vector-borne viral disease remains largely passive in most Southeast Asian countries, without adequate laboratory support. We review here the factors that may have contributed to the changing epidemiology of dengue in Southeast Asia as well as challenges of disease prevention. We also discuss a regional approach to active dengue virus surveillance, focusing on urban areas where the viruses are maintained, which may be a solution to limited financial resources since most of the countries in the region have developing economies. A regional approach would also result in a greater likelihood of success in disease prevention since the large volume of human travel is a major factor contributing to the geographical spread of dengue viruses.

  20. Dengue

    MedlinePlus

    ... Epidemiology Transmission, information on epidemics and stats... Entomology & Ecology Mosquito that spreads dengue and its ecology... Clinical & Laboratory Guidance Tools for clinicians and laboratorians... ...

  1. Serotype and genotype analysis of dengue virus by sequencing followed by phylogenetic analysis using samples from three mini outbreaks-2007-2009 in Pakistan

    PubMed Central

    2011-01-01

    Background Since the first reported outbreak of dengue hemorrhagic fever in Pakistan, several mini outbreaks have erupted in the region. Dengue virus serotype 3 (DEN-3) was first documented in 2005 outbreak in Karachi. Reports show that serotype 3 is prevalent in Lahore since 2008. Serotype 2 (DEN-2) is the major circulating serotype in Pakistan as it is documented since 1994. We have conducted a detailed study of three outbreaks of dengue virus infection that occurred in years 2007, 2008 and 2009 in Lahore by using molecular techniques such as PCR and nucleotide sequencing of the C-prM gene junction of Dengue virus. Results Through the analysis of 114 serum samples collected over the period of three years (2007-2009), total 20 patients were found to be infected with dengue virus. In year 2007, four were positive for serotype 2 and one sample was positive for serotype DEN-3. In 2008, five samples had concurrent infection with serotypes DEN-2 and DEN-3 while three samples were infected only with serotype DEN-2. In year 2009, one sample had concurrent infection with serotypes DEN-2 and DEN-3 while six were positive for serotype DEN-2 only. Conclusions Our study showed that serotype DEN-2 was dominant in positive samples of dengue virus infection collected during the period of three years (2007-2009). The other serotype present was serotype DEN-3. Genotypes of serotype DEN-2 and serotype DEN-3 were subtype IV and subtype III, respectively. PMID:21906394

  2. Longitudinal study of Thai people media exposure, knowledge, and behavior on dengue fever prevention and control.

    PubMed

    Boonchutima, Smith; Kachentawa, Kirati; Limpavithayakul, Manasanun; Prachansri, Anan

    2017-03-09

    Dengue hemorrhagic fever is transmitted through a bite by a dengue -infected Aedes aegypti mosquito. It was first reported in the mid -20th century in Thailand, and since then its epidemiology has been of great concern and has spread all across the country. The alarming incidence of dengue posed a serious threat to human health in all major cities of Thailand. This study was aimed at identifying the level of awareness of dengue fever in Thai population knowledge for prevention and control, and most importantly contribution of media in educating masses for dengue control measures. It is longitudinal in nature and was conducted in 25 provinces of Thailand during 2013-2015. Approximately 7772 respondents participated in this study, with the selection of provinces based on considerations like population, prevalence and demography. A pre-tested structured questionnaire was used to collect information relevant to study participants' demographic profile, pre-existing knowledge about dengue fever and its reinforcement through media, and population attitudes toward prevention and control. Over the period of three years, a positive trend was revealed relevant to the contribution of media in educating and reminding the Thai population of dengue, without any uniformity or powerful campaigns. Based on the results drawn from this study, we conclude that despite the measures undertaken to prevent dengue fever, there is insufficient media exposure. An interdisciplinary approach involving the community participation, media, and government is needed to overcome dengue threat in Thailand.

  3. Vaccines licensed and in clinical trials for the prevention of dengue.

    PubMed

    Torresi, J; Ebert, G; Pellegrini, M

    2017-02-14

    Dengue has become a major global public health threat with almost half of the world's population living in at-risk areas. Vaccination would likely represent an effective strategy for the management of dengue disease in endemic regions, however to date there is only one licensed preventative vaccine for dengue infection. The development of a vaccine against dengue virus (DENV) has been hampered by an incomplete understanding of protective immune responses against DENV. The most clinically advanced dengue vaccine is the chimeric yellow fever-dengue vaccine (CYD) that employs the yellow fever virus 17D strain as the replication backbone (Chimerivax-DEN; CYD-TDV). This vaccine had an overall pooled protective efficacy of 65.6% but was substantially more effective against severe dengue and dengue hemorrhagic fever. Several other vaccine approaches have been developed including live attenuated chimeric dengue vaccines (DENVax and LAV Delta 30), DEN protein subunit V180 vaccine (DEN1-80E) and DENV DNA vaccines. These vaccines have been shown to be immunogenic in animals and also safe and immunogenic in humans. However, these vaccines are yet to progress to phase III trials to determine their protective efficacy against dengue. This review will summarize the details of vaccines that have progressed to clinical trials in humans.

  4. Low sensitivity of NS1 protein tests evidenced during a dengue type 2 virus outbreak in Santos, Brazil, in 2010.

    PubMed

    Felix, Alvina Clara; Romano, Camila Malta; Centrone, Cristiane de Campos; Rodrigues, Célia Lima; Villas-Boas, Lucy; Araújo, Evaldo Stanislau; de Matos, Andréia Manso; Carvalho, Karina Inácio; Martelli, Celina Maria Turchi; Kallas, Esper Georges; Pannuti, Claúdio Sérgio; Levi, José Eduardo

    2012-12-01

    In 2010, a large outbreak of dengue occurred in Santos, Brazil. The detection of the NS1 antigen was used for diagnosis in addition to the detection of IgG, IgM, and RNA. A large number of NS1 false-negative results were obtained. A total of 379 RNA-positive samples were selected for thorough evaluation. NS1 was reactive in 37.7% of cases. Most of the cases were characterized as a secondary infection by dengue 2 virus. Sequencing of NS1 positive and negative isolates did not reveal any mutation that could justify the diagnostic failure. Use of existing NS1 tests in the Brazilian population may present a low negative predictive value, and they should be used with caution, preferentially after performing a validation with samples freshly obtained during the ongoing epidemic.

  5. Paediatric Dengue Fever diagnosed through parents' epidemiologic report and preventive strategy during the acute phase of infection.

    PubMed

    Poddighe, Dimitri; Bonomelli, Irene; Giardinetti, Silvia; Nedbal, Marco; Bruni, Paola

    2016-01-01

    In Europe, Dengue Fever is one of the most frequent imported diseases and also autochthonous cases occurred in areas where the insect vector is present. Here, we describe a child returning from Philippines and diagnosed with Dengue Fever, through the information provided by parents about an ongoing outbreak in their municipality. An appropriate clinical management in the hospital was established to monitor the occurrence of complications and to cancel the risk of dengue virus transmission in the acute phase of infection.

  6. 75 FR 34146 - Draft Guideline for the Prevention and Control of Norovirus Gastroenteritis Outbreaks in...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-16

    ... of Norovirus Gastroenteritis Outbreaks in Healthcare Settings AGENCY: Centers for Disease Control and... for the Prevention and Control of Norovirus Gastroenteritis Outbreaks in Healthcare Settings... infection prevention staff, healthcare epidemiologists, healthcare administrators, nurses, other...

  7. Evaluation of a commercial real-time PCR kit for detection of dengue virus in samples collected during an outbreak in Goiania, Central Brazil, in 2005.

    PubMed

    Levi, José Eduardo; Tateno, Adriana Fumie; Machado, Adriana Freire; Ramalho, Débora Camillo; de Souza, Vanda Akico Ueda Fick; Guilarde, Adriana Oliveira; de Rezende Feres, Valéria Christina; Martelli, Celina Maria Turchi; Turchi, Marília Dalva; Siqueira, João Bosco; Pannuti, Cláudio Sérgio

    2007-06-01

    In the past 2 decades, dengue has reemerged in Brazil as a significant public health problem. Clinicians demand a diagnostic test with high sensitivity that is applicable during the early symptomatic phase. We aimed to test two distinct molecular methods on samples from suspected dengue cases during an outbreak in Central Brazil. Acute-phase serum specimens from 254 patients suspected of having dengue were collected during 2005 in the city of Goiânia, Central Brazil. Samples were blindly evaluated by real-time and multiplex PCR in addition to routine immunoglobulin M serology and virus culture. Overall, acute dengue was confirmed by serology, multiplex PCR, or virus isolation for 80% of patients (203/254). Another four patients presented real-time PCR-positive results as the unique marker of dengue. Higher real-time PCR positivity levels and viral loads were observed in the early symptomatic phase of disease (< or =5 days) than after this period. Multiplex and real-time PCR assays presented a high kappa agreement (0.85). According to multiplex PCR, 60 samples harbored dengue virus type 3 (DEN-3), 4 samples harbored DEN-2, and 1 sample displayed a pattern compatible with a double infection with DEN-2 and -3. The dengue virus real-time kit was found to be practical and adjustable for high throughput, to display the best performance in the early symptomatic phase of dengue cases, and to be valuable for confirming dengue diagnosis in a timely manner.

  8. ProactiveVector control strategies and improved monitoring and evaluation practices for dengue prevention.

    PubMed

    Eisen, Lars; Beaty, Barry J; Morrison, Amy C; Scott, Thomas W

    2009-11-01

    Despite tremendous efforts by public health organizations in dengue-endemic countries, it has proven difficult to achieve effective and sustainable control of the primary dengue virus vector Aedes aegypti (L.) and to effectively disrupt dengue outbreaks. This problem has multiple root causes, including uncontrolled urbanization, increased global spread of dengue viruses, and vector and dengue control programs not being provided adequate resources. In this forum article, we give an overview of the basic elements of a vector and dengue control program and describe a continuous improvement cyclical model to systematically and incrementally improve control program performance by regular efforts to identify ineffective methods and inferior technology, and then replacing them with better performing alternatives. The first step includes assessments of the overall resource allocation among vector/dengue control program activities, the efficacy of currently used vector control methods, and the appropriateness of technology used to support the program. We expect this will reveal that 1) some currently used vector control methods are not effective, 2) resource allocations often are skewed toward reactive vector control measures, and 3) proactive approaches commonly are underfunded and therefore poorly executed. Next steps are to conceptualize desired changes to vector control methods or technologies used and then to operationally determine in pilot studies whether these changes are likely to improve control program performance. This should be followed by a shift in resource allocation to replace ineffective methods and inferior technology with more effective and operationally tested alternatives. The cyclical and self-improving nature of the continuous improvement model will produce locally appropriate management strategies that continually are adapted to counter changes in vector population or dengue virus transmission dynamics. We discuss promising proactive vector control

  9. Reemergence of Dengue in Southern Texas, 2013

    PubMed Central

    Thomas, Dana L.; Santiago, Gilberto A.; Abeyta, Roman; Hinojosa, Steven; Torres-Velasquez, Brenda; Adam, Jessica K.; Evert, Nicole; Caraballo, Elba; Hunsperger, Elizabeth; Muñoz-Jordán, Jorge L.; Smith, Brian; Banicki, Alison; Tomashek, Kay M.; Gaul, Linda

    2016-01-01

    During a dengue epidemic in northern Mexico, enhanced surveillance identified 53 laboratory-positive cases in southern Texas; 26 (49%) patients acquired the infection locally, and 29 (55%) were hospitalized. Of 83 patient specimens that were initially IgM negative according to ELISA performed at a commercial laboratory, 14 (17%) were dengue virus positive by real-time reverse transcription PCR performed at the Centers for Disease Control and Prevention. Dengue virus types 1 and 3 were identified, and molecular phylogenetic analysis demonstrated close identity with viruses that had recently circulated in Mexico and Central America. Of 51 household members of 22 dengue case-patients who participated in household investigations, 6 (12%) had been recently infected with a dengue virus and reported no recent travel, suggesting intrahousehold transmission. One household member reported having a recent illness consistent with dengue. This outbreak reinforces emergence of dengue in southern Texas, particularly when incidence is high in northern Mexico. PMID:27191223

  10. Reemergence of Dengue in Southern Texas, 2013.

    PubMed

    Thomas, Dana L; Santiago, Gilberto A; Abeyta, Roman; Hinojosa, Steven; Torres-Velasquez, Brenda; Adam, Jessica K; Evert, Nicole; Caraballo, Elba; Hunsperger, Elizabeth; Muñoz-Jordán, Jorge L; Smith, Brian; Banicki, Alison; Tomashek, Kay M; Gaul, Linda; Sharp, Tyler M

    2016-06-01

    During a dengue epidemic in northern Mexico, enhanced surveillance identified 53 laboratory-positive cases in southern Texas; 26 (49%) patients acquired the infection locally, and 29 (55%) were hospitalized. Of 83 patient specimens that were initially IgM negative according to ELISA performed at a commercial laboratory, 14 (17%) were dengue virus positive by real-time reverse transcription PCR performed at the Centers for Disease Control and Prevention. Dengue virus types 1 and 3 were identified, and molecular phylogenetic analysis demonstrated close identity with viruses that had recently circulated in Mexico and Central America. Of 51 household members of 22 dengue case-patients who participated in household investigations, 6 (12%) had been recently infected with a dengue virus and reported no recent travel, suggesting intrahousehold transmission. One household member reported having a recent illness consistent with dengue. This outbreak reinforces emergence of dengue in southern Texas, particularly when incidence is high in northern Mexico.

  11. Dengue among United Nations mission in Haiti personnel, 1995: implications for preventive medicine.

    PubMed

    Gambel, J M; Drabick, J J; Swalko, M A; Henchal, E A; Rossi, C A; Martinez-Lopez, L

    1999-04-01

    The incidence of dengue infections has been increasing in the Caribbean, and cases have been identified among successive deployments of multinational peacekeepers to Haiti (1994-1997). In the absence of an effective vaccine or chemoprophylaxis to prevent dengue fever, vector-control operations and use of personal protection measures to prevent arthropod bites are the most effective means of limiting disease transmission. During our 5-month deployment as part of the United Nations Mission in Haiti, 79 cases of recent dengue fever were identified among 249 patients (32%) presenting with febrile illness to the 86th Combat Support Hospital. Further investigation revealed low unit readiness to perform standard vector-control activities and poor individual adherence to measures to prevent arthropod bites. Command enforcement of existing field preventive medicine doctrine is essential to prevent casualties caused by dengue, other arthropod-borne infections, and nuisance arthropod bites during military deployments.

  12. Value of syndromic surveillance within the Armed Forces for early warning during a dengue fever outbreak in French Guiana in 2006

    PubMed Central

    Meynard, Jean-Baptiste; Chaudet, Hervé; Texier, Gaetan; Ardillon, Vanessa; Ravachol, Françoise; Deparis, Xavier; Jefferson, Henry; Dussart, Philippe; Morvan, Jacques; Boutin, Jean-Paul

    2008-01-01

    Background A dengue fever outbreak occured in French Guiana in 2006. The objectives were to study the value of a syndromic surveillance system set up within the armed forces, compared to the traditional clinical surveillance system during this outbreak, to highlight issues involved in comparing military and civilian surveillance systems and to discuss the interest of syndromic surveillance for public health response. Methods Military syndromic surveillance allows the surveillance of suspected dengue fever cases among the 3,000 armed forces personnel. Within the same population, clinical surveillance uses several definition criteria for dengue fever cases, depending on the epidemiological situation. Civilian laboratory surveillance allows the surveillance of biologically confirmed cases, within the 200,000 inhabitants. Results It was shown that syndromic surveillance detected the dengue fever outbreak several weeks before clinical surveillance, allowing quick and effective enhancement of vector control within the armed forces. Syndromic surveillance was also found to have detected the outbreak before civilian laboratory surveillance. Conclusion Military syndromic surveillance allowed an early warning for this outbreak to be issued, enabling a quicker public health response by the armed forces. Civilian surveillance system has since introduced syndromic surveillance as part of its surveillance strategy. This should enable quicker public health responses in the future. PMID:18597694

  13. Shellfish-associated enteric virus illness: virus localization, disease outbreaks and prevention

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Numerous outbreaks of shellfish-borne enteric virus illness have been reported worldwide. Most notable among the outbreaks are those involving norovirus illness and hepatitis A. Lessons learned from outbreak investigations indicate that most outbreaks are preventable. Anthropogenic sources of con...

  14. [Differences and similarities in approach of integrated strategy for dengue prevention and control between Colombia and Peru].

    PubMed

    Castro-Orozco, Raimundo; Alvis-Guzmán, Nelson; Gómez-Arias, Rubén

    2015-10-01

    We analyzed and compared two Integrated Management Strategies for Dengue Prevention and Control (IMS-dengue Colombia and IMS-dengue Peru), through a narrative review of available literature, in order to identify common and dissimilar patterns in two Andean countries with epidemiological differences in the context of dengue disease. We were able to identify differences related to: formal assessment of problem, formation of groups of actors, and quantitative information provided by performance indicators. These limitations identified in IMS-dengue Colombia 2006-2010 were overcome in a new version of the strategy (IMS-dengue Colombia 2012-2021). We were able to document an epidemiological impact of implementation of IMS-dengue Colombia 2006-2010. Additionally, a gradual increase was observed in incidence rates of dengue cases that could be related to the strengthening of surveillance system of IMS- dengue Peru.

  15. Assessing positivity and circulating levels of NS1 in samples from a 2012 dengue outbreak in Rio de Janeiro, Brazil.

    PubMed

    Allonso, Diego; Meneses, Marcelo D F; Fernandes, Carlos A; Ferreira, Davis F; Mohana-Borges, Ronaldo

    2014-01-01

    Dengue virus (DENV) represents a major threat to public health worldwide. Early DENV diagnosis should not only detect the infection but also identify patients with a higher likelihood to develop severe cases. Previous studies have suggested the potential for NS1 to serve as a viral marker for dengue severity. However, further studies using different sera panels are required to confirm this hypothesis. In this context, we developed a lab-based ELISA to detect and quantitate NS1 protein from the four DENV serotypes and from primary and secondary cases. This approach was used to calculate the circulating NS1 concentration in positive samples. We also tested the NS1 positivity of DENV-positive samples according to the Platelia Dengue NS1 Ag assay. A total of 128 samples were positive for DENV infection and were classified according to the WHO guidelines. The overall NS1 positivity was 68% according to the Platelia assay, whereas all samples were NS1-positive when analyzed with our lab-based ELISA. Fifty-four samples were positive by PCR, revealing a co-circulation of DENV1 and DENV4, and the NS1 positivity for DENV4 samples was lower than that for DENV1. The circulating NS1 concentration ranged from 7 to 284 ng/mL. Our results support previous data indicating the low efficiency of the Platelia assay to detect DENV4 infection. Moreover, this work is the first to analyze NS1 antigenemia using retrospective samples from a Brazilian outbreak.

  16. Potential Risk of Dengue and Chikungunya Outbreaks in Northern Italy Based on a Population Model of Aedes albopictus (Diptera: Culicidae)

    PubMed Central

    Montarsi, Fabrizio; Baldacchino, Frédéric Alexandre; Metz, Markus; Capelli, Gioia; Rizzoli, Annapaola; Pugliese, Andrea; Rosà, Roberto; Poletti, Piero; Merler, Stefano

    2016-01-01

    The rapid invasion and spread of Aedes albopictus (Skuse, 1894) within new continents and climatic ranges has created favorable conditions for the emergence of tropical arboviral diseases in the invaded areas. We used mosquito abundance data from 2014 collected across ten sites in northern Italy to calibrate a population model for Aedes albopictus and estimate the potential of imported human cases of chikungunya or dengue to generate the condition for their autochthonous transmission in the absence of control interventions. The model captured intra-year seasonality and heterogeneity across sites in mosquito abundance, based on local temperature patterns and the estimated site-specific mosquito habitat suitability. A robust negative correlation was found between the latter and local late spring precipitations, indicating a possible washout effect on larval breeding sites. The model predicts a significant risk of chikungunya outbreaks in most sites if a case is imported between the beginning of summer and up to mid-November, with an average outbreak probability between 4.9% and 25%, depending on the site. A lower risk is predicted for dengue, with an average probability between 4.2% and 10.8% for cases imported between mid-July and mid-September. This study shows the importance of an integrated entomological and medical surveillance for the evaluation of arboviral disease risk, which is a precondition for designing cost-effective vector control programs. PMID:27304211

  17. A Comprehensive Entomological, Serological and Molecular Study of 2013 Dengue Outbreak of Swat, Khyber Pakhtunkhwa, Pakistan

    PubMed Central

    Khan, Jehangir; Khan, Inamullah; Amin, Ibne

    2016-01-01

    Background Aedes aegypti and Aedes albopictus play a fundamental role in transmission of dengue virus to humans. A single infected Aedes mosquito is capable to act as a reservoir/amplifier host for dengue virus and may cause epidemics via horizontal and vertical modes of dengue virus (DENV) transmission. The present and future dengue development can be clarified by understanding the elements which help the dissemination of dengue transmission. The current study deals with molecular surveillance of dengue in addition to ecological and social context of 2013 dengue epidemics in Swat, Pakistan. Methods Herein, we reported dengue vectors surveillance in domestic and peridomistic containers in public and private places in 7 dengue epidemic-prone sites in District Swat, Pakistan from July to November 2013. Using the Flaviviruses genus-specific reverse transcriptase (RT) semi nested-PCR assay, we screened blood samples (N = 500) of dengue positive patients, 150 adult mosquito pools and 25 larval pools. Results The 34 adult and 7 larval mosquito pools were found positive. The adult positive pools comprised 30 pools of Ae. aegypti and 4 pools of Ae. albopictus, while among the 7 larval pools, 5 pools of Ae. aegypti and 2 pools of Ae. albopictus were positive. The detected putative genomes of dengue virus were of DENV-2 (35% in 14 mosquito pools & 39% in serum) and DENV-3 (65% in 27 mosquito pools & 61% in serum). The higher vector density and dengue transmission rate was recorded in July and August (due to favorable conditions for vector growth). About 37% of Ae. aegpti and 34% Ae. albopictus mosquitoes were collected from stagnant water in drums, followed by drinking water tanks (23% & 26%), tires (20% & 18%) and discarded containers (10% & 6%). Among the surveyed areas, Saidu was heavily affected (26%) by dengue followed by Kanju (20% and Landikas (12%). The maximum infection was observed in the age group of <15 (40%) followed by 15–45 (35%) and >45 (25%) years and was

  18. Community participation in the prevention and control of dengue: the patio limpio strategy in Mexico.

    PubMed

    Tapia-Conyer, Roberto; Méndez-Galván, Jorge; Burciaga-Zúñiga, Pierre

    2012-05-01

    Community participation is vital to prevent and control the spread of dengue in Latin America. Initiatives such as the integrated management strategy for dengue prevention and control (IMS-Dengue) and integrated vector management (IVM) incorporate social mobilisation and behavioural change at the community level as part of a wider strategy to control dengue. These strategies aim to improve the efficacy, cost-effectiveness, environmental impact and sustainability of vector control strategies. Community empowerment is a key aspect of the strategy as it allows the local population to drive eradication of the disease in their environment. Through the patio limpio campaign, the concept of community participation has been employed in Mexico to raise awareness of the consequences of dengue. patio limpio consists of training local people to identify, eliminate, monitor and evaluate vector breeding sites systematically in households under their supervision. A community participation programme in Guerrero State found that approximately 54% were clean and free of breeding sites. Households that were not visited and assessed had a 2·4-times higher risk of developing dengue than those that were. However, after a year, only 30% of trained households had a clean backyard. This emphasises the need for a sustainable process to encourage individuals to maintain efforts in keeping their environment free of dengue.

  19. Preventing dengue through mobile phones: evidence from a field experiment in Peru.

    PubMed

    Dammert, Ana C; Galdo, Jose C; Galdo, Virgilio

    2014-05-01

    Dengue is the most rapidly spreading mosquito-borne viral disease in the world (WHO, 2009). During the last two decades, the dramatic rise in the number of dengue infections has been particularly evident in Latin American and the Caribbean countries. This paper examines the experimental evidence of the effectiveness of mobile phone technology in improving households' health preventive behavior in dengue-endemic areas. The main results suggest that repeated exposure to health information encourages households' uptake of preventive measures against dengue. As a result, the Breteau Index in treatment households, an objective measure of dengue risk transmission, is 0.10 standard deviations below the mean of the control group, which shows a reduction in the number of containers per household that test positive for dengue larvae. The estimates also show marginally significant effects of the intervention on self-reported dengue symptoms. Moreover, we use a multiple treatment framework that randomly assigns households to one of the four treatment groups in order to analyze the impacts of framing on health behavior. Different variants emphasized information on monetary and non-monetary benefits and costs. The main results show no statistical differences among treatment groups.

  20. Factors influencing preventive behaviors for dengue infection among housewives in Colombo, Sri Lanka.

    PubMed

    Chanyasanha, Charnchudhi; Guruge, Geethika Rathnawardana; Sujirarat, Dusit

    2015-01-01

    Dengue is an infectious disease prevalent in Sri Lanka. Some factors may influence preventive behaviors. This cross-sectional study aimed to determine the knowledge, attitude, and preventive behaviors associated with dengue and analyzed the factors influencing preventive behaviors among housewives in Colombo, Sri Lanka. The analytical study was designed, and data were collected using a structured questionnaire. The χ(2) test and binary logistic regression were used to analyze data. The mean age of housewives was 39.41 years, 91% were married, 52% were Buddhist, and 46.5% had a family monthly income of 15 000 to 25 000 rupees. The knowledge of dengue preventive behaviors was 69.2%. The majority (91.5%) had a positive attitude toward dengue prevention. Only 39.3% used a mosquito net, and 89.3% had water storage container covers. Overall, 58.5% were knowledgeable about preventive measures. Age, religion, family income, education, knowledge, and attitude were associated with preventive behaviors. These findings are useful for dengue control in Colombo.

  1. Widespread fear of dengue transmission but poor practices of dengue prevention: A study in the slums of Delhi, India

    PubMed Central

    Mazumdar, Sumit; Solanki, Vandana

    2017-01-01

    Background This study has been conducted to throw light on the knowledge and practices related to dengue fever among the poor population living in Delhi’s slums. Materials A household survey was conducted in 2013 among 3,350 households. The households were stratified by a number of variables related to socio-economic status and health events such as hospitalisation. The data collection was completed through face-to-face interviews conducted with the help of 25 field investigators. Results About 8% of the households had at least one diagnosed dengue case. In comparison to the population surveyed, teenagers (15–19 years) and adults (30–34 years) were more affected whereas children under four years of age were underrepresented. Housewives are more affected by dengue (24%) compared to their share of the population surveyed (17%). Despite the fact that 77% of the respondents are worried about mosquitoes, only 43% of them monitor environment to avoid the presence of breeding sites. Conclusion One cannot exclude the possibility that though young children under the age of four years are exposed to the virus, either their cases were asymptomatic or family members infected during this period had potentially more serious symptoms leading to hospitalisation. This result could thus be explained by budget-related health choices made by this population which do not favour small children. Educational programs should target housewives to improve their impact, as they are the ones mostly responsible for water storage and cleanliness of the house and its neighbourhood. Even with a dengue experience and potentially an acute perception of the risk and its factors, a proper management of environmental conditions is lacking. This along with the fact that word-of-mouth is the main source of information quoted should be a message for municipality health workers to give door-to-door information on how to prevent breeding sites and dengue infection. PMID:28187147

  2. Epidemiological Scenario of Dengue in Brazil.

    PubMed

    Fares, Rafaelle C G; Souza, Katia P R; Añez, Germán; Rios, Maria

    2015-01-01

    Dengue is the most important reemerging mosquito-borne viral disease worldwide. It is caused by any of four Dengue virus types or serotypes (DENV-1 to DENV-4) and is transmitted by mosquitoes from the genus Aedes. Ecological changes have favored the geographic expansion of the vector and, since the dengue pandemic in the Asian and Pacific regions, the infection became widely distributed worldwide, reaching Brazil in 1845. The incidence of dengue in Brazil has been frequently high, and the number of cases in the country has at some point in time represented up to 60% of the dengue reported cases worldwide. This review addresses vector distribution, dengue outbreaks, circulating serotypes and genotypes, and prevention approaches being utilized in Brazil.

  3. Epidemiological Scenario of Dengue in Brazil

    PubMed Central

    Fares, Rafaelle C. G.; Souza, Katia P. R.; Añez, Germán; Rios, Maria

    2015-01-01

    Dengue is the most important reemerging mosquito-borne viral disease worldwide. It is caused by any of four Dengue virus types or serotypes (DENV-1 to DENV-4) and is transmitted by mosquitoes from the genus Aedes. Ecological changes have favored the geographic expansion of the vector and, since the dengue pandemic in the Asian and Pacific regions, the infection became widely distributed worldwide, reaching Brazil in 1845. The incidence of dengue in Brazil has been frequently high, and the number of cases in the country has at some point in time represented up to 60% of the dengue reported cases worldwide. This review addresses vector distribution, dengue outbreaks, circulating serotypes and genotypes, and prevention approaches being utilized in Brazil. PMID:26413514

  4. Notes from the Field: Outbreak of Locally Acquired Cases of Dengue Fever--Hawaii, 2015.

    PubMed

    Johnston, David; Viray, Melissa; Ushiroda, Jenny; Whelen, A Christian; Sciulli, Rebecca; Gose, Remedios; Lee, Roland; Honda, Eric; Park, Sarah Y

    2016-01-22

    On October 21, 2015, the Hawaii Department of Health (HDOH) was notified of a positive dengue immunoglobulin M (IgM) antibody result in a woman residing on Hawaii Island (also known as the Big Island). The patient had no history of travel off the island, and other family members reported having similar signs and symptoms, which consisted of fever, headache, myalgias and arthralgias, and a generalized erythematous rash. HDOH initiated an investigation to identify any additional cases and potential exposure sources. On October 24, HDOH received report of a group of mainland U.S. visitors who had traveled together on Hawaii Island, including several who had developed a febrile illness. Additionally, on October 27, HDOH was notified of an unrelated person, also on Hawaii Island, with a positive dengue IgM result. As of November 26, 2015, HDOH had identified 107 laboratory-confirmed cases of dengue fever, with dates of onset ranging from September 11 to November 18, 2015.

  5. Prevention and control of dengue-the light at the end of the tunnel.

    PubMed

    Pang, Tikki; Mak, Tippi K; Gubler, Duane J

    2017-03-01

    Advances in the development of new dengue control tools, including vaccines and vector control, herald a new era of desperately needed dengue prevention and control. The burden of dengue has expanded for decades, and now affects more than 120 countries. Complex, large-scale global forces have and will continue to contribute to the expansion of dengue, including population growth, unplanned urbanisation, and suboptimal mosquito control in urban centres. Although no so-called magic bullets are available, there is new optimism following the first licensure of a dengue vaccine and other promising vaccine candidates, and the development of novel vector control interventions to help control dengue and other expanding mosquito-borne diseases such as Zika virus. Implementation of effective and sustainable immunisation programmes to complement existing methods will add complexity to the health systems of affected countries, which have varying levels of robustness and maturity. Long-term high prioritisation and adequate resources are needed. The way forward is full commitment to addressing a complex disease with a set of solutions integrating vaccination and vector control methods. A whole systems approach is thus needed to integrate these various approaches and strategies for controlling dengue within the goal of universal health coverage. The ultimate objective of these interventions will be to reduce the disease burden in a sustainable and equitable manner.

  6. Management of animal botulism outbreaks: from clinical suspicion to practical countermeasures to prevent or minimize outbreaks.

    PubMed

    Anniballi, Fabrizio; Fiore, Alfonsina; Löfström, Charlotta; Skarin, Hanna; Auricchio, Bruna; Woudstra, Cédric; Bano, Luca; Segerman, Bo; Koene, Miriam; Båverud, Viveca; Hansen, Trine; Fach, Patrick; Tevell Aberg, Annica; Hedeland, Mikael; Olsson Engvall, Eva; De Medici, Dario

    2013-09-01

    Botulism is a severe neuroparalytic disease that affects humans, all warm-blooded animals, and some fishes. The disease is caused by exposure to toxins produced by Clostridium botulinum and other botulinum toxin-producing clostridia. Botulism in animals represents a severe environmental and economic concern because of its high mortality rate. Moreover, meat or other products from affected animals entering the food chain may result in a public health problem. To this end, early diagnosis is crucial to define and apply appropriate veterinary public health measures. Clinical diagnosis is based on clinical findings eliminating other causes of neuromuscular disorders and on the absence of internal lesions observed during postmortem examination. Since clinical signs alone are often insufficient to make a definitive diagnosis, laboratory confirmation is required. Botulinum antitoxin administration and supportive therapies are used to treat sick animals. Once the diagnosis has been made, euthanasia is frequently advisable. Vaccine administration is subject to health authorities' permission, and it is restricted to a small number of animal species. Several measures can be adopted to prevent or minimize outbreaks. In this article we outline all phases of management of animal botulism outbreaks occurring in wet wild birds, poultry, cattle, horses, and fur farm animals.

  7. [Preventing deaths from dengue: a space and challenge for primary health care].

    PubMed

    Martínez Torres, Eric

    2006-07-01

    Dengue is an arthropod-borne viral disease whose frequency has increased steadily in the Americas over the past 25 years. The type of dengue that carries the highest mortality is the clinical variant known as dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS). Even though no vaccine or drug against the disease is available, successful management consists of preventing serious illness through patient follow-up and monitoring danger signals so as to be able to initiate aggressive intravenous rehydration and prevent shock or treat it early and successfully. These measures are also useful in preventing other complications, such as massive hemorrhage, disseminated intravascular coagulation, multiple organ failure, and respiratory failure due to non-cardiogenic pulmonary edema. Primary health care (PHC) settings and the community are ideal spaces for this type of preventive management based on health education and active case detection. It involves training all medical and nursing staff, students, and community health workers, as well as reorganizing health care in PHC units and hospitals and redistributing available resources during a dengue epidemic.

  8. Effect of community participation on household environment to mitigate dengue transmission in Thailand.

    PubMed

    Suwannapong, N; Tipayamongkholgul, M; Bhumiratana, A; Boonshuyar, C; Howteerakul, N; Poolthin, S

    2014-03-01

    Due to the absence of dengue vaccination, vector control is the only measure to prevent dengue outbreaks. The key element of dengue prevention is to eliminate vector habitats. Clean household environment, preventive behaviors of household members and community participation in dengue prevention and control are key successful elements. This study aimed to investigate the associations between environmental factors, dengue knowledge, perception and preventive behaviors of household and collaboration of community members and household risk of dengue by using mixed methods. One dengue epidemic province was selected from each region of Thailand including Bangkok. Two districts, one from the highest and another from the lowest dengue incidence areas, were selected from those provinces. The household leaders, community members, and local authorities in highest dengue incidence areas were interviewed by using questionnaire and through group interviews. The environment of each selected household was observed. Of 4,561 households, 194 were reported having dengue case(s) in the past year and that outdoor solid waste disposal significantly influenced household risk of dengue (OR=1.62; 95% CI=1.16-2.29). In contrast, having gardening areas reduced dengue risk at household level by 32%. High level of community participation in dengue prevention and control in uninfected areas and the information from local authorities and community members reconfirmed that community participation was the key factor against dengue outbreaks. Sustainable process of encouraging community members to eliminate vector breeding sites such as outdoor solid waste disposal is likely to lead to an achievement in dengue prevention and control.

  9. A Survey of Insecticide Resistance in Aedes albopictus (Diptera: Culicidae) During a 2014 Dengue Fever Outbreak in Guangzhou, China.

    PubMed

    Yiguan, Wang; Xin, Liu; Chengling, Li; Su, Tianyun; Jianchao, Jin; Yuhong, Guo; Dongsheng, Ren; Zhicong, Yang; Qiyong, Liu; Fengxia, Meng

    2016-12-23

    A dengue fever outbreak in Guangzhou, Guangdong Province, China, in 2014 resulted in ∼37,000 cases and five deaths. Insecticides were sprayed to control the vector of this outbreak, Aedes albopictus (Skuse), a species of mosquito. Aedes albopictus specimens collected from Huadu District (HD), Huangpu District (HP), Luogang District (LG), and Nansha District (NS) in Guangzhou were evaluated using WHO-recommended bioassays for both larvae and adult mosquitoes to determine population resistance to deltamethrin, beta-cypermethrin, cypermethrin, permethrin, dichlorvos, temephos, propoxur, and DDT. Compared with a susceptible laboratory strain of Ae. albopictus (S-lab), all populations showed decreased sensitivities to the eight insecticides, with resistance ratios (RRs) ranging from 2.2 to 275. The RRs were 6.8-275 for pyrethroids, 2.2-4.4 for organophosphates, 5.7-9.0 for carbamates, and 5.3-94.3 for organochlorines. For adult mosquitoes, all populations were sensitive to dichlorvos with 100% mortalities. Mosquitoes from HP, LG, and NS were also sensitive to propoxur. But for other tested insecticides, different degrees of resistance (mortality rate ranging from 11.7% to 94.7%) were observed. Among the four field populations, the resistance levels are presented as follows in descending order: HP > HD > NS > LG. The levels among insecticides classes were pyrethroids > organochlorines > carbamates > organophosphates.

  10. An integrated ecosystem approach for sustainable prevention and control of dengue in Central Havana.

    PubMed

    Bonet, Mariano; Spiegel, Jerry M; Ibarra, Ana Maria; Kouri, Gustavo; Pintre, Alfredo; Yassi, Annalee

    2007-01-01

    The authors developed and evaluated a comprehensive participatory ecosystem health approach for preventing the transmission of dengue, the most prevalent vector-borne disease in Cuba and the Latin America-Caribbean region. The integrated surveillance system central to this initiative encompassed three main subsystems (environmental; entomological; clinical-epidemiologic), relying on extensive community involvement. The study was conducted in Central Havana, Cuba. Indicators from each subsystem were selected and mapped using a GIS procedure providing instant visualization by city block in the municipality. To elucidate the factors affecting control and prevention efforts, perceived needs and risks, as well as knowledge, attitudes, and behaviors related to dengue, were assessed. Specific factors associated with the presence of mosquito breeding sites and risks of dengue were examined in a case-control study.

  11. Developing new approaches for detecting and preventing Aedes aegypti population outbreaks: basis for surveillance, alert and control system.

    PubMed

    Regis, Lêda; Monteiro, Antonio Miguel; Melo-Santos, Maria Alice Varjal de; SilveiraJr, José Constantino; Furtado, André Freire; Acioli, Ridelane Veiga; Santos, Gleice Maria; Nakazawa, Mitsue; Carvalho, Marilia Sá; Ribeiro Jr, Paulo Justiniano; Souza, Wayner Vieira de

    2008-02-01

    A new approach to dengue vector surveillance based on permanent egg-collection using a modified ovitrap and Bacillus thuringiensis israelensis(Bti) was evaluated in different urban landscapes in Recife, Northeast Brazil. From April 2004 to April 2005, 13 egg-collection cycles of four weeks were carried out. Geo-referenced ovitraps containing grass infusion, Bti and three paddles were placed at fixed sampling stations distributed over five selected sites. Continuous egg-collections yielded more than four million eggs laid into 464 sentinel-ovitraps over one year. The overall positive ovitrap index was 98.5% (over 5,616 trap observations). The egg density index ranged from 100 to 2,500 eggs per trap-cycle, indicating a wide spread and high density of Aedes aegypti (Diptera: Culicidae) breeding populations in all sites. Fluctuations in population density over time were observed, particularly a marked increase from January on, or later, according to site. Massive egg-collection carried out at one of the sites prevented such a population outbreak. At intra-site level, egg counts made it possible to identify spots where the vector population is consistently concentrated over the time, pinpointing areas that should be considered high priority for control activities. The results indicate that these could be promising strategies for detecting and preventing Ae. aegypti population outbreaks.

  12. Climate and the Timing of Imported Cases as Determinants of the Dengue Outbreak in Guangzhou, 2014: Evidence from a Mathematical Model

    PubMed Central

    Spear, Robert C.; Marshall, John M.; Yang, Zhicong; Gong, Peng

    2016-01-01

    As the world’s fastest spreading vector-borne disease, dengue was estimated to infect more than 390 million people in 2010, a 30-fold increase in the past half century. Although considered to be a non-endemic country, mainland China had 55,114 reported dengue cases from 2005 to 2014, of which 47,056 occurred in 2014. Furthermore, 94% of the indigenous cases in this time period were reported in Guangdong Province, 83% of which were in Guangzhou City. In order to determine the possible determinants of the unprecedented outbreak in 2014, a population-based deterministic model was developed to describe dengue transmission dynamics in Guangzhou. Regional sensitivity analysis (RSA) was adopted to calibrate the model and entomological surveillance data was used to validate the mosquito submodel. Different scenarios were created to investigate the roles of the timing of an imported case, climate, vertical transmission from mosquitoes to their offspring, and intervention. The results suggested that an early imported case was the most important factor in determining the 2014 outbreak characteristics. Precipitation and temperature can also change the transmission dynamics. Extraordinary high precipitation in May and August, 2014 appears to have increased vector abundance. Considering the relatively small number of cases in 2013, the effect of vertical transmission was less important. The earlier and more frequent intervention in 2014 also appeared to be effective. If the intervention in 2014 was the same as that in 2013, the outbreak size may have been over an order of magnitude higher than the observed number of new cases in 2014.The early date of the first imported and locally transmitted case was largely responsible for the outbreak in 2014, but it was influenced by intervention, climate and vertical transmission. Early detection and response to imported cases in the spring and early summer is crucial to avoid large outbreaks in the future. PMID:26863623

  13. A phylogenetic analysis using full-length viral genomes of South American dengue serotype 3 in consecutive Venezuelan outbreaks reveals novel NS5 mutation

    PubMed Central

    Schmidt, DJ; Pickett, BE; Camacho, D; Comach, G; Xhaja, K; Lennon, NJ; Rizzolo, K; de Bosch, N; Becerra, A; Nogueira, ML; Mondini, A; da Silva, EV; Vasconcelos, PF; Muñoz-Jordán, JL; Santiago, GA; Ocazionez, R; Gehrke, L; Lefkowitz, EJ; Birren, BW; Henn, MR; Bosch, I

    2013-01-01

    Dengue virus currently causes 50-100 million infections annually. Comprehensive knowledge about the evolution of Dengue in response to selection pressure is currently unavailable, but would greatly enhance vaccine design efforts. In the current study, we sequenced 187 new dengue virus serotype 3(DENV-3) genotype III whole genomes isolated from Asia and the Americas. We analyzed them together with previously-sequenced isolates to gain a more detailed understanding of the evolutionary adaptations existing in this prevalent American serotype. In order to analyze the phylogenetic dynamics of DENV-3 during outbreak periods; we incorporated datasets of 48 and 11 sequences spanning two major outbreaks in Venezuela during 2001 and 2007-2008 respectively. Our phylogenetic analysis of newly sequenced viruses shows that subsets of genomes cluster primarily by geographic location, and secondarily by time of virus isolation. DENV-3 genotype III sequences from Asia are significantly divergent from those from the Americas due to their geographical separation and subsequent speciation. We measured amino acid variation for the E protein by calculating the Shannon entropy at each position between Asian and American genomes. We found a cluster of 7 amino acid substitutions having high variability within E protein domain III, which has previously been implicated in serotype-specific neutralization escape mutants. No novel mutations were found in the E protein of sequences isolated during either Venezuelan outbreak. Shannon entropy analysis of the NS5 polymerase mature protein revealed that a G374E mutation, in a region that contributes to interferon resistance in other flaviviruses by interfering with JAK-STAT signaling was present in both the Asian and American sequences from the 2007-2008 Venezuelan outbreak, but was absent in the sequences from the 2001 Venezuelan outbreak. In addition to E, several NS5 amino acid changes were unique to the 2007-2008 epidemic in Venezuela and may

  14. Role of primary care providers in dengue prevention and control in the community.

    PubMed

    Ang, K T; Rohani, I; Look, C H

    2010-03-01

    Dengue fever is a major public health threat in Malaysia, especially in the highly urbanized states of Selangor and the Federal Territory of Kuala Lumpur. It is believed that many seek treatment at the primary care clinics and are not admitted. This study aims at establishing the fact that primary care practitioners, as the first point of patient contacts, play a crucial role in advising patients suspected of having dengue to take early preventive measures to break the chain of dengue transmission. A total of 236 patients admitted to two government hospitals for suspected dengue fever were interviewed using a structured questionnaire over a one week period in December 2008. It was found that 83.9% of the patients had sought treatment at a Primary Care (PC) facility before admission to the hospital, with 68.7% of them seeking treatment on two or more occasions. The mean time period for seeking treatment at primary care clinic was one and a half (1.4) days of fever, compared to almost five (4.9) days for admission. The majority of patients (96-98%) reported that primary care practitioners had not given them any advice on preventive measures to be taken even though 51.9% of the patients had been told they could be having dengue fever. This study showed the need for primary care providers to be more involved in the control and prevention of dengue in the community, as these patients were seen very early in their illness compared to when they were admitted.

  15. Historical Compilation and Georeferencing of Dengue and Chikungunya outbreak data for Disease Modeling

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The risk of vector-borne disease spread is increasing due to significant changes and variability in the global climate and increasing global travel and trade. Understanding the relationships between climate variability and disease outbreak patterns are critical to the design and construction of pred...

  16. Molecular Characterization and Viral Origin of the 2015 Dengue Outbreak in Xishuangbanna, Yunnan, China

    PubMed Central

    Zhao, Yujiao; Li, Lihua; Ma, Dehong; Luo, Jia; Ma, Zhiqiang; Wang, Xiaodan; Pan, Yue; Chen, Junying; Xi, Juemin; Yang, Jiajia; Qiu, Lijuan; Bai, Chunhai; Jiang, Liming; Shan, Xiyun; Sun, Qiangming

    2016-01-01

    A total of 1067 serum samples were collected from febrile patients in Xishuangbanna, Yunnan, 2015. Of these, 852 cases were confirmed to be dengue NS1-positive. 76 structural protein genes were sequenced through RT-PCR based on the viral RNAs extracted from serum samples. Phylogenetic analysis revealed that all strains were classified as cosmopolitan genotype of DENV-2. After comparing with the DENV-2SS, 173 base substitutions were found in 76 sequences, resulting in 43 nonsynonymous mutations, of which 22 mutations existed among all samples. According to secondary structure prediction, 8 new possible nucelotide/protein binding sites were found and another 4 sites were lost among the 775 amino acids of DENV structural proteins as compared with DENV-2SS. Meanwhile, 6 distinct amino acid changes were found in the helix and strand regions, and the distribution of the exposed and buried regions was slightly altered. The results indicated that the epidemic dengue strains of Xishuangbanna in 2015 are most similar to the Indian strain in 2001 and the Sri Lankan strain in 2004. Moreover, it also show a very strong similarity to the epidemic strains of Fujian province in 1999 and 2010, which show that there is an internal recycling epidemic trend of DENV in China. PMID:27681163

  17. [Exploration study of knowledge and attitudes related to prevention and transmission of dengue in Puerto Rico in 2012].

    PubMed

    Rivera Rodríguez, Ian J; Puig Rivera, Augusto A; Morales-Borges, Raúl H

    2013-01-01

    We got one of the most significant epidemics of the history of Dengue in Puerto Rico despite all major educational efforts made. The objective is to determine how much knowledge the people have about the prevention and transmission of Dengue virus. We administered a questionnaire of fifteen questions to 140 people of different communities at the metropolitan area as well as in the East area of Puerto Rico during the months of September to November of 2012. 88% were adults, 100 were women and 40 men. The majority was from Caguas, Carolina, San Juan, and Bayamon. 60% were professionals. One hundred percent knew what Dengue is and 90% knows the mosquito. 77% of the participants know the actual epidemics, but the men got a 10% higher knowledge than women on the subject. Around 47% are not prepared to fight the Dengue virus, but they have great knowledge about the preventive measures and the clinical Management of Dengue Syndrome. 66% did not know that Puerto Rico has a Dengue Center from the CDC located at the Island. Only 17.5% of the participants knows that the Dengue Virus can be transmitted through transfusion of blood components. Our study met our objectives showing that we have good knowledge about Dengue, but there is poor knowledge about the transmission of Dengue Virus through transfusion of blood components. There is a big necessity to develop community strategies to eliminate this disease. We recommend repeating this study with more collaboration from other entities, more questions, and more participants.

  18. Dengue virus 2 American-Asian genotype identified during the 2006/2007 outbreak in Piauí, Brazil reveals a Caribbean route of introduction and dissemination of dengue virus in Brazil.

    PubMed

    Barcelos Figueiredo, Leandra; Sakamoto, Tetsu; Leomil Coelho, Luiz Felipe; de Oliveira Rocha, Eliseu Soares; Gomes Cota, Marcela Menezes; Ferreira, Gustavo Portela; de Oliveira, Jaquelline Germano; Kroon, Erna Geessien

    2014-01-01

    Dengue virus (DENV) is the most widespread arthropod-borne virus, and the number and severity of outbreaks has increased worldwide in recent decades. Dengue is caused by DENV-1, DENV- 2, DENV-3 and DENV-4 which are genetically distant. The species has been subdivided into genotypes based on phylogenetic studies. DENV-2, which was isolated from dengue fever patients during an outbreak in Piaui, Brazil in 2006/2007 was analyzed by sequencing the envelope (E) gene. The results indicated a high similarity among the isolated viruses, as well as to other DENV-2 from Brazil, Central America and South America. A phylogenetic and phylogeographic analysis based on DENV-2E gene sequences revealed that these viruses are grouped together with viruses of the American-Asian genotype in two distinct lineages. Our results demonstrate the co-circulation of two American-Asian genotype lineages in northeast Brazil. Moreover, we reveal that DENV-2 lineage 2 was detected in Piauí before it disseminated to other Brazilian states and South American countries, indicating the existence of a new dissemination route that has not been previously described.

  19. Household Dengue Prevention Interventions, Expenditures, and Barriers to Aedes aegypti Control in Machala, Ecuador.

    PubMed

    Heydari, Naveed; Larsen, David A; Neira, Marco; Beltrán Ayala, Efraín; Fernandez, Prissila; Adrian, Jefferson; Rochford, Rosemary; Stewart-Ibarra, Anna M

    2017-02-16

    The Aedes aegypti mosquito is an efficient vector for the transmission of Zika, chikungunya, and dengue viruses, causing major epidemics and a significant social and economic burden throughout the tropics and subtropics. The primary means of preventing these diseases is household-level mosquito control. However, relatively little is known about the economic burden of Ae. aegypti control in resource-limited communities. We surveyed residents from 40 households in a high-risk community at the urban periphery in the city of Machala, Ecuador, on dengue perceptions, vector control interventions, household expenditures, and factors influencing purchasing decisions. The results of this study show that households spend a monthly median of US$2.00, or 1.90% (range: 0.00%, 9.21%) of their family income on Ae. aegypti control interventions. Households reported employing, on average, five different mosquito control and dengue prevention interventions, including aerosols, liquid sprays, repellents, mosquito coils, and unimpregnated bed nets. We found that effectiveness and cost were the most important factors that influence people's decisions to purchase a mosquito control product. Our findings will inform the development and deployment of new Ae. aegypti control interventions by the public health and private sectors, and add to prior studies that have focused on the economic burden of dengue-like illness.

  20. Household Dengue Prevention Interventions, Expenditures, and Barriers to Aedes aegypti Control in Machala, Ecuador

    PubMed Central

    Heydari, Naveed; Larsen, David A.; Neira, Marco; Beltrán Ayala, Efraín; Fernandez, Prissila; Adrian, Jefferson; Rochford, Rosemary; Stewart-Ibarra, Anna M.

    2017-01-01

    The Aedes aegypti mosquito is an efficient vector for the transmission of Zika, chikungunya, and dengue viruses, causing major epidemics and a significant social and economic burden throughout the tropics and subtropics. The primary means of preventing these diseases is household-level mosquito control. However, relatively little is known about the economic burden of Ae. aegypti control in resource-limited communities. We surveyed residents from 40 households in a high-risk community at the urban periphery in the city of Machala, Ecuador, on dengue perceptions, vector control interventions, household expenditures, and factors influencing purchasing decisions. The results of this study show that households spend a monthly median of US$2.00, or 1.90% (range: 0.00%, 9.21%) of their family income on Ae. aegypti control interventions. Households reported employing, on average, five different mosquito control and dengue prevention interventions, including aerosols, liquid sprays, repellents, mosquito coils, and unimpregnated bed nets. We found that effectiveness and cost were the most important factors that influence people’s decisions to purchase a mosquito control product. Our findings will inform the development and deployment of new Ae. aegypti control interventions by the public health and private sectors, and add to prior studies that have focused on the economic burden of dengue-like illness. PMID:28212349

  1. The Dynamics, Causes and Possible Prevention of Hepatitis E Outbreaks

    PubMed Central

    Nannyonga, Betty; Sumpter, David J. T.; Mugisha, Joseph Y. T.; Luboobi, Livingstone S.

    2012-01-01

    Rapidly spreading infectious diseases are a serious risk to public health. The dynamics and the factors causing outbreaks of these diseases can be better understood using mathematical models, which are fit to data. Here we investigate the dynamics of a Hepatitis E outbreak in the Kitgum region of northern Uganda during 2007 to 2009. First, we use the data to determine that is approximately 2.25 for the outbreak. Secondly, we use a model to estimate that the critical level of latrine and bore hole coverages needed to eradicate the epidemic is at least and respectively. Lastly, we further investigate the relationship between the co-infection factor for malaria and Hepatitis E on the value of for Hepatitis E. Taken together, these results provide us with a better understanding of the dynamics and possible causes of Hepatitis E outbreaks. PMID:22911752

  2. Dengue human infection models to advance dengue vaccine development.

    PubMed

    Larsen, Christian P; Whitehead, Stephen S; Durbin, Anna P

    2015-12-10

    Dengue viruses (DENV) currently infect approximately 400 million people each year causing millions to seek care and overwhelming the health care infrastructure in endemic areas. Vaccines to prevent dengue and therapeutics to treat dengue are not currently available. The efficacy of the most advanced candidate vaccine against symptomatic dengue in general and DENV-2 in particular was much lower than expected, despite the ability of the vaccine to induce neutralizing antibody against all four DENV serotypes. Because seroconversion to the DENV serotypes following vaccination was thought to be indicative of induced protection, these results have made it more difficult to assess which candidate vaccines should or should not be evaluated in large studies in endemic areas. A dengue human infection model (DHIM) could be extremely valuable to down-select candidate vaccines or therapeutics prior to engaging in efficacy trials in endemic areas. Two DHIM have been developed to assess the efficacy of live attenuated tetravalent (LATV) dengue vaccines. The first model, developed by the Laboratory of Infectious Diseases at the U. S. National Institutes of Health, utilizes a modified DENV-2 strain DEN2Δ30. This virus was derived from the DENV-2 Tonga/74 that caused only very mild clinical infection during the outbreak from which it was recovered. DEN2Δ30 induced viremia in 100%, rash in 80%, and neutropenia in 27% of the 30 subjects to whom it was given. The Walter Reed Army Institute of Research (WRAIR) is developing a DHIM the goal of which is to identify DENV that cause symptomatic dengue fever. WRAIR has evaluated seven viruses and has identified two that meet dengue fever criteria. Both of these models may be very useful in the evaluation and down-selection of candidate dengue vaccines and therapeutics.

  3. [Co-infection by Chikungunya virus (CHIK-V) and dengue virus (DEN-V) during a recent outbreak in Cali, Colombia: Report of a fatal case].

    PubMed

    Rosso, Fernando; Pacheco, Robinson; Rodríguez, Sarita; Bautista, Diego

    2016-08-01

    The recent outbreaks of Chikungunya (CHIK-V) virus in endemic areas of dengue (DEN-V) could increase the risk of co-infection. CHIK infection has been considered not severe and with very unusual mortality, however DEN is associated with severe manifestations and increased mortality. Little is known about coinfection. It is possible that co-infection could generate severe cases. We present a case report of co-infection DEN-V -3 and CHIK-V in an elderly patient who developed acute renal failure, dengue shock syndrome (DSS), progresses to multiple organ failure and died. With the recent emergence of CHIK-V in Colombia, the possibility of co-infection with DEN-V should be suspected, especially in severe cases.

  4. Knowledge, perceptions, and practices with respect to the prevention of dengue in a mid-Pacific coastal village of Costa Rica.

    PubMed

    Egedus, Victoria L; Ortega, José Morales; Obando, Anabelle Alfaro

    2014-09-01

    Dengue fever is the fastest spreading, most prevalent and deadly arthropod-borne viral disease worldwide, present in over 125 countries. In 2013, Costa Rica is experiencing the highest number of Dengue infections since the virus's reintroduction to the country in 1993. This study evaluated the Dengue-related knowledge of 320 community members, and polled opinions on how to better educate and mobilize the community on Dengue prevention in Quebrada Ganado, Costa Rica during March-May, 2013. In addition, property inspections were used to find relationships between knowledge or opinions and presence ofAedes breeding sites. Results showed that while citizens knew the virus is transmitted by mosquitoes that reproduce near water, they lacked knowledge on Aedes habits and confused it with other mosquitoes. Eighty-one percent of respondents assumed some responsibility for dengue prevention. Suggestions for improved education included consistent and continual information on the risks and dangers dengue poses to an individual. Characteristics relating to households with more positive breeding sites were: lower education level, higher prevalence of dengue infections in the household, lesser knowledge of dengue symptoms, a lower rating on the dangers of dengue and a lower rating on the importance of preventative actions. While a range of prevention methods are implemented, active community involvement is highly important for successful Dengue prevention. Continual evaluation is necessary to make more immediate, long-term behavioral societal changes, and to maximize the economic resources spent on Dengue prevention.

  5. Epidemiological Characteristics and Risk Factors of Dengue Infection in Korean Travelers

    PubMed Central

    2016-01-01

    Dengue viral infection has rapidly spread around the world in recent decades. In Korea, autochthonous cases of dengue fever have not been confirmed yet. However, imported dengue cases have been increased since 2001. The risk of developing severe dengue in Korean has been increased by the accumulation of past-infected persons with residual antibodies to dengue virus and the remarkable growth of traveling to endemic countries in Southeast Asia. Notably, most of imported dengue cases were identified from July to December, suggesting that traveling during rainy season of Southeast Asia is considered a risk factor for dengue infection. Analyzing national surveillance data from 2011 to 2015, males aged 20–29 years are considered as the highest risk group. But considering the age and gender distribution of travelers, age groups 10–49 except 20–29 years old males have similar risks for infection. To minimize a risk of dengue fever and severe dengue, travelers should consider regional and seasonal dengue situation. It is recommended to prevent from mosquito bites or to abstain from repetitive visit to endemic countries. In addition, more active surveillance system and monitoring the prevalence asymptomatic infection and virus serotypes are required to prevent severe dengue and indigenous dengue outbreak. PMID:27822922

  6. Epidemiological Characteristics and Risk Factors of Dengue Infection in Korean Travelers.

    PubMed

    Je, Sungmo; Bae, Wonjun; Kim, Jiyeon; Seok, Seung Hyeok; Hwang, Eung Soo

    2016-12-01

    Dengue viral infection has rapidly spread around the world in recent decades. In Korea, autochthonous cases of dengue fever have not been confirmed yet. However, imported dengue cases have been increased since 2001. The risk of developing severe dengue in Korean has been increased by the accumulation of past-infected persons with residual antibodies to dengue virus and the remarkable growth of traveling to endemic countries in Southeast Asia. Notably, most of imported dengue cases were identified from July to December, suggesting that traveling during rainy season of Southeast Asia is considered a risk factor for dengue infection. Analyzing national surveillance data from 2011 to 2015, males aged 20-29 years are considered as the highest risk group. But considering the age and gender distribution of travelers, age groups 10-49 except 20-29 years old males have similar risks for infection. To minimize a risk of dengue fever and severe dengue, travelers should consider regional and seasonal dengue situation. It is recommended to prevent from mosquito bites or to abstain from repetitive visit to endemic countries. In addition, more active surveillance system and monitoring the prevalence asymptomatic infection and virus serotypes are required to prevent severe dengue and indigenous dengue outbreak.

  7. Clinician Survey to Determine Knowledge of Dengue and Clinical Management Practices, Texas, 2014.

    PubMed

    Adam, Jessica K; Abeyta, Roman; Smith, Brian; Gaul, Linda; Thomas, Dana L; Han, George; Sharp, Tyler M; Waterman, Stephen H; Tomashek, Kay M

    2017-01-30

    Dengue, a mosquito-borne viral disease, is increasingly being identified as a cause of outbreaks in the United States. During July-December 2013, a total of three south Texas counties reported 53 laboratory-confirmed dengue cases; 26 were locally acquired, constituting the largest outbreak in Texas since 2005. Because dengue outbreaks are expected to continue in south Texas and early case identification and timely treatment can reduce mortality, we sought to determine clinicians' knowledge of dengue and its clinical management. A survey was sent to 2,375 south Texas clinicians; 217 (9%) completed the survey. Approximately half of participants demonstrated knowledge needed to identify dengue cases, including symptoms (56%), early indicators of shock (54%), or timing of thrombocytopenia (48%). Fewer than 20% correctly identified all prevention messages, severe dengue warning signs, or circumstances in which a dengue patient should return for care. Knowledge of clinical management was limited; few participants correctly identified scenarios when plasma leakage occurred (10%) or a crystalloid solution was indicated (7%); however, 45% correctly identified when a blood transfusion was indicated. Because of the ongoing threat of dengue, we recommend clinicians in south Texas receive dengue clinical management training.

  8. Review of fungal outbreaks and infection prevention in healthcare settings during construction and renovation.

    PubMed

    Kanamori, Hajime; Rutala, William A; Sickbert-Bennett, Emily E; Weber, David J

    2015-08-01

    Hospital construction and renovation activities are an ever-constant phenomenon in healthcare facilities, causing dust contamination and possible dispersal of fungal spores. We reviewed fungal outbreaks that occurred during construction and renovation over the last 4 decades as well as current infection prevention strategies and control measures. Fungal outbreaks still occur in healthcare settings, especially among patients with hematological malignancies and those who are immunocompromised. The causative pathogens of these outbreaks were usually Aspergillus species, but Zygomycetes and other fungi were occasionally reported. Aspergillus most commonly caused pulmonary infection. The overall mortality of construction/renovation-associated fungal infection was approximately 50%. The minimal concentration of fungal spores by air sampling for acquisition of fungal infections remains to be determined. Performing infection control risk assessments and implementing the recommended control measures is essential to prevent healthcare-associated fungal outbreaks during construction and renovation.

  9. Large Outbreak Caused by Methicillin Resistant Staphylococcus pseudintermedius ST71 in a Finnish Veterinary Teaching Hospital – From Outbreak Control to Outbreak Prevention

    PubMed Central

    Grönthal, Thomas; Moodley, Arshnee; Nykäsenoja, Suvi; Junnila, Jouni; Guardabassi, Luca; Thomson, Katariina; Rantala, Merja

    2014-01-01

    Introduction The purpose of this study was to describe a nosocomial outbreak caused by methicillin resistant Staphylococcus pseudintermedius (MRSP) ST71 SCCmec II-III in dogs and cats at the Veterinary Teaching Hospital of the University of Helsinki in November 2010 – January 2012, and to determine the risk factors for acquiring MRSP. In addition, measures to control the outbreak and current policy for MRSP prevention are presented. Methods Data of patients were collected from the hospital patient record software. MRSP surveillance data were acquired from the laboratory information system. Risk factors for MRSP acquisition were analyzed from 55 cases and 213 controls using multivariable logistic regression in a case-control study design. Forty-seven MRSP isolates were analyzed by pulsed field gel electrophoresis and three were further analyzed with multi-locus sequence and SCCmec typing. Results Sixty-three MRSP cases were identified, including 27 infections. MRSPs from the cases shared a specific multi-drug resistant antibiogram and PFGE-pattern indicated clonal spread. Four risk factors were identified; skin lesion (OR = 6.2; CI95% 2.3–17.0, P = 0.0003), antimicrobial treatment (OR = 3.8, CI95% 1.0–13.9, P = 0.0442), cumulative number of days in the intensive care unit (OR = 1.3, CI95% 1.1–1.6, P = 0.0007) or in the surgery ward (OR = 1.1, CI95% 1.0–1.3, P = 0.0401). Tracing and screening of contact patients, enhanced hand hygiene, cohorting and barrier nursing, as well as cleaning and disinfection were used to control the outbreak. To avoid future outbreaks and spread of MRSP a search-and-isolate policy was implemented. Currently nearly all new MRSP findings are detected in screening targeted to risk patients on admission. Conclusion Multidrug resistant MRSP is capable of causing a large outbreak difficult to control. Skin lesions, antimicrobial treatment and prolonged hospital stay increase the probability of acquiring

  10. Meteorological Factors for Dengue Fever Control and Prevention in South China

    PubMed Central

    Gu, Haogao; Leung, Ross Ka-Kit; Jing, Qinlong; Zhang, Wangjian; Yang, Zhicong; Lu, Jiahai; Hao, Yuantao; Zhang, Dingmei

    2016-01-01

    Dengue fever (DF) is endemic in Guangzhou and has been circulating for decades, causing significant economic loss. DF prevention mainly relies on mosquito control and change in lifestyle. However, alert fatigue may partially limit the success of these countermeasures. This study investigated the delayed effect of meteorological factors, as well as the relationships between five climatic variables and the risk for DF by boosted regression trees (BRT) over the period of 2005–2011, to determine the best timing and strategy for adapting such preventive measures. The most important meteorological factor was daily average temperature. We used BRT to investigate the lagged relationship between dengue clinical burden and climatic variables, with the 58 and 62 day lag models attaining the largest area under the curve. The climatic factors presented similar patterns between these two lag models, which can be used as references for DF prevention in the early stage. Our results facilitate the development of the Mosquito Breeding Risk Index for early warning systems. The availability of meteorological data and modeling methods enables the extension of the application to other vector-borne diseases endemic in tropical and subtropical countries. PMID:27589777

  11. Laboratory-Based Surveillance and Molecular Characterization of Dengue Viruses in Taiwan, 2014.

    PubMed

    Chang, Shu-Fen; Yang, Cheng-Fen; Hsu, Tung-Chieh; Su, Chien-Ling; Lin, Chien-Chou; Shu, Pei-Yun

    2016-04-01

    We present the results of a laboratory-based surveillance of dengue in Taiwan in 2014. A total of 240 imported dengue cases were identified. The patients had arrived from 16 countries, and Malaysia, Indonesia, the Philippines, and China were the most frequent importing countries. Phylogenetic analyses showed that genotype I of dengue virus type 1 (DENV-1) and the cosmopolitan genotype of DENV-2 were the predominant DENV strains circulating in southeast Asia. The 2014 dengue epidemic was the largest ever to occur in Taiwan since World War II, and there were 15,492 laboratory-confirmed indigenous dengue cases. Phylogenetic analysis showed that the explosive dengue epidemic in southern Taiwan was caused by a DENV-1 strain of genotype I imported from Indonesia. There were several possible causes of this outbreak, including delayed notification of the outbreak, limited staff and resources for control measures, abnormal weather conditions, and a serious gas pipeline explosion in the dengue hot spot areas in Kaohsiung City. However, the results of this surveillance indicated that both active and passive surveillance systems should be strengthened so appropriate public health measures can be taken promptly to prevent large-scale dengue outbreaks.

  12. Healthcare Outbreaks Associated With a Water Reservoir and Infection Prevention Strategies.

    PubMed

    Kanamori, Hajime; Weber, David J; Rutala, William A

    2016-06-01

    Hospital water may serve as a reservoir of healthcare-associated pathogens, and contaminated water can lead to outbreaks and severe infections. The clinical features of waterborne outbreaks and infections as well as prevention strategies and control measures are reviewed. The common waterborne pathogens were bacteria, including Legionella and other gram-negative bacteria, and nontuberculous mycobacteria, although fungi and viruses were occasionally described. These pathogens caused a variety of infections, including bacteremia and invasive and disseminated diseases, particularly among immunocompromised hosts and critically ill adults as well as neonates. Waterborne outbreaks occurred in healthcare settings with emergence of new reported reservoirs, including electronic faucets (Pseudomonas aeruginosa and Legionella), decorative water wall fountains (Legionella), and heater-cooler devices used in cardiac surgery (Mycobacterium chimaera). Advanced molecular techniques are useful for achieving a better understanding of reservoirs and transmission pathways of waterborne pathogens. Developing prevention strategies based on water reservoirs provides a practical approach for healthcare personnel.

  13. CD8+ T cells prevent antigen-induced antibody-dependent enhancement of dengue disease in mice.

    PubMed

    Zellweger, Raphaël M; Eddy, William E; Tang, William W; Miller, Robyn; Shresta, Sujan

    2014-10-15

    Dengue virus (DENV) causes pathologies ranging from the febrile illness dengue fever to the potentially lethal severe dengue disease. A major risk factor for developing severe dengue disease is the presence of subprotective DENV-reactive Abs from a previous infection (or from an immune mother), which can induce Ab-dependent enhancement of infection (ADE). However, infection in the presence of subprotective anti-DENV Abs does not always result in severe disease, suggesting that other factors influence disease severity. In this study we investigated how CD8(+) T cell responses influence the outcome of Ab-mediated severe dengue disease. Mice were primed with aluminum hydroxide-adjuvanted UV-inactivated DENV prior to challenge with DENV. Priming failed to induce robust CD8(+) T cell responses, and it induced nonneutralizing Ab responses that increased disease severity upon infection. Transfer of exogenous DENV-activated CD8(+) T cells into primed mice prior to infection prevented Ab-dependent enhancement and dramatically reduced viral load. Our results suggest that in the presence of subprotective anti-DENV Abs, efficient CD8(+) T cell responses reduce the risk of Ab-mediated severe dengue disease.

  14. Forecast of Dengue Incidence Using Temperature and Rainfall

    PubMed Central

    Hii, Yien Ling; Zhu, Huaiping; Ng, Nawi; Ng, Lee Ching; Rocklöv, Joacim

    2012-01-01

    Introduction An accurate early warning system to predict impending epidemics enhances the effectiveness of preventive measures against dengue fever. The aim of this study was to develop and validate a forecasting model that could predict dengue cases and provide timely early warning in Singapore. Methodology and Principal Findings We developed a time series Poisson multivariate regression model using weekly mean temperature and cumulative rainfall over the period 2000–2010. Weather data were modeled using piecewise linear spline functions. We analyzed various lag times between dengue and weather variables to identify the optimal dengue forecasting period. Autoregression, seasonality and trend were considered in the model. We validated the model by forecasting dengue cases for week 1 of 2011 up to week 16 of 2012 using weather data alone. Model selection and validation were based on Akaike's Information Criterion, standardized Root Mean Square Error, and residuals diagnoses. A Receiver Operating Characteristics curve was used to analyze the sensitivity of the forecast of epidemics. The optimal period for dengue forecast was 16 weeks. Our model forecasted correctly with errors of 0.3 and 0.32 of the standard deviation of reported cases during the model training and validation periods, respectively. It was sensitive enough to distinguish between outbreak and non-outbreak to a 96% (CI = 93–98%) in 2004–2010 and 98% (CI = 95%–100%) in 2011. The model predicted the outbreak in 2011 accurately with less than 3% possibility of false alarm. Significance We have developed a weather-based dengue forecasting model that allows warning 16 weeks in advance of dengue epidemics with high sensitivity and specificity. We demonstrate that models using temperature and rainfall could be simple, precise, and low cost tools for dengue forecasting which could be used to enhance decision making on the timing, scale of vector control operations, and utilization of limited

  15. Protect Yourself and Your Baby from Dengue

    MedlinePlus

    Protect Yourself and Your Baby from Dengue Avoid mosquito bites during pregnancy to prevent dengue in your ... To prevent dengue virus infection during pregnancy » Use mosquito repellents with up to 50% DEET, picaridin, IR3535 ...

  16. [An inter-sector participatory strategy in Cuba using an ecosystem approach to prevent dengue transmission at the local level].

    PubMed

    Díaz, Cristina; Torres, Yisel; Cruz, Ana Margarita de la; Alvarez, Angel M; Piquero, María Eugenia; Valero, Aida; Fuentes, Omar

    2009-01-01

    Cuba is located among a group of countries with high dengue incidence. Following several epidemics in the last 10 years, the country designed, implemented, and evaluated a participatory strategy based on the Ecohealth approach. The aim was to promote inter-sector ecosystem management to decrease Aedes aegypti infestation and prevent dengue transmission in the municipality of Cotorro, in Havana city. The study adopted a participatory research methodology. The strategy ensured active participation by the community, diverse sectors, and government in the production of healthy ecosystems. Timely and integrated measures for prevention and control were developed, thereby decreasing the risk of vector proliferation and local dengue transmission. The approach allowed holistic problem analysis, priority setting, and administration of solutions. The strategy has been sustained two years after concluding the process.

  17. Cross-Sectional Survey on the Dengue Knowledge, Attitudes and Preventive Practices Among Students and Staff of a Public University in Malaysia.

    PubMed

    Lugova, H; Wallis, S

    2017-04-01

    Behavioural impact programmes are especially effective for dengue control and prevention. Universities are key settings for health promotion, so understanding factors that influence the practice of dengue prevention within a university community becomes important. This study aimed to examine the factors affecting dengue knowledge, attitude and preventive practices amongst students and staff of a public university. A cross-sectional survey study was conducted in Kuala Lumpur, Malaysia. A total of 372 students and staff of the NDUM were recruited by stratified sampling method. Data were collected via self-administered pre-tested structured questionnaires covering socio-demography and dengue KAP. Data were analysed descriptively. For bivariate analysis, Chi square test was applied. To explore the factors independently associated with the practice of dengue prevention, a logistic regression model was introduced. Overall, the participants had moderate dengue-related knowledge, good attitudes and good preventive practices. The majority had misconceptions about mosquito biting habits (83.8 %), seasonality of dengue epidemics (73.2 %), and mosquito breeding sites (70.3 %). Staff were more likely to have good dengue-related knowledge (p < 0.001) and attitudes (p = 0.008) than students. There was statistically significant positive association between the level of dengue knowledge and monthly average household income (p = 0.008), age (p < 0.001) and education (p < 0.001). Having good attitudes towards dengue was associated with being a non-Malay (p = 0.034), having higher monthly average household income (p = 0.047) and tertiary education (p < 0.001). In regression analysis, only dengue knowledge and dengue attitudes were significantly and positively associated with practice of dengue prevention. Dengue preventive strategies amongst university students and staff should focus on maintaining good dengue-related preventive practices

  18. A scabies outbreak in a diabetic and collagen disease ward: Management and prevention

    PubMed Central

    Furuya, Kenta; Nakajima, Hitoshi; Sasaki, Yousuke; Ishiko, Akira; Urita, Yoshihisa

    2016-01-01

    Scabies is an infection caused by Sarcoptes scabiei. In developed countries, scabies remains an important public health problem in hospitals and care facilities among elderly or immunocompromised patients. There are a number of medical providers who have not experienced scabies and there has been confusion surrounding its management and prevention. Therefore, the aim of the present study was to identify the optimal approach for the management and prevention of scabies. A scabies outbreak occurred between June 2014 and October 2014 in the Toho University School of Medicine, Omori Hospital (Tokyo, Japan), and the current study investigates factors concerning the outbreak, such as disease recognition, diagnostic strategy, medical staff experience and correspondence after the outbreak occurred. Six patients were newly diagnosed with scabies including patients, medical staff and family of the medical staff. An infection control committee was implemented and required a follow-up survey of 181 people (144 patients and 37 medical staff). It took ~4 months to resolve the outbreak. Scabies is highly infectious, and sufficient knowledge is required to care for the patients and prevent the infection of healthy people. In this example, the spread of infection was controlled by prompt action. PMID:28105102

  19. Social Media-Based Civic Engagement Solutions for Dengue Prevention in Sri Lanka: Results of Receptivity Assessment

    ERIC Educational Resources Information Center

    Lwin, May O.; Vijaykumar, Santosh; Foo, Schubert; Fernando, Owen Noel Newton; Lim, Gentatsu; Panchapakesan, Chitra; Wimalaratne, Prasad

    2016-01-01

    This article focuses on a novel social media-based system that addresses dengue prevention through an integration of three components: predictive surveillance, civic engagement and health education. The aim was to conduct a potential receptivity assessment of this system among smartphone users in the city of Colombo, the epicenter of the dengue…

  20. Use of Insecticide-Treated School Uniforms for Prevention of Dengue in Schoolchildren: A Cost-Effectiveness Analysis

    PubMed Central

    Tozan, Yesim; Ratanawong, Pitcha; Louis, Valérie R.; Kittayapong, Pattamaporn; Wilder-Smith, Annelies

    2014-01-01

    Background Dengue-related illness is a leading cause of hospitalization and death, particularly among children. Practical, acceptable and affordable measures are urgently needed to protect this age group. Schools where children spend most of their day is proposed as an ideal setting to implement preventive strategies against day-biting Aedes mosquitoes. The use of insecticide-treated school uniforms is a promising strategy currently under investigation. Methods Using a decision-analytic model, we evaluated the cost-effectiveness of the use of insecticide-treated school uniforms for prevention of dengue, compared with a “do-nothing” alternative, in schoolchildren from the societal perspective. We explored how the potential economic value of the intervention varied under various scenarios of intervention effectiveness and cost, as well as dengue infection risk in school-aged children, using data specific to Thailand. Results At an average dengue incidence rate of 5.8% per year in school-aged children, the intervention was cost-effective (ICER≤$16,440) in a variety of scenarios when the intervention cost per child was $5.3 or less and the intervention effectiveness was 50% or higher. In fact, the intervention was cost saving (ICER<0) in all scenarios in which the intervention cost per child was $2.9 or less per year and the intervention effectiveness was 50% or higher. The results suggested that this intervention would be of no interest to Thai policy makers when the intervention cost per child was $10.6 or higher per year regardless of intervention effectiveness (ICER>$16,440). Conclusions Our results present the potential economic value of the use of insecticide-treated uniforms for prevention of dengue in schoolchildren in a typical dengue endemic setting and highlight the urgent need for additional research on this intervention. PMID:25247556

  1. Dengue Prevention

    MedlinePlus

    ... Protection Against Mosquitoes, Ticks, and Other Insects and Arthropods Get Email Updates To receive a monthly update ... Protection Against Mosquitoes, Ticks, and Other Insects and Arthropods Get Email Updates To receive a monthly update ...

  2. Validation and Application of a Commercial Quantitative Real-Time Reverse Transcriptase-PCR Assay in Investigation of a Large Dengue Virus Outbreak in Southern Taiwan

    PubMed Central

    Tsai, Huey-Pin; Tsai, You-Yuan; Lin, I-Ting; Kuo, Pin-Hwa; Chang, Kung-Chao; Chen, Jung-Chin; Ko, Wen-Chien; Wang, Jen-Ren

    2016-01-01

    Background Accurate, rapid, and early diagnosis of dengue virus (DENV) infections is essential for optimal clinical care. Here, we evaluated the efficacy of the quantitative real-time PCR (qRT-PCR)-LightMix dengue virus EC kit for DENV detection using samples from a dengue outbreak in Taiwan in 2015. Methods Sera from patients with suspected DENV infection were analyzed and compared using the LightMix kit, a Dengue NS1 Ag + Ab Combo kit for detection of NS1 antigen and DENV-specific IgM and IgG antibodies, and an “in-house” qualitative DENV-specific RT-PCR assay. Results A total of 8,989, 8,954, and 1581 samples were subjected to NS1 antigen detection, IgM and IgG detection, and LightMix assays, respectively. The LightMix assay yielded a linear curve for viral loads (VL) between 102 and 106 copies/reaction, and the minimum detection limits for DENV serotype 1 (DENV1) and DENV2, DENV3, and DENV4 were 1, 10, and 100 focus forming units (FFU)/mL, respectively. There was 88.9% concordance between the results obtained using the NS1 antigen combo kit and by LightMix analysis, and the diagnostic sensitivity and specificity of the two methods were 89.4 and 100%, and 84.7 and 100%, respectively. Notably, fatal cases were attributed to DENV2 infection, and 79.5% (27/34) of these cases occurred in patients ≥ 71 years of age. Among these older patients, 82.3% (14/17) were NS1/IgM/IgG (+/-/-), exhibiting VLs between 106–109 copies/mL, which was markedly higher than the rate observed in the other age groups. Conclusions The LightMix assay was effective for early diagnosis of DENV infection. Our data indicate that high VLs during primary infection in elderly patients may be a positive predictor for severe illness, and may contribute to high mortality rates. PMID:27732593

  3. Transmission-blocking antibodies against mosquito C-type lectins for dengue prevention.

    PubMed

    Liu, Yang; Zhang, Fuchun; Liu, Jianying; Xiao, Xiaoping; Zhang, Siyin; Qin, Chengfeng; Xiang, Ye; Wang, Penghua; Cheng, Gong

    2014-02-01

    C-type lectins are a family of proteins with carbohydrate-binding activity. Several C-type lectins in mammals or arthropods are employed as receptors or attachment factors to facilitate flavivirus invasion. We previously identified a C-type lectin in Aedes aegypti, designated as mosquito galactose specific C-type lectin-1 (mosGCTL-1), facilitating the attachment of West Nile virus (WNV) on the cell membrane. Here, we first identified that 9 A. aegypti mosGCTL genes were key susceptibility factors facilitating DENV-2 infection, of which mosGCTL-3 exhibited the most significant effect. We found that mosGCTL-3 was induced in mosquito tissues with DENV-2 infection, and that the protein interacted with DENV-2 surface envelop (E) protein and virions in vitro and in vivo. In addition, the other identified mosGCTLs interacted with the DENV-2 E protein, indicating that DENV may employ multiple mosGCTLs as ligands to promote the infection of vectors. The vectorial susceptibility factors that facilitate pathogen invasion may potentially be explored as a target to disrupt the acquisition of microbes from the vertebrate host. Indeed, membrane blood feeding of antisera against mosGCTLs dramatically reduced mosquito infective ratio. Hence, the immunization against mosGCTLs is a feasible approach for preventing dengue infection. Our study provides a future avenue for developing a transmission-blocking vaccine that interrupts the life cycle of dengue virus and reduces disease burden.

  4. Dengue viral infections

    PubMed Central

    Malavige, G; Fernando, S; Fernando, D; Seneviratne, S

    2004-01-01

    Dengue viral infections are one of the most important mosquito borne diseases in the world. They may be asymptomatic or may give rise to undifferentiated fever, dengue fever, dengue haemorrhagic fever (DHF), or dengue shock syndrome. Annually, 100 million cases of dengue fever and half a million cases of DHF occur worldwide. Ninety percent of DHF subjects are children less than 15 years of age. At present, dengue is endemic in 112 countries in the world. No vaccine is available for preventing this disease. Early recognition and prompt initiation of appropriate treatment are vital if disease related morbidity and mortality are to be limited. This review outlines aspects of the epidemiology of dengue infections, the dengue virus and its mosquito vector, clinical features and pathogenesis of dengue infections, and the management and control of these infections. PMID:15466994

  5. Dengue viral infections.

    PubMed

    Malavige, G N; Fernando, S; Fernando, D J; Seneviratne, S L

    2004-10-01

    Dengue viral infections are one of the most important mosquito borne diseases in the world. They may be asymptomatic or may give rise to undifferentiated fever, dengue fever, dengue haemorrhagic fever (DHF), or dengue shock syndrome. Annually, 100 million cases of dengue fever and half a million cases of DHF occur worldwide. Ninety percent of DHF subjects are children less than 15 years of age. At present, dengue is endemic in 112 countries in the world. No vaccine is available for preventing this disease. Early recognition and prompt initiation of appropriate treatment are vital if disease related morbidity and mortality are to be limited. This review outlines aspects of the epidemiology of dengue infections, the dengue virus and its mosquito vector, clinical features and pathogenesis of dengue infections, and the management and control of these infections.

  6. Research on dengue and dengue-like illness in East Asia and the Western Pacific during the First Half of the 20th century.

    PubMed

    Kuno, Goro

    2007-01-01

    Dengue has become an enormous medical problem worldwide since the end of the World War II (WWII). Despite a voluminous amount of research conducted worldwide for many years to elucidate the mechanism of the development of the two severe forms of dengue (dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS)), to develop effective vaccines and to design reliable disease control and prevention strategies, the goals of achieving these objectives are not in sight yet. For such a medical research that requires a multi-directional approach to resolve a variety of research questions, sometimes it is necessary to step back and re-examine historically how the current status of the expanding global problems and sudden emergence of severe forms of dengue have evolved in the first place. To examine the history of dengue epidemiology, it is first necessary to put in perspective all relevant documents, including a large number of nearly forgotten, old Japanese publications regarding dengue outbreaks and allied background information in East Asia and the Western Pacific that were documented before the emergence of the haemorrhagic disease outbreaks in the 1950s there. The compiled data in this review, thus, fill in for the first time many blanks in the early epidemiologic history of dengue in this part of the world. Besides the data for epidemiologists, virologic data, clinical studies of haemorrhagic manifestation, significance in military medicine and entomologic investigations covered in this review should be useful for the current researchers investigating any of those subjects.

  7. Molecular epidemiology suggests Venezuela as the origin of the dengue outbreak in Madeira, Portugal in 2012-2013.

    PubMed

    Franco, L; Pagan, I; Serre Del Cor, N; Schunk, M; Neumayr, A; Molero, F; Potente, A; Hatz, C; Wilder-Smith, A; Sánchez-Seco, M P; Tenorio, A

    2015-07-01

    An explosive epidemic occurred in Madeira Island (Portugal) from October 2012 to February 2013. Published data showed that dengue virus type 1 introduced from South America was the incriminated virus. We aim to determine the origin of the strain introduced to Madeira by travellers returning to Europe. Using phylogeographic analysis and complete envelope sequences we have demonstrated that the most probable origin of the strain is Venezuela.

  8. Preventative Vaccines for Zika Virus Outbreak: Preliminary Evaluation.

    PubMed

    Kim, Eun; Erdos, Geza; Huang, Shaohua; Kenniston, Thomas; Falo, Louis D; Gambotto, Andrea

    2016-11-01

    Since it emerged in Brazil in May 2015, the mosquito-borne Zika virus (ZIKV) has raised global concern due to its association with a significant rise in the number of infants born with microcephaly and neurological disorders such as Guillain-Barré syndrome. We developed prototype subunit and adenoviral-based Zika vaccines encoding the extracellular portion of the ZIKV envelope gene (E) fused to the T4 fibritin foldon trimerization domain (Efl). The subunit vaccine was delivered intradermally through carboxymethyl cellulose microneedle array (MNA). The immunogenicity of these two vaccines, named Ad5.ZIKV-Efl and ZIKV-rEfl, was tested in C57BL/6 mice. Prime/boost immunization regimen was associated with induction of a ZIKV-specific antibody response, which provided neutralizing immunity. Moreover, protection was evaluated in seven-day-old pups after virulent ZIKV intraperitoneal challenge. Pups born to mice immunized with Ad5.ZIKV-Efl were all protected against lethal challenge infection without weight loss or neurological signs, while pups born to dams immunized with MNA-ZIKV-rEfl were partially protected (50%). No protection was seen in pups born to phosphate buffered saline-immunized mice. This study illustrates the preliminary efficacy of the E ZIKV antigen vaccination in controlling ZIKV infectivity, providing a promising candidate vaccine and antigen format for the prevention of Zika virus disease.

  9. Social media-based civic engagement solutions for dengue prevention in Sri Lanka: results of receptivity assessment

    PubMed Central

    Lwin, May O.; Vijaykumar, Santosh; Foo, Schubert; Fernando, Owen Noel Newton; Lim, Gentatsu; Panchapakesan, Chitra; Wimalaratne, Prasad

    2016-01-01

    This article focuses on a novel social media-based system that addresses dengue prevention through an integration of three components: predictive surveillance, civic engagement and health education. The aim was to conduct a potential receptivity assessment of this system among smartphone users in the city of Colombo, the epicenter of the dengue epidemic in the island country of Sri Lanka. Grounded in Protection Motivation Theory (PMT) and using a convenience sampling approach, the cross-sectional survey assessed perceived severity (PSe), perceived susceptibility (PSu), perceived response efficacy (PRE), perceived self-efficacy (PSE) and intention-to-use (IU) among 513 individuals. The overall receptivity to the system was high with a score of >4.00 on a five-point scale. Participants belonging to younger, better educated and higher income groups reported significantly better perceptions of the efficaciousness of the system, were confident in their ability to use the system, and planned to use it in the future. PMT variables contributed significantly to regression models predicting IU. We concluded that a social media-based system for dengue prevention will be positively received among Colombo residents and a targeted, strategic health communication effort to raise dengue-related threat perceptions will be needed to encourage greater adoption and use of the system. PMID:26668207

  10. Social media-based civic engagement solutions for dengue prevention in Sri Lanka: results of receptivity assessment.

    PubMed

    Lwin, May O; Vijaykumar, Santosh; Foo, Schubert; Fernando, Owen Noel Newton; Lim, Gentatsu; Panchapakesan, Chitra; Wimalaratne, Prasad

    2016-02-01

    This article focuses on a novel social media-based system that addresses dengue prevention through an integration of three components: predictive surveillance, civic engagement and health education. The aim was to conduct a potential receptivity assessment of this system among smartphone users in the city of Colombo, the epicenter of the dengue epidemic in the island country of Sri Lanka. Grounded in Protection Motivation Theory (PMT) and using a convenience sampling approach, the cross-sectional survey assessed perceived severity (PSe), perceived susceptibility (PSu), perceived response efficacy (PRE), perceived self-efficacy (PSE) and intention-to-use (IU) among 513 individuals. The overall receptivity to the system was high with a score of >4.00 on a five-point scale. Participants belonging to younger, better educated and higher income groups reported significantly better perceptions of the efficaciousness of the system, were confident in their ability to use the system, and planned to use it in the future. PMT variables contributed significantly to regression models predicting IU. We concluded that a social media-based system for dengue prevention will be positively received among Colombo residents and a targeted, strategic health communication effort to raise dengue-related threat perceptions will be needed to encourage greater adoption and use of the system.

  11. Prevention of Tetanus Outbreak Following Natural Disaster in Indonesia: Lessons Learned from Previous Disasters.

    PubMed

    Pascapurnama, Dyshelly Nurkartika; Murakami, Aya; Chagan-Yasutan, Haorile; Hattori, Toshio; Sasaki, Hiroyuki; Egawa, Shinichi

    2016-01-01

    In Indonesia, the Aceh earthquake and tsunami in 2004 killed 127,000 people and caused half a million injuries, while the Yogyakarta earthquake in 2006 caused 5,700 deaths and 37,000 injuries. Because disaster-affected areas are vulnerable to epidemic-prone diseases and tetanus is one such disease that is preventable, we systematically reviewed the literature related to tetanus outbreaks following previous two natural disasters in Indonesia. Based on our findings, recommendations for proper vaccination and education can be made for future countermeasures. Using specified keywords related to tetanus and disasters, relevant documents were screened from PubMed, the WHO website, and books. Reports offering limited data and those released before 2004 were excluded. In all, 16 publications were reviewed systematically. Results show that 106 cases of tetanus occurred in Aceh, with a case fatality ratio (CFR) of 18.9%; 71 cases occurred in Yogyakarta, with CFR of 36.6%. For both outbreaks, most patients had been wounded during scavenging or evacuation after the disaster occurred. Poor access to health care because of limited transportation or hospital facilities, and low vaccination coverage and lack of awareness of tetanus risk contributed to delayed treatment and case severity. Tetanus outbreaks after disasters are preventable by increasing vaccination coverage, improving wound care treatment, and establishing a regular surveillance system, in addition to good practices of disaster management and supportive care following national guidelines. Furthermore, health education for communities should be provided to raise awareness of tetanus risk reduction.

  12. Dengue virus and Japanese encephalitis virus epidemiological shifts in Nepal: a case of opposing trends.

    PubMed

    Dumre, Shyam P; Shakya, Geeta; Na-Bangchang, Kesara; Eursitthichai, Veerachai; Rudi Grams, Hans; Upreti, Senendra R; Ghimire, Prakash; KC, Khagendra; Nisalak, Ananda; Gibbons, Robert V; Fernandez, Stefan

    2013-04-01

    We report on the changing epidemiology of two important flaviviruses in Nepal: Japanese encephalitis (JE) and dengue viruses. Morbidity and mortality in Nepal is in the thousands since JE was introduced in 1978. Nepal launched an extensive laboratory-based JE surveillance in 2004. Nepal experienced a remarkable reduction in disease burden after mass immunizations from 2005 to 2010, when 2,040 JE infections and 205 JE-related deaths were confirmed. With its emergence in 2006, dengue has become a significant challenge in the country, highlighted by a sudden outbreak in 2010 that resulted in 359 confirmed dengue infections. Currently, both viruses cocirculate in Nepal. Here, we document the remarkable expansion of dengue in Nepal, which urgently requires national surveillance to refine the burden and make recommendations regarding control and prevention programs. We believe that the use of existing JE surveillance network for integrated dengue surveillance may represent the most appropriate alternative.

  13. Prevention of Dengue Fever: An Exploratory School-Community Intervention Involving Students Empowered as Change Agents

    ERIC Educational Resources Information Center

    Jayawardene, Wasantha P.; Lohrmann, David K.; YoussefAgha, Ahmed H.; Nilwala, Dayani C.

    2011-01-01

    Background: Dengue fever and dengue hemorrhagic fever (DF/DHF) are epidemic and endemic in tropical and subtropical countries including Sri Lanka. Numerous structural and community interventions have been shown to be effective in interrupting the life cycle of mosquitoes that transmit DF/DHF; however, these interventions are not always implemented…

  14. Mathematical Modelling of Immune Parameters in the Evolution of Severe Dengue

    PubMed Central

    Perera, S. S. N.; Malavige, G. N.; Jayasinghe, Saroj

    2017-01-01

    Aims. Predicting the risk of severity at an early stage in an individual patient will be invaluable in preventing morbidity and mortality caused by dengue. We hypothesized that such predictions are possible by analyzing multiple parameters using mathematical modeling. Methodology. Data from 11 adult patients with dengue fever (DF) and 25 patients with dengue hemorrhagic fever (DHF) were analyzed. Multivariate statistical analysis was performed to study the characteristics and interactions of parameters using dengue NS1 antigen levels, dengue IgG antibody levels, platelet counts, and lymphocyte counts. Fuzzy logic fundamentals were used to map the risk of developing severe forms of dengue. The cumulative effects of the parameters were incorporated using the Hamacher and the OWA operators. Results. The operator classified the patients according to the severity level during the time period of 96 hours to 120 hours after the onset of fever. The accuracy ranged from 53% to 89%. Conclusion. The results show a robust mathematical model that explains the evolution from dengue to its serious forms in individual patients. The model allows prediction of severe cases of dengue which could be useful for optimal management of patients during a dengue outbreak. Further analysis of the model may also deepen our understanding of the pathways towards severe illness. PMID:28293273

  15. Mathematical Modelling of Immune Parameters in the Evolution of Severe Dengue.

    PubMed

    Premaratne, M K; Perera, S S N; Malavige, G N; Jayasinghe, Saroj

    2017-01-01

    Aims. Predicting the risk of severity at an early stage in an individual patient will be invaluable in preventing morbidity and mortality caused by dengue. We hypothesized that such predictions are possible by analyzing multiple parameters using mathematical modeling. Methodology. Data from 11 adult patients with dengue fever (DF) and 25 patients with dengue hemorrhagic fever (DHF) were analyzed. Multivariate statistical analysis was performed to study the characteristics and interactions of parameters using dengue NS1 antigen levels, dengue IgG antibody levels, platelet counts, and lymphocyte counts. Fuzzy logic fundamentals were used to map the risk of developing severe forms of dengue. The cumulative effects of the parameters were incorporated using the Hamacher and the OWA operators. Results. The operator classified the patients according to the severity level during the time period of 96 hours to 120 hours after the onset of fever. The accuracy ranged from 53% to 89%. Conclusion. The results show a robust mathematical model that explains the evolution from dengue to its serious forms in individual patients. The model allows prediction of severe cases of dengue which could be useful for optimal management of patients during a dengue outbreak. Further analysis of the model may also deepen our understanding of the pathways towards severe illness.

  16. Laboratory surveillance of dengue in Argentina, 1995-2001.

    PubMed

    Avilés, Gabriela; Paz, Maria Valeria; Rangeon, Griselda; Ranaivoarisoa, Marie Y; Verzeri, Nora; Roginski, Sandra; Baroni, Pablo; Enria, Delia

    2003-06-01

    Local transmission of dengue fever virus in Argentina is increased by the presence of Aedes aegypti mosquitoes and dengue outbreaks in neighboring countries. From 1995 to 2001, a laboratory-based active surveillance program detected 922 dengue cases. Indigenous transmission involving dengue-1 and -2 serotypes was confirmed only in subtropical areas in northern Argentina.

  17. Challenges for the formulation of a universal vaccine against dengue.

    PubMed

    Chokephaibulkit, Kulkanya; Perng, Guey Chuen

    2013-05-01

    Dengue is rapidly becoming a disease of an escalating global public health concern. The disease is a vector-borne disease, transmitted by the bite of an Aedes spp. mosquito. Dynamic clinical manifestations, ranging from asymptomatic, flu-like febrile illness, dengue fever (DF) to dengue hemorrhagic fever (DHF) with or without dengue shock syndrome (DSS), make the disease one of the most challenging to diagnose and treat. DF is a self-limited illness, while DHF/DSS, characterized by plasma leakage resulting from an increased vascular permeability, can have severe consequences, including death. The pathogenesis of dengue virus infection remains poorly understood, mainly due to the lack of a suitable animal model that can recapitulate the cardinal features of human dengue diseases. Currently, there is no specific treatment or antiviral therapy available for dengue virus infection and supportive care with vigilant monitoring is the principle course of treatment. Since vector control programs have been largely unsuccessful in preventing outbreaks, vaccination seems to be the most viable option for prevention. There are four dengue viral serotypes and each one of them is capable of causing severe dengue. Although immunity induced by infection by one serotype is effective in protection against the homologous viral serotype, it only has a transient protective effect against infection with the other three serotypes. The meager cross protective immunity generated wanes over time and may even induce a harmful effect at the time of subsequent secondary infection. Thus, it is imperative to have a vaccine that can elicit equal and long-lasting immunity to all four serotypes simultaneously. Numerous tetravalent vaccines are currently either in the pipeline for clinical trials or under development. For those frontrunner tetravalent vaccines in clinical trials, despite good safety and immunogenicity profiles registered, issues such as imbalanced immune responses between serotypes

  18. Failure of vaccination to prevent outbreaks of foot-and-mouth disease.

    PubMed Central

    Woolhouse, M. E.; Haydon, D. T.; Pearson, A.; Kitching, R. P.

    1996-01-01

    Outbreaks of foot-and-mouth disease persist in dairy cattle herds in Saudi Arabia despite revaccination at intervals of 4-6 months. Vaccine trials provide data on antibody responses following vaccination. Using this information we developed a mathematical model of the decay of protective antibodies with which we estimated the fraction of susceptible animals at a given time after vaccination. The model describes the data well, suggesting over 95% take with an antibody half-life of 43 days. Farm records provided data on the time course of five outbreaks. We applied a 'SLIR' epidemiological model to these data, fitting a single parameter representing disease transmission rate. The analysis provides estimates of the basic reproduction number R(0), which may exceed 70 in some cases. We conclude that the critical intervaccination interval which would provide herd immunity against FMDV is unrealistically short, especially for heterologous challenge. We suggest that it may not be possible to prevent foot-and-mouth disease outbreaks on these farms using currently available vaccines. PMID:8666082

  19. A State-by-State Assessment of Food Service Regulations for Prevention of Norovirus Outbreaks.

    PubMed

    Kambhampati, Anita; Shioda, Kayoko; Gould, L Hannah; Sharp, Donald; Brown, Laura G; Parashar, Umesh D; Hall, Aron J

    2016-09-01

    Noroviruses are the leading cause of foodborne disease in the United States. Foodborne transmission of norovirus is often associated with contamination of food during preparation by an infected food worker. The U.S. Food and Drug Administration's Food Code provides model food safety regulations for preventing transmission of foodborne disease in restaurants; however, adoption of specific provisions is at the discretion of state and local governments. We analyzed the food service regulations of all 50 states and the District of Columbia (i.e., 51 states) to describe differences in adoption of norovirus-related Food Code provisions into state food service regulations. We then assessed potential correlations between adoption of these regulations and characteristics of foodborne norovirus outbreaks reported to the National Outbreak Reporting System from 2009 through 2014. Of the 51 states assessed, all (100%) required food workers to wash their hands, and 39 (76%) prohibited bare-hand contact with ready-to-eat food. Thirty states (59%) required exclusion of staff with vomiting and diarrhea until 24 h after cessation of symptoms. Provisions requiring a certified food protection manager (CFPM) and a response plan for contamination events (i.e., vomiting) were least commonly adopted; 26 states (51%) required a CFPM, and 8 (16%) required a response plan. Although not statistically significant, states that adopted the provisions prohibiting bare-hand contact (0.45 versus 0.74, P =0.07), requiring a CFPM (0.38 versus 0.75, P =0.09), and excluding ill staff for ≥24 h after symptom resolution (0.44 versus 0.73, P =0.24) each reported fewer foodborne norovirus outbreaks per million person-years than did those states without these provisions. Adoption and compliance with federal recommended food service regulations may decrease the incidence of foodborne norovirus outbreaks.

  20. Dengue fever

    MedlinePlus

    ... to occur and you have symptoms of the disease. Prevention Clothing, mosquito repellent, and netting can help reduce the risk of mosquito bites that can spread dengue fever and other infections. Limit outdoor activity during mosquito season, especially when they are most active, at ... Mosquito, adult feeding on the ...

  1. Reemergence of dengue in Mauritius.

    PubMed

    Issack, Mohammad I; Pursem, Vidula N; Barkham, Timothy M S; Ng, Lee Ching; Inoue, Masafumi; Manraj, Shyam S

    2010-04-01

    Dengue reemerged in Mauritius in 2009 after an absence of >30 years, and >200 cases were confirmed serologically. Molecular studies showed that the outbreak was caused by dengue virus type 2. Phylogenetic analysis of the envelope gene identified 2 clades of the virus. No case of hemorrhagic fever was recorded.

  2. Impact of health education based intervention on community's awareness of dengue and its prevention in Delhi, India.

    PubMed

    Kusuma, Yadlapalli S; Burman, Deepa; Kumari, Rita; Lamkang, Anjana S; Babu, Bontha V

    2017-03-01

    Dengue is endemic in India. The capital, Delhi, continues to witness a higher number of cases due to urbanization-related factors. This study is intended to implement health education towards prevention of dengue, and to assess its impact on people's knowledge and practices related to causes and prevention of dengue among urban poor in Delhi. Pre- ( n = 484) and post- ( n = 496) intervention surveys from 15 sub-clusters from five slums/slum-like settlements in Delhi were carried out. Health education based intervention was carried out through partnership with the municipal bodies and non-governmental organizations. Socio-demographic characteristics of participants were similar in both surveys. Intervention resulted in significant increase in knowledge on cause, symptom perception and mosquito behaviour in terms of breeding and biting habits. Practice of personal protection measures increased significantly. The participation of people increased during intervention compared to the routine programme. Health education based interventions are instrumental in improving people's knowledge and behaviour. Hence, routine health educational activities as a supportive strategy in the health system need to be strengthened. New integrated approaches such as eco-bio-social approaches with community participation are to be developed and tested in endemic settings like Delhi.

  3. Integrating participatory community mobilization processes to improve dengue prevention: an eco-bio-social scaling up of local success in Machala, Ecuador

    PubMed Central

    Mitchell-Foster, Kendra; Ayala, Efraín Beltrán; Breilh, Jaime; Spiegel, Jerry; Wilches, Ana Arichabala; Leon, Tania Ordóñez; Delgado, Jefferson Adrian

    2015-01-01

    Background This project investigates the effectiveness and feasibility of scaling-up an eco-bio-social approach for implementing an integrated community-based approach for dengue prevention in comparison with existing insecticide-based and emerging biolarvicide-based programs in an endemic setting in Machala, Ecuador. Methods An integrated intervention strategy (IIS) for dengue prevention (an elementary school-based dengue education program, and clean patio and safe container program) was implemented in 10 intervention clusters from November 2012 to November 2013 using a randomized controlled cluster trial design (20 clusters: 10 intervention, 10 control; 100 households per cluster with 1986 total households). Current existing dengue prevention programs served as the control treatment in comparison clusters. Pupa per person index (PPI) is used as the main outcome measure. Particular attention was paid to social mobilization and empowerment with IIS. Results Overall, IIS was successful in reducing PPI levels in intervention communities versus control clusters, with intervention clusters in the six paired clusters that followed the study design experiencing a greater reduction of PPI compared to controls (2.2 OR, 95% CI: 1.2 to 4.7). Analysis of individual cases demonstrates that consideration for contexualizing programs and strategies to local neighborhoods can be very effective in reducing PPI for dengue transmission risk reduction. Conclusions In the rapidly evolving political climate for dengue control in Ecuador, integration of successful social mobilization and empowerment strategies with existing and emerging biolarvicide-based government dengue prevention and control programs is promising in reducing PPI and dengue transmission risk in southern coastal communities like Machala. However, more profound analysis of social determination of health is called for to assess sustainability prospects. PMID:25604763

  4. Public knowledge and preventive behavior during a large-scale Salmonella outbreak: results from an online survey in the Netherlands

    PubMed Central

    2014-01-01

    Background Food-borne Salmonella infections are a worldwide concern. During a large-scale outbreak, it is important that the public follows preventive advice. To increase compliance, insight in how the public gathers its knowledge and which factors determine whether or not an individual complies with preventive advice is crucial. Methods In 2012, contaminated salmon caused a large Salmonella Thompson outbreak in the Netherlands. During the outbreak, we conducted an online survey (n = 1,057) to assess the general public’s perceptions, knowledge, preventive behavior and sources of information. Results Respondents perceived Salmonella infections and the 2012 outbreak as severe (m = 4.21; five-point scale with 5 as severe). Their knowledge regarding common food sources, the incubation period and regular treatment of Salmonella (gastro-enteritis) was relatively low (e.g., only 28.7% knew that Salmonella is not normally treated with antibiotics). Preventive behavior differed widely, and the majority (64.7%) did not check for contaminated salmon at home. Most information about the outbreak was gathered through traditional media and news and newspaper websites. This was mostly determined by time spent on the medium. Social media played a marginal role. Wikipedia seemed a potentially important source of information. Conclusions To persuade the public to take preventive actions, public health organizations should deliver their message primarily through mass media. Wikipedia seems a promising instrument for educating the public about food-borne Salmonella. PMID:24479614

  5. Dengue Contingency Planning: From Research to Policy and Practice

    PubMed Central

    Runge-Ranzinger, Silvia; Kroeger, Axel; Olliaro, Piero; McCall, Philip J.; Sánchez Tejeda, Gustavo; Lloyd, Linda S.; Hakim, Lokman; Bowman, Leigh R.; Horstick, Olaf; Coelho, Giovanini

    2016-01-01

    Background Dengue is an increasingly incident disease across many parts of the world. In response, an evidence-based handbook to translate research into policy and practice was developed. This handbook facilitates contingency planning as well as the development and use of early warning and response systems for dengue fever epidemics, by identifying decision-making processes that contribute to the success or failure of dengue surveillance, as well as triggers that initiate effective responses to incipient outbreaks. Methodology/Principal findings Available evidence was evaluated using a step-wise process that included systematic literature reviews, policymaker and stakeholder interviews, a study to assess dengue contingency planning and outbreak management in 10 countries, and a retrospective logistic regression analysis to identify alarm signals for an outbreak warning system using datasets from five dengue endemic countries. Best practices for managing a dengue outbreak are provided for key elements of a dengue contingency plan including timely contingency planning, the importance of a detailed, context-specific dengue contingency plan that clearly distinguishes between routine and outbreak interventions, surveillance systems for outbreak preparedness, outbreak definitions, alert algorithms, managerial capacity, vector control capacity, and clinical management of large caseloads. Additionally, a computer-assisted early warning system, which enables countries to identify and respond to context-specific variables that predict forthcoming dengue outbreaks, has been developed. Conclusions/Significance Most countries do not have comprehensive, detailed contingency plans for dengue outbreaks. Countries tend to rely on intensified vector control as their outbreak response, with minimal focus on integrated management of clinical care, epidemiological, laboratory and vector surveillance, and risk communication. The Technical Handbook for Surveillance, Dengue Outbreak

  6. Preventive behaviors by the level of perceived infection sensitivity during the Korea outbreak of Middle East Respiratory Syndrome in 2015

    PubMed Central

    2016-01-01

    OBJECTIVES This study was performed to investigate the relationship between community residents’ infection sensitivity and their levels of preventive behaviors during the 2015 Middle East Respiratory Syndrome (MERS) outbreak in Korea. METHODS Seven thousands two hundreds eighty one participants from nine areas in Gyeonggi-do including Pyeongtaek, the origin of the outbreak in 2015 agreed to participate in the survey and the data from 6,739 participants were included in the final analysis. The data on the perceived infection sensitivity were subjected to cluster analysis. The levels of stress, reliability/practice of preventive behaviors, hand washing practice and policy credibility during the outbreak period were analyzed for each cluster. RESULTS Cluster analysis of infection sensitivity due to the MERS outbreak resulted in classification of participants into four groups: the non-sensitive group (14.5%), social concern group (17.4%), neutral group (29.1%), and overall sensitive group (39.0%). A logistic regression analysis found that the overall sensitive group with high sensitivity had higher stress levels (17.80; 95% confidence interval [CI], 13.77 to 23.00), higher reliability on preventive behaviors (5.81; 95% CI, 4.84 to 6.98), higher practice of preventive behaviors (4.53; 95% CI, 3.83 to 5.37) and higher practice of hand washing (2.71; 95% CI, 2.13 to 3.43) during the outbreak period, compared to the non-sensitive group. CONCLUSIONS Infection sensitivity of community residents during the MERS outbreak correlated with gender, age, occupation, and health behaviors. When there is an outbreak in the community, there is need to maintain a certain level of sensitivity while reducing excessive stress, as well as promote the practice of preventive behaviors among local residents. In particular, target groups need to be notified and policies need to be established with a consideration of the socio-demographic characteristics of the community. PMID:28092927

  7. Dengue Fever

    MedlinePlus

    ... Old Feeding Your 1- to 2-Year-Old Dengue Fever KidsHealth > For Parents > Dengue Fever Print A ... can help lower the chances of infection. About Dengue Fever Dengue (DEN-gee) fever is caused by ...

  8. Genetic Analysis of Aedes aegypti Using Random Amplified Polymorphic DNA (RAPD) Markers from Dengue Outbreaks in Pakistan

    PubMed Central

    Ashraf, Hafiz Muhammad; Zahoor, Muhammad Kashif; Nasir, Shabab; Majeed, Humara Naz; Zahoor, Sarwat

    2016-01-01

    Background: Keeping in view the havoc situation of dengue fever in Pakistan, the current study was designed to demonstrate the genetic variations, gene flow and rate of migration from Lahore and Faisalabad. Methods: The larvae were collected from both natural and artificial breeding places from each collection site. The adult mosquitoes were collected by means of sweep net and battery-operated aspirator. DNA extraction was performed using TNE buffer method. Ten GeneLink-A series RAPD primers were used for PCR amplification and the data was analyzed through POPGENE. Results: The number of amplification products produced per primer varied from 8–12, ranging from 200 to 2000 bp with an average of 10.0 bands per primer. The percentage of polymorphic loci amplified by each primer varied from 22.5 to 51%. The UPGMA dendrogram demonstrates two distinct groups from Faisalabad and Lahore populations. The genetic diversity ranged from 0.260 in Faisalabad to 0.294 in Lahore with a total heterozygosity of 0.379. The GST value for nine populations within Lahore was 0.131 (Nm= 3.317), whereas for nine populations in Faisalabad GST value was 0.117 (Nm= 3.773). The overall genetic variation among eighteen populations showed GST= 0.341 and Nm= 1.966. Conclusion: The genetic relatedness and Nm value show that Ae. aegypti populations exhibit intra-population gene flow both in Faisalabad and Lahore. Although, both cities show a distinct pattern of genetic structure; however, few areas from both the cities show genetic similarity. The gene flow and the genetic relatedness in few populations of Lahore and Faisalabad cities need further investigation. PMID:28032107

  9. Evidence based community mobilization for dengue prevention in Nicaragua and Mexico (Camino Verde, the Green Way): cluster randomized controlled trial

    PubMed Central

    Nava-Aguilera, Elizabeth; Arosteguí, Jorge; Morales-Perez, Arcadio; Suazo-Laguna, Harold; Legorreta-Soberanis, José; Hernandez-Alvarez, Carlos; Fernandez-Salas, Ildefonso; Paredes-Solís, Sergio; Balmaseda, Angel; Cortés-Guzmán, Antonio Juan; Serrano de los Santos, René; Coloma, Josefina; Ledogar, Robert J; Harris, Eva

    2015-01-01

    Objective To test whether community mobilization adds effectiveness to conventional dengue control. Design Pragmatic open label parallel group cluster randomized controlled trial. Those assessing the outcomes and analyzing the data were blinded to group assignment. Centralized computerized randomization after the baseline study allocated half the sites to intervention, stratified by country, evidence of recent dengue virus infection in children aged 3-9, and vector indices. Setting Random sample of communities in Managua, capital of Nicaragua, and three coastal regions in Guerrero State in the south of Mexico. Participants Residents in a random sample of census enumeration areas across both countries: 75 intervention and 75 control clusters (about 140 households each) were randomized and analyzed (60 clusters in Nicaragua and 90 in Mexico), including 85 182 residents in 18 838 households. Interventions A community mobilization protocol began with community discussion of baseline results. Each intervention cluster adapted the basic intervention—chemical-free prevention of mosquito reproduction—to its own circumstances. All clusters continued the government run dengue control program. Main outcome measures Primary outcomes per protocol were self reported cases of dengue, serological evidence of recent dengue virus infection, and conventional entomological indices (house index: households with larvae or pupae/households examined; container index: containers with larvae or pupae/containers examined; Breteau index: containers with larvae or pupae/households examined; and pupae per person: pupae found/number of residents). Per protocol secondary analysis examined the effect of Camino Verde in the context of temephos use. Results With cluster as the unit of analysis, serological evidence from intervention sites showed a lower risk of infection with dengue virus in children (relative risk reduction 29.5%, 95% confidence interval 3.8% to 55.3%), fewer reports of

  10. Dengue virus vaccine development.

    PubMed

    Yauch, Lauren E; Shresta, Sujan

    2014-01-01

    Dengue virus (DENV) is a significant cause of morbidity and mortality in tropical and subtropical regions, causing hundreds of millions of infections each year. Infections range from asymptomatic to a self-limited febrile illness, dengue fever (DF), to the life-threatening dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS). The expanding of the habitat of DENV-transmitting mosquitoes has resulted in dramatic increases in the number of cases over the past 50 years, and recent outbreaks have occurred in the United States. Developing a dengue vaccine is a global health priority. DENV vaccine development is challenging due to the existence of four serotypes of the virus (DENV1-4), which a vaccine must protect against. Additionally, the adaptive immune response to DENV may be both protective and pathogenic upon subsequent infection, and the precise features of protective versus pathogenic immune responses to DENV are unknown, complicating vaccine development. Numerous vaccine candidates, including live attenuated, inactivated, recombinant subunit, DNA, and viral vectored vaccines, are in various stages of clinical development, from preclinical to phase 3. This review will discuss the adaptive immune response to DENV, dengue vaccine challenges, animal models used to test dengue vaccine candidates, and historical and current dengue vaccine approaches.

  11. Impact of human mobility on the emergence of dengue epidemics in Pakistan

    PubMed Central

    Wesolowski, Amy; Qureshi, Taimur; Boni, Maciej F.; Sundsøy, Pål Roe; Johansson, Michael A.; Rasheed, Syed Basit; Engø-Monsen, Kenth; Buckee, Caroline O.

    2015-01-01

    The recent emergence of dengue viruses into new susceptible human populations throughout Asia and the Middle East, driven in part by human travel on both local and global scales, represents a significant global health risk, particularly in areas with changing climatic suitability for the mosquito vector. In Pakistan, dengue has been endemic for decades in the southern port city of Karachi, but large epidemics in the northeast have emerged only since 2011. Pakistan is therefore representative of many countries on the verge of countrywide endemic dengue transmission, where prevention, surveillance, and preparedness are key priorities in previously dengue-free regions. We analyze spatially explicit dengue case data from a large outbreak in Pakistan in 2013 and compare the dynamics of the epidemic to an epidemiological model of dengue virus transmission based on climate and mobility data from ∼40 million mobile phone subscribers. We find that mobile phone-based mobility estimates predict the geographic spread and timing of epidemics in both recently epidemic and emerging locations. We combine transmission suitability maps with estimates of seasonal dengue virus importation to generate fine-scale dynamic risk maps with direct application to dengue containment and epidemic preparedness. PMID:26351662

  12. Impact of human mobility on the emergence of dengue epidemics in Pakistan.

    PubMed

    Wesolowski, Amy; Qureshi, Taimur; Boni, Maciej F; Sundsøy, Pål Roe; Johansson, Michael A; Rasheed, Syed Basit; Engø-Monsen, Kenth; Buckee, Caroline O

    2015-09-22

    The recent emergence of dengue viruses into new susceptible human populations throughout Asia and the Middle East, driven in part by human travel on both local and global scales, represents a significant global health risk, particularly in areas with changing climatic suitability for the mosquito vector. In Pakistan, dengue has been endemic for decades in the southern port city of Karachi, but large epidemics in the northeast have emerged only since 2011. Pakistan is therefore representative of many countries on the verge of countrywide endemic dengue transmission, where prevention, surveillance, and preparedness are key priorities in previously dengue-free regions. We analyze spatially explicit dengue case data from a large outbreak in Pakistan in 2013 and compare the dynamics of the epidemic to an epidemiological model of dengue virus transmission based on climate and mobility data from ∼40 million mobile phone subscribers. We find that mobile phone-based mobility estimates predict the geographic spread and timing of epidemics in both recently epidemic and emerging locations. We combine transmission suitability maps with estimates of seasonal dengue virus importation to generate fine-scale dynamic risk maps with direct application to dengue containment and epidemic preparedness.

  13. [Dengue fever--not just a tropical infectious disease].

    PubMed

    Stock, Ingo

    2016-03-01

    Dengue fever is a viral disease that is transmitted primarily by Aedes mosquitoes, i. e., A. aegypti and A. albopictus. Other species are rarely involved. The disease is caused by dengue virus, an enveloped RNA virus which belongs to the family of flaviviridae. Although most infections are asymptomatic, in 20 to 30 percentages all cases infections are accompanied with high fever and other influenza-like signs of illness. Serious medical conditions with lethal complications also occur. During the last decades, the incidence of dengue fever rose sharply in many tropical and subtropical countries. In some of these regions, dengue is one of the leading causes of death in children. In Europe, since a few years a strong clustering of dengue fever cases has been registered in travelers returning from certain tropical or subtropical regions. Recently, autochthonous outbreaks have been observed on the Atlantic island of Madeira and in a few other regions of South Europe. Treatment of dengue fever is supportive and symptomatic, a specific therapy does not exist. For prevention of disease, vector control is of crucial importance.

  14. Management of Pneumocystis jirovecii Pneumonia in Kidney Transplantation to Prevent Further Outbreak

    PubMed Central

    Goto, Norihiko; Futamura, Kenta; Okada, Manabu; Yamamoto, Takayuki; Tsujita, Makoto; Hiramitsu, Takahisa; Narumi, Shunji; Watarai, Yoshihiko

    2015-01-01

    The outbreak of Pneumocystis jirovecii pneumonia (PJP) among kidney transplant recipients is emerging worldwide. It is important to control nosocomial PJP infection. A delay in diagnosis and treatment increases the number of reservoir patients and the number of cases of respiratory failure and death. Owing to the large number of kidney transplant recipients compared to other types of organ transplantation, there are greater opportunities for them to share the same time and space. Although the use of trimethoprim-sulfamethoxazole (TMP-SMX) as first choice in PJP prophylaxis is valuable for PJP that develops from infections by trophic forms, it cannot prevent or clear colonization, in which cysts are dominant. Colonization of P. jirovecii is cleared by macrophages. While recent immunosuppressive therapies have decreased the rate of rejection, over-suppressed macrophages caused by the higher levels of immunosuppression may decrease the eradication rate of colonization. Once a PJP cluster enters these populations, which are gathered in one place and uniformly undergoing immunosuppressive therapy for kidney transplantation, an outbreak can occur easily. Quick actions for PJP patients, other recipients, and medical staff of transplant centers are required. In future, lifelong prophylaxis may be required even in kidney transplant recipients. PMID:26609250

  15. Asymmetric competition prevents the outbreak of an opportunistic species after coral reef degradation.

    PubMed

    González-Rivero, Manuel; Bozec, Yves-Marie; Chollett, Iliana; Ferrari, Renata; Schönberg, Christine H L; Mumby, Peter J

    2016-05-01

    Disturbance releases space and allows the growth of opportunistic species, excluded by the old stands, with a potential to alter community dynamics. In coral reefs, abundances of fast-growing, and disturbance-tolerant sponges are expected to increase and dominate as space becomes available following acute coral mortality events. Yet, an increase in abundance of these opportunistic species has been reported in only a few studies, suggesting certain mechanisms may be acting to regulate sponge populations. To gain insights into mechanisms of population control, we simulated the dynamics of the common reef-excavating sponge Cliona tenuis in the Caribbean using an individual-based model. An orthogonal hypothesis testing approach was used, where four candidate mechanisms-algal competition, stock-recruitment limitation, whole and partial mortality-were incorporated sequentially into the model and the results were tested against independent field observations taken over a decade in Belize, Central America. We found that releasing space after coral mortality can promote C. tenuis outbreaks, but such outbreaks can be curtailed by macroalgal competition. The asymmetrical competitive superiority of macroalgae, given by their capacity to pre-empt space and outcompete with the sponge in a size-dependant fashion, supports their capacity to steal the opportunity from other opportunists. While multiple system stages can be expected in coral reefs following intense perturbation macroalgae may prevent the growth of other space-occupiers, such as bioeroding sponges, under low grazing pressure.

  16. Infection prevention and control of the Ebola outbreak in Liberia, 2014-2015: key challenges and successes.

    PubMed

    Cooper, Catherine; Fisher, Dale; Gupta, Neil; MaCauley, Rose; Pessoa-Silva, Carmem L

    2016-01-05

    Prior to the 2014-2015 Ebola outbreak, infection prevention and control (IPC) activities in Liberian healthcare facilities were basic. There was no national IPC guidance, nor dedicated staff at any level of government or healthcare facility (HCF) to ensure the implementation of best practices. Efforts to improve IPC early in the outbreak were ad hoc and messaging was inconsistent. In September 2014, at the height of the outbreak, the national IPC Task Force was established with a Ministry of Health (MoH) mandate to coordinate IPC response activities. A steering group of the Task Force, including representatives of the World Health Organization (WHO) and the United States Centers for Disease Control and Prevention (CDC), supported MoH leadership in implementing standardized messaging and IPC training for the health workforce. This structure, and the activities implemented under this structure, played a crucial role in the implementation of IPC practices and successful containment of the outbreak. Moving forward, a nationwide culture of IPC needs to be maintained through this governance structure in Liberia's health system to prevent and respond to future outbreaks.

  17. A Social Media mHealth Solution to Address the Needs of Dengue Prevention and Management in Sri Lanka

    PubMed Central

    Rathnayake, Vajira Sampath; Lim, Gentatsu; Panchapakesan, Chitra; Foo, Schubert; Wijayamuni, Ruwan; Wimalaratne, Prasad; Fernando, Owen Noel Newton

    2016-01-01

    Background Sri Lanka has witnessed a series of dengue epidemics over the past five years, with the western province, home to the political capital of Colombo, bearing more than half of the dengue burden. Existing dengue monitoring prevention programs are exhausted as public health inspectors (PHIs) cope with increasing workloads and paper-based modes of surveillance and education, characterizing a reactive system unable to cope with the enormity of the problem. On the other hand, the unprecedented proliferation and affordability of mobile phones since 2009 and a supportive political climate have thus far remained unexploited for the use of mobile-based interventions for dengue management. Objective To conduct a needs assessment of PHIs in Colombo with respect to their dengue-related tasks and develop a new mobile-based system to address these needs while strengthening existing systems. Methods One-on-one in-depth interviews were conducted with 29 PHIs to a) gain a nuanced, in-depth understanding of the current state of surveillance practices, b) understand the logistical, technological and social challenges they confront, and c) identify opportunities for mobile-based interventions. Quantitative analysis included simple descriptive statistics while qualitative analysis comprised textual analysis of 209 pages of transcripts (or nearly 600 minutes of conversations) using grounded theory approaches. Results Current paper-based data collection practices for dengue surveillance involved a circuitous, time consuming process that could take between 7-10 days to officially report and record a single case. PHIs confronted challenges in terms of unreliable, standalone GIS devices, delays in registering mosquito breeding sites and lack of engagement from communities while delivering dengue education. These findings, in concert with a high motivation to use mobile-based systems, informed the development of Mo-Buzz, a mobile-based system that integrates three components

  18. Economic and Disease Burden of Dengue in Mexico

    PubMed Central

    Undurraga, Eduardo A.; Betancourt-Cravioto, Miguel; Ramos-Castañeda, José; Martínez-Vega, Ruth; Méndez-Galván, Jorge; Gubler, Duane J.; Guzmán, María G.; Halstead, Scott B.; Harris, Eva; Kuri-Morales, Pablo; Tapia-Conyer, Roberto; Shepard, Donald S.

    2015-01-01

    Background Dengue imposes a substantial economic and disease burden in most tropical and subtropical countries. Dengue incidence and severity have dramatically increased in Mexico during the past decades. Having objective and comparable estimates of the economic burden of dengue is essential to inform health policy, increase disease awareness, and assess the impact of dengue prevention and control technologies. Methods and Findings We estimated the annual economic and disease burden of dengue in Mexico for the years 2010–2011. We merged multiple data sources, including a prospective cohort study; patient interviews and macro-costing from major hospitals; surveillance, budget, and health data from the Ministry of Health; WHO cost estimates; and available literature. We conducted a probabilistic sensitivity analysis using Monte Carlo simulations to derive 95% certainty levels (CL) for our estimates. Results suggest that Mexico had about 139,000 (95%CL: 128,000–253,000) symptomatic and 119 (95%CL: 75–171) fatal dengue episodes annually on average (2010–2011), compared to an average of 30,941 symptomatic and 59 fatal dengue episodes reported. The annual cost, including surveillance and vector control, was US$170 (95%CL: 151–292) million, or $1.56 (95%CL: 1.38–2.68) per capita, comparable to other countries in the region. Of this, $87 (95%CL: 87–209) million or $0.80 per capita (95%CL: 0.62–1.12) corresponds to illness. Annual disease burden averaged 65 (95%CL: 36–99) disability-adjusted life years (DALYs) per million population. Inclusion of long-term sequelae, co-morbidities, impact on tourism, and health system disruption during outbreaks would further increase estimated economic and disease burden. Conclusion With this study, Mexico joins Panama, Puerto Rico, Nicaragua, and Thailand as the only countries or areas worldwide with comprehensive (illness and preventive) empirical estimates of dengue burden. Burden varies annually; during an outbreak

  19. Is drought helping or killing dengue? Investigation of spatiotemporal relationship between dengue fever and drought

    NASA Astrophysics Data System (ADS)

    Lee, Chieh-Han; Yu, Hwa-Lung

    2015-04-01

    Dengue Fever is a vector-borne disease that is transmitted between human and mosquitos in tropical and sub-tropical regions. Previous studies have found significant relationship between the epidemic of dengue cases and climate variables, especially temperature and precipitation. Besides, the natural phenomena (e.g., drought) are considered that significantly drop the number of dengue cases by killing vector's breeding environment. However, in Kaohsiung City, Taiwan, there are evidences that the temporal pattern of dengue is correlated to drought events. Kaohsiung City experienced two main dengue outbreaks in 2002 and 2014 that both years were confirmed with serious drought. Especially in 2014, Kaohsiung City was suffered from extremely dengue outbreak in 2014 that reported the highest number of dengue cases in the history. This study constructs the spatiotemporal model of dengue incidences and index of drought events (Standardized Precipitation Index, SPI) based on the distributed lag nonlinear model (DLNM). Other meteorological measures are also included in the analysis.

  20. Use of the Health Belief Model for the Assessment of Public Knowledge and Household Preventive Practices in Karachi, Pakistan, a Dengue-Endemic City

    PubMed Central

    Siddiqui, Taranum Ruba; Ghazal, Saima; Bibi, Safia; Ahmed, Waquaruddin; Sajjad, Shaimuna Fareeha

    2016-01-01

    Background Prevention is most effective in reducing dengue infection risk, especially in endemic countries like Pakistan. Evaluation of public awareness and health beliefs regarding dengue fever (DF) is important for devising disease control strategies. This study assessed dengue knowledge, health beliefs, and preventive practices against DF in different socioeconomic groups of Karachi, Pakistan. Methodology In this community-based cross-sectional study, 6 randomly selected towns were visited, 2 persons (man and woman) per household were interviewed using a structured questionnaire, and household practices were observed. Information regarding DF was shared through a printed pamphlet. Multivariate logistic regression analysis of variables associated with dengue knowledge and practices was conducted. Principal Findings We interviewed 608 Karachi residents (mean age: 33.2 ± 13.35 years); 7.7%, 71.9%, and 20.4% had a high, middle, and low socioeconomic status, respectively. The mean knowledge score was 6.4 ± 2.10 out of 14. The mean preventive practices score was 9 ± 1.8 out of 17. Predictors of dengue knowledge were perceived threat (odds ratio [OR] = 1.802; 95% confidence interval [CI] = 1.19–2.71; p = 0.005), self-efficacy (OR = 2.910; 95% CI = 1.77–4.76; p = 0.000), and television as an information source (OR = 3.202; 95% CI = 1.97–5.17; p = 0.000). Predictors of dengue preventive practices were perceived threat (OR = 1.502; 95% CI = 1.02–2.19; p = 0.036), self-efficacy (OR = 1.982; 95% CI = 1.34–2.91; p = 0.000), and dengue knowledge (OR = 1.581; 95% CI = 1.05–2.37; p = 0.028). Conclusions Public knowledge about DF is low in Karachi. Knowledge, threat perception, and self-efficacy are significant predictors of adequate dengue preventive practices. Prevention and control strategies should focus on raising awareness about dengue contraction risk and severity through television. Health messages should be designed to increase individual self

  1. Dengue in China: Comprehensive Phylogenetic Evaluation Reveals Evidence of Endemicity and Complex Genetic Diversity

    PubMed Central

    Chen, Rubing; Han, Guan-Zhu

    2016-01-01

    Despite the increasing threat of dengue outbreaks in China, it is still considered as an imported disease and its introduction and/or circulation patterns remain obscure. On the basis of the most extensive phylogenetic analysis to date, we showed highly complex genetic diversity of dengue viruses (DENVs) in south China with up to 20 different clades/lineages from multiple serotypes co-circulating in the same year. Despite that most of these clades/lineages were resulted from imported cases, evidence of local persistence of DENV serotype 1 (DENV-1) was observed, indicating its potential endemicity in Guangdong province. This study, therefore, provided an overview of DENV genetic diversity and evolutionary dynamics in China, which will be useful for developing policies to prevent and control future dengue outbreaks in China. PMID:26458780

  2. Dengue is still an imported disease in China: a case study in Guangzhou.

    PubMed

    Sang, Shaowei; Chen, Bin; Wu, Haixia; Yang, Zhicong; Di, Biao; Wang, Lihua; Tao, Xiaoyan; Liu, Xiaobo; Liu, Qiyong

    2015-06-01

    Dengue virus and its four serotypes (DENV 1-4) infect approximately 390 million people worldwide each year, with most cases in tropical and subtropical regions. Because of repeated introduction of DENV from epidemic regions and suitable weather conditions, many regions have shifted from hypo-endemicity to hyper-endemicity over recent decades. Since the first dengue outbreak in 1978, it is crucial to understand the current situation in China over nearly 40 years. The purpose of the study was to examine whether dengue in China was endemic or not, which is essential for relevant dengue control and prevention strategy implementation in China. The study, combining epidemiological characteristics of dengue from the disease notification system, phylogenetic and phylogeographic analyses, showed that all four serotypes had been detected in Guangzhou, China, which was dominated by DENV 1-2. The Maximum Likelihood tree analytic results showed that the virus detected in Guangzhou localized in different clades, except of virus of 2002 and 2003 clustered together. There existed the mutual introductions between Guangzhou and Southeast Asia. Most of the viruses were imported from Southeast Asia and the sources of outbreaks in Guangzhou mainly originated from Thailand, Indonesia, and the Philippines. The study indicates that dengue in China still remains as an imported disease, with the possibility of localization.

  3. Improved dengue fever prevention through innovative intervention methods in the city of Salto, Uruguay

    PubMed Central

    Basso, César; García da Rosa, Elsa; Romero, Sonnia; González, Cristina; Lairihoy, Rosario; Roche, Ingrid; Caffera, Ruben M.; da Rosa, Ricardo; Calfani, Marisel; Alfonso-Sierra, Eduardo; Petzold, Max; Kroeger, Axel; Sommerfeld, Johannes

    2015-01-01

    Background Uruguay is located at the southern border of Aedes aegypti distribution on the South American sub-continent. The reported dengue cases in the country are all imported from surrounding countries. One of the cities at higher risk of local dengue transmission is Salto, a border city with heavy traffic from dengue endemic areas. Methods We completed an intervention study using a cluster randomized trial design in 20 randomly selected ‘clusters’ in Salto. The clusters were located in neighborhoods of differing geography and economic, cultural and social aspects. Results Entomological surveys were carried out to measure the impact of the intervention on vector densities. Through participatory processes of all stakeholders, an appropriate ecosystem management intervention was defined. Residents collected the abundant small water holding containers and the Ministry of Public Health and the Municipality of Salto were responsible for collecting and eliminating them. Additional vector breeding places were large water tanks; they were either altered so that they could not hold water any more or covered so that oviposition by mosquitoes could not take place. Conclusions The response from the community and national programme managers was encouraging. The intervention evidenced opportunities for cost savings and reducing dengue vector densities (although not to statistically significant levels). The observed low vector density limits the potential reduction due to the intervention. A larger sample size is needed to obtain a statistically significant difference. PMID:25604764

  4. Dengue Surveillance in Veterans Affairs Healthcare Facilities, 2007–2010

    PubMed Central

    Schirmer, Patricia L.; Lucero-Obusan, Cynthia A.; Benoit, Stephen R.; Santiago, Luis M.; Stanek, Danielle; Dey, Achintya; Martinez, Mirsonia; Oda, Gina; Holodniy, Mark

    2013-01-01

    Background Although dengue is endemic in Puerto Rico (PR), 2007 and 2010 were recognized as epidemic years. In the continental United States (US), outside of the Texas-Mexico border, there had not been a dengue outbreak since 1946 until dengue re-emerged in Key West, Florida (FL), in 2009–2010. The objective of this study was to use electronic and manual surveillance systems to identify dengue cases in Veterans Affairs (VA) healthcare facilities and then to clinically compare dengue cases in Veterans presenting for care in PR and in FL. Methodology Outpatient encounters from 1/2007–12/2010 and inpatient admissions (only available from 10/2009–12/2010) with dengue diagnostic codes at all VA facilities were identified using VA's Electronic Surveillance System for Early Notification of Community-based Epidemics (ESSENCE). Additional case sources included VA data from Centers for Disease Control and Prevention BioSense and VA infection preventionists. Case reviews were performed. Categorical data was compared using Mantel-Haenszel or Fisher Exact tests and continuous variables using t-tests. Dengue case residence was mapped. Findings Two hundred eighty-eight and 21 PR and FL dengue cases respectively were identified. Of 21 FL cases, 12 were exposed in Key West and 9 were imported. During epidemic years, FL cases had significantly increased dengue testing and intensive care admissions, but lower hospitalization rates and headache or eye pain symptoms compared to PR cases. There were no significant differences in clinical symptoms, laboratory abnormalities or outcomes between epidemic and non-epidemic year cases in FL and PR. Confirmed/probable cases were significantly more likely to be hospitalized and have thrombocytopenia or leukopenia compared to suspected cases. Conclusions Dengue re-introduction in the continental US warrants increased dengue surveillance and education in VA. Throughout VA, under-testing of suspected cases highlights the need to emphasize use

  5. A spatiotemporal dengue fever early warning model accounting for nonlinear associations with meteorological factors: a Bayesian maximum entropy approach

    NASA Astrophysics Data System (ADS)

    Lee, Chieh-Han; Yu, Hwa-Lung; Chien, Lung-Chang

    2014-05-01

    Dengue fever has been identified as one of the most widespread vector-borne diseases in tropical and sub-tropical. In the last decade, dengue is an emerging infectious disease epidemic in Taiwan especially in the southern area where have annually high incidences. For the purpose of disease prevention and control, an early warning system is urgently needed. Previous studies have showed significant relationships between climate variables, in particular, rainfall and temperature, and the temporal epidemic patterns of dengue cases. However, the transmission of the dengue fever is a complex interactive process that mostly understated the composite space-time effects of dengue fever. This study proposes developing a one-week ahead warning system of dengue fever epidemics in the southern Taiwan that considered nonlinear associations between weekly dengue cases and meteorological factors across space and time. The early warning system based on an integration of distributed lag nonlinear model (DLNM) and stochastic Bayesian Maximum Entropy (BME) analysis. The study identified the most significant meteorological measures including weekly minimum temperature and maximum 24-hour rainfall with continuous 15-week lagged time to dengue cases variation under condition of uncertainty. Subsequently, the combination of nonlinear lagged effects of climate variables and space-time dependence function is implemented via a Bayesian framework to predict dengue fever occurrences in the southern Taiwan during 2012. The result shows the early warning system is useful for providing potential outbreak spatio-temporal prediction of dengue fever distribution. In conclusion, the proposed approach can provide a practical disease control tool for environmental regulators seeking more effective strategies for dengue fever prevention.

  6. Non-specific alert system for dengue epidemic outbreaks in areas of endemic malaria. A hospital-based evaluation in Cayenne (French Guiana).

    PubMed Central

    Carme, B.; Sobesky, M.; Biard, M. H.; Cotellon, P.; Aznar, C.; Fontanella, J. M.

    2003-01-01

    The emergence of dengue haemorrhagic fever is a public health problem in Latin America and the Caribbean. This study, carried out in French Guiana where malaria is endemic, evaluated the value and the limitations of a non-specific alert system including all patients admitted to the emergency department of Cayenne Hospital, between 1 January 1996 and June 2001. Four indices were studied on a weekly basis: the emergency malaria negative index (EMN), the EMN thrombocytopenia index (EMNT), the dengue suspected index: EMNT/EMN ratio; and the number of hospitalized patients with dengue fever according to the Department of Medical Information. These indices were retrospectively compared with data from the Arbovirus Reference Centre at the Pasteur Institute in French Guiana. Using the non-specific indices, we were able to identify four clear epidemics, two of which were shown to be linked to dengue. Variations in the incidence of malaria had no marked effect on this alert system. We propose that this simple, cheap, sensitive and reactive alert system be used to improve the serological and virological monitoring of dengue and to facilitate adequate and timely vector control measures. It could be used in all regions at risk of dengue and malaria. PMID:12613750

  7. Prospects for dengue vaccines for travelers

    PubMed Central

    2016-01-01

    Travel-acquired dengue cases have been increasing as the overall global dengue burden has expanded. In Korea, imported dengue cases have been reported since 2000 when it first became a notifiable disease. During the first four months of 2016, three times more dengue cases were reported in Korea than during the same period the previous year. A safe and efficacious vaccine for travelers would be beneficial to prevent dengue disease in individual travelers and potentially decrease the risk of virus spread to non-endemic areas. Here, we summarize the characteristics of dengue vaccines for travelers and review dengue vaccines currently licensed or in clinical development. PMID:27489798

  8. Preventing the spread of malaria and dengue fever using genetically modified mosquitoes.

    PubMed

    James, Anthony A

    2007-01-01

    In this candid interview, Anthony A. James explains how mosquito genetics can be exploited to control malaria and dengue transmission. Population replacement strategy, the idea that transgenic mosquitoes can be released into the wild to control disease transmission, is introduced, as well as the concept of genetic drive and the design criterion for an effective genetic drive system. The ethical considerations of releasing genetically-modified organisms into the wild are also discussed.

  9. [The historical evolution of dengue prevention and control programs in Brazil].

    PubMed

    Ferreira, Beatriz Jansen; Souza, Maria de Fátima Marinho; Soares Filho, Adauto Martins; Carvalho, André Anderson

    2009-01-01

    An epidemiological analysis of the forms and distribution of Dengue fever in Brazil and worldwide was carried out. The National Program of Dengue Control (NPDC) was evaluated based on the data available at 'Diagdengue' an official computerized information system allowing to follow-up the implantation and impact of the Program. A factorial analysis was performed by means of a set of indicators contributing to variability. The indicator scores were added and the cities demanding for prior attention of the NPCD were classified for the construction of an index, which is presented three-monthly for every state, with intervals distributed between 0 and 9. The implantation of the NCPD is irregular. Cities with bad implantation are predominating in the north and northeast of the country. In the second analysis, socio-economic variables of the selected cities were added. For the association tests these cities were classified into two groups: 'Bad' and 'Good/Very Good', based on the association of the index of building infestation informed in the FAD (Yellow Fever and Dengue) database and the constructed index. Associations were verified based on variance analysis, trend test and trend estimate. It was observed that cities with low rates of illiteracy, efficient garbage collection and high ratio of sanitary installations are correlated with a good classification of the city according to Diagdengue.

  10. Valuing the broader benefits of dengue vaccination, with a preliminary application to Brazil.

    PubMed

    Bärnighausen, Till; Bloom, David E; Cafiero, Elizabeth T; O'Brien, Jennifer C

    2013-04-01

    The incidence of dengue has been on the rise since at least the 1960s, bringing greater urgency to the need for a vaccine to prevent the disease. Recent advances suggest that the scientific world is moving closer to an effective dengue vaccine. However, there are concerns that the price of a future vaccine could limit its uptake. High prices, in addition to other challenges, have already weighed negatively in government decisions to include other new vaccines in national immunization programs, e.g., the pneumococcal, rotavirus, and human papillomavirus vaccines. Recent research on the value of vaccination, however, suggests that vaccination confers benefits that are often neglected by traditional economic evaluations. In the case of dengue, commonly overlooked benefits are likely to include reduced spending on outbreak control, averted losses in tourism flows, and avoided productivity losses due to long-term dengue sequelae. Accounting for these and other broader benefits of dengue vaccination could reveal significantly greater economic value and strengthen the case for inclusion of dengue vaccination in national immunization programs. In this article we discuss a framework for the broader value of vaccination and review its application in the context of dengue vaccination for Brazil.

  11. Innovative community-based ecosystem management for dengue and Chagas disease prevention in low and middle income countries in Latin America and the Caribbean.

    PubMed

    Finkelman, Jacobo

    2015-02-01

    In 2009, the WHO Special Programme for Research and Training in Tropical Diseases (TDR) and the International Development Research Centre (IDRC) launched a call for innovative community-based ecosystem management research projects for dengue and Chagas disease prevention in low and middle income countries in Latin America and the Caribbean. Eight research institutions were selected. The outputs of these projects led to a better understanding of the interaction between ecological, biological, social and economic (eco-bio-social) determinants of dengue and Chagas disease in Latin America and the Caribbean. Both diseases are considered highly relevant in the regional health agendas.

  12. Time-Lagging Interplay Effect and Excess Risk of Meteorological/Mosquito Parameters and Petrochemical Gas Explosion on Dengue Incidence

    PubMed Central

    Chang, Ko; Chen, Chaur-Dong; Shih, Chien-Ming; Lee, Tzu-Chi; Wu, Ming-Tsang; Wu, Deng-Chyang; Chen, Yen-Hsu; Hung, Chih-Hsing; Wu, Meng-Chieh; Huang, Chun-Chi; Lee, Chien-Hung; Ho, Chi-Kung

    2016-01-01

    In Kaohsiung, a metropolitan city in Taiwan at high risk of dengue epidemic, weather factors combined with an accidental petrochemical gas explosion (PGE) may affect mosquito‒human dynamics in 2014. Generalized estimating equations with lagged-time Poisson regression analyses were used to evaluate the effect of meteorological/mosquito parameters and PGE on dengue incidences (2000–2014) in Kaohsiung. Increased minimum temperatures rendered a 2- and 3-month lagging interactive effect on higher dengue risks, and higher rainfall exhibited a 1- and 2-month lagging interplay effect on lower risks (interaction, P ≤ 0.001). The dengue risk was significantly higher than that in a large-scale outbreak year (2002) from week 5 after PGE accident in 2014 (2.9‒8.3-fold for weeks 5‒22). The greatest cross-correlation of dengue incidences in the PGE-affected and PGE-neighboring districts was identified at weeks 1 after the PGE (rs = 0.956, P < 0.001). Compared with the reference years, the combined effect of minimum temperature, rainfall, and PGE accounted for 75.1% of excess dengue risk in 2014. In conclusion, time-lagging interplay effects from minimum temperature and rainfall may be respectively associated with early and near environments facilitating dengue transmission. Events that interact with weather and influence mosquito‒human dynamics, such as PGEs, should not be ignored in dengue prevention and control. PMID:27733774

  13. Dengue encephalitis

    PubMed Central

    Borawake, Kapil; Prayag, Parikshit; Wagh, Atul; Dole, Swati

    2011-01-01

    We report a case of dengue fever with features of encephalitis. The diagnosis of dengue was confirmed by the serum antibodies to dengue and the presence of a dengue antigen in the cerebrospinal fluid. This patient had characteristic magnetic resonance imaging brain findings, mainly involving the bilateral thalami, with hemorrhage. Dengue is not primarily a neurotropic virus and encephalopathy is a common finding in Dengue. Hence various other etiological possibilities were considered before concluding this as a case of Dengue encephalitis. This case explains the importance of considering the diagnosis of dengue encephalitis in appropriate situations. PMID:22013316

  14. [An outbreak of epidemic louse-borne typhus in Tokyo 1914: a study on the prevention of epidemics].

    PubMed

    Watanabe, Mikio

    2002-12-01

    In 1914, the third year of the Taisho era, a period of democracy and prosperity of Japan, Tokyo was attached by an outbreak of epidemic louse-borne typhus. The number of patients was 4,119 and number of deaths was 778 (mortality rate of 18.9%) in Tokyo and 7,309 patients had been suffering from typhus fever that year in Japan. Many possible causes of the outbreak were suspected by the Health Authority of the Home Office, but these were not confirmed. One of the most likely reasons is the poor and congested living conditions of seasonal construction workers. Laborers had moved from the northwest region of Japan where typhus fever had developed occasionally in those days. Some of the laborers probably brought pathogenic germs with lice. The main preventive method for epidemic louse-borne typhus was isolation of patients and disinfecting of the areas. Kitasato Shibasaburou proposed the improvement of residential conditions of workers to prevent the prevalence of disease, but the proposal was not accepted because of financial reasons of the government. Recurrence of the outbreak did not occur in the following years. However, a huge outbreak of typhus fever with 32,366 patients and 3,351 deaths, was documented in 1946, amidst the disordered conditions of Japan after World War II.

  15. How can health systems be strengthened to control and prevent an Ebola outbreak? A narrative review

    PubMed Central

    Regmi, Krishna; Gilbert, Ruth; Thunhurst, Colin

    2015-01-01

    The emergence and re-emergence of infectious diseases are now more than ever considered threats to public health systems. There have been over 20 outbreaks of Ebola in the past 40 years. Only recently, the World Health Organization has declared a public health emergency of international concern (PHEIC) in West Africa, with a projected estimate of 1.2 million deaths expected in the next 6 months. Ebola virus is a highly virulent pathogen, often fatal in humans and non-human primates. Ebola is now a great priority for global health security and often becomes fatal if left untreated. This study employed a narrative review. Three major databases – MEDLINE, EMBASE, and Global Health – were searched using both ‘text-words’ and ‘thesaurus terms’. Evidence shows that low- and middle-income countries (LMICs) are not coping well with the current challenges of Ebola, not only because they have poor and fragile systems but also because there are poor infectious disease surveillance and response systems in place. The identification of potential cases is problematic, particularly in the aspects of contact tracing, infection control, and prevention, prior to the diagnosis of the case. This review therefore aims to examine whether LMICs’ health systems would be able to control and manage Ebola in future and identifies two key elements of health systems strengthening that are needed to ensure the robustness of the health system to respond effectively. PMID:26609690

  16. From primary care to hospitalization: clinical warning signs of severe dengue fever in children and adolescents during an outbreak in Rio de Janeiro, Brazil.

    PubMed

    Gibson, Gerusa; Souza-Santos, Reinaldo; Brasil, Patrícia; Pacheco, Antonio Guilherme; Cruz, Oswaldo G; Honório, Nildimar Alves; Kubelka, Claire; Carvalho, Marilia Sá

    2013-01-01

    We analyzed factors associated with severe cases of dengue in children and adolescents hospitalized during the 2007/2008 epidemic in Rio de Janeiro, Brazil. This is a retrospective case-control study that covers 88 cases of severe dengue in patients admitted to four tertiary care children's hospitals. Controls consisted of 22 children with non-severe dengue living in the same neighborhood as the patients with severe dengue. Differences in prevalence of the clinical signs - abdominal pain, breathing difficulty, drowsiness or irritability - emerged on the third day after the onset of symptoms, in the febrile stage. Cases and controls received first medical care at the same clinical stage of disease. However, hospital admission of severe cases occurred later, on average between the third and fourth day after the onset of the disease. Early discharge of patients with fever whose condition could have progressed to severe dengue may have been a consequence of the type of medical assistance provided by primary care units, suggesting deficiencies both in the use of the risk classification protocol and patient triage.

  17. Poliomyelitis outbreaks in Angola genetically linked to India: risk factors and implications for prevention of outbreaks due to wild poliovirus importations.

    PubMed

    Kidd, Sarah; Goodson, James L; Aramburu, Javier; Morais, Alda; Gaye, Abou; Wannemuehler, Kathleen; Buffington, Joanna; Gerber, Sue; Wassilak, Steven; Uzicanin, Amra

    2011-05-12

    We conducted an investigation of two outbreaks of poliomyelitis in Angola during 2007-2008 due to wild poliovirus (WPV) genetically linked to India. A case-control study including 27 case-patients and 76 age- and neighborhood-matched control-subjects was conducted to assess risk factors associated with paralytic poliomyelitis, and epidemiologic links to India were explored through in-depth case-patient interviews. In multivariable analysis, case-patients were more likely than control-subjects to be undervaccinated with fewer than four routine doses of oral poliovirus vaccine (adjusted matched odds ratio [aMOR], 4.1; 95% confidence interval [CI], 1.2-13.6) and have an adult household member who traveled outside the province of residence in the 2 months preceding onset of paralysis (aMOR, 3.2; 95% CI, 1.2-8.6). No epidemiologic link with India was identified. These findings underscore the importance of routine immunization to prevent outbreaks following WPV importations and suggest a possible role of adults in sustaining WPV transmission.

  18. Preparedness for the prevention and control of influenza outbreaks on passenger ships in the EU: the SHIPSAN TRAINET project communication.

    PubMed

    Mouchtouri, Va; Black, N; Nichols, G; Paux, T; Riemer, T; Rjabinina, J; Schlaich, C; Menel Lemos, C; Kremastinou, J; Hadjichristodoulou, C

    2009-05-28

    Passenger ships carry a large number of people in confined spaces. A case of the new influenza A (H1N1) virus aboard a passenger ship is an expected event and would lead to rapid spread of the virus, if preventive measures are not in place. However, many cruise lines have detailed policies and procedures to deal with cases of influenza like illness (ILI). The EU SHIPSAN and SHIPSAN TRAINET projects include in their objectives guidelines for the prevention and control of communicable diseases aboard passenger ships. A literature review showed that from 1997 to 2005, nine confirmed outbreaks of influenza were linked to passenger ships, with attack rates up to 37%. It is important to establish and maintain a surveillance system for ILI aboard passenger ships, in order to systematically collect data that can help to determine the baseline illness levels. Monitoring these will enable early identification of outbreaks and allow timely implementation of control measures.

  19. Effectiveness analysis of fumigation strategy in dengue disease prevention program (Case study: Jakarta province, Indonesia)

    NASA Astrophysics Data System (ADS)

    Agustine, D.; Mahatma, Y.; Aldila, D.

    2015-03-01

    Mathematical model of dengue disease with fumigation intervention for mosquito population will discussed in this article. Interaction between human and mosquitoes population will based on SIR-SI host-vector model. Side effect of fumigation where mosquito capable to developed a resistance to fumigation will be accommodated in to the model. Equilibrium points and basic reproductive ratio as the endemic criteria will be shown analytically. Some numerical results are shown to give a back up reasoning for analytical result. We conclude that resistance of mosquitoes to fumigation intervention play an important role in fumigation strategy.

  20. An educational programme on dengue fever prevention and control for females in Jeddah high schools.

    PubMed

    Ibrahim, N K; Abalkhail, B; Rady, M; Al-Bar, H

    2009-01-01

    A mass communication campaign was conducted at 20 randomly selected female high schools and 2 school supervision centres in Jeddah to improve knowledge, attitudes and practices of students, teachers and supervisors about dengue fever. A total of 5977 pre- and post-intervention questionnaires were completed and the intervention was conducted using lectures and audiovisual aids. A marked improvement in all areas of knowledge, attitudes and practices was observed after the programme in all groups. Students obtained the highest improvement in mean knowledge scores after the programme compared to the other 2 groups. There is a need to expand such programmes to all Jeddah schools.

  1. Antiviral activity of Thiosemicarbazones derived from α-amino acids against Dengue virus.

    PubMed

    Padmanabhan, Padmapriya; Khaleefathullah, Sheriff; Kaveri, Krishansamy; Palani, Gunasekaran; Ramanathan, Giriprasath; Thennarasu, Sathiah; Tirichurapalli Sivagnanam, Uma

    2017-03-01

    The endemicity and seasonal outbreaks of Dengue disease in most tropical and subtropical countries underscores an urgent need to develop effective prevention and control measures. Development of a Dengue vaccine, which is complicated by the Antibody Dependent Enhancement effect (ADE), a viral inhibitor, seems prudent as it would inhibit the spread of the virus. In vitro methods such as MTT assay and plaque formation unit reduction assays were employed for screening the viral inhibitory property of α-amino acid based Thiosemicarbazides. The results elicits that at concentrations not exceeding the maximum non cytotoxic concentration (MNCC), these compounds completely prevented Dengue virus infection in vero cells as indicated by the absence of cytopathic effects in a dose-dependent manner. The high potency of Bz-Trp-TSC against all four types of Dengue virus infection elevates Thiosemicarbazide as a lead antiviral agent for Dengue disease. Screening small molecules for antiviral activity against the most rapidly spreading mosquito-borne viral disease is being explored by several research groups. Our findings would help to augment the efforts to identify the lead compounds for antiviral therapy to combat the Dengue disease. J. Med. Virol. 89:546-552, 2017. © 2016 Wiley Periodicals, Inc.

  2. Measles outbreak in a pediatric oncology unit and the role of ribavirin in prevention of complications and containment of the outbreak.

    PubMed

    Roy Moulik, Nirmalya; Kumar, Archana; Jain, Amita; Jain, Parul

    2013-10-01

    The role of oral ribavirin in treatment and containment of a measles outbreak in 15 children in an oncology unit is presented. Measles was diagnosed on clinical features and history of contact. Measles specific IgM ELISA and RNA were positive in 7 of 15 and 2 of 7 tested children, respectively. Duration of illness was longer in unimmunized as compared to immunized children (P = 0.02). Complications were higher in hematological malignancies (P = 0.025). Delay in starting ribavirin was associated with fatal complications (2 of 2 vs. 0 of 13, P = 0.009). Ribavirin prevented measles in all (21 of 21) patients exposed to the cases.

  3. Baseline Evaluation of a Participatory Mobile Health Intervention for Dengue Prevention in Sri Lanka

    ERIC Educational Resources Information Center

    Lwin, May O.; Vijaykumar, Santosh; Lim, Gentatsu; Fernando, Owen Noel Newton; Rathnayake, Vajira Sampath; Foo, Schubert

    2016-01-01

    Challenges posed by infectious disease outbreaks have led to a range of participatory mobile phone-based innovations that use the power of crowdsourcing for disease surveillance. However, the dynamics of participatory behavior by crowds in such interventions have yet to be examined. This article reports results from a baseline evaluation of one…

  4. Surveillance for dengue and dengue-associated neurologic syndromes in the United States.

    PubMed

    Waterman, Stephen H; Margolis, Harold S; Sejvar, James J

    2015-05-01

    Autochthonous dengue virus transmission has occurred in the continental United States with increased frequency during the last decade; the principal vector, Aedes aegypti, has expanded its geographic distribution in the southern United States. Dengue, a potentially fatal arboviral disease, is underreported, and US clinicians encountering patients with acute febrile illness consistent with dengue are likely to not be fully familiar with dengue diagnosis and management. Recently, investigators suggested that an outbreak of dengue likely occurred in Houston during 2003 based on retrospective laboratory testing of hospitalized cases with encephalitis and aseptic meningitis. Although certain aspects of the Houston testing results and argument for local transmission are doubtful, the report highlights the importance of prospective surveillance for dengue in Aedes-infested areas of the United States, the need for clinical training on dengue and its severe manifestations, and the need for laboratory testing in domestic patients presenting with febrile neurologic illness in these regions to include dengue.

  5. Surveillance for Dengue and Dengue-Associated Neurologic Syndromes in the United States

    PubMed Central

    Waterman, Stephen H.; Margolis, Harold S.; Sejvar, James J.

    2015-01-01

    Autochthonous dengue virus transmission has occurred in the continental United States with increased frequency during the last decade; the principal vector, Aedes aegypti, has expanded its geographic distribution in the southern United States. Dengue, a potentially fatal arboviral disease, is underreported, and US clinicians encountering patients with acute febrile illness consistent with dengue are likely to not be fully familiar with dengue diagnosis and management. Recently, investigators suggested that an outbreak of dengue likely occurred in Houston during 2003 based on retrospective laboratory testing of hospitalized cases with encephalitis and aseptic meningitis. Although certain aspects of the Houston testing results and argument for local transmission are doubtful, the report highlights the importance of prospective surveillance for dengue in Aedes-infested areas of the United States, the need for clinical training on dengue and its severe manifestations, and the need for laboratory testing in domestic patients presenting with febrile neurologic illness in these regions to include dengue. PMID:25371183

  6. [Classical dengue transmission dynamics involving mechanical control and prophylaxis].

    PubMed

    Toro-Zapata, Hernán D; Restrepo, Leonardo D; Vergaño-Salazar, Juan G; Muñoz-Loaiza, Aníbal

    2010-12-01

    Dengue fever transmission dynamics were studied in an endemic region considering the use of preventative measures and mechanical control in reducing transmission of the disease. A system of ordinary differential equations was proposed, describing the dynamics and their evolution as determined by numerical simulation. Different mechanical control and prophylaxis strategies were compared to the situation without control. The basic reproduction number R₀ was determined R₀ to show that if R₀ > 1 there would be a risk of an epidemic and otherwise the disease would have low impact levels. The basic reproduction number helps determine the dynamics' future pattern and contrast the results so obtained with those obtained numerically. It was concluded that although prophylaxis and mechanical control alone provide effective results in controlling the disease, if both controls are combined then infection levels become significantly reduced. Around 60 % mechanical control and prevention levels are needed to provide suitable results in controlling dengue outbreaks.

  7. Institutional Preparedness to Prevent Future Middle East Respiratory Syndrome Coronavirus-Like Outbreaks in Republic of Korea

    PubMed Central

    2016-01-01

    A year has passed since the Middle East respiratory syndrome (MERS) outbreak in the Republic of Korea. This 2015 outbreak led to a better understanding of healthcare infection control. The first Korean patient infected by Middle East Respiratory Syndrome Coronavirus (MERS-CoV) was diagnosed on May 20, 2015, after he returned from Qatar and Bahrain. Thereafter, 186 Korean people were infected with the MERS-CoV in a short time through human-to-human transmission. All these cases were linked to healthcare settings, and 25 (13.5 %) infected patients were healthcare workers. Phylogenetic analysis suggested that the MERS-CoV isolate found in the Korean patient was closely related to the Qatar strain, and did not harbor transmission efficiency-improving mutations. Nevertheless, with the same infecting virus strain, Korea experienced the largest MERS-CoV outbreak outside the Arabian Peninsula, primarily due to the different characteristics of population density and the healthcare system. We aimed to review the epidemiological features and existing knowledge on the Korean MERS outbreak, and suggest methods to prevent future epidemics. PMID:27433377

  8. Outbreak of resistant Acinetobacter baumannii- measures and proposal for prevention and control.

    PubMed

    Romanelli, Roberta Maia de Castro; Jesus, Lenize Adriana de; Clemente, Wanessa Trindade; Lima, Stella Sala Soares; Rezende, Edna Maria; Coutinho, Rosane Luiza; Moreira, Ricardo Luiz Fontes; Neves, Francelli Aparecida Cordeiro; Brás, Nelma de Jesus

    2009-10-01

    Acinetobacter baumannii colonization and infection, frequent in Intensive Care Unit (ICU) patients, is commonly associated with high morbimortality. Several outbreaks due to multidrug-resistant (MDR) A. baumanii have been reported but few of them in Brazil. This study aimed to identify risk factors associated with colonization and infection by MDR and carbapenem-resistant A. baumannii strains isolated from patients admitted to the adult ICU at HC/UFMG. A case-control study was performed from January 2007 to June 2008. Cases were defined as patients colonized or infected by MDR/carbapenem-resistant A. baumannii, and controls were patients without MDR/carbapenem-resistant A. baumannii isolation, in a 1:2 proportion. For statistical analysis, due to changes in infection control guidelines, infection criteria and the notification process, this study was divided into two periods. During the first period analyzed, from January to December 2007, colonization or infection by MDR/carbapenem-resistant A. baumannii was associated with prior infection, invasive device utilization, prior carbapenem use and clinical severity. In the multivariate analysis, prior infection and mechanical ventilation proved to be statistically significant risk factors. Carbapenem use showed a tendency towards a statistical association. During the second study period, from January to June 2008, variables with a significant association with MDR/carbapenem-resistant A. baumannii colonization/infection were catheter utilization, carbapenem and third-generation cephalosporin use, hepatic transplantation, and clinical severity. In the multivariate analysis, only CVC use showed a statistical difference. Carbapenem and third-generation cephalosporin use displayed a tendency to be risk factors. Risk factors must be focused on infection control and prevention measures considering A. baumanni dissemination.

  9. Factors affecting prevention and control of viral gastroenteritis outbreaks in care homes.

    PubMed

    Vivancos, R; Trainor, E; Oyinloye, A; Keenan, A

    2012-10-01

    We assess the effect of key care quality indicators on viral gastroenteritis outbreaks and control in care homes using mandatory inspection data collected by a non-departmental public body. Outbreak occurrence was associated with care home size but not with overall quality or individual environmental standards. Care home size, hygiene and infection control standard scores were inversely associated with attack rate in residents, whereas delayed reporting to the local public health agency was associated with higher attack rates.

  10. Transfusion support in patients with dengue fever.

    PubMed

    Kaur, Paramjit; Kaur, Gagandeep

    2014-09-01

    Dengue fever has emerged as a global public health problem in the recent decades. The clinical spectrum of the disease ranges from dengue fever to dengue hemorrhagic fever and dengue shock syndrome. The disease is characterized by increased capillary permeability, thrombocytopenia and coagulopathy. Thrombocytopenia with hemorrhagic manifestations warrants platelet transfusions. There is lack of evidence-based guidelines for transfusion support in patients with dengue fever. This contributes to inappropriate use of blood components and blood centers constantly face the challenge of inventory management during dengue outbreaks. The current review is aimed to highlight the role of platelets and other blood components in the management of dengue. The review was performed after searching relevant published literature in PubMed, Science Direct, Google scholar and various text books and journal articles.

  11. Early central nervous system involvement in a young patient with dengue encephalitis.

    PubMed

    Alice, V; Cheong, B M K

    2016-02-01

    A previously well 13-year-old boy presented with a short history of fever and altered mental status. His mother was admitted for dengue fever and there had been a recent dengue outbreak in their neighbourhood. He was diagnosed with dengue encephalitis as both his dengue non-structural protein 1 (NS-1) antigen and cerebrospinal fluid (CSF) dengue polymerase chain reaction (PCR) were positive. He did not have haemoconcentration, thrombocytopenia or any warning signs associated with severe dengue. He recovered fully with supportive treatment. This case highlights the importance of considering the diagnosis of dengue encephalitis in patients from dengue endemic areas presenting with an acute febrile illness and neurological symptoms.

  12. Clustering, climate and dengue transmission.

    PubMed

    Junxiong, Pang; Yee-Sin, Leo

    2015-06-01

    Dengue is currently the most rapidly spreading vector-borne disease, with an increasing burden over recent decades. Currently, neither a licensed vaccine nor an effective anti-viral therapy is available, and treatment largely remains supportive. Current vector control strategies to prevent and reduce dengue transmission are neither efficient nor sustainable as long-term interventions. Increased globalization and climate change have been reported to influence dengue transmission. In this article, we reviewed the non-climatic and climatic risk factors which facilitate dengue transmission. Sustainable and effective interventions to reduce the increasing threat from dengue would require the integration of these risk factors into current and future prevention strategies, including dengue vaccination, as well as the continuous support and commitment from the political and environmental stakeholders.

  13. Knowledge, attitudes and preventive behaviors related to dengue vector breeding control measures among adults in communities of Vientiane, capital of the Lao PDR.

    PubMed

    Sayavong, Chanthalay; Chompikul, Jiraporn; Wongsawass, Somsak; Rattanapan, Cheerwit

    2015-01-01

    This research aimed to determine the knowledge, attitudes and preventive behaviors (KAP) of adults in relation to dengue vector control measures in the communities of Vientiane, the capital of the Lao PDR. A total of 207 respondents were actively participating in this cross-sectional descriptive study in 2011. Representatives of households were interviewed face-to-face by six trained interviewers using a structured questionnaire. KAP reliabilities of 0.89, 0.91 and 0.95 were reported in the pilot sample of 30 cases. The associations between each independent variable and prevention behavior were tested with chi-square tests. Multiple logistic regression was used to determine the factors that were significantly associated with preventive behavior while controlling for the other variables. The results revealed that 51.69% of the respondents had a high level of knowledge. More than 94% of the respondents knew that dengue fever is a dangerous communicable disease and that dengue fever is transmitted from person to person via mosquitoes. More than half (56.52%) of the participants had positive attitudes toward vector control measures, and 52.17% exhibited a high level of preventive behavior in terms of dengue vector control measures. Preventive behaviors were significantly associated with information provided from sources that included health personnel (p = 0.038) and heads of villages (p=0.031) and with knowledge levels (p < 0.001). This study suggests that proactive health education through appropriated mass media and community clean-up campaigns should strengthen and encourage community participation, particularly in terms of addressing mosquito larvae in overlooked places, such as the participants' own homes, for example, in flower vases and ant traps.

  14. Auditing the Management of Vaccine-Preventable Disease Outbreaks: The Need for a Tool

    PubMed Central

    Torner, Nuria; Carnicer-Pont, Dolors; Castilla, Jesus; Cayla, Joan; Godoy, Pere; Dominguez, Angela

    2011-01-01

    Public health activities, especially infectious disease control, depend on effective teamwork. We present the results of a pilot audit questionnaire aimed at assessing the quality of public health services in the management of VPD outbreaks. Audit questionnaire with three main areas indicators (structure, process and results) was developed. Guidelines were set and each indicator was assessed by three auditors. Differences in indicator scores according to median size of outbreaks were determined by ANOVA (significance at p≤0.05). Of 154 outbreaks; eighteen indicators had a satisfactory mean score, indicator “updated guidelines” and “timely reporting” had a poor mean score (2.84±106 and 2.44±1.67, respectively). Statistically significant differences were found according to outbreak size, in the indicators “availability of guidelines/protocol updated less than 3 years ago” (p = 0.03) and “days needed for outbreak control” (p = 0.04). Improving availability of updated guidelines, enhancing timely reporting and adequate recording of control procedures taken is needed to allow for management assessment and improvement. PMID:21249188

  15. Auditing the management of vaccine-preventable disease outbreaks: the need for a tool.

    PubMed

    Torner, Nuria; Carnicer-Pont, Dolors; Castilla, Jesus; Cayla, Joan; Godoy, Pere; Dominguez, Angela

    2011-01-13

    Public health activities, especially infectious disease control, depend on effective teamwork. We present the results of a pilot audit questionnaire aimed at assessing the quality of public health services in the management of VPD outbreaks. Audit questionnaire with three main areas indicators (structure, process and results) was developed. Guidelines were set and each indicator was assessed by three auditors. Differences in indicator scores according to median size of outbreaks were determined by ANOVA (significance at p≤0.05). Of 154 outbreaks; eighteen indicators had a satisfactory mean score, indicator "updated guidelines" and "timely reporting" had a poor mean score (2.84±106 and 2.44±1.67, respectively). Statistically significant differences were found according to outbreak size, in the indicators "availability of guidelines/protocol updated less than 3 years ago" (p = 0.03) and "days needed for outbreak control" (p = 0.04). Improving availability of updated guidelines, enhancing timely reporting and adequate recording of control procedures taken is needed to allow for management assessment and improvement.

  16. [Risk perception and strategies for mass communication on dengue in the Americas].

    PubMed

    San Martín, José Luis; Prado, Mónica

    2004-02-01

    Dengue is clearly a very serious public health problem. In the Americas the number of dengue cases has been increasing since the 1960s, and outbreaks of the disease have been occurring more frequently. Furthermore, the density of infestation with the disease vector, the Aedes aegypti mosquito, is high in the Americas. The general strategy for preventing and controlling dengue and dengue hemorrhagic fever is based on promoting behavior changes that lead to incorporating the community in controlling the disease, particularly the vector. In order to achieve this, mass communication programs on dengue should have two primary aims: converting information into practice and encouraging the community to take over prevention and control measures. The new generation of programs should be designed based on the local sanitation structure (water distribution and waste disposal) as well as information on community organizations and the roles of different family members. Furthermore, the new programs should incorporate all the following ten components: epidemiological surveillance, intersectoral actions, community participation, managing the environment and basic services, patient care, case reporting, education, using insecticides and vector control, training, and preparing for emergencies. Communication should be aimed at modifying the behavior of individuals and the community by empowering them to carry out prevention and control measures.

  17. Emergence of Epidemic Dengue-1 Virus in the Southern Province of Sri Lanka

    PubMed Central

    Nagahawatte, Ajith; Devasiri, Vasantha; Kodikara Arachichi, Wasantha; Strouse, John J.; Sessions, October M.; Kurukulasooriya, Ruvini; Uehara, Anna; Howe, Shiqin; Ong, Xin Mei; Tan, Sharon; Chow, Angelia; Tummalapalli, Praveen; De Silva, Aruna D.; Østbye, Truls; Woods, Christopher W.; Gubler, Duane J.; Reller, Megan E.

    2016-01-01

    Background Dengue is a frequent cause of acute febrile illness with an expanding global distribution. Since the 1960s, dengue in Sri Lanka has been documented primarily along the heavily urbanized western coast with periodic shifting of serotypes. Outbreaks from 2005–2008 were attributed to a new clade of DENV-3 and more recently to a newly introduced genotype of DENV-1. In 2007, we conducted etiologic surveillance of acute febrile illness in the Southern Province and confirmed dengue in only 6.3% of febrile patients, with no cases of DENV-1 identified. To re-evaluate the importance of dengue as an etiology of acute febrile illness in this region, we renewed fever surveillance in the Southern Province to newly identify and characterize dengue. Methodology/Principal Findings A cross-sectional surveillance study was conducted at the largest tertiary care hospital in the Southern Province from 2012–2013. A total of 976 patients hospitalized with acute undifferentiated fever were enrolled, with 64.3% male and 31.4% children. Convalescent blood samples were collected from 877 (89.6%). Dengue virus isolation, dengue RT-PCR, and paired IgG ELISA were performed. Acute dengue was confirmed as the etiology for 388 (39.8%) of 976 hospitalizations, with most cases (291, 75.0%) confirmed virologically and by multiple methods. Among 351 cases of virologically confirmed dengue, 320 (91.2%) were due to DENV-1. Acute dengue was associated with self-reported rural residence, travel, and months having greatest rainfall. Sequencing of selected dengue viruses revealed that sequences were most closely related to those described from China and Southeast Asia, not nearby India. Conclusions/Significance We describe the first epidemic of DENV-1 in the Southern Province of Sri Lanka in a population known to be susceptible to this serotype because of prior study. Dengue accounted for 40% of acute febrile illnesses in the current study. The emergence of DENV-1 as the foremost serotype in

  18. Real-time forecasts of dengue epidemics

    NASA Astrophysics Data System (ADS)

    Yamana, T. K.; Shaman, J. L.

    2015-12-01

    Dengue is a mosquito-borne viral disease prevalent in the tropics and subtropics, with an estimated 2.5 billion people at risk of transmission. In many areas with endemic dengue, disease transmission is seasonal but prone to high inter-annual variability with occasional severe epidemics. Predicting and preparing for periods of higher than average transmission is a significant public health challenge. Here we present a model of dengue transmission and a framework for optimizing model simulations with real-time observational data of dengue cases and environmental variables in order to generate ensemble-based forecasts of the timing and severity of disease outbreaks. The model-inference system is validated using synthetic data and dengue outbreak records. Retrospective forecasts are generated for a number of locations and the accuracy of these forecasts is quantified.

  19. Dengue NS1 and prM antibodies increase the sensitivity of acute dengue diagnosis test and differentiate from Japanese encephalitis infection.

    PubMed

    Gowri Sankar, S; Balaji, T; Venkatasubramani, K; Thenmozhi, V; Dhananjeyan, K J; Paramasivan, R; Tyagi, B K; John Vennison, S

    2014-05-01

    Accurate and early diagnosis of dengue infection is essential for dengue case management. In outbreak conditions, it is essential to include two different tests to diagnose dengue and the choice depends on the number of days after the onset of illness in which the sample is collected. During the laboratory diagnosis of dengue in late acute and convalescent phase by MAC-ELISA, it is necessary to rule out possible cross reactions of closely related flavivirus, such as Japanese encephalitis virus which is commonly co-circulating. In the present investigation, the usefulness of dengue virus NS1 and prM antibodies in diagnosing and differentiating dengue from Japanese encephalitis infection was assessed using samples collected during out-breaks. It was shown here that, detection of antibodies against dengue NS1 and prM proteins increases the sensitivity of dengue diagnosis until 15days. Moreover, detection of antibodies against both proteins was able to differentiate dengue from Japanese encephalitis infection.

  20. [Epidemiological evaluation of a rapidly-prevented tularemia outbreak in Canakkale province, Turkey].

    PubMed

    Tatman Otkun, Müşerref; Akçalı, Alper; Karadenizli, Aynur; Ozbey, Nilgün; Gazel, Deniz; Sener, Alper; Güçlü, Oğuz; Tanrıöver, Arzu; Otkun, Metin

    2011-01-01

    linkage between these acute cases (n= 2) and the other seropositive subjects (n= 34) was the use of local water supply system. It was learned that water obtained through reverse osmosis system had been used as drinking water at Baliklicesme village. Pre- and post-reverse osmosis system water samples from Baliklicesme village and samples from water supply of Sinekci village revealed positive results for F.tularensis by PCR. Since the only epidemiological relation between these two villages was using local water supply, tularemia cases encountered in this area were attributed to a waterborne epidemic and an automatic chlorination system was set up at each water reservoir in these villages. The establishment of these preventive measures curbed the growth of the epidemic. The cases presenting with throat sore, fever, lymphadenopathy (more than 2 cm), non-responsive to beta-lactam antibiotics, should be further investigated for tularemia. This work emphasizes that systematic setup and control of water disinfection systems are crucial to prevent tularemia outbreaks. Community and related authorities should be educated about the importance of water sanitation and chlorination.

  1. Dengue Fever

    MedlinePlus

    ... away from areas that have a dengue fever epidemic, the risk of contracting dengue fever is small for international travelers./p> Reviewed by: Elana ... Transfusions Cholera West Nile Virus First Aid: Vomiting Are Insect ...

  2. Mosquitoes, models, and dengue.

    PubMed

    Lifson, A R

    1996-05-04

    In the last 10 years dengue has spread markedly through Latin America and the Caribbean (Dominican Republic, Jamaica, Barbados, Mexico, Guatemala, El Salvador, Honduras, Nicaragua, Costa Rica, Panama, Ecuador, Colombia, Venezuela, and Brazil). The mosquito Aedes aegypti has taken advantage of increased urbanization and crowding to transmit the dengue virus. The mosquito infests tires, cans, and water jars near dwellings. The female mosquito practices multiple, interrupted feeding. Thus, mosquito infesting and feeding practices facilitate dengue transmission in crowded conditions. Factors contributing to the spread of dengue include numbers of infected and susceptible human hosts, strain of dengue virus, size of mosquito population, feeding habits, time from infection to ability to transmit virus for both vector and host, likelihood of virus transmission from human to mosquito to human, and temperature (which affects vector distribution, size, feeding habits, and extrinsic incubation period). Public health models may use simulation models to help them plan or evaluate the potential impact of different intervention strategies and/or of environmental changes (e.g., global warming). Other factors contributing to the dengue epidemic are international travel, urbanization, population growth, crowding, poverty, a weakened public health infrastructure, and limited support for sustained disease control programs. Molecular epidemiology by nucleic acid sequence analysis is another sophisticated technique used to study infectious diseases. It showed that dengue type 3 isolated from Panama and Nicaragua in 1994 was identical to that responsible for the major dengue hemorrhagic fever epidemics in Sri Lanka and India in the 1980s. Public health officials must remember three priorities relevant to dengue and other emerging infections: the need to strengthen surveillance efforts, dedicated and sustained involvement in prevention and control needs at the local level, and a strong

  3. Preventing community-wide transmission of Cryptosporidium: a proactive public health response to a swimming pool-associated outbreak--Auglaize County, Ohio, USA.

    PubMed

    Cope, J R; Prosser, A; Nowicki, S; Roberts, M W; Roberts, J M; Scheer, D; Anderson, C; Longsworth, A; Parsons, C; Goldschmidt, D; Johnston, S; Bishop, H; Xiao, L; Hill, V; Beach, M; Hlavsa, M C

    2015-12-01

    The incidence of recreational water-associated outbreaks in the United States has significantly increased, driven, at least in part, by outbreaks both caused by Cryptosporidium and associated with treated recreational water venues. Because of the parasite's extreme chlorine tolerance, transmission can occur even in well-maintained treated recreational water venues (e.g. pools) and a focal cryptosporidiosis outbreak can evolve into a community-wide outbreak associated with multiple recreational water venues and settings (e.g. childcare facilities). In August 2004 in Auglaize County, Ohio, multiple cryptosporidiosis cases were identified and anecdotally linked to pool A. Within 5 days of the first case being reported, pool A was hyperchlorinated to achieve 99·9% Cryptosporidium inactivition. A case-control study was launched to epidemiologically ascertain the outbreak source 11 days later. A total of 150 confirmed and probable cases were identified; the temporal distribution of illness onset was peaked, indicating a point-source exposure. Cryptosporidiosis was significantly associated with swimming in pool A (matched odds ratio 121·7, 95% confidence interval 27·4-∞) but not with another venue or setting. The findings of this investigation suggest that proactive implementation of control measures, when increased Cryptosporidium transmission is detected but before an outbreak source is epidemiologically ascertained, might prevent a focal cryptosporidiosis outbreak from evolving into a community-wide outbreak.

  4. Preventing Community-wide Transmission of Cryptosporidium: A Proactive Public Health Response to a Swimming Pool–Associated Outbreak — Auglaize County, Ohio, USA

    PubMed Central

    Cope, J.R.; Prosser, A.; Nowicki, S.; Roberts, M.W.; Scheer, D.; Anderson, C.; Longsworth, A.; Parsons, C.; Goldschmidt, D.; Johnston, S.; Bishop, H.; Xiao, L.; Hill, V.; Beach, M.; Hlavsa, M.C.

    2015-01-01

    Summary The incidence of recreational water–associated outbreaks in the United States has significantly increased, driven, at least in part, by outbreaks both caused by Cryptosporidium and associated with treated recreational water venues. Because of the parasite's extreme chlorine tolerance, transmission can occur even in well-maintained treated recreational water venues, (e.g., pools) and a focal cryptosporidiosis outbreak can evolve into a community-wide outbreak associated with multiple recreational water venues and settings (e.g., child care facilities). In August 2004 in Auglaize County, Ohio, multiple cryptosporidiosis cases were identified and anecdotally linked to Pool A. Within 5 days of the first case being reported, Pool A was hyperchlorinated to achieve 99.9% Cryptosporidium inactivition. A case-control study was launched to epidemiologically ascertain the outbreak source 11 days later. A total of 150 confirmed and probable cases were identified; the temporal distribution of illness onset was peaked, indicating a point-source exposure. Cryptosporidiosis was significantly associated with swimming in Pool A (matched odds ratio 121.7, 95% confidence interval 27.4–∞) but not with another venue or setting. The findings of this investigation suggest that proactive implementation of control measures, when increased Cryptosporidium transmission is detected but before an outbreak source is epidemiologically ascertained, might prevent a focal cryptosporidiosis outbreak from evolving into a community-wide outbreak. PMID:25907106

  5. Modelling the control strategies against dengue in Singapore

    PubMed Central

    BURATTINI, M. N.; CHEN, M.; CHOW, A.; COUTINHO, F. A. B.; GOH, K. T.; LOPEZ, L. F.; MA, S.; MASSAD, E.

    2008-01-01

    SUMMARY Notified cases of dengue infections in Singapore reached historical highs in 2004 (9459 cases) and 2005 (13 817 cases) and the reason for such an increase is still to be established. We apply a mathematical model for dengue infection that takes into account the seasonal variation in incidence, characteristic of dengue fever, and which mimics the 2004–2005 epidemics in Singapore. We simulated a set of possible control strategies and confirmed the intuitive belief that killing adult mosquitoes is the most effective strategy to control an ongoing epidemic. On the other hand, the control of immature forms was very efficient in preventing the resurgence of dengue epidemics. Since the control of immature forms allows the reduction of adulticide, it seems that the best strategy is to combine both adulticide and larvicide control measures during an outbreak, followed by the maintenance of larvicide methods after the epidemic has subsided. In addition, the model showed that the mixed strategy of adulticide and larvicide methods introduced by the government seems to be very effective in reducing the number of cases in the first weeks after the start of control. PMID:17540051

  6. A Dengue Vaccine.

    PubMed

    Durbin, Anna P

    2016-06-30

    Denvaxia is the first licensed vaccine for the prevention of dengue. It is a live vaccine developed using recombinant DNA technology. The vaccine is given as three doses over the course of a year and has the potential to prevent hundreds of thousands of hospitalizations each year.

  7. Dengue prevention at the household level: preliminary evaluation of a mesh cover for flowerpot saucers.

    PubMed

    Schall, Virgínia Torres; Barros, Héliton da Silva; Jardim, João Bosco; Secundino, Nágila Francinete Costa; Pimenta, Paulo Filemon Paolucci

    2009-10-01

    The effectiveness of a polyester mesh cover (evidengue), aimed at preventing the access of female Aedes aegypti mosquitoes to flowerpot saucers, was evaluated in laboratory. Two saucers of flowerpot with water were individually wrapped with the cover was placed with their respective pots in two entomological cages. One identical set of flowerpot and saucer was placed in a third cage. In each cage, 20 gravid females, fed on mouse blood, were released. Results show that the cover was effective to prevent access of females. Further tests are necessary to assess cover effectiveness as a device to prevent saucer oviposition.

  8. Recent Advances in Dengue: Relevance to Puerto Rico.

    PubMed

    Noyd, David H; Sharp, Tyler M

    2015-06-01

    Dengue represents an increasingly important public health challenge in Puerto Rico, with recent epidemics in 2007, 2010, and 2012-2013. Although recent advances in dengue vaccine development offer hope for primary prevention, the role of health professionals in the diagnosis and management of dengue patients is paramount. Case definitions for dengue, dengue with warning signs, and severe dengue provide a framework to guide clinical decision-making. Furthermore, the differentiation between dengue and other acute febrile illnesses, such as leptospirosis and chikungunya, is necessary for the appropriate diagnosis and management of cases. An understanding of dengue epidemiology and surveillance in Puerto Rico provides context for clinicians in epidemic and non-epidemic periods. This review aims to improve health professionals' ability to diagnose dengue, and as highlight the relevance of recent advances in dengue prevention and management in Puerto Rico.

  9. Policymakers' views on dengue fever/dengue haemorrhagic fever and the need for dengue vaccines in four southeast Asian countries.

    PubMed

    DeRoeck, Denise; Deen, Jacqueline; Clemens, John D

    2003-12-08

    A survey of policymakers and other influential professionals in four southeast Asian countries (Cambodia, Indonesia, Philippines and Vietnam) was conducted to determine policymakers' views on the public health importance of dengue fever and dengue haemorrhagic fever (DHF), the need for a vaccine and the determinants influencing its potential introduction. The survey, which involved face-to-face interviews with policymakers, health programme managers, researchers, opinion leaders and other key informants, revealed an almost uniformly high level of concern about dengue fever/DHF and a high perceived need for a dengue vaccine. Several characteristics of the disease contribute to this high sense of priority, including its geographic spread, occurrence in outbreaks, the recurrent risk of infection each dengue season, its severity and the difficulty in diagnosis and management, its urban predominance, its burden on hospitals, and its economic toll on governments and families. Research felt to be key to future decision-making regarding dengue vaccine introduction include: disease surveillance studies, in-country vaccine trials or pilot projects, and studies on the economic burden of dengue and the cost-effectiveness of dengue vaccines. The results suggest favourable conditions for public and private sector markets for dengue vaccines and the need for creative financing strategies to ensure their accessibility to poor children in dengue-endemic countries.

  10. Public Health Responses to and Challenges for the Control of Dengue Transmission in High-Income Countries: Four Case Studies

    PubMed Central

    Viennet, Elvina; Ritchie, Scott A.; Williams, Craig R.; Faddy, Helen M.; Harley, David

    2016-01-01

    Dengue has a negative impact in low- and lower middle-income countries, but also affects upper middle- and high-income countries. Despite the efforts at controlling this disease, it is unclear why dengue remains an issue in affluent countries. A better understanding of dengue epidemiology and its burden, and those of chikungunya virus and Zika virus which share vectors with dengue, is required to prevent the emergence of these diseases in high-income countries in the future. The purpose of this review was to assess the relative burden of dengue in four high-income countries and to appraise the similarities and differences in dengue transmission. We searched PubMed, ISI Web of Science, and Google Scholar using specific keywords for articles published up to 05 May 2016. We found that outbreaks rarely occur where only Aedes albopictus is present. The main similarities between countries uncovered by our review are the proximity to dengue-endemic countries, the presence of a competent mosquito vector, a largely nonimmune population, and a lack of citizens’ engagement in control of mosquito breeding. We identified important epidemiological and environmental issues including the increase of local transmission despite control efforts, population growth, difficulty locating larval sites, and increased human mobility from neighboring endemic countries. Budget cuts in health and lack of practical vaccines contribute to an increased risk. To be successful, dengue-control programs for high-income countries must consider the epidemiology of dengue in other countries and use this information to minimize virus importation, improve the control of the cryptic larval habitat, and engage the community in reducing vector breeding. Finally, the presence of a communicable disease center is critical for managing and reducing future disease risks. PMID:27643596

  11. Public Health Responses to and Challenges for the Control of Dengue Transmission in High-Income Countries: Four Case Studies.

    PubMed

    Viennet, Elvina; Ritchie, Scott A; Williams, Craig R; Faddy, Helen M; Harley, David

    2016-09-01

    Dengue has a negative impact in low- and lower middle-income countries, but also affects upper middle- and high-income countries. Despite the efforts at controlling this disease, it is unclear why dengue remains an issue in affluent countries. A better understanding of dengue epidemiology and its burden, and those of chikungunya virus and Zika virus which share vectors with dengue, is required to prevent the emergence of these diseases in high-income countries in the future. The purpose of this review was to assess the relative burden of dengue in four high-income countries and to appraise the similarities and differences in dengue transmission. We searched PubMed, ISI Web of Science, and Google Scholar using specific keywords for articles published up to 05 May 2016. We found that outbreaks rarely occur where only Aedes albopictus is present. The main similarities between countries uncovered by our review are the proximity to dengue-endemic countries, the presence of a competent mosquito vector, a largely nonimmune population, and a lack of citizens' engagement in control of mosquito breeding. We identified important epidemiological and environmental issues including the increase of local transmission despite control efforts, population growth, difficulty locating larval sites, and increased human mobility from neighboring endemic countries. Budget cuts in health and lack of practical vaccines contribute to an increased risk. To be successful, dengue-control programs for high-income countries must consider the epidemiology of dengue in other countries and use this information to minimize virus importation, improve the control of the cryptic larval habitat, and engage the community in reducing vector breeding. Finally, the presence of a communicable disease center is critical for managing and reducing future disease risks.

  12. Gravitraps for management of dengue clusters in Singapore.

    PubMed

    Lee, Caleb; Vythilingam, Indra; Chong, Chee-Seng; Abdul Razak, Muhammad Aliff; Tan, Cheong-Huat; Liew, Christina; Pok, Kwoon-Yong; Ng, Lee-Ching

    2013-05-01

    Although Singapore has an intensive dengue control program, dengue remains endemic with regular outbreaks. We report development and use of a novel adult oviposition trap, the Gravitrap, in managing dengue cluster areas. The Gravitrap is a simple, hay infusion-filled cylindrical trap with a sticky inner surface to serve as an oviposition site for gravid female Aedes mosquitoes. Wire gauze fitted above the water level minimizes the risk of it being an unwanted breeding habitat. The Gravitrap was deployed in 11 dengue cluster areas throughout Singapore. Aedes aegypti was the predominant mosquito caught in the trap and some (5.73%) were found to be positive for dengue virus.

  13. Analyzing the spatio-temporal relationship between dengue vector larval density and land-use using factor analysis and spatial ring mapping

    PubMed Central

    2012-01-01

    land were significantly and positively correlated (p = 0.05) during the month of May, and perennial vegetation showed a highly significant and positive correlation (p = 0.001) in the month of March with C.I. and significant and positive correlation (p <= 0.05) with B.I., respectively. Conclusions The study concluded that gasoline stations/workshops, rice paddy, marsh/swamp and deciduous forests played highly significant role in dengue vector growth. Thus, the spatio-temporal relationships of dengue vector larval density and land-use types may help to predict favorable dengue habitat, and thereby enables public healthcare managers to take precautionary measures to prevent impending dengue outbreak. PMID:23043443

  14. Strategies to Prevent Cholera Introduction during International Personnel Deployments: A Computational Modeling Analysis Based on the 2010 Haiti Outbreak

    PubMed Central

    Lewnard, Joseph A.; Antillón, Marina; Gonsalves, Gregg; Miller, Alice M.; Ko, Albert I.; Pitzer, Virginia E.

    2016-01-01

    Background Introduction of Vibrio cholerae to Haiti during the deployment of United Nations (UN) peacekeepers in 2010 resulted in one of the largest cholera epidemics of the modern era. Following the outbreak, a UN-commissioned independent panel recommended three pre-deployment intervention strategies to minimize the risk of cholera introduction in future peacekeeping operations: screening for V. cholerae carriage, administering prophylactic antimicrobial chemotherapies, or immunizing with oral cholera vaccines. However, uncertainty regarding the effectiveness of these approaches has forestalled their implementation by the UN. We assessed how the interventions would have impacted the likelihood of the Haiti cholera epidemic. Methods and Findings We developed a stochastic model for cholera importation and transmission, fitted to reported cases during the first weeks of the 2010 outbreak in Haiti. Using this model, we estimated that diagnostic screening reduces the probability of cases occurring by 82% (95% credible interval: 75%, 85%); however, false-positive test outcomes may hamper this approach. Antimicrobial chemoprophylaxis at time of departure and oral cholera vaccination reduce the probability of cases by 50% (41%, 57%) and by up to 61% (58%, 63%), respectively. Chemoprophylaxis beginning 1 wk before departure confers a 91% (78%, 96%) reduction independently, and up to a 98% reduction (94%, 99%) if coupled with vaccination. These results are not sensitive to assumptions about the background cholera incidence rate in the endemic troop-sending country. Further research is needed to (1) validate the sensitivity and specificity of rapid test approaches for detecting asymptomatic carriage, (2) compare prophylactic efficacy across antimicrobial regimens, and (3) quantify the impact of oral cholera vaccine on transmission from asymptomatic carriers. Conclusions Screening, chemoprophylaxis, and vaccination are all effective strategies to prevent cholera introduction

  15. Pacemaker pocket infection due to environmental mycobacteria: Successful management of an outbreak and steps for prevention in future

    PubMed Central

    Bharat, Vijaya; Hittinahalli, Vivek; Mishra, Meenakshi; Pradhan, Sridhar

    2016-01-01

    Background An outbreak of surgical site infection (SSI) due to environmental mycobacteria (EMB) occurred in a hospital in Eastern India. Method A quality improvement project (QIP) was undertaken to analyze the causes and prevent further outbreak. Step (1) Proof of the need: Four patients who had undergone pacemaker implantation consecutively during a 10-day period developed SSI. Step (2) Diagnostic journey: Since all patients developed SSI within 2 months of implantation, a common source of infection was likely. Atypical mycobacteria (AMB) were grown from surgical sites as well as from the surface of operation table, image intensifier, and lead aprons. It was a rapid growing variety that lacked pigment, a characteristic of EMB with pathogenic potential. The EMB was finally traced to its source, the overhead water tank. Step (3) Remedial journey: By thorough cleaning of the water tank and enriching its chlorine content, the EMB was eliminated from its source. Step (4) Holding the gains: Protocol for cleaning the water tank once in 3 months was made. A checklist was prepared to ensure compliance to asepsis protocol in the operation theater. In the ensuing 5 years, the infection did not recur. Result The bacteria that caused SSI were identified as EMB that grew in the water tank and contaminated the operation room. It could be eliminated by appropriate measures. Interpretation Water is a potential reservoir for EMB. Use of the term ‘environmental mycobacteria’ instead of ‘atypical mycobacteria’ will generate awareness about contamination as the cause of SSI. PMID:26896269

  16. Co-circulation of Dengue and Chikungunya Viruses, Al Hudaydah, Yemen, 2012.

    PubMed

    Rezza, Giovanni; El-Sawaf, Gamal; Faggioni, Giovanni; Vescio, Fenicia; Al Ameri, Ranya; De Santis, Riccardo; Helaly, Ghada; Pomponi, Alice; Metwally, Dalia; Fantini, Massimo; Qadi, Hussein; Ciccozzi, Massimo; Lista, Florigio

    2014-08-01

    We investigated 400 cases of dengue-like illness in persons hospitalized during an outbreak in Al Hudaydah, Yemen, in 2012. Overall, 116 dengue and 49 chikungunya cases were diagnosed. Dengue virus type 2 was the predominant serotype. The co-circulation of these viruses indicates that mosquitoborne infections represent a public health threat in Yemen.

  17. Novel dengue virus type 1 from travelers to Yap State, Micronesia.

    PubMed

    Nukui, Yoko; Tajima, Shigeru; Kotaki, Akira; Ito, Mikako; Takasaki, Tomohiko; Koike, Kazuhiko; Kurane, Ichiro

    2006-02-01

    Dengue virus type 1 (DENV-1), which was responsible for the dengue fever outbreak in Yap State, Micronesia, in 2004, was isolated from serum samples of 4 dengue patients in Japan. Genome sequencing demonstrated that this virus belonged to genotype IV and had a 29-nucleotide deletion in the 3 noncoding region.

  18. Cardiac tamponade presenting as early manifestation in dengue fever.

    PubMed

    Bendwal, Suresh; Malviya, Kavita; Jatav, O P; Malviya, Kapil

    2014-03-01

    Dengue fever (DF) is an outbreak prone viral disease transmitted by aedes mosquitoes. It is often associated with evidence of plasma leakage due to increased vascular permeability manifested by pleural effusion, ascites, hypoproteinaemia and pericardial effusion. Cases of small pericardial effusion have been reported in association with dengue fever, largely with dengue haemorrhagic fever (DHF) during epidemic outbreaks. Dengue may rarely present with cardiac tamponade as early manifestation and urgent pericardiocentesis is life saving. A 34 year old male presented with low grade fever, headache, myalgia and breathlessness. Echocardiography revealed large pericardial effusion with right ventricular diagnostic collapse requiring urgent drainage. Subsequently patient improved. Dengue serology (both IgM and IgG) was reported as markedly elevated supporting a diagnosis of classic dengue fever.

  19. Dengue fever: a primer for the otolaryngologist.

    PubMed

    Arnaoutakis, Demetri; Padhya, Tapan A

    2013-07-01

    It has been estimated that more than 50 million cases of dengue occur worldwide each year, mostly in the tropics. In light of recent cases appearing in central and southern Florida, dengue has reemerged as a public health issue in the United States with respect to infection control and prevention. We review the course of dengue infection and its clinical presentation from the perspective of the practicing otolaryngologist, and we outline tactics for prevention and management.

  20. Dengue Type 3 Virus, Saint Martin, 2003–2004

    PubMed Central

    Pastorino, Boris A.M.; Bessaud, Maël; Gravier, Patrick; Tock, Fabienne; Couissinier-Paris, Patricia; Martial, Jenny; Huc-Anais, Patricia; Césaire, Raymond; Grandadam, Marc; Tolou, Hugues J.

    2005-01-01

    We describe the spread of a dengue virus during an outbreak in Saint Martin island (French West Indies) during winter 2003–2004. Dengue type 3 viruses were isolated from 6 patients exhibiting clinical symptoms. This serotype had not been detected on the island during the preceding 3 years. Genome sequence determinations and analyses showed a common origin with dengue type 3 viruses isolated in Martinique 2 years earlier. PMID:15890134

  1. Fatal Dengue Myocarditis despite the Use of Extracorporeal Membrane Oxygenation

    PubMed Central

    2016-01-01

    Dengue is an important mosquitoes-borne viral disease which is endemic in tropics and subtropics region. Rapid spreading of disease to previously unaffected region was found in recent years. Atypical manifestations, such as myocarditis, were reported during large outbreak. There is a wide range of clinical manifestations of cardiac involvement in dengue, but rarely fatal. Here we reported a case of fulminant dengue myocarditis in fatal outcome despite cardiac mechanical support. PMID:28018687

  2. The dengue vaccine pipeline: Implications for the future of dengue control.

    PubMed

    Schwartz, Lauren M; Halloran, M Elizabeth; Durbin, Anna P; Longini, Ira M

    2015-06-26

    Dengue has become the most rapidly expanding mosquito-borne infectious disease on the planet, surpassing malaria and infecting at least 390 million people per year. There is no effective treatment for dengue illness other than supportive care, especially for severe cases. Symptoms can be mild or life-threatening as in dengue hemorrhagic fever and dengue shock syndrome. Vector control has been only partially successful in decreasing dengue transmission. The potential use of safe and effective tetravalent dengue vaccines is an attractive addition to prevent disease or minimize the possibility of epidemics. There are currently no licensed dengue vaccines. This review summarizes the current status of all dengue vaccine candidates in clinical evaluation. Currently five candidate vaccines are in human clinical trials. One has completed two Phase III trials, two are in Phase II trials, and three are in Phase I testing.

  3. The Dengue Vaccine Pipeline: Implications for the Future of Dengue Control

    PubMed Central

    Schwartz, Lauren M.; Halloran, M. Elizabeth; Durbin, Anna P.; Longini, Ira M.

    2015-01-01

    Dengue has become the most rapidly expanding mosquito-borne infectious disease on the planet, surpassing malaria and infecting at least 390 million people per year. There is no effective treatment for dengue illness other than supportive care, especially for severe cases. Symptoms can be mild or life-threatening as in dengue hemorrhagic fever and dengue shock syndrome. Vector control has been only partially successful in decreasing dengue transmission. The potential use of safe and effective tetravalent dengue vaccines is an attractive addition to prevent disease or minimize the possibility of epidemics. There are currently no licensed dengue vaccines. This review summarizes the current status of all dengue vaccine candidates in clinical evaluation. Currently five candidate vaccines are in human clinical trials. One has completed two Phase III trials, two are in Phase II trials, and three are in Phase I testing. PMID:25989449

  4. Dengue virus type 3, South Pacific Islands, 2013.

    PubMed

    Cao-Lormeau, Van-Mai; Roche, Claudine; Musso, Didier; Mallet, Henri-Pierre; Dalipanda, Tenneth; Dofai, Alfred; Nogareda, Francisco; Nilles, Eric J; Aaskov, John

    2014-06-01

    After an 18-year absence, dengue virus serotype 3 reemerged in the South Pacific Islands in 2013. Outbreaks in western (Solomon Islands) and eastern (French Polynesia) regions were caused by different genotypes. This finding suggested that immunity against dengue virus serotype, rather than virus genotype, was the principal determinant of reemergence.

  5. Strategies for preventing invasive plant outbreaks after prescribed fire in ponderosa pine forest

    USGS Publications Warehouse

    Symstad, Amy J.; Newton, Wesley E.; Swanson, Daniel J.

    2014-01-01

    Land managers use prescribed fire to return a vital process to fire-adapted ecosystems, restore forest structure from a state altered by long-term fire suppression, and reduce wildfire intensity. However, fire often produces favorable conditions for invasive plant species, particularly if it is intense enough to reveal bare mineral soil and open previously closed canopies. Understanding the environmental or fire characteristics that explain post-fire invasive plant abundance would aid managers in efficiently finding and quickly responding to fire-caused infestations. To that end, we used an information-theoretic model-selection approach to assess the relative importance of abiotic environmental characteristics (topoedaphic position, distance from roads), pre-and post-fire biotic environmental characteristics (forest structure, understory vegetation, fuel load), and prescribed fire severity (measured in four different ways) in explaining invasive plant cover in ponderosa pine forest in South Dakota’s Black Hills. Environmental characteristics (distance from roads and post-fire forest structure) alone provided the most explanation of variation (26%) in post-fire cover of Verbascum thapsus (common mullein), but a combination of surface fire severity and environmental characteristics (pre-fire forest structure and distance from roads) explained 36–39% of the variation in post-fire cover of Cirsium arvense (Canada thistle) and all invasives together. For four species and all invasives together, their pre-fire cover explained more variation (26–82%) in post-fire cover than environmental and fire characteristics did, suggesting one strategy for reducing post-fire invasive outbreaks may be to find and control invasives before the fire. Finding them may be difficult, however, since pre-fire environmental characteristics explained only 20% of variation in pre-fire total invasive cover, and less for individual species. Thus, moderating fire intensity or targeting areas

  6. Inferring the Spatio-temporal Patterns of Dengue Transmission from Surveillance Data in Guangzhou, China

    PubMed Central

    Liu, Jiming; Tan, Qi; Shi, Benyun

    2016-01-01

    Background Dengue is a serious vector-borne disease, and incidence rates have significantly increased during the past few years, particularly in 2014 in Guangzhou. The current situation is more complicated, due to various factors such as climate warming, urbanization, population increase, and human mobility. The purpose of this study is to detect dengue transmission patterns and identify the disease dispersion dynamics in Guangzhou, China. Methodology We conducted surveys in 12 districts of Guangzhou, and collected daily data of Breteau index (BI) and reported cases between September and November 2014 from the public health authority reports. Based on the available data and the Ross-Macdonald theory, we propose a dengue transmission model that systematically integrates entomologic, demographic, and environmental information. In this model, we use (1) BI data and geographic variables to evaluate the spatial heterogeneities of Aedes mosquitoes, (2) a radiation model to simulate the daily mobility of humans, and (3) a Markov chain Monte Carlo (MCMC) method to estimate the model parameters. Results/Conclusions By implementing our proposed model, we can (1) estimate the incidence rates of dengue, and trace the infection time and locations, (2) assess risk factors and evaluate the infection threat in a city, and (3) evaluate the primary diffusion process in different districts. From the results, we can see that dengue infections exhibited a spatial and temporal variation during 2014 in Guangzhou. We find that urbanization, vector activities, and human behavior play significant roles in shaping the dengue outbreak and the patterns of its spread. This study offers useful information on dengue dynamics, which can help policy makers improve control and prevention measures. PMID:27105350

  7. Trends in clinical trials of dengue vaccine

    PubMed Central

    Marimuthu, Priya; Ravinder, Jamuna Rani

    2016-01-01

    Dengue is one of the most important vector-borne disease and an increasing problem worldwide because of current globalization trends. Roughly, half the world's population lives in dengue endemic countries, and nearly 100 million people are infected annually with dengue. India has the highest burden of the disease with 34% of the global cases. In the context of an expanding and potentially fatal infectious disease without effective prevention or specific treatment, the public health value of a protective vaccine is clear. There is no licensed dengue vaccine is available still, but several vaccines are under development. Keeping in view the rise in dengue prevalence globally, there is a need to increase clinical drug and vaccine research on dengue. This paper briefly reviews on the development and current status of dengue vaccine to provide information to policymakers, researchers, and public health experts to design and implement appropriate vaccine for prophylactic intervention. PMID:27843790

  8. Pre-West Nile virus outbreak: perceptions and practices to prevent mosquito bites and viral encephalitis in the United States.

    PubMed

    Herrington, James E

    2003-01-01

    Mosquitoes can transmit over 100 of the viruses that can cause encephalitis, meningitis, and hemorrhagic disease in humans (Chin 2000; Gubler 1996; Monath 1989). While much is known about the ecology, epidemiology, and clinical manifestations of the arboviral encephalitides (Campbell et al. 2002; Centers for Disease Control and Prevention 1997; Gubler 1998; Hayes 1989; Hubálek and Halouzka 1999), little empirical research exists regarding the U.S. population's knowledge of mosquitoes and arboviral encephalitis, particularly prior to the U.S. outbreak of West Nile virus (WNV) in 1999. A nationally representative 55-item survey instrument was successfully administered to 1,500 adults in the United States and an additional 250 adults in six states in the Northeast (Connecticut, Delaware, New Jersey, New York, Pennsylvania, and Rhode Island) regarding mosquitoes and mosquito-borne viral encephalitis. A summary outcome measure for mosquito bite prevention was created. Analyses revealed that the following were statistically significant predictors of behaviors taken to prevent mosquito bites: being concerned about being bitten by mosquitoes, perceived effectiveness of staying indoors in late afternoon and early evening was protective, perceived effectiveness that mosquito repellent is not harmful to health, owning dogs and/or cats as pets, being married, and being > or = 18-44 years old. Being concerned about being bitten by mosquitoes was the most robust predictor of behavioral action to prevent mosquito bites (OR = 7.3; 95% CI = 4.3, 12.2). Observed misperceptions and inadequate knowledge regarding insect repellents suggest increased promotion of the safety and efficacy of DEET-containing insect repellents is warranted.

  9. Dengue hemorrhagic fever--U.S.-Mexico border, 2005.

    PubMed

    2007-08-10

    Dengue fever is a mosquito-transmitted disease caused by any of four closely related virus serotypes (DEN-1, DEN-2, DEN-3, and DEN-4) of the genus Flavivirus. Infection with one of these serotypes provides lifelong immunity to the infecting serotype only. Therefore, persons can acquire a second dengue infection from a different serotype, and second infections place them at greater risk for dengue hemorrhagic fever (DHF), the more severe form of the disease. DHF is characterized by bleeding manifestations, thrombocytopenia, and increased vascular permeability that can lead to life-threatening shock. In south Texas, near the border with Mexico, sporadic, locally acquired outbreaks of dengue fever have been reported previously; however, on the Texas side of the border, these outbreaks have not included recognized cases of locally acquired DHF in persons native to the area. In July 2005, a case of DHF was reported in a resident of Brownsville, Texas. In August 2005, health authorities in the neighboring state of Tamaulipas, Mexico, reported an ongoing dengue outbreak with 1,251 cases of dengue fever, including 223 cases (17.8%) of DHF. To characterize this dengue outbreak, the Texas Department of State Health Services (TDSHS), Mexican health authorities, and CDC conducted a clinical and epidemiologic investigation. This report summarizes the results of that investigation, which determined that the percentage of DHF cases associated with dengue fever outbreaks at the Texas-Tamaulipas border has increased. Health-care providers along the U.S. border with Mexico should be vigilant for DHF and familiar with its diagnosis and management to reduce the number of severe illnesses and deaths associated with outbreaks of dengue fever.

  10. Gamma interferon (IFN-γ) receptor restricts systemic dengue virus replication and prevents paralysis in IFN-α/β receptor-deficient mice.

    PubMed

    Prestwood, Tyler R; Morar, Malika M; Zellweger, Raphaël M; Miller, Robyn; May, Monica M; Yauch, Lauren E; Lada, Steven M; Shresta, Sujan

    2012-12-01

    We previously reported that mice lacking alpha/beta and gamma interferon receptors (IFN-α/βR and -γR) uniformly exhibit paralysis following infection with the dengue virus (DENV) clinical isolate PL046, while only a subset of mice lacking the IFN-γR alone and virtually no mice lacking the IFN-α/βR alone develop paralysis. Here, using a mouse-passaged variant of PL046, strain S221, we show that in the absence of the IFN-α/βR, signaling through the IFN-γR confers approximately 140-fold greater resistance against systemic vascular leakage-associated dengue disease and virtually complete protection from dengue-induced paralysis. Viral replication in the spleen was assessed by immunohistochemistry and flow cytometry, which revealed a reduction in the number of infected cells due to IFN-γR signaling by 2 days after infection, coincident with elevated levels of IFN-γ in the spleen and serum. By 4 days after infection, IFN-γR signaling was found to restrict DENV replication systemically. Clearance of DENV, on the other hand, occurred in the absence of IFN-γR, except in the central nervous system (CNS) (brain and spinal cord), where clearance relied on IFN-γ from CD8(+) T cells. These results demonstrate the roles of IFN-γR signaling in protection from initial systemic and subsequent CNS disease following DENV infection and demonstrate the importance of CD8(+) T cells in preventing DENV-induced CNS disease.

  11. Use of the CDC Autocidal Gravid Ovitrap to Control and Prevent Outbreaks of Aedes aegypti (Diptera: Culicidae)

    PubMed Central

    Barrera, Roberto; Amador, Manuel; Acevedo, Veronica; Caban, Belkis; Felix, Gilberto; Mackay, Andrew J.

    2015-01-01

    Populations of Aedes aegypti (L.) can be managed through reductions in adult mosquito survival, number of offspring produced, or both. Direct adult mortality can be caused by the use of space sprays or residual insecticides to mosquito resting sites, and with a variety of residual insecticide-impregnated surfaces that are being tested, such as curtains, covers for water-storage vessels, bednets, and ovitraps. The fertility of Ae. aegypti populations can be reduced by the use of autocidal oviposition cups that prevent the development of mosquitoes inside the trap by mechanical means or larvicides, as well as by releasing sterile, transgenic, and para-transgenic mosquitoes. Survival and fertility can be simultaneously reduced by capturing gravid female Ae. aegypti with sticky gravid traps. We tested the effectiveness of the novel Centers for Disease Control and Prevention autocidal gravid ovitrap (CDC-AGO trap) to control natural populations of Ae. aegypti under field conditions in two isolated urban areas (reference vs. intervention areas) in southern Puerto Rico for 1 yr. There were significant reductions in the captures of female Ae. aegypti (53–70%) in the intervention area. The presence of three to four AGO control traps per home in 81% of the houses prevented outbreaks of Ae. aegypti, which would be expected after rains. Mosquito captures in BG-Sentinel and AGO traps were significantly and positively correlated, showing that AGO traps are useful and inexpensive mosquito surveillance devices. The use of AGO traps to manage Ae. aegypti populations is compatible with other control means such as source reduction, larviciding, adulticiding, sterile insect techniques, induced cytoplasmic incompatibility, and dominant lethal gene systems. PMID:24605464

  12. Use of the CDC autocidal gravid ovitrap to control and prevent outbreaks of Aedes aegypti (Diptera: Culicidae).

    PubMed

    Barrera, Roberto; Amador, Manuel; Acevedo, Veronica; Caban, Belkis; Felix, Gilberto; Mackay, Andrew J

    2014-01-01

    Populations ofAedes aegypti (L.) can be managed through reductions in adult mosquito survival, number of offspring produced, or both. Direct adult mortality can be caused by the use of space sprays or residual insecticides to mosquito resting sites, and with a variety of residual insecticide-impregnated surfaces that are being tested, such as curtains, covers for water-storage vessels, bednets, and ovitraps. The fertility ofAe. aegypti populations can be reduced by the use of autocidal oviposition cups that prevent the development of mosquitoes inside the trap by mechanical means or larvicides, as well as by releasing sterile, transgenic, and para-transgenic mosquitoes. Survival and fertility can be simultaneously reduced by capturing gravid female Ae. aegypti with sticky gravid traps. We tested the effectiveness of the novel Centers for Disease Control and Prevention autocidal gravid ovitrap (CDC-AGO trap) to control natural populations ofAe. aegypti under field conditions in two isolated urban areas (reference vs. intervention areas) in southern Puerto Rico for 1 yr. There were significant reductions in the captures of female Ae. aegypti (53-70%) in the intervention area The presence of three to four AGO control traps per home in 81% of the houses prevented outbreaks of Ae. aegypti, which would be expected after rains. Mosquito captures in BG-Sentinel and AGO traps were significantly and positively correlated, showing that AGO traps are useful and inexpensive mosquito surveillance devices. The use of AGO traps to manage Ae. aegypti populations is compatible with other control means such as source reduction, larviciding, adulticiding, sterile insect techniques, induced cytoplasmic incompatibility, and dominant lethal gene systems.

  13. Impact of infectious disease epidemics on tuberculosis diagnostic, management, and prevention services: experiences and lessons from the 2014-2015 Ebola virus disease outbreak in West Africa.

    PubMed

    Ansumana, Rashid; Keitell, Samuel; Roberts, Gregory M T; Ntoumi, Francine; Petersen, Eskild; Ippolito, Giuseppe; Zumla, Alimuddin

    2017-03-01

    The World Health Organization (WHO) Global Tuberculosis Report 2015 states that 28% of the world's 9.6 million new tuberculosis (TB) cases are in the WHO Africa Region. The Mano River Union (MRU) countries of West Africa-Guinea, Sierra Leone, and Liberia-have made incremental sustained investments into TB control programmes over the past two decades. The devastating Ebola virus disease (EVD) outbreak of 2014-2015 in West Africa impacted significantly on all sectors of the healthcare systems in the MRU countries, including the TB prevention and control programmes. The EVD outbreak also had an adverse impact on the healthcare workforce and healthcare service delivery. At the height of the EVD outbreak, numerous staff members in all MRU countries contracted EBV at the Ebola treatment units and died. Many healthcare workers were also infected in healthcare facilities that were not Ebola treatment units but were national hospitals and peripheral health units that were unprepared for receiving patients with EVD. In all three MRU countries, the disruption to TB services due to the EVD epidemic will no doubt have increased Mycobacterium tuberculosis transmission, TB morbidity and mortality, and decreased patient adherence to TB treatment, and the likely impact will not be known for several years to come. In this viewpoint, the impact that the EVD outbreak had on TB diagnostic, management, and prevention services is described. Vaccination against TB with BCG in children under 5 years of age was affected adversely by the EVD epidemic. The EVD outbreak was a result of global failure and represents yet another 'wake-up call' to the international community, and particularly to African governments, to reach a consensus on new ways of thinking at the national, regional, and global levels for building healthcare systems that can sustain their function during outbreaks. This is necessary so that other disease control programmes (like those for TB, malaria, and HIV) are not

  14. Current issues in the economics of vaccination against dengue.

    PubMed

    Tozan, Yesim

    2016-01-01

    Dengue is a major public health concern in tropical and subtropical areas of the world. The prospects for dengue prevention have recently improved with the results of efficacy trials of a tetravalent dengue vaccine. Although partially effective, once licensed, its introduction can be a public health priority in heavily affected countries because of the perceived public health importance of dengue. This review explores the most immediate economic considerations of introducing a new dengue vaccine and evaluates the published economic analyses of dengue vaccination. Findings indicate that the current economic evidence base is of limited utility to support country-level decisions on dengue vaccine introduction. There are a handful of published cost-effectiveness studies and no country-specific costing studies to project the full resource requirements of dengue vaccine introduction. Country-level analytical expertise in economic analyses, another gap identified, needs to be strengthened to facilitate evidence-based decision-making on dengue vaccine introduction in endemic countries.

  15. Unusual Presentation of Dengue Fever Leading to Unnecessary Appendectomy.

    PubMed

    Kumar, Lovekesh; Singh, Mahendra; Saxena, Ashish; Kolhe, Yuvraj; Karande, Snehal K; Singh, Narendra; Venkatesh, P; Meena, Rambabu

    2015-01-01

    Dengue fever is the most important arbovirus illness with an estimated incidence of 50-100 million cases per year. The common symptoms of dengue include fever, rash, malaise, nausea, vomiting, and musculoskeletal pain. Dengue fever may present as acute abdomen leading to diagnostic dilemma. The acute surgical complications of dengue fever include acute pancreatitis, acute acalculous cholecystitis, nonspecific peritonitis, and acute appendicitis. We report a case of dengue fever that mimicked acute appendicitis leading to unnecessary appendectomy. A careful history examination for dengue-related signs, and serial hemogram over the first 3-4 days of disease may prevent unnecessary appendectomy.

  16. Unusual Presentation of Dengue Fever Leading to Unnecessary Appendectomy

    PubMed Central

    Kumar, Lovekesh; Singh, Mahendra; Saxena, Ashish; Kolhe, Yuvraj; Karande, Snehal K.; Singh, Narendra; Venkatesh, P.; Meena, Rambabu

    2015-01-01

    Dengue fever is the most important arbovirus illness with an estimated incidence of 50–100 million cases per year. The common symptoms of dengue include fever, rash, malaise, nausea, vomiting, and musculoskeletal pain. Dengue fever may present as acute abdomen leading to diagnostic dilemma. The acute surgical complications of dengue fever include acute pancreatitis, acute acalculous cholecystitis, nonspecific peritonitis, and acute appendicitis. We report a case of dengue fever that mimicked acute appendicitis leading to unnecessary appendectomy. A careful history examination for dengue-related signs, and serial hemogram over the first 3-4 days of disease may prevent unnecessary appendectomy. PMID:26167314

  17. Social justice, climate change, and dengue.

    PubMed

    Chang, Aileen Y; Fuller, Douglas O; Carrasquillo, Olveen; Beier, John C

    2014-06-14

    Climate change should be viewed fundamentally as an issue of global justice. Understanding the complex interplay of climatic and socioeconomic trends is imperative to protect human health and lessen the burden of diseases such as dengue fever. Dengue fever is rapidly expanding globally. Temperature, rainfall, and frequency of natural disasters, as well as non-climatic trends involving population growth and migration, urbanization, and international trade and travel, are expected to increase the prevalence of mosquito breeding sites, mosquito survival, the speed of mosquito reproduction, the speed of viral incubation, the distribution of dengue virus and its vectors, human migration patterns towards urban areas, and displacement after natural disasters. The burden of dengue disproportionately affects the poor due to increased environmental risk and decreased health care. Mobilization of social institutions is needed to improve the structural inequalities of poverty that predispose the poor to increased dengue fever infection and worse outcomes. This paper reviews the link between dengue and climatic factors as a starting point to developing a comprehensive understanding of how climate change affects dengue risk and how institutions can address the issues of social justice and dengue outbreaks that increasingly affect vulnerable urban populations.

  18. DENGUE VACCINES.

    PubMed

    Thisyakorn, Usa; Thisyakorn, Chule

    2015-01-01

    The uniqueness of the dengue viruses (DENVs) and the spectrum of disease resulting from infection have made dengue vaccine development difficult. Several vaccine candidates are currently being evaluated in clinical studies. The candidate currently at the most advanced clinical development stage, a live-attenuated tetravalent vaccine based on the chimeric yellow fever-dengue virus (CYD-TDV), has progressed to Phase 3 efficacy studies. Several other live-attenuated vaccines, as well as subunit, DNA, and purified inactivated vaccine candidates are at earlier stages of clinical development. Additional technological approaches, such as virus-vectored and Virus-Like Particles (VLP)-based vaccines are under evaluation in preclinical studies.

  19. The Epidemiological Characteristics and Dynamic Transmission of Dengue in China, 2013

    PubMed Central

    lu, Liang; Bi, Peng; Lv, Ming; Liu, Qiyong

    2016-01-01

    Background There was a dengue epidemic in several regions of China in 2013. No study has explored the dynamics of dengue transmission between different geographical locations with dengue outbreaks in China. The purpose of the study is to analyze the epidemiological characteristics and to explore the dynamic transmission of dengue in China, 2013. Methodology and Principal Findings Records of dengue cases of 2013 were obtained from the China Notifiable Disease Surveillance System. Full E-gene sequences of dengue virus detected from the outbreak regions of China were download from GenBank. Geographical Information System and heatmaps were used to describe the epidemiological characteristics. Maximum Likelihood phylogenetic and Bayesian phylogeographic analyses were conducted to explore the dengue dynamic transmission. Yunnan Province and Guangdong Province had the highest imported cases in the 2013 epidemic. In the locations with local dengue transmission, most of imported cases occurred from June to November 2013 while local dengue cases developed from July to December, 2013. There were significant variations for the incidences of dengue, in terms of age distributions, among different geographic locations. However, gender differences were identified in Guangzhou, Foshan and Xishuangbanna. DENV 1–3 were detected in all locations with the disease outbreaks. Some genotypes were detected in more than one locations and more than one genotypes have been detected in several locations. The dengue viruses introduced to outbreak areas were predominantly from Southeast Asia. In Guangdong Province, the phylogeographical results indicated that dengue viruses of DENV 1 were transmitted to neighboring cities Foshan and Zhongshan from Guangzhou city, and then transmitted to Jiangmen city. The virus in DENV 3 was introduced to Guangzhou city, Guangdong Province from Xishuangbanna prefecture, Yunnan Province. Conclusions Repeated dengue virus introductions from Southeast Asia and

  20. Climatic factors influencing dengue cases in Dhaka city: A model for dengue prediction

    PubMed Central

    Karim, Md. Nazmul; Munshi, Saif Ullah; Anwar, Nazneen; Alam, Md. Shah

    2012-01-01

    Background & objectives: Transmission of dengue virus depends on the presence of Aedes mosquito. Mosquito generation and development is known to be influenced by the climate. This study was carried out to examine whether the climatic factors data can be used to predict yearly dengue cases of Dhaka city, Bangladesh. Methods: Monthly reported dengue cases and climate data for the years 2000–2008 were obtained from the Directorate General of Health Services (DGHS) and Meteorological Department of Dhaka, Bangladesh, respectively. Data for the period 2000 to 2007 were used for development of a model through multiple linear regressions. Retrospective validation of the model was done with 2001, 2003, 2005 and 2008 data. Log transformation of the dependent variable was done to normalize data for linear regression. Average monthly humidity, rainfall, minimum and maximum temperature were used as independent variables and number of dengue cases reported monthly was used as dependent variable. Accuracy of the model for predicting outbreak was assessed through receiver operative characteristics (ROC) curve. Results: Climatic factors, i.e. rainfall, maximum temperature and relative humidity were significantly correlated with monthly reported dengue cases. The model incorporating climatic data of two-lag month explained 61 per cent of variation in number of reported dengue cases and this model was found to predict dengue outbreak (≥ 200 cases) with considerable accuracy [area under ROC curve = 0.89, 95%CI = (0.89-0.98)]. Interpretation & conclusions: Our results showed that the climate had a major effect on the occurrence of dengue infection in Dhaka city. Though the prediction model had some limitations in predicting the monthly number of dengue cases, it could forecast possible outbreak two months in advance with considerable accuracy. PMID:22885261

  1. A two-dose heterologous prime-boost vaccine regimen eliciting sustained immune responses to Ebola Zaire could support a preventive strategy for future outbreaks

    PubMed Central

    Shukarev, Georgi; Callendret, Benoit; Luhn, Kerstin; Douoguih, Macaya

    2017-01-01

    ABSTRACT The consequences of the 2013–16 Ebola Zaire virus disease epidemic in West Africa were grave. The economies, healthcare systems and communities of Guinea, Sierra Leone and Liberia were devastated by over 18 months of active Ebola virus transmission, followed by sporadic resurgences potentially related to sexual transmission by survivors with viral persistence in body fluids following recovery. The need to develop and implement strategies to prevent and mitigate future outbreaks is now beyond dispute. The potential for unpredictable outbreaks of indeterminate duration, and control challenges posed by the possibility of sporadic re-emergence, mean that implementation of an effective vaccination program for outbreak containment necessitates a vaccine providing durable immunity. Heterologous prime-boost vaccine regimens deliver the same or similar antigens through different vaccine types, the first to prime and the second to boost the immune system. Ad26.ZEBOV/MVA-BN-Filo is an investigational Ebola Zaire vaccine regimen that uses this heterologous prime-boost approach. Preliminary Phase 1 data suggest that Ad26.ZEBOV/MVA-BN-Filo confers durable immunity for at least 240 d and is well-tolerated with a good safety profile. This regimen may therefore be suitable for prophylactic use in a regional or targeted population vaccination strategy, and could potentially aid prevention and control of future Ebola outbreaks. PMID:27925844

  2. Substitution of the precursor peptide prevents anti-prM antibody-mediated antibody-dependent enhancement of dengue virus infection.

    PubMed

    Wang, Ying; Si, Lu-Lu; Guo, Xiao-Lan; Cui, Guo-Hui; Fang, Dan-Yun; Zhou, Jun-Mei; Yan, Hui-Jun; Jiang, Li-Fang

    2017-02-02

    Antibody-dependent enhancement (ADE) is currently considered as the mechanism underlying the pathogenesis of severe dengue disease. Many studies have shown that precursor (pr) peptide-specific antibodies do not efficiently neutralize infection but potently promote ADE of dengue virus (DENV) infection. To explore the effect of pr peptide substitution on neutralization and ADE of DENV infection, the rabbit anti-prM polyclonal antibodies (pAbs) and anti-JEVpr/DENV-M pAbs were prepared, and the neutralization and ADE of these two pAbs were further compared. Here, we report that both anti-JEVpr/DENV-M and anti-prM pAbs exhibited broad cross-reactivity and only partial neutralization with four DENV serotypes and immature DENV. Rabbit anti-prM pAbs showed a significant enhancement in a broad range of serum dilutions. However, there was no statistically significant difference in the enhancing activity of rabbit anti-JEVpr/DENV-M pAbs at various levels of dilution. These results demonstrate that anti-prM antibody-mediated ADE can be prevented by JEV pr peptide replacement. The present study contribute further to research on the pathogenesis of DENV infection.

  3. Investigation of spatiotemporal relationship between dengue fever and drought

    NASA Astrophysics Data System (ADS)

    Lee, Chieh-Han; Yu, Hwa-Lung

    2016-04-01

    Dengue Fever is a vector-borne disease that is transmitted between human and mosquitos in tropical and sub-tropical regions. Previous studies have found significant relationship between the epidemic of dengue cases and climate variables, especially temperature and precipitation. Besides, the natural phenomena (e.g., drought) are considered that significantly drop the number of dengue cases by killing vector's breeding environment. However, in Kaohsiung City, Taiwan, there are evidences that the temporal pattern of dengue is correlated to drought events. Kaohsiung City experienced two main dengue outbreaks in 2002 and 2014 that both years were confirmed with serious drought. Especially in 2014, Kaohsiung City was suffered from extremely dengue outbreak in 2014 that reported the highest number of dengue cases in the history. Otherwise, another nearby city, Tainan City, had reported the biggest outbreak in 2015. This study constructs the spatiotemporal model of dengue incidences and index of drought events (Standardized Precipitation Index, SPI) based on the distributed lag nonlinear model (DLNM). Other meteorological measures are also included in the analysis.

  4. Dengue Epidemiology

    MedlinePlus

    ... Address What's this? Submit What's this? Submit Button ... fever (DF) is caused by any of four closely related viruses, or serotypes: dengue 1-4. Infection with one serotype does not protect against the ...

  5. [Dengue fever in the Reunion Island and in South Western islands of the Indian Ocean].

    PubMed

    D'Ortenzio, E; Balleydier, E; Baville, M; Filleul, L; Renault, P

    2011-09-01

    South Western islands of the Indian Ocean are permanently threatened by dengue fever outbreaks. On the Reunion Island, two dengue outbreaks were biologically documented (1977-1978 and 2004). And since July 2004 there has been an inter-epidemic period for the island with sporadic cases and clusters. Between January 1, 2007 and October 5, 2009, the epidemiologic surveillance system detected five confirmed autochthonous cases, five confirmed imported cases (South-East Asia), and 71 probable cases. All the five autochthonous confirmed cases occurred in Saint-Louis during two consecutive clusters. In other South Western islands of the Indian Ocean, several dengue fever outbreaks have been reported. Importation of dengue virus from South-East Asia is a major risk for a new outbreak on the island. The introduction of a new serotype could lead to the emergence of new and severe clinical forms, including dengue hemorrhagic fever.

  6. A Two-Year Review on Epidemiology and Clinical Characteristics of Dengue Deaths in Malaysia, 2013-2014

    PubMed Central

    Woon, Yuan Liang; Hor, Chee Peng; Hussin, Narwani; Zakaria, Ariza; Goh, Pik Pin; Cheah, Wee Kooi

    2016-01-01

    Background Dengue infection is the fastest spreading mosquito-borne viral disease, which affects people living in the tropical and subtropical countries. Malaysia had large dengue outbreaks in recent years. We aimed to study the demographics and clinical characteristics associated with dengue deaths in Malaysia. Methods We conducted a retrospective review on all dengue deaths that occurred nationwide between 1st January 2013 and 31st December 2014. Relevant data were extracted from mortality review reports and investigational forms. These cases were categorized into children (<15 years), adults (15–59 years) and elderly (≥60 years) to compare their clinical characteristics. Results A total of 322 dengue deaths were reviewed. Their mean age was 40.7±19.30 years, half were females and 72.5% were adults. The median durations of first medical contact, and hospitalization were 1 and 3 days, respectively. Diabetes and hypertension were common co-morbidities among adults and elderly. The most common warning signs reported were lethargy and vomiting, with lethargy (p = 0.038) being more common in children, while abdominal pain was observed more often in the adults (p = 0.040). But 22.4% did not have any warning signs. Only 34% were suspected of dengue illness at their initial presentation. More adults developed severe plasma leakage (p = 0.018). More than half (54%) suffered from multi-organ involvement, and 20.2% were free from any organ involvement. Dengue deaths occurred at the median of 3 days post-admission. Dengue shock syndrome (DSS) contributed to more than 70% of dengue deaths, followed by severe organ involvement (69%) and severe bleeding (29.7%). Conclusion In Malaysia, dengue deaths occurred primarily in adult patients. DSS was the leading cause of death, regardless of age groups. The atypical presentation and dynamic progression of severe dengue in this cohort prompts early recognition and aggressive intervention to prevent deaths. Trial Registration

  7. Fostering prevention and care delivery services capability on HIV pandemic and Ebola outbreak symbiosis in Africa.

    PubMed

    Tambo, Ernest; Yah, Clarence S; Ugwu, Chidiebere E; Olalubi, Oluwasogo A; Wurie, Isatta; Jonhson, Jeannetta K; Ngogang, Jeanne Y

    2016-01-31

    Human immunodeficiency virus (HIV) and the re-emerging Ebola virus disease (EVD) are closely intertwined and remain a persistent public health threat and global challenge. Their origin and rapid transmission and spread have similar boundaries and share overlapping impact characteristics, including related symptoms and other interactions. The controversies and global threat of these viruses require rapid response policy and evidence-based implementation findings. The constraints and dual burden inflicted by Ebola and HIV infections are highly characterized by similar socio-demographics, socio-economic and political factors. EVD has similar effects and burdens to HIV infection. This study seeks to understand EVD in the context of HIV epidemic despite the challenges in developing an effective vaccine against HIV and EVD. Our findings show that early understanding, prevention and treatment of these diseases a global health threat mainly in Africa is important and valuable. The lessons learned so far from HIV and Ebola epidemics are crucial in health programming and execution of rapid response interventions and continued vigilance against EVD before it become another worldwide health menace. Therefore, the current regional West Africa EVD requires strengthening healthcare systems and building preparedness and response capacity. Importantly, appropriate community participation, health education and resilience coupled with deployment of effective novel diagnostic approaches in early warning and surveillance of threats and emerging diseases. Therefore, there is an urgent need to develop novel key strategies are crucial in curbing the constant viral resurgence, persistence transmission dynamics and spread, as well in accelerating Ebola vaccines regimen (immunization) development and national implementation plans in achieving sustained control, and eventual elimination.

  8. Dengue Virus Serotypes Circulating in Khyber Pakhtunkhwa Province, Pakistan, 2013-2015

    PubMed Central

    Suleman, Muhammad; Faryal, Rani; Alam, Muhammad Masroor; Sharif, Salmaan; Shaukat, Shahzad; Aamir, Uzma Bashir; Khurshid, Adnan; Angez, Mehar; Umair, Massab; Sufian, Mian Muhammad; Arshad, Yasir

    2017-01-01

    From 2013 to 2015, the National Institute of Health, Pakistan, received 1,270 blood samples of suspected dengue cases reported from inpatient and outpatient departments of various hospitals in Khyber Pakhtunkhwa (KPK) province. In this study, we determined the circulating dengue virus (DENV) serotypes using real-time reverse transcriptase (RT)-PCR to understand the serotype-based epidemiology of DENV. All four serotypes (DENV-1 [6%], DENV-2 [33%], DENV-3 [47%], and DENV-4 [0.1%]) were found circulating during the study period. Our findings suggest the need for an active surveillance system coupled with the laboratory diagnosis, especially in the chronic endemic areas of the country. Public awareness programs are needed for effective control and prevention of outbreaks in the future. PMID:28029002

  9. Dengue Virus Serotypes Circulating in Khyber Pakhtunkhwa Province, Pakistan, 2013-2015.

    PubMed

    Suleman, Muhammad; Faryal, Rani; Alam, Muhammad Masroor; Sharif, Salmaan; Shaukat, Shahzad; Aamir, Uzma Bashir; Khurshid, Adnan; Angez, Mehar; Umair, Massab; Sufian, Mian Muhammad; Arshad, Yasir; Zaidi, Syed Sohail Zahoor

    2017-03-01

    From 2013 to 2015, the National Institute of Health, Pakistan, received 1,270 blood samples of suspected dengue cases reported from inpatient and outpatient departments of various hospitals in Khyber Pakhtunkhwa (KPK) province. In this study, we determined the circulating dengue virus (DENV) serotypes using real-time reverse transcriptase (RT)-PCR to understand the serotype-based epidemiology of DENV. All four serotypes (DENV-1 [6%], DENV-2 [33%], DENV-3 [47%], and DENV-4 [0.1%]) were found circulating during the study period. Our findings suggest the need for an active surveillance system coupled with the laboratory diagnosis, especially in the chronic endemic areas of the country. Public awareness programs are needed for effective control and prevention of outbreaks in the future.

  10. Dengue virus serotype 4, northeastern Peru, 2008.

    PubMed

    Forshey, Brett M; Morrison, Amy C; Cruz, Cristhopher; Rocha, Claudio; Vilcarromero, Stalin; Guevara, Carolina; Camacho, Daria E; Alava, Araceli; Madrid, César; Beingolea, Luis; Suarez, Victor; Comach, Guillermo; Kochel, Tadeusz J

    2009-11-01

    In 2008, dengue virus serotype 4 (DENV-4) emerged in northeastern Peru, causing a large outbreak and displacing DENV-3, which had predominated for the previous 6 years. Phylogenetic analysis of 2008 and 2009 isolates support their inclusion into DENV-4 genotype II, forming a lineage distinct from strains that had previously circulated in the region.

  11. Dengue in Florida (USA)

    PubMed Central

    Rey, Jorge R.

    2014-01-01

    Florida (USA), particularly the southern portion of the State, is in a precarious situation concerning arboviral diseases. The geographic location, climate, lifestyle, and the volume of travel and commerce are all conducive to arbovirus transmission. During the last decades, imported dengue cases have been regularly recorded in Florida, and the recent re-emergence of dengue as a major public health concern in the Americas has been accompanied by a steady increase in the number of imported cases. In 2009, there were 28 cases of locally transmitted dengue in Key West, and in 2010, 65 cases were reported. Local transmission was also reported in Martin County in 2013 (29 cases), and isolated locally transmitted cases were also reported from other counties in the last five years. Dengue control and prevention in the future will require close cooperation between mosquito control and public health agencies, citizens, community and government agencies, and medical professionals to reduce populations of the vectors and to condition citizens and visitors to take personal protection measures that minimize bites by infected mosquitoes. PMID:26462955

  12. Economic Impact of Dengue Illness in the Americas

    PubMed Central

    Shepard, Donald S.; Coudeville, Laurent; Halasa, Yara A.; Zambrano, Betzana; Dayan, Gustavo H.

    2011-01-01

    The growing burden of dengue in endemic countries and outbreaks in previously unaffected countries stress the need to assess the economic impact of this disease. This paper synthesizes existing studies to calculate the economic burden of dengue illness in the Americas from a societal perspective. Major data sources include national case reporting data from 2000 to 2007, prospective cost of illness studies, and analyses quantifying underreporting in national routine surveillance systems. Dengue illness in the Americas was estimated to cost $2.1 billion per year on average (in 2010 US dollars), with a range of $1–4 billion in sensitivity analyses and substantial year to year variation. The results highlight the substantial economic burden from dengue in the Americas. The burden for dengue exceeds that from other viral illnesses, such as human papillomavirus (HPV) or rotavirus. Because this study does not include some components (e.g., vector control), it may still underestimate total economic consequences of dengue. PMID:21292885

  13. Ongoing dengue epidemic - Angola, June 2013.

    PubMed

    2013-06-21

    On April 1, 2013, the Public Health Directorate of Angola announced that six cases of dengue had been reported to the Ministry of Health of Angola (MHA). As of May 31, a total of 517 suspected dengue cases had been reported and tested for dengue with a rapid diagnostic test (RDT). A total of 313 (60.5%) specimens tested positive for dengue, including one from a patient who died. All suspected cases were reported from Luanda Province, except for two from Malanje Province. Confirmatory diagnostic testing of 49 specimens (43 RDT-positive and six RDT-negative) at the CDC Dengue Branch confirmed dengue virus (DENV) infection in 100% of the RDT-positive specimens and 50% of the RDT-negative specimens. Only DENV-1 was detected by molecular diagnostic testing. Phylogenetic analysis indicated this virus has been circulating in the region since at least 1968, strongly suggesting that dengue is endemic in Angola. Health-care professionals throughout Angola should be aware of the ongoing epidemic, the recommended practices for clinical management of dengue patients, and the need to report cases to MHA. Persons in Angola should seek medical care for acute febrile illness to reduce the risk for developing complications. Laboratory-confirmed dengue also has been reported from seven countries on four continents among persons who had recently traveled to Luanda, including 79 persons from Portugal. Angola is the third of four African countries to report a dengue outbreak in 2013. Persons returning from Africa with acute febrile illness should seek medical care, including testing for DENV infection, and suspected cases should be reported to public health authorities.

  14. Cross-serotype neutralization of dengue virus in Aotus nancymae monkeys.

    PubMed

    Kochel, Tadeusz J; Watts, Douglas M; Gozalo, Alfonso S; Ewing, Daniel F; Porter, Kevin R; Russell, Kevin L

    2005-03-15

    Previously, we observed that serum from humans immune to dengue serotype 1 (dengue-1) neutralized the American genotype of dengue serotype 2 (American-2) to a greater extent than it neutralized the Asian genotype of dengue serotype 2 (Asian-2). To determine if this activity is protective, Aotus nancymae monkeys were infected with dengue-1 followed by either American-2 or Asian-2. Dengue-1-infected animals produced antibody with neutralizing titers of 2656 antibodies against dengue-1, 409 against American-2, and <20 against Asian-2. Infection with American-2 did not produce detectable viremia in either dengue-1-immune or dengue-1-naive animals. These findings support the hypothesis that dengue-1 immunity might have prevented disease or altered the severity of disease in individuals sequentially infected with dengue-1 and American-2.

  15. Awareness of dengue and practice of dengue control among the semi-urban community: a cross sectional survey.

    PubMed

    Naing, Cho; Ren, Wong Yih; Man, Chan Yuk; Fern, Koh Pei; Qiqi, Chua; Ning, Choo Ning; Ee, Clarice Wong Syun

    2011-12-01

    Primary prevention is the most effective measure in dengue prevention and control. The objectives were (i) to determine the level of knowledge and practice of dengue control amongst the study community, and (ii) to explore the factors affecting practice of dengue control in the study area. A cross-sectional study was conducted in a semi-urban Town of Malaysia, using a structured questionnaire covering sociodemography, knowledge related to dengue, knowledge related to Aedes mosquito and preventive measures against the disease. For comparison of survey responses, chi-square test was applied for categorical data. To explore the factors affecting the practice of dengue control, a linear regression model was introduced. Almost all of the respondents (95%) had heard about dengue. Overall, misconceptions of dengue transmission were identified and the practice of dengue control in the study population was insufficient. About half (50.5%) had misconceptions that Aedes can breed in dirty water and the preferred biting time is dusk or sunset (45.6%). Only 44.5% of the households surveyed had covered their water containers properly. Significant associations were found between knowledge scores of dengue and age (P = 0.001), education level (P = 0.001), marital status (P = 0.012), and occupation (P = 0.007). In regression analysis, only the knowledge of dengue was significantly and positively associated with practice on dengue control. A future study with larger samples and more variables to assess the knowledge, attitudes and practices of dengue control is recommended.

  16. Dengue serotype surveillance among patients admitted for dengue in two major hospitals in Selangor, Malaysia, 2010-2011.

    PubMed

    Ab-Fatah, M; Subenthiran, S; Abdul-Rahman, P S A; Saat, Z; Thayan, R

    2015-03-01

    Dengue serotype surveillance is important as any changes in serotype distribution may result in an outbreak or increase in severe dengue cases. This study aimed to determine circulating dengue serotypes in two hospitals in Selangor. Serum samples were collected from patients admitted for dengue at these two major public hospitals i.e. Hospital Sungai Buloh (HSB) and Hospital Tunku Ampuan Rahimah (HTAR) between November 2010 and August 2011 and subjected to real-time RT-PCR using SYBR® Green. All four dengue serotypes were detected in samples from both hospitals. The predominating serotype was dengue 1 in samples from both hospitals (HSB, DENV-1; 25.53 % and HTAR, DENV-1; 32.1 %).

  17. 77 FR 4048 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Initial Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-26

    ... Dengue Epidemiology, Outcomes, and Prevention in Sentinel Surveillance and Research Sites in Puerto Rico... to ``Evaluation of Dengue Epidemiology, Outcomes and Prevention in Sentinel Surveillance and...

  18. International Dengue Vaccine Communication and Advocacy: Challenges and Way Forward.

    PubMed

    Carvalho, Ana; Van Roy, Rebecca; Andrus, Jon

    2016-01-01

    Dengue vaccine introduction will likely occur soon. However, little has been published on international dengue vaccine communication and advocacy. More effort at the international level is required to review, unify and strategically disseminate dengue vaccine knowledge to endemic countries' decision makers and potential donors. Waiting to plan for the introduction of new vaccines until licensure may delay access in developing countries. Concerted efforts to communicate and advocate for vaccines prior to licensure are likely challenged by unknowns of the use of dengue vaccines and the disease, including uncertainties of vaccine impact, vaccine access and dengue's complex pathogenesis and epidemiology. Nevertheless, the international community has the opportunity to apply previous best practices for vaccine communication and advocacy. The following key strategies will strengthen international dengue vaccine communication and advocacy: consolidating existing coalitions under one strategic umbrella, urgently convening stakeholders to formulate the roadmap for integrated dengue prevention and control, and improving the dissemination of dengue scientific knowledge.

  19. Dengue vaccines: challenges, development, current status and prospects.

    PubMed

    Ghosh, A; Dar, L

    2015-01-01

    Infection with dengue virus (DENV) is the most rapidly spreading mosquito-borne viral disease in the world. The clinical spectrum of dengue, caused by any of the four serotypes of DENV, ranges from mild self-limiting dengue fever to severe dengue, in the form dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Increased rates of hospitalization due to severe dengue, during outbreaks, result in massive economic losses and strained health services. In the absence of specific antiviral therapy, control of transmission of DENV by vector management is the sole method available for decreasing dengue-associated morbidity. Since vector control strategies alone have not been able to satisfactorily achieve reduction in viral transmission, the implementation of a safe, efficacious and cost-effective dengue vaccine as a supplementary measure is a high public health priority. However, the unique and complex immunopathology of dengue has complicated vaccine development. Dengue vaccines have also been challenged by critical issues like lack of animal models for the disease and absence of suitable markers of protective immunity. Although no licensed dengue vaccine is yet available, several vaccine candidates are under phases of development, including live attenuated virus vaccines, live chimeric virus vaccines, inactivated virus vaccines, subunit vaccines, DNA vaccines and viral-vectored vaccines. Although some vaccine candidates have progressed from animal trials to phase II and III in humans, a number of issues regarding implementation of dengue vaccine in countries like India still need to be addressed. Despite the current limitations, collaborative effects of regulatory bodies like World Health Organization with vaccine manufacturers and policy makers, to facilitate vaccine development and standardize field trials can make a safe and efficacious dengue vaccine a reality in near future.

  20. An innovative forecasting and dashboard system for Malaysian dengue trends

    NASA Astrophysics Data System (ADS)

    Jamil, Jastini Mohd; Shaharanee, Izwan Nizal Mohd

    2016-08-01

    Dengue fever has been recognized in over 100 countries and 2.5 billion people live in areas where dengue is endemic. It is currently a serious arthropod-borne disease, affecting around 50-100 million people worldwide every year. Dengue fever is also prevalent in Malaysia with numerous cases including mortality recorded over the past year. In 2012, a total of 21,900 cases of dengue fever were reported with 35 deaths. Dengue, a mosquito-transmitted virus, causes a high fever accompanied by significant pain in afflicted patient and the Aedes Aegypti mosquito is the primary disease carrier. Knowing the dangerous effect of dengue fever, thus one of the solutions is to implement an innovative forecasting and dashboard system of dengue spread in Malaysia, with emphasize on an early prediction of dengue outbreak. Specifically, the model developed will provide with a valuable insight into strategically managing and controlling the future dengue epidemic. Importantly, this research will deliver the message to health policy makers such as The Ministry of Health Malaysia (MOH), practitioners, and researchers of the importance to integrate their collaboration in exploring the potential strategies in order to reduce the future burden of the increase in dengue transmission cases in Malaysia.

  1. Climate-Based Models for Understanding and Forecasting Dengue Epidemics

    PubMed Central

    Descloux, Elodie; Mangeas, Morgan; Menkes, Christophe Eugène; Lengaigne, Matthieu; Leroy, Anne; Tehei, Temaui; Guillaumot, Laurent; Teurlai, Magali; Gourinat, Ann-Claire; Benzler, Justus; Pfannstiel, Anne; Grangeon, Jean-Paul; Degallier, Nicolas; De Lamballerie, Xavier

    2012-01-01

    Background Dengue dynamics are driven by complex interactions between human-hosts, mosquito-vectors and viruses that are influenced by environmental and climatic factors. The objectives of this study were to analyze and model the relationships between climate, Aedes aegypti vectors and dengue outbreaks in Noumea (New Caledonia), and to provide an early warning system. Methodology/Principal Findings Epidemiological and meteorological data were analyzed from 1971 to 2010 in Noumea. Entomological surveillance indices were available from March 2000 to December 2009. During epidemic years, the distribution of dengue cases was highly seasonal. The epidemic peak (March–April) lagged the warmest temperature by 1–2 months and was in phase with maximum precipitations, relative humidity and entomological indices. Significant inter-annual correlations were observed between the risk of outbreak and summertime temperature, precipitations or relative humidity but not ENSO. Climate-based multivariate non-linear models were developed to estimate the yearly risk of dengue outbreak in Noumea. The best explicative meteorological variables were the number of days with maximal temperature exceeding 32°C during January–February–March and the number of days with maximal relative humidity exceeding 95% during January. The best predictive variables were the maximal temperature in December and maximal relative humidity during October–November–December of the previous year. For a probability of dengue outbreak above 65% in leave-one-out cross validation, the explicative model predicted 94% of the epidemic years and 79% of the non epidemic years, and the predictive model 79% and 65%, respectively. Conclusions/Significance The epidemic dynamics of dengue in Noumea were essentially driven by climate during the last forty years. Specific conditions based on maximal temperature and relative humidity thresholds were determinant in outbreaks occurrence. Their persistence was also

  2. Study of a measles outbreak in Granada with preventive measures applied by the courts, Spain, 2010 to 2011.

    PubMed

    Navarro, E; Mochón, M M; Galicia, M D; Marín, I; Laguna, J

    2013-10-24

    Measles had practically been eliminated in Granada since the systematic vaccination of children with two doses introduced in 1984. However, in 2009 the disease returned in the form of small outbreaks. This study describes the measles outbreak that occurred in Granada from October 2010 to August 2011 and the measures imposed to control it. Information was sourced from the records of the Andalusian epidemiological surveillance system. A total of 308 cases were recorded, representing an incidence rate of 33.6 cases per 100,000 inhabitants. The first wave of the epidemic took place in Granada city, with the majority of cases occurring among families who lived in the Albaycín neighbourhood and were opposed to vaccination for ideological and/or religious reasons. The initial cases were in unvaccinated children aged 1 to 13 years. The outbreak later spread throughout the province. To control the outbreak, the vaccination schedule for the exposed children was brought up to date. The Regional Ministry of Health decided to take legal action in order to ensure vaccination of those in the initial nucleus of the outbreak.

  3. Role of cognitive parameters in dengue hemorrhagic fever and dengue shock syndrome

    PubMed Central

    2013-01-01

    Dengue is becoming recognized as one of the most important vector-borne human diseases. It is predominant in tropical and subtropical zones but its geographical distribution is progressively expanding, making it an escalating global health problem of today. Dengue presents with spectrum of clinical manifestations, ranging from asymptomatic, undifferentiated mild fever, dengue fever (DF), to dengue hemorrhagic fever (DHF) with or without shock (DSS), a life-threatening illness characterized by plasma leakage due to increased vascular permeability. Currently, there are no antiviral modalities or vaccines available to treat and prevent dengue. Supportive care with close monitoring is the standard clinical practice. The mechanisms leading to DHF/DSS remains poorly understood. Multiple factors have been attributed to the pathological mechanism, but only a couple of these hypotheses are popular in scientific circles. The current discussion focuses on underappreciated factors, temperature, natural IgM, and endotoxin, which may be critical components playing roles in dengue pathogenesis. PMID:24305068

  4. Understanding the relative importance of global dengue risk factors.

    PubMed

    Lowe, Rachel

    2015-10-01

    Dengue is a mosquito-transmitted viral infection of major international public health concern. Global environmental and socio-economic change has created ideal conditions for the global expansion of dengue transmission. Innovative modelling tools help in understanding the global determinants of dengue risk and the relative impact of environmental and socio-economic factors on dengue transmission and spread. While climatic factors may act as a limiting factor on the global scale, other processes may play a dominant role at the local level. Understanding the spatial scales at which environmental and socio-economic factors dominate can help to target appropriate dengue control and prevention strategies.

  5. Visualization and detection of spatio-temporal hot-spot and cluster for dengue in Petaling district, Malaysia

    NASA Astrophysics Data System (ADS)

    Rizwan, M.; Dass, Sarat C.; Sagayan, Vijanth

    2016-11-01

    Hot-spot and cluster detection is a part of disease surveillance to find out which regions are effected most by the disease. Analysis of these clusters of disease used for longer periods of time can lead to future prediction of disease outbreaks. Dengue is one of the most important arboviral disease in Malaysia which needs proper surveillance and control strategies. Our current study presents hot-spot and cluster detection of dengue outbreaks in the district of Petaling, Selangor in Malaysia during the year 2014 using the registered cases of dengue in the district. Detected hot-spot from this spatio-temporal analysis of registered dengue could provide a trend for the future dengue outbreak predictions. Use of dengue registered cases for the future prediction could be more effective then using land use variables and climate data. R software is used for the hot-spots detection. Custom clustering definition is considered for the analysis.

  6. Flu Outbreaks Force Schools to Adjust Plans: Classes Canceled in Some Places to Prevent Spread of Influenza

    ERIC Educational Resources Information Center

    Jacobson, Linda; Bowman, Darcia Harris

    2004-01-01

    A flu outbreak at Madison Junior High School in Ohio prompted school officials to close the building for two days. At Webber Junior High School in Fort Collins, Colorado, where absenteeism recently hit 20 percent for two bad weeks, educators were forced to slow the pace of schoolwork so sick students did not fall behind. This article reports on…

  7. Transient CD4/CD8 ratio inversion and aberrant immune activation during dengue virus infection.

    PubMed

    Liu, Ching-Chuan; Huang, Kao-Jean; Lin, Yee-Shin; Yeh, Trai-Ming; Liu, Hsiao-Sheng; Lei, Huan-Yao

    2002-10-01

    The immune status after dengue virus infection was studied in dengue patients from an outbreak of serotype 3 dengue virus infection in the southern part of Taiwan during November and December 1998. Consecutive blood samples from 29 dengue patients, of whom 21 had dengue fever and 8 had dengue hemorrhagic fever/dengue shock syndrome, were collected, and the immunophenotypes of the peripheral blood mononuclear cells were determined by flow cytometry. The early activation marker CD69 appeared on lymphocytes and monocytes at day 4 after the onset of fever, and declined afterward. However, a transient reverse in the CD4/CD8 ratio occurred at days 6-10 after the onset of fever. The CD4/CD8 ratio inversion was manifested in 10 of 29 dengue patients and was encountered more frequently in dengue hemorrhagic fever/dengue shock syndrome than in dengue fever patients. Analysis of the clinical blood cell count of these 10 cases showed that increase of immature neutrophils developed at fever days 5-6, CD4(dim) or CD8(dim) monocytosis at days 6-7, and atypical lymphocytosis at days 8-10 after the onset of fever. Serum IL-6 was found at either day 7 or day 9-11. The PHA-stimulated T-cell response was depressed as well. These changes in immune parameters indicate aberrant immune activation during dengue virus infection and might be involved in the pathogenesis of dengue virus infection.

  8. A review of the vector management methods to prevent and control outbreaks of West Nile virus infection and the challenge for Europe

    PubMed Central

    2014-01-01

    West Nile virus infection is a growing concern in Europe. Vector management is often the primary option to prevent and control outbreaks of the disease. Its implementation is, however, complex and needs to be supported by integrated multidisciplinary surveillance systems and to be organized within the framework of predefined response plans. The impact of the vector control measures depends on multiple factors and the identification of the best combination of vector control methods is therefore not always straightforward. Therefore, this contribution aims at critically reviewing the existing vector control methods to prevent and control outbreaks of West Nile virus infection and to present the challenges for Europe. Most West Nile virus vector control experiences have been recently developed in the US, where ecological conditions are different from the EU and vector control is organized under a different regulatory frame. The extrapolation of information produced in North America to Europe might be limited because of the seemingly different epidemiology in the European region. Therefore, there is an urgent need to analyse the European experiences of the prevention and control of outbreaks of West Nile virus infection and to perform robust cost-benefit analysis that can guide the implementation of the appropriate control measures. Furthermore, to be effective, vector control programs require a strong organisational backbone relying on a previously defined plan, skilled technicians and operators, appropriate equipment, and sufficient financial resources. A decision making guide scheme is proposed which may assist in the process of implementation of vector control measures tailored on specific areas and considering the available information and possible scenarios. PMID:25015004

  9. Epidemiology of dengue: past, present and future prospects

    PubMed Central

    Murray, Natasha Evelyn Anne; Quam, Mikkel B; Wilder-Smith, Annelies

    2013-01-01

    Dengue is currently regarded globally as the most important mosquito-borne viral disease. A history of symptoms compatible with dengue can be traced back to the Chin Dynasty of 265–420 AD. The virus and its vectors have now become widely distributed throughout tropical and subtropical regions of the world, particularly over the last half-century. Significant geographic expansion has been coupled with rapid increases in incident cases, epidemics, and hyperendemicity, leading to the more severe forms of dengue. Transmission of dengue is now present in every World Health Organization (WHO) region of the world and more than 125 countries are known to be dengue endemic. The true impact of dengue globally is difficult to ascertain due to factors such as inadequate disease surveillance, misdiagnosis, and low levels of reporting. Currently available data likely grossly underestimates the social, economic, and disease burden. Estimates of the global incidence of dengue infections per year have ranged between 50 million and 200 million; however, recent estimates using cartographic approaches suggest this number is closer to almost 400 million. The expansion of dengue is expected to increase due to factors such as the modern dynamics of climate change, globalization, travel, trade, socioeconomics, settlement and also viral evolution. No vaccine or specific antiviral therapy currently exists to address the growing threat of dengue. Prompt case detection and appropriate clinical management can reduce the mortality from severe dengue. Effective vector control is the mainstay of dengue prevention and control. Surveillance and improved reporting of dengue cases is also essential to gauge the true global situation as indicated in the objectives of the WHO Global Strategy for Dengue Prevention and Control, 2012–2020. More accurate data will inform the prioritization of research, health policy, and financial resources toward reducing this poorly controlled disease. The objective

  10. Infection prevention and control interventions in the first outbreak of methicillin-resistant Staphylococcus aureus infections in an equine hospital in Sweden

    PubMed Central

    2012-01-01

    Background The first outbreak of methicillin-resistant Staphylococcus aureus (MRSA) infection in horses in Sweden occurred in 2008 at the University Animal Hospital and highlighted the need for improved infection prevention and control. The present study describes interventions and infection prevention control in an equine hospital setting July 2008 - April 2010. Method This descriptive study of interventions is based on examination of policy documents, medical records, notes from meetings and cost estimates. MRSA cases were identified through clinical sampling and telephone enquiries about horses post-surgery. Prospective sampling in the hospital environment with culture for MRSA and genotyping of isolates by spa-typing and pulsed-field gel electrophoresis (PFGE) were performed. Results Interventions focused on interruption of indirect contact spread of MRSA between horses via staff and equipment and included: Temporary suspension of elective surgery; and identification and isolation of MRSA-infected horses; collaboration was initiated between authorities in animal and human public health, human medicine infection control and the veterinary hospital; extensive cleaning and disinfection was performed; basic hygiene and cleaning policies, staff training, equipment modification and interior renovation were implemented over seven months. Ten (11%) of 92 surfaces sampled between July 2008 and April 2010 tested positive for MRSA spa-type 011, seven of which were from the first of nine sampling occasions. PFGE typing showed the isolates to be the outbreak strain (9 of 10) or a closely related strain. Two new cases of MRSA infection occurred 14 and 19 months later, but had no proven connections to the outbreak cases. Conclusions Collaboration between relevant authorities and the veterinary hospital and formation of an infection control committee with an executive working group were required to move the intervention process forward. Support from hospital management and the

  11. Dengue Virus Seroconversion in Travelers to Dengue-Endemic Areas.

    PubMed

    Olivero, Rosemary M; Hamer, Davidson H; MacLeod, William B; Benoit, Christine M; Sanchez-Vegas, Carolina; Jentes, Emily S; Chen, Lin H; Wilson, Mary E; Marano, Nina; Yanni, Emad A; Ooi, Winnie W; Karchmer, Adolf W; Kogelman, Laura; Barnett, Elizabeth D

    2016-11-02

    We conducted a prospective study to measure dengue virus (DENV) antibody seroconversion in travelers to dengue-endemic areas. Travelers seen in the Boston Area Travel Medicine Network planning to visit dengue-endemic countries for ≥ 2 weeks were enrolled from 2009 to 2010. Pre- and post-travel blood samples and questionnaires were collected. Post-travel sera were tested for anti-DENV IgG by indirect IgG enzyme-linked immunosorbent assay (ELISA) and anti-DENV IgM by capture IgM ELISA. Participants with positive post-travel anti-DENV IgG or IgM were tested for pre-travel anti-DENV IgG and IgM; they were excluded from the seroconversion calculation if either pre-travel anti-DENV IgG or IgM were positive. Paired sera and questionnaires were collected for 62% (589/955) of enrolled travelers. Most participants were 19-64 years of age, female, and white. The most common purposes of travel were tourism and visiting friends and relatives; most trips were to Asia or Africa. Median length of travel was 21 days. DENV antibody seroconversion by either anti-DENV IgM or IgG ELISA was 2.9-6.8%; lower range percent excluded potential false-positive anti-DENV IgG due to receipt of yellow fever or Japanese encephalitis vaccines at enrollment; upper range percent excluded proven false-positive anti-DENV IgM. Eighteen percent of those with seroconversion reported dengue-like symptoms. Seroconversion was documented for travel to Africa as well as countries and regions known to be highly dengue endemic (India, Brazil, southeast Asia). Given widespread risk of dengue, travel medicine counseling should include information on risk of dengue in endemic areas and advice on preventing insect bites and seeking prompt medical attention for febrile illness.

  12. Effect of dengue-1 antibodies on American dengue-2 viral infection and dengue haemorrhagic fever.

    PubMed

    Kochel, Tadeusz J; Watts, Douglas M; Halstead, Scott B; Hayes, Curtis G; Espinoza, Angelica; Felices, Vidal; Caceda, Roxana; Bautista, Christian T; Montoya, Ysabel; Douglas, Susan; Russell, Kevin L

    2002-07-27

    In Iquitos, Peru, no cases of dengue haemorrhagic fever have been recorded in individuals infected with dengue-1 virus followed by American genotype dengue-2 (American dengue-2) virus. We assayed serum samples collected in Iquitos that tested positive for antibodies of monotype dengue-1 and monotype dengue-2 using a plaque reduction neutralisation test to determine their ability to neutralise the infectivity of two dengue-1 viruses, two American dengue-2 viruses, and two Asian dengue-2 viruses. Sera positive for the dengue-1 antibody neutralised dengue-1 viruses and American dengue-2 viruses much more effectively than Asian dengue-2 viruses. Neutralisation of American dengue-2 virus by sera positive for dengue-1 antibodies may account for the absence of dengue haemorrhagic fever in individuals infected with dengue-1 in 1990-91 followed by American dengue-2 virus in 1995 in Iquitos, Peru.

  13. Early Guillain-Barré Syndrome associated with acute dengue fever.

    PubMed

    Simon, O; Billot, S; Guyon, D; Daures, M; Descloux, E; Gourinat, A C; Molko, N; Dupont-Rouzeyrol, M

    2016-04-01

    Various forms of neurological manifestations are reported in dengue fever. We describe here three cases of concomitant Guillain-Barré syndrome and dengue virus (DENV) infection during the largest DENV-1 outbreak in New Caledonia. Research of viral RNA was positive in both blood and CSF samples. All patients were treated with intravenous polyvalent immunoglobulins and recovered without sequelae within one week.

  14. Wolbachia versus dengue

    PubMed Central

    Bull, James J.; Turelli, Michael

    2013-01-01

    A novel form of biological control is being applied to the dengue virus. The agent is the maternally transmitted bacterium Wolbachia, naturally absent from the main dengue vector, the mosquito Aedes aegypti. Three Wolbachia-based control strategies have been proposed. One is suppression of mosquito populations by large-scale releases of males incompatible with native females; this intervention requires ongoing releases. The other interventions transform wild mosquito populations with Wolbachia that spread via the frequency-dependent fitness advantage of Wolbachia-infected females; those interventions potentially require just a single, local release for area-wide disease control. One of these latter strategies uses Wolbachia that shortens mosquito life, indirectly preventing viral maturation/transmission. The other strategy uses Wolbachia that block viral transmission. All interventions can be undermined by viral, bacterial or mosquito evolution; viral virulence in humans may also evolve. We examine existing theory, experiments and comparative evidence to motivate predictions about evolutionary outcomes. (i) The life-shortening strategy seems the most likely to be thwarted by evolution. (ii) Mosquito suppression has a reasonable chance of working locally, at least in the short term, but long-term success over large areas is challenging. (iii) Dengue blocking faces strong selection for viral resistance but may well persist indefinitely at some level. Virulence evolution is not mathematically predictable, but comparative data provide no precedent for Wolbachia increasing dengue virulence. On balance, our analysis suggests that the considerable possible benefits of these technologies outweigh the known negatives, but the actual risk is largely unknown. PMID:24481199

  15. Space-time clustering characteristics of dengue based on ecological, socio-economic and demographic factors in northern Sri Lanka.

    PubMed

    Anno, Sumiko; Imaoka, Keiji; Tadono, Takeo; Igarashi, Tamotsu; Sivaganesh, Subramaniam; Kannathasan, Selvam; Kumaran, Vaithehi; Surendran, Sinnathamby Noble

    2015-11-26

    The aim of the present study was to identify geographical areas and time periods of potential clusters of dengue cases based on ecological, socio-economic and demographic factors in northern Sri Lanka from January 2010 to December 2013. Remote sensing (RS) was used to develop an index comprising rainfall, humidity and temperature data. Remote sensing data gathered by the AVNIR-2 instrument onboard the ALOS satellite were used to detect urbanisation, and a digital land cover map was used to extract land cover information. Other data on relevant factors and dengue outbreaks were collected through institutions and extant databases. The analysed RS data and databases were integrated into a geographical information system (GIS) enabling space-time clustering analysis. Our results indicate that increases in the number of combinations of ecological, socio-economic and demographic factors that are present or above the average contribute to significantly high rates of space-time dengue clusters. The spatio-temporal association that consolidates the two kinds of associations into one can ensure a more stable model for forecasting. An integrated spatiotemporal prediction model at a smaller level using ecological, socioeconomic and demographic factors could lead to substantial improvements in dengue control and prevention by allocating the right resources to the appropriate places at the right time.

  16. In the midst of a large measles outbreak, EDs take steps to bolster screening procedures, prevent potential transmissions.

    PubMed

    2015-04-01

    A large, multi-state outbreak of measles is prompting EDs around the country to bolster their screening procedures and provide education to staff, most of whom have never seen a measles case. Dozens of people in more than 17 states have been confirmed to have the disease, with most of these cases associated with an outbreak that began at an amusement park in southern California. Measles is extremely contagious, infecting nine out of 10 people exposed to the virus if they are susceptible to the disease. In cases in which a contagious disease is suspected, experts advise emergency providers to protect themselves before proceeding to the traditional vital signs. It's a concept referred to as "vital sign zero." Once a measles case is confirmed, experts say emergency staff should isolate the patient with protection such as an N-95 mask, and inform both the hospital's infection control department and public health authorities.

  17. Mitigating the Risk of Transfusion-Transmitted Dengue in Australia

    PubMed Central

    Rooks, Kelly; Seed, Clive R.; Fryk, Jesse J.; Hyland, Catherine A.; Harley, Robert J.; Holmberg, Jerry A.; Marks, Denese C.; Flower, Robert L. P.

    2016-01-01

    Dengue viruses (DENV 1–4) are a risk to transfusion safety, with several transfusion-transmitted (TT) cases reported globally. DENV 1–4 are endemic in over 100 countries, with seasonal outbreaks occurring in northeastern Australia. To mitigate TT-DENV risk in Australia, fresh blood components are not manufactured from donors returning from any area (domestic/overseas) with known dengue transmission. Alternatively, TT-DENV risk may be mitigated using an appropriate blood donor screening assay. We aimed to determine the rate of dengue infection in donors during dengue outbreaks in Australia. Plasma samples were collected from blood donors during local dengue outbreaks. All samples were tested for the presence of DENV RNA and selected samples were tested for DENV antigen (nonstructural protein 1, NS1) with two assays. No donors residing in high risk areas had detectable levels of DENV RNA or NS1 and no cases of DENV viremia were detected in blood donors residing in areas of Australia experiencing DENV outbreaks. Definitive conclusions could not be drawn from this study; however, the lack of detection of DENV RNA or antigen in donations suggests that the current risk of TT-DENV is low and maintaining the fresh component restriction for “at-risk” donors is appropriate. PMID:27957384

  18. Diagnosis of Dengue Infection Using Conventional and Biosensor Based Techniques

    PubMed Central

    Parkash, Om; Hanim Shueb, Rafidah

    2015-01-01

    Dengue is an arthropod-borne viral disease caused by four antigenically different serotypes of dengue virus. This disease is considered as a major public health concern around the world. Currently, there is no licensed vaccine or antiviral drug available for the prevention and treatment of dengue disease. Moreover, clinical features of dengue are indistinguishable from other infectious diseases such as malaria, chikungunya, rickettsia and leptospira. Therefore, prompt and accurate laboratory diagnostic test is urgently required for disease confirmation and patient triage. The traditional diagnostic techniques for the dengue virus are viral detection in cell culture, serological testing, and RNA amplification using reverse transcriptase PCR. This paper discusses the conventional laboratory methods used for the diagnosis of dengue during the acute and convalescent phase and highlights the advantages and limitations of these routine laboratory tests. Subsequently, the biosensor based assays developed using various transducers for the detection of dengue are also reviewed. PMID:26492265

  19. Dengue vaccine: a valuable asset for the future.

    PubMed

    Jindal, Harashish; Bhatt, Bhumika; Malik, Jagbir Singh; S K, Shashikantha

    2014-01-01

    Dengue has emerged as one of the major global public health problems. The disease has broken out of its shell and has spread due to increased international travel and climatic changes. Globally, over 2.5 billion people accounting for >40% of the world's population are at risk from dengue. Since the 1940s, dengue vaccines have been under investigation. A live-attenuated tetravalent vaccine based on chimeric yellow fever-dengue virus (CYD-TDV) has progressed to phase III efficacy studies. Dengue vaccine has been found to be a cost-effective intervention to reduce morbidity and mortality. Current dengue vaccine candidates aim to protect against the 4 dengue serotypes, but the recent discovery of a fifth serotype could complicate vaccine development. In recent years, an urgent need has been felt for a vaccine to prevent the morbidity and mortality from this disease in a cost-effective way.

  20. Diagnosis of Dengue Infection Using Conventional and Biosensor Based Techniques.

    PubMed

    Parkash, Om; Shueb, Rafidah Hanim

    2015-10-19

    Dengue is an arthropod-borne viral disease caused by four antigenically different serotypes of dengue virus. This disease is considered as a major public health concern around the world. Currently, there is no licensed vaccine or antiviral drug available for the prevention and treatment of dengue disease. Moreover, clinical features of dengue are indistinguishable from other infectious diseases such as malaria, chikungunya, rickettsia and leptospira. Therefore, prompt and accurate laboratory diagnostic test is urgently required for disease confirmation and patient triage. The traditional diagnostic techniques for the dengue virus are viral detection in cell culture, serological testing, and RNA amplification using reverse transcriptase PCR. This paper discusses the conventional laboratory methods used for the diagnosis of dengue during the acute and convalescent phase and highlights the advantages and limitations of these routine laboratory tests. Subsequently, the biosensor based assays developed using various transducers for the detection of dengue are also reviewed.

  1. Community beliefs and practices about dengue in Puerto Rico

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In spite of long-term endemicity and repeated government and private efforts, effective, sustained community participation for dengue prevention is still a challenge in Puerto Rico. This study explored differences found in interviews conducted in 2001 in attitudes toward dengue and its prevention by...

  2. 'ANOTHER VECTOR BORNE CHALLENGE TO COMBAT- ZIKA VIRUS OUTBREAKS'.

    PubMed

    Shoaib, Maria; Faraz, Ahmad; Ahmed, Syed Ahsanuddin

    2016-01-01

    Zika virus is a single-stranded RNA virus of the Flaviviridae family. It is known to transmit to humans primarily through the bite of an infected Aedes species mosquito which is also known to carry dengue, chikungunya & yellow fever virus. Transmission is anthroponotic (human-to-vector-to-human) during outbreaks, Perinatally in utero, sexually and via infected blood transfusion. It is mild and self-limiting infection lasting for several days to a week. However, it is suspected as a cause of Guillain Barre Syndrome. There is a teratogenic association of Zika virus causing congenital birth defects like microcephaly and neurologic abnormalities. Treatment is generally supportive and for symptomatic relief. No specific antiviral treatment or vaccine is yet available for Zika virus disease. It highlights importance of preventive public health measures at the community level and avoids travelling to the endemic areas.

  3. Outbreak of tick-borne relapsing fever at the north rim of the Grand Canyon: evidence for effectiveness of preventive measures.

    PubMed

    Paul, W S; Maupin, G; Scott-Wright, A O; Craven, R B; Dennis, D T

    2002-01-01

    An outbreak of tick-borne relapsing fever (TBRF) originating at the North Rim of Grand Canyon National Park was investigated in 1990. To determine risk factors for the disease, almost 7,000 parties of visitors were surveyed; over half responded, representing > 10,000 people. Fifteen cases of confirmed or probable TBRF were identified in visitors and 2 in employees. All patients except one experienced symptoms after overnight stays in a group of cabins that had not been rodent-proofed after a TBRF outbreak in 1973 (relative risk for visitors [RR] 8.2, 95% confidence interval [CI] 1.1-62). Seven cases of TBRF were associated with a single cabin (RR 98, 95% CI 30-219). Structural flaws and rodent nests were common in the implicated cabins and rare in unaffected cabins. This investigation suggests that measures to rodent-proof cabins at sites where TBRF is endemic prevent reinfestation of cabins by infected rodents and tick vectors, thereby preventing the spread of disease in humans.

  4. Identification of the prediction model for dengue incidence in Can Tho city, a Mekong Delta area in Vietnam.

    PubMed

    Phung, Dung; Huang, Cunrui; Rutherford, Shannon; Chu, Cordia; Wang, Xiaoming; Nguyen, Minh; Nguyen, Nga Huy; Manh, Cuong Do

    2015-01-01

    The Mekong Delta is highly vulnerable to climate change and a dengue endemic area in Vietnam. This study aims to examine the association between climate factors and dengue incidence and to identify the best climate prediction model for dengue incidence in Can Tho city, the Mekong Delta area in Vietnam. We used three different regression models comprising: standard multiple regression model (SMR), seasonal autoregressive integrated moving average model (SARIMA), and Poisson distributed lag model (PDLM) to examine the association between climate factors and dengue incidence over the period 2003-2010. We validated the models by forecasting dengue cases for the period of January-December, 2011 using the mean absolute percentage error (MAPE). Receiver operating characteristics curves were used to analyze the sensitivity of the forecast of a dengue outbreak. The results indicate that temperature and relative humidity are significantly associated with changes in dengue incidence consistently across the model methods used, but not cumulative rainfall. The Poisson distributed lag model (PDLM) performs the best prediction of dengue incidence for a 6, 9, and 12-month period and diagnosis of an outbreak however the SARIMA model performs a better prediction of dengue incidence for a 3-month period. The simple or standard multiple regression performed highly imprecise prediction of dengue incidence. We recommend a follow-up study to validate the model on a larger scale in the Mekong Delta region and to analyze the possibility of incorporating a climate-based dengue early warning method into the national dengue surveillance system.

  5. Hypokalemic quadriparesis in dengue.

    PubMed

    Mishra, Vikas; Harbada, Rishit; Sharma, Akhilesh; Mishra, Meenakshi

    2015-01-01

    Dengue infection is the leading cause of illness and death in tropical and subtropical regions of the world. The common complications associated with dengue fever are usual hematological abnormalities, shock, and organ failure. The neurological complications of dengue are uncommon. However, evidence of dengue virus neurotropism and complications has been slowly but surely rising as seen from increased literature on this subject over the last decade. We report an uncommon case of hypokalemic quadriparesis with dengue that had a favorable outcome.

  6. Internet-based media coverage on dengue in Sri Lanka between 2007 and 2015

    PubMed Central

    Wilder-Smith, Annelies; Cohn, Emily; Lloyd, David C.; Tozan, Yesim; Brownstein, John S.

    2016-01-01

    Background Internet-based media coverage to explore the extent of awareness of a disease and perceived severity of an outbreak at a national level can be used for early outbreak detection. Dengue has emerged as a major public health problem in Sri Lanka since 2009. Objective To compare Internet references to dengue in Sri Lana with references to other diseases (malaria and influenza) in Sri Lanka and to compare Internet references to dengue in Sri Lanka with notified cases of dengue in Sri Lanka. Design We examined Internet-based news media articles on dengue queried from HealthMap for Sri Lanka, for the period January 2007 to November 2015. For comparative purposes, we compared hits on dengue with hits on influenza and malaria. Results There were 565 hits on dengue between 2007 and 2015, with a rapid rise in 2009 and followed by a rising trend ever since. These hits were highly correlated with the national epidemiological trend of dengue. The volume of digital media coverage of dengue was much higher than of influenza and malaria. Conclusions Dengue in Sri Lanka is receiving increasing media attention. Our findings underpin previous claims that digital media reports reflect national epidemiological trends, both in annual trends and inter-annual seasonal variation, thus acting as proxy biosurveillance to provide early warning and situation awareness of emerging infectious diseases. PMID:27178645

  7. Internet-based media coverage on dengue in Sri Lanka between 2007 and 2015.

    PubMed

    Wilder-Smith, Annelies; Cohn, Emily; Lloyd, David C; Tozan, Yesim; Brownstein, John S

    2016-01-01

    Background Internet-based media coverage to explore the extent of awareness of a disease and perceived severity of an outbreak at a national level can be used for early outbreak detection. Dengue has emerged as a major public health problem in Sri Lanka since 2009. Objective To compare Internet references to dengue in Sri Lana with references to other diseases (malaria and influenza) in Sri Lanka and to compare Internet references to dengue in Sri Lanka with notified cases of dengue in Sri Lanka. Design We examined Internet-based news media articles on dengue queried from HealthMap for Sri Lanka, for the period January 2007 to November 2015. For comparative purposes, we compared hits on dengue with hits on influenza and malaria. Results There were 565 hits on dengue between 2007 and 2015, with a rapid rise in 2009 and followed by a rising trend ever since. These hits were highly correlated with the national epidemiological trend of dengue. The volume of digital media coverage of dengue was much higher than of influenza and malaria. Conclusions Dengue in Sri Lanka is receiving increasing media attention. Our findings underpin previous claims that digital media reports reflect national epidemiological trends, both in annual trends and inter-annual seasonal variation, thus acting as proxy biosurveillance to provide early warning and situation awareness of emerging infectious diseases.

  8. Developing a Time Series Predictive Model for Dengue in Zhongshan, China Based on Weather and Guangzhou Dengue Surveillance Data

    PubMed Central

    Liu, Kangkang; Xia, Yao; Lu, Yi; Jing, Qinlong; Yang, Zhicong; Hu, Wenbiao; Lu, Jiahai

    2016-01-01

    Background Dengue is a re-emerging infectious disease of humans, rapidly growing from endemic areas to dengue-free regions due to favorable conditions. In recent decades, Guangzhou has again suffered from several big outbreaks of dengue; as have its neighboring cities. This study aims to examine the impact of dengue epidemics in Guangzhou, China, and to develop a predictive model for Zhongshan based on local weather conditions and Guangzhou dengue surveillance information. Methods We obtained weekly dengue case data from 1st January, 2005 to 31st December, 2014 for Guangzhou and Zhongshan city from the Chinese National Disease Surveillance Reporting System. Meteorological data was collected from the Zhongshan Weather Bureau and demographic data was collected from the Zhongshan Statistical Bureau. A negative binomial regression model with a log link function was used to analyze the relationship between weekly dengue cases in Guangzhou and Zhongshan, controlling for meteorological factors. Cross-correlation functions were applied to identify the time lags of the effect of each weather factor on weekly dengue cases. Models were validated using receiver operating characteristic (ROC) curves and k-fold cross-validation. Results Our results showed that weekly dengue cases in Zhongshan were significantly associated with dengue cases in Guangzhou after the treatment of a 5 weeks prior moving average (Relative Risk (RR) = 2.016, 95% Confidence Interval (CI): 1.845–2.203), controlling for weather factors including minimum temperature, relative humidity, and rainfall. ROC curve analysis indicated our forecasting model performed well at different prediction thresholds, with 0.969 area under the receiver operating characteristic curve (AUC) for a threshold of 3 cases per week, 0.957 AUC for a threshold of 2 cases per week, and 0.938 AUC for a threshold of 1 case per week. Models established during k-fold cross-validation also had considerable AUC (average 0.938–0.967). The

  9. Spotlight on measles in Italy: why outbreaks of a vaccine-preventable infection continue in the 21st century.

    PubMed

    Piccirilli, Giulia; Lazzarotto, Tiziana; Chiereghin, Angela; Serra, Laura; Gabrielli, Liliana; Lanari, Marcello

    2015-03-01

    Measles is a serious infectious disease that can lead to significant morbidity and mortality. Remarkable progress has been made through measles vaccination in reducing the number of people dying from measles. In the last years, concerns about the safety of vaccines have led to decline in immunization coverage rates and new outbreaks of measles in many European countries, including Italy. We believe that it is important to reinforce the message that measles vaccine is safe and highly effective through appropriate information campaigns and public awareness.

  10. Cost of Dengue Vector Control Activities in Malaysia.

    PubMed

    Packierisamy, P Raviwharmman; Ng, Chiu-Wan; Dahlui, Maznah; Inbaraj, Jonathan; Balan, Venugopalan K; Halasa, Yara A; Shepard, Donald S

    2015-11-01

    Dengue fever, an arbovirus disease transmitted by Aedes mosquitoes, has recently spread rapidly, especially in the tropical countries of the Americas and Asia-Pacific regions. It is endemic in Malaysia, with an annual average of 37,937 reported dengue cases from 2007 to 2012. This study measured the overall economic impact of dengue in Malaysia, and estimated the costs of dengue prevention. In 2010, Malaysia spent US$73.5 million or 0.03% of the country's GDP on its National Dengue Vector Control Program. This spending represented US$1,591 per reported dengue case and US$2.68 per capita population. Most (92.2%) of this spending occurred in districts, primarily for fogging. A previous paper estimated the annual cost of dengue illness in the country at US$102.2 million. Thus, the inclusion of preventive activities increases the substantial estimated cost of dengue to US$175.7 million, or 72% above illness costs alone. If innovative technologies for dengue vector control prove efficacious, and a dengue vaccine was introduced, substantial existing spending could be rechanneled to fund them.

  11. Cost of Dengue Vector Control Activities in Malaysia

    PubMed Central

    Packierisamy, P. Raviwharmman; Ng, Chiu-Wan; Dahlui, Maznah; Inbaraj, Jonathan; Balan, Venugopalan K.; Halasa, Yara A.; Shepard, Donald S.

    2015-01-01

    Dengue fever, an arbovirus disease transmitted by Aedes mosquitoes, has recently spread rapidly, especially in the tropical countries of the Americas and Asia-Pacific regions. It is endemic in Malaysia, with an annual average of 37,937 reported dengue cases from 2007 to 2012. This study measured the overall economic impact of dengue in Malaysia, and estimated the costs of dengue prevention. In 2010, Malaysia spent US$73.5 million or 0.03% of the country's GDP on its National Dengue Vector Control Program. This spending represented US$1,591 per reported dengue case and US$2.68 per capita population. Most (92.2%) of this spending occurred in districts, primarily for fogging. A previous paper estimated the annual cost of dengue illness in the country at US$102.2 million. Thus, the inclusion of preventive activities increases the substantial estimated cost of dengue to US$175.7 million, or 72% above illness costs alone. If innovative technologies for dengue vector control prove efficacious, and a dengue vaccine was introduced, substantial existing spending could be rechanneled to fund them. PMID:26416116

  12. Oviposition Site Selection by the Dengue Vector Aedes aegypti and Its Implications for Dengue Control

    PubMed Central

    Wong, Jacklyn; Stoddard, Steven T.; Astete, Helvio; Morrison, Amy C.; Scott, Thomas W.

    2011-01-01

    Background Because no dengue vaccine or antiviral therapy is commercially available, controlling the primary mosquito vector, Aedes aegypti, is currently the only means to prevent dengue outbreaks. Traditional models of Ae. aegypti assume that population dynamics are regulated by density-dependent larval competition for food and little affected by oviposition behavior. Due to direct impacts on offspring survival and development, however, mosquito choice in oviposition site can have important consequences for population regulation that should be taken into account when designing vector control programs. Methodology/Principal Findings We examined oviposition patterns by Ae. aegypti among 591 naturally occurring containers and a set of experimental containers in Iquitos, Peru. Using larval starvation bioassays as an indirect measure of container food content, we assessed whether females select containers with the most food for their offspring. Our data indicate that choice of egg-laying site is influenced by conspecific larvae and pupae, container fill method, container size, lid, and sun exposure. Although larval food positively influenced oviposition, our results did not support the hypothesis that females act primarily to maximize food for larvae. Females were most strongly attracted to sites containing immature conspecifics, even when potential competitors for their progeny were present in abundance. Conclusion/Significance Due to strong conspecific attraction, egg-laying behavior may contribute more to regulating Ae. aegypti populations than previously thought. If highly infested containers are targeted for removal or larvicide application, females that would have preferentially oviposited in those sites may instead distribute their eggs among other suitable, previously unoccupied containers. Strategies that kill mosquitoes late in their development (i.e., insect growth regulators that kill pupae rather than larvae) will enhance vector control by creating

  13. A brief review on dengue molecular virology, diagnosis, treatment and prevalence in Pakistan

    PubMed Central

    2012-01-01

    Dengue virus infection is a serious health problem infecting 2.5 billion people worldwide. Dengue is now endemic in more than 100 countries, including Pakistan. Each year hundreds of people get infected with dengue in Pakistan. Currently, there is no vaccine available for the prevention of Dengue virus infection due to four viral serotypes. Dengue infection can cause death of patients in its most severity, meanwhile many antiviral compounds are being tested against dengue virus infection to eradicate this disease but still there is a need to develop an efficient, low-cost and safe vaccine that can target all the four serotypes of dengue virus. This review summarizes dengue molecular virology, important drug targets, prevalence in Pakistan, diagnosis, treatment and medicinal plant inhibitors against dengue. PMID:22929369

  14. Enhancing the Immunogenicity of a Tetravalent Dengue DNA Vaccine

    DTIC Science & Technology

    2016-08-01

    AWARD NUMBER: W81XWH-15-2-0029 TITLE: Enhancing the Immunogenicity of a Tetravalent Dengue DNA Vaccine PRINCIPAL INVESTIGATOR: Maya...TITLE AND SUBTITLE Enhancing the Immunogenicity of a Tetravalent Dengue DNA 5a. CONTRACT NUMBER Vaccine 5b. GRANT NUMBER 5c. PROGRAM ELEMENT...the top infectious diseases that afflict US Military personnel deployed overseas. Developing a successful vaccine to prevent dengue fever in DoD

  15. Outbreaks where food workers have been implicated in the spread of foodborne disease. Part 8. Gloves as barriers to prevent contamination of food by workers.

    PubMed

    Todd, Ewen C D; Michaels, Barry S; Greig, Judy D; Smith, Debra; Bartleson, Charles A

    2010-09-01

    The role played by food workers and other individuals in the contamination of food has been identified as an important contributing factor leading to foodborne outbreaks. To prevent direct bare hand contact with food and food surfaces, many jurisdictions have made glove use compulsory for food production and preparation. When properly used, gloves can substantially reduce opportunities for food contamination. However, gloves have limitations and may become a source of contamination if they are punctured or improperly used. Experiments conducted in clinical and dental settings have revealed pinhole leaks in gloves. Although such loss of glove integrity can lead to contamination of foods and surfaces, in the food industry improper use of gloves is more likely than leakage to lead to food contamination and outbreaks. Wearing jewelry (e.g., rings) and artificial nails is discouraged because these items can puncture gloves and allow accumulation of microbial populations under them. Occlusion of the skin during long-term glove use in food operations creates the warm, moist conditions necessary for microbial proliferation and can increase pathogen transfer onto foods through leaks or exposed skin or during glove removal. The most important issue is that glove use can create a false sense of security, resulting in more high-risk behaviors that can lead to cross-contamination when employees are not adequately trained.

  16. Climate Change and Aedes Vectors: 21st Century Projections for Dengue Transmission in Europe.

    PubMed

    Liu-Helmersson, Jing; Quam, Mikkel; Wilder-Smith, Annelies; Stenlund, Hans; Ebi, Kristie; Massad, Eduardo; Rocklöv, Joacim

    2016-05-01

    Warming temperatures may increase the geographic spread of vector-borne diseases into temperate areas. Although a tropical mosquito-borne viral disease, a dengue outbreak occurred in Madeira, Portugal, in 2012; the first in Europe since 1920s. This outbreak emphasizes the potential for dengue re-emergence in Europe given changing climates. We present estimates of dengue epidemic potential using vectorial capacity (VC) based on historic and projected temperature (1901-2099). VC indicates the vectors' ability to spread disease among humans. We calculated temperature-dependent VC for Europe, highlighting 10 European cities and three non-European reference cities. Compared with the tropics, Europe shows pronounced seasonality and geographical heterogeneity. Although low, VC during summer is currently sufficient for dengue outbreaks in Southern Europe to commence-if sufficient vector populations (either Ae. aegypti and Ae. albopictus) were active and virus were introduced. Under various climate change scenarios, the seasonal peak and time window for dengue epidemic potential increases during the 21st century. Our study maps dengue epidemic potential in Europe and identifies seasonal time windows when major cities are most conducive for dengue transmission from 1901 to 2099. Our findings illustrate, that besides vector control, mitigating greenhouse gas emissions crucially reduces the future epidemic potential of dengue in Europe.

  17. Diffusion Pattern and Hotspot Detection of Dengue in Belo Horizonte, Minas Gerais, Brazil

    PubMed Central

    Pessanha, José Eduardo Marques Pessanha; Caiaffa, Waleska Teixeira; Almeida, Maria Cristina de Mattos; Brandão, Silvana Tecles; Proietti, Fernando Augusto

    2012-01-01

    This study considers the dengue occurrence in the city of Belo Horizonte over the last fifteen years. Approximately 186,000 cases registered from 1996 to 2011 were analyzed. The home address of individuals whose dengue case was notified was used as a proxy for exposure location. For determining possible outbreaks of disease and the specific patterns of dengue cases, spatial statistics used included Kernel's estimation. The occurrence of waves of dengue outbreaks was correlated with climatic and vector presence data. Outbreaks had different durations and intensities: case clustering, thinned out both spatially and temporally. These findings may be useful for public health professionals responsible for fighting the disease providing some tools for improving evaluation of interventions such as vector control and patient care, minimizing the collective and individual burden of the disease. PMID:22536269

  18. 78 FR 16505 - Prospective Grant of Exclusive License: Chimeric West Nile/Dengue Viruses

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-15

    ...: Chimeric West Nile/Dengue Viruses AGENCY: Centers for Disease Control and Prevention (CDC), Department of... license, in the field of use of in vitro diagnostics for dengue virus infection, to practice the... Application 61/049,342, filed 4/30/2008, entitled ``Engineered, Chimeric West Nile/Dengue Viruses;''...

  19. Preparing towards Preventing and Containing an Ebola Virus Disease Outbreak: What Socio-cultural Practices May Affect Containment Efforts in Ghana?

    PubMed Central

    Adongo, Philip Baba; Tabong, Philip Teg-Nefaah; Asampong, Emmanuel; Ansong, Joana; Robalo, Magda; Adanu, Richard M.

    2016-01-01

    Background Ebola Virus Disease (EVD) is a condition with high fatality. Though the disease is deadly, taking precautions to reduce contact with infected people and their secretions can prevent cross- infection. In the 2014 EVD outbreak, socio-cultural factors were identified to be responsible for the spread of the disease in the three most affected countries in West Africa. In this light, we undertook this study to identify socio-cultural factors that may influence the prevention and containment of EVD in Ghana and ways to address such practices. Methods We conducted a descriptive qualitative study in five regions in Ghana. Twenty-five focus group discussions (5 in each region) with community members (4 in each region) and nurses (1 in each region) were conducted. In addition, forty (40) in-depth interviews were conducted with various stakeholders and opinion leaders; eight in each region. All interviews were recorded using a digital voice recorder and transcribed. With the aid of Nvivo 10 for windows, we analyzed the data using framework analysis. Results We found that socio-cultural practices, such as care of the body of dead and burial practices, widowhood rites and anointing children with water used to rinse the dead, were common. These practices require individuals coming into direct contact with either the dead or items used to take care of the dead. Social norms also require frequent handshakes in all social gatherings such as funeral, and religious congregations. We also found that self-medication (using herbs and orthodox medications) was a common practice. People use both biomedical and non-orthodox health outlets either simultaneously or in sequence in times of ill-health. Conclusion The study concludes that high risk socio-cultural practices were common among Ghanaians and generally perceived as indispensable. These high risk practices may hinder containment efforts in the event of an outbreak. Community leaders should be engaged in any social

  20. Interaction of Mean Temperature and Daily Fluctuation Influences Dengue Incidence in Dhaka, Bangladesh.

    PubMed

    Sharmin, Sifat; Glass, Kathryn; Viennet, Elvina; Harley, David

    2015-01-01

    Local weather influences the transmission of the dengue virus. Most studies analyzing the relationship between dengue and climate are based on relatively coarse aggregate measures such as mean temperature. Here, we include both mean temperature and daily fluctuations in temperature in modelling dengue transmission in Dhaka, the capital of Bangladesh. We used a negative binomial generalized linear model, adjusted for rainfall, anomalies in sea surface temperature (an index for El Niño-Southern Oscillation), population density, the number of dengue cases in the previous month, and the long term temporal trend in dengue incidence. In addition to the significant associations of mean temperature and temperature fluctuation with dengue incidence, we found interaction of mean and temperature fluctuation significantly influences disease transmission at a lag of one month. High mean temperature with low fluctuation increases dengue incidence one month later. Besides temperature, dengue incidence was also influenced by sea surface temperature anomalies in the current and previous month, presumably as a consequence of concomitant anomalies in the annual rainfall cycle. Population density exerted a significant positive influence on dengue incidence indicating increasing risk of dengue in over-populated Dhaka. Understanding these complex relationships between climate, population, and dengue incidence will help inform outbreak prediction and control.

  1. Analysis of effects of meteorological factors on dengue incidence in Sri Lanka using time series data.

    PubMed

    Goto, Kensuke; Kumarendran, Balachandran; Mettananda, Sachith; Gunasekara, Deepa; Fujii, Yoshito; Kaneko, Satoshi

    2013-01-01

    In tropical and subtropical regions of eastern and South-eastern Asia, dengue fever (DF) and dengue hemorrhagic fever (DHF) outbreaks occur frequently. Previous studies indicate an association between meteorological variables and dengue incidence using time series analyses. The impacts of meteorological changes can affect dengue outbreak. However, difficulties in collecting detailed time series data in developing countries have led to common use of monthly data in most previous studies. In addition, time series analyses are often limited to one area because of the difficulty in collecting meteorological and dengue incidence data in multiple areas. To gain better understanding, we examined the effects of meteorological factors on dengue incidence in three geographically distinct areas (Ratnapura, Colombo, and Anuradhapura) of Sri Lanka by time series analysis of weekly data. The weekly average maximum temperature and total rainfall and the total number of dengue cases from 2005 to 2011 (7 years) were used as time series data in this study. Subsequently, time series analyses were performed on the basis of ordinary least squares regression analysis followed by the vector autoregressive model (VAR). In conclusion, weekly average maximum temperatures and the weekly total rainfall did not significantly affect dengue incidence in three geographically different areas of Sri Lanka. However, the weekly total rainfall slightly influenced dengue incidence in the cities of Colombo and Anuradhapura.

  2. Epidemiological trends of dengue disease in Colombia (2000-2011): a systematic review.

    PubMed

    Villar, Luis Angel; Rojas, Diana Patricia; Besada-Lombana, Sandra; Sarti, Elsa

    2015-03-01

    A systematic literature review was conducted to describe the epidemiology of dengue disease in Colombia. Searches of published literature in epidemiological studies of dengue disease encompassing the terms "dengue", "epidemiology," and "Colombia" were conducted. Studies in English or Spanish published between 1 January 2000 and 23 February 2012 were included. The searches identified 225 relevant citations, 30 of which fulfilled the inclusion criteria defined in the review protocol. The epidemiology of dengue disease in Colombia was characterized by a stable "baseline" annual number of dengue fever cases, with major outbreaks in 2001-2003 and 2010. The geographical spread of dengue disease cases showed a steady increase, with most of the country affected by the 2010 outbreak. The majority of dengue disease recorded during the review period was among those <15 years of age. Gaps identified in epidemiological knowledge regarding dengue disease in Colombia may provide several avenues for future research, namely studies of asymptomatic dengue virus infection, primary versus secondary infections, and under-reporting of the disease. Improved understanding of the factors that determine disease expression and enable improvement in disease control and management is also important.

  3. Developing a Social Autopsy Tool for Dengue Mortality: A Pilot Study

    PubMed Central

    Arauz, María José; Ridde, Valéry; Hernández, Libia Milena; Charris, Yaneth; Carabali, Mabel; Villar, Luis Ángel

    2015-01-01

    Background Dengue fever is a public health problem in the tropical and sub-tropical world. Dengue cases have grown dramatically in recent years as well as dengue mortality. Colombia has experienced periodic dengue outbreaks with numerous dengue related-deaths, where the Santander department has been particularly affected. Although social determinants of health (SDH) shape health outcomes, including mortality, it is not yet understood how these affect dengue mortality. The aim of this pilot study was to develop and pre-test a social autopsy (SA) tool for dengue mortality. Methods and Findings The tool was developed and pre-tested in three steps. First, dengue fatal cases and ‘near misses’ (those who recovered from dengue complications) definitions were elaborated. Second, a conceptual framework on determinants of dengue mortality was developed to guide the construction of the tool. Lastly, the tool was designed and pre-tested among three relatives of fatal cases and six near misses in 2013 in the metropolitan zone of Bucaramanga. The tool turned out to be practical in the context of dengue mortality in Colombia after some modifications. The tool aims to study the social, individual, and health systems determinants of dengue mortality. The tool is focused on studying the socioeconomic position and the intermediary SDH rather than the socioeconomic and political context. Conclusions The SA tool is based on the scientific literature, a validated conceptual framework, researchers’ and health professionals’ expertise, and a pilot study. It is the first time that a SA tool has been created for the dengue mortality context. Our work furthers the study on SDH and how these are applied to neglected tropical diseases, like dengue. This tool could be integrated in surveillance systems to provide complementary information on the modifiable and avoidable death-related factors and therefore, be able to formulate interventions for dengue mortality reduction. PMID:25658485

  4. The dengue viruses.

    PubMed Central

    Henchal, E A; Putnak, J R

    1990-01-01

    Dengue, a major public health problem throughout subtropical and tropical regions, is an acute infectious disease characterized by biphasic fever, headache, pain in various parts of the body, prostration, rash, lymphadenopathy, and leukopenia. In more severe or complicated dengue, patients present with a severe febrile illness characterized by abnormalities of hemostasis and increased vascular permeability, which in some instances results in a hypovolemic shock. Four distinct serotypes of the dengue virus (dengue-1, dengue-2, dengue-3, and dengue-4) exist, with numerous virus strains found worldwide. Molecular cloning methods have led to a greater understanding of the structure of the RNA genome and definition of virus-specific structural and nonstructural proteins. Progress towards producing safe, effective dengue virus vaccines, a goal for over 45 years, has been made. Images PMID:2224837

  5. Dengue fever (image)

    MedlinePlus

    Dengue fever, or West Nile fever, is a mild viral illness transmitted by mosquitoes which causes fever, ... second exposure to the virus can result in Dengue hemorrhagic fever, a life-threatening illness.

  6. Dengue Fever Testing

    MedlinePlus

    ... name: Dengue Antibodies (IgG, IgM); Dengue Virus by PCR Related tests: Arbovirus Testing , West Nile Virus Testing , ... testing are available: Molecular testing ( polymerase chain reaction, PCR )—this type of test detects the genetic material ...

  7. Chapter 3. Integration of botanicals and microbial pesticides for the control of dengue vector, Aedes aegypti (Insecta: Diptera: Culicidae)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Mosquitoes are the single most important group of insects in terms of public health significance and causing diseases such as malaria, filariasis, dengue fever, Japanese encephalitis and other fevers. There has been an outbreak of Chikungunya and dengue all over the India from 2006 – 2009. Aedes ae...

  8. Dengue reemergence in Argentina.

    PubMed

    Avilés, G; Rangeón, G; Vorndam, V; Briones, A; Baroni, P; Enria, D; Sabattini, M S

    1999-01-01

    Aedes aegypti, eradicated from Argentina in 1963, has now reinfested the country as far south as Buenos Aires. In 1997, four persons with travel histories to Brazil, Ecuador, or Venezuela had confirmed dengue, and surveillance for indigenous transmission allowed the detection of 19 dengue cases in Salta Province. These cases of dengue are the first in Argentina since 1916 and represent a new southern extension of dengue virus.

  9. Dengue reemergence in Argentina.

    PubMed Central

    Avilés, G.; Rangeón, G.; Vorndam, V.; Briones, A.; Baroni, P.; Enria, D.; Sabattini, M. S.

    1999-01-01

    Aedes aegypti, eradicated from Argentina in 1963, has now reinfested the country as far south as Buenos Aires. In 1997, four persons with travel histories to Brazil, Ecuador, or Venezuela had confirmed dengue, and surveillance for indigenous transmission allowed the detection of 19 dengue cases in Salta Province. These cases of dengue are the first in Argentina since 1916 and represent a new southern extension of dengue virus. PMID:10460181

  10. A new challenge for hospitals in southeast France: monitoring local populations of Aedes albopictus to prevent nosocomial transmission of dengue or chikungunya.

    PubMed

    Cotteaux-Lautard, Christelle; Berenger, Jean-Michel; Fusca, François; Chardon, Hubert; Simon, Fabrice; Pagès, Frederic

    2013-03-01

    Aedes albopictus was first identified in southern France in 2004, inducing an emerging risk for autochthonous transmission around imported cases of dengue or chikungunya, and also for mosquito-borne nosocomial transmission in hospitals. Aedes albopictus has been present in Marseille since September 2009 and in Aix-en-Provence since August 2010. Because of the possible admission of viremic patients with dengue or chikungunya in the hospitals of these cities, a mosquito survey was conducted in 2011 in 2 of the hospitals, with the use of mosquito traps. Aedes albopictus was detected with Eisenhans II traps and egg traps in both hospitals during the warm season.

  11. The Critical Role of Early Dengue Surveillance and Limitations of Clinical Reporting – Implications for Non-Endemic Countries

    PubMed Central

    Kao, Jui-Hung; Chen, Chaur-Dong; Chu, Yin-Hsia; Cheng, Hau-Yuan; Liu, Jien-Wei; Shih, Fuh-Yuan; Shu, Pei-Yun; Lin, Chien-Chou; Tsai, Wu-Hsiung; Ku, Chia-Chi; Ho, Chi-Kung; King, Chwan-Chuen

    2016-01-01

    The increasing dengue burden and epidemic severity worldwide have highlighted the need to improve surveillance. In non-endemic areas such as Taiwan, where outbreaks start mostly with imported cases from Southeast Asia, a closer examination of surveillance dynamics to detect cases early is necessary. To evaluate problems with dengue surveillance and investigate the involvement of different factors at various epidemic stages, we investigated 632 laboratory-confirmed indigenous dengue cases in Kaohsiung City, Taiwan during 2009–2010. The estimated sensitivity of clinical surveillance was 82.4% (521/632). Initially, the modified serological surveillance (targeting only the contacts of laboratory-confirmed dengue cases) identified clinically unrecognized afebrile cases in younger patients who visited private clinics and accounted for 30.4% (35/115) of the early-stage cases. Multivariate regression indicated that hospital/medical center visits [Adjusted Odds Ratio (aOR): 11.6, 95% confidence interval (CI): 6.3–21.4], middle epidemic stage [aOR: 2.4 (1.2–4.7)], fever [aOR: 2.3 (2.3–12.9)], and musculo-articular pain [aOR: 1.9 (1.05–3.3)] were significantly associated with clinical reporting. However, cases with pruritus/rash [aOR: 0.47 (0.26–0.83)] and diarrhea [aOR: 0.47 (0.26–0.85)] were underreported. In conclusion, multiple factors contributed to dengue surveillance problems. To prevent a large-scale epidemic and minimize severe dengue cases, there is a need for integrated surveillance incorporating entomological, clinical, serological, and virological surveillance systems to detect early cases, followed by immediate prevention and control measures and continuous evaluation to ensure effectiveness. This effort will be particularly important for an arbovirus, such as Zika virus, with a high asymptomatic infection ratio. For dengue- non-endemic countries, we recommend serological surveillance be implemented in areas with high Aedes mosquito indices or many

  12. Preventive and social cost implications of Ebola Virus Disease (EVD) outbreak on selected organizations in Lagos state, Nigeria

    PubMed Central

    Olugasa, Babasola Oluseyi; Oshinowo, Oluwafunmilola Yemisi; Odigie, Eugene Amienwanlen

    2015-01-01

    Introduction As Ebola virus disease (EVD) continues to pose public health challenge in West Africa, with attending fears and socio-economic implications in the current epidemic challenges. It is compelling to estimate the social and preventive costs of EVD containment in a Nigerian city. Hence, this study was to determine the social and preventive cost implications of EVD among selected public institutions in Lagos, Nigeria, from July to December, 2014. Methods Questionnaires and key-informants interview were administered to respondents and administrators of selected hospitals, hotels and schools in Eti-Osa Local Government Area of Lagos State. Knowledge of disease transmission, mortality and protocols for prevention, including cost of specific preventive measures adopted against EVD were elicited from respondents. Descriptive statistics and categorical analysis were used to summarize and estimate social and preventive costs incurred by respective institutions. Results An estimated five million, nineteen thousand, three hundred and seventy-nine Naira and eighty kobo (N5,019,379.80) only was observed as direct and social cost implication of EVD prevention. This amount translated into a conservative estimate of one billion, twenty-seven million, ninety-four thousand, seven hundred and fifty-six Naira (N1,027,094,756.10) for a total of four thousand schools, two hundred and fifty-three hospitals and one thousand, four hundred and fifty one hotels in Lagos during the period (July 20-November 20, 2014). Conclusion The high cost of prevention of EVD within the short time-frame indicated high importance attached to a preventive policy against highly pathogenic zoonotic disease in Nigeria. PMID:26740848

  13. Dengue virus sero-cross-reactivity drives antibody-dependent enhancement of infection with zika virus

    PubMed Central

    Dejnirattisai, Wanwisa; Supasa, Piyada; Wongwiwat, Wiyada; Rouvinski, Alexander; Barba-Spaeth, Giovanna; Duangchinda, Thaneeya; Sakuntabhai, Anavaj; Cao-Lormeau, Van-Mai; Malasit, Prida; Rey, Felix A; Mongkolsapaya, Juthathip; Screaton, Gavin R

    2016-01-01

    Zika virus (ZIKV) was discovered in 1947 and was thought to lead to relatively mild disease. The recent explosive outbreak of ZIKV in South America has led to widespread concern with reports of neurological sequelae ranging from Guillain Barré syndrome to microcephaly. ZIKV infection has occurred in areas previously exposed to dengue, a flavivirus closely related to ZIKV. Here we investigate the serological crossreaction between the two viruses. Dengue immune plasma substantially crossreacted with ZIKV and could drive antibody-dependent enhancement of ZIKV infection. Using a panel of human anti-dengue monoclonal antibodies we showed that most antibodies reacting to dengue envelope protein also reacted to ZIKV. Antibodies to linear epitopes including the immunodominant fusion loop epitope while able to bind ZIKV could not neutralize the virus but instead promoted ADE. These data indicate that dengue immunity may drive higher ZIKV replication and have clear implications for disease pathogenesis and future ZIKV and dengue vaccine programs. PMID:27339099

  14. Emergence of the Severe Syndrome and Mortality Associated with Dengue and Dengue-Like Illness: Historical Records (1890 to 1950) and Their Compatibility with Current Hypotheses on the Shift of Disease Manifestation

    PubMed Central

    Kuno, Goro

    2009-01-01

    Summary: Outbreaks of the severe dengue syndrome, dengue hemorrhagic fever (DHF), emerged beginning in the 1950s, marking a dramatic change in the dengue syndrome. While intense investigations in multiple directions have been conducted for many years to elucidate the intrinsic mechanisms conducive to the development of DHF, no consensus has yet emerged. Meanwhile, relatively little attention has been paid to the occurrence of severe dengue and death prior to the 1950s. This comprehensive review was designed to evaluate outbreak records in the early dengue history to better understand the epidemiologic background and other factors that existed before the emergence of DHF outbreaks. By applying a set of stringent criteria to remove unreliable data as much as possible and by interpreting the results conservatively, a short list of etiologically more reliable outbreaks with high mortality was obtained. The results show that severe dengue syndrome, clinically very much compatible with DHF, occurred far more frequently in multiple locations than it had been assumed before; that the magnitudes of mortality in several outbreaks were not negligible; and that the epidemiologic background features shared among these outbreaks in the early period were, with the exceptions of more limited demographic changes, generally similar to the post-1950 conditions. PMID:19366911

  15. Symptomatic Dengue Disease in Five Southeast Asian Countries: Epidemiological Evidence from a Dengue Vaccine Trial.

    PubMed

    Nealon, Joshua; Taurel, Anne-Frieda; Capeding, Maria Rosario; Tran, Ngoc Huu; Hadinegoro, Sri Rezeki; Chotpitayasunondh, Tawee; Chong, Chee Kheong; Wartel, T Anh; Beucher, Sophie; Frago, Carina; Moureau, Annick; Simmerman, Mark; Laot, Thelma; L'Azou, Maïna; Bouckenooghe, Alain

    2016-08-01

    Dengue incidence has increased globally, but empirical burden estimates are scarce. Prospective methods are best-able to capture all severities of disease. CYD14 was an observer-blinded dengue vaccine study conducted in children 2-14 years of age in Indonesia, Malaysia, Thailand, the Philippines, and Vietnam. The control group received no vaccine and resembled a prospective, observational study. We calculated the rates of dengue according to different laboratory or clinical criteria to make inferences about dengue burden, and compared with rates reported in the passive surveillance systems to calculate expansion factors which describe under-reporting. Over 6,933 person-years of observation in the control group there were 319 virologically confirmed dengue cases, a crude attack rate of 4.6%/year. Of these, 92 cases (28.8%) were clinically diagnosed as dengue fever or dengue hemorrhagic fever by investigators and 227 were not, indicating that most symptomatic disease fails to satisfy existing case definitions. When examining different case definitions, there was an inverse relationship between clinical severity and observed incidence rates. CYD14's active surveillance system captured a greater proportion of symptomatic dengue than national passive surveillance systems, giving rise to expansion factors ranging from 0.5 to 31.7. This analysis showed substantial, unpredictable and variable under-reporting of symptomatic dengue, even within a controlled clinical trial environment, and emphasizes that burden estimates are highly sensitive to case definitions. These data will assist in generating disease burden estimates and have important policy implications when considering the introduction and health economics of dengue prevention and control interventions.

  16. Symptomatic Dengue Disease in Five Southeast Asian Countries: Epidemiological Evidence from a Dengue Vaccine Trial

    PubMed Central

    Taurel, Anne-Frieda; Capeding, Maria Rosario; Tran, Ngoc Huu; Hadinegoro, Sri Rezeki; Chotpitayasunondh, Tawee; Chong, Chee Kheong; Wartel, T. Anh; Beucher, Sophie; Frago, Carina; Moureau, Annick; Simmerman, Mark; Laot, Thelma; L’Azou, Maïna; Bouckenooghe, Alain

    2016-01-01

    Dengue incidence has increased globally, but empirical burden estimates are scarce. Prospective methods are best-able to capture all severities of disease. CYD14 was an observer-blinded dengue vaccine study conducted in children 2–14 years of age in Indonesia, Malaysia, Thailand, the Philippines, and Vietnam. The control group received no vaccine and resembled a prospective, observational study. We calculated the rates of dengue according to different laboratory or clinical criteria to make inferences about dengue burden, and compared with rates reported in the passive surveillance systems to calculate expansion factors which describe under-reporting. Over 6,933 person-years of observation in the control group there were 319 virologically confirmed dengue cases, a crude attack rate of 4.6%/year. Of these, 92 cases (28.8%) were clinically diagnosed as dengue fever or dengue hemorrhagic fever by investigators and 227 were not, indicating that most symptomatic disease fails to satisfy existing case definitions. When examining different case definitions, there was an inverse relationship between clinical severity and observed incidence rates. CYD14’s active surveillance system captured a greater proportion of symptomatic dengue than national passive surveillance systems, giving rise to expansion factors ranging from 0.5 to 31.7. This analysis showed substantial, unpredictable and variable under-reporting of symptomatic dengue, even within a controlled clinical trial environment, and emphasizes that burden estimates are highly sensitive to case definitions. These data will assist in generating disease burden estimates and have important policy implications when considering the introduction and health economics of dengue prevention and control interventions. PMID:27532617

  17. Yellow Fever Outbreak - Kongo Central Province, Democratic Republic of the Congo, August 2016.

    PubMed

    Otshudiema, John O; Ndakala, Nestor G; Mawanda, Elande-Taty K; Tshapenda, Gaston P; Kimfuta, Jacques M; Nsibu, Loupy-Régence N; Gueye, Abdou S; Dee, Jacob; Philen, Rossanne M; Giese, Coralie; Murrill, Christopher S; Arthur, Ray R; Kebela, Benoit I

    2017-03-31

    On April 23, 2016, the Democratic Republic of the Congo's (DRC's) Ministry of Health declared a yellow fever outbreak. As of May 24, 2016, approximately 90% of suspected yellow fever cases (n = 459) and deaths (45) were reported in a single province, Kongo Central Province, that borders Angola, where a large yellow fever outbreak had begun in December 2015. Two yellow fever mass vaccination campaigns were conducted in Kongo Central Province during May 25-June 7, 2016 and August 17-28, 2016. In June 2016, the DRC Ministry of Health requested assistance from CDC to control the outbreak. As of August 18, 2016, a total of 410 suspected yellow fever cases and 42 deaths were reported in Kongo Central Province. Thirty seven of the 393 specimens tested in the laboratory were confirmed as positive for yellow fever virus (local outbreak threshold is one laboratory-confirmed case of yellow fever). Although not well-documented for this outbreak, malaria, viral hepatitis, and typhoid fever are common differential diagnoses among suspected yellow fever cases in this region. Other possible diagnoses include Zika, West Nile, or dengue viruses; however, no laboratory-confirmed cases of these viruses were reported. Thirty five of the 37 cases of yellow fever were imported from Angola. Two-thirds of confirmed cases occurred in persons who crossed the DRC-Angola border at one market city on the DRC side, where ≤40,000 travelers cross the border each week on market day. Strategies to improve coordination between health surveillance and cross-border trade activities at land borders and to enhance laboratory and case-based surveillance and health border screening capacity are needed to prevent and control future yellow fever outbreaks.

  18. Post dengue neurological complication.

    PubMed

    Hasliza, A H; Tohid, H; Loh, K Y; Santhi, P

    2015-01-01

    Dengue infection is highly endemic in many tropical countries including Malaysia. However, neurological complications arising from dengue infection is not common; Gullain-Barre syndrome (GBS) is one of these infrequent complications. In this paper, we have reported a case in which a 39-year-old woman presented with a neurological complication of dengue infection without typical symptoms and signs of dengue fever. She had a history of acute gastroenteritis (AGE) followed by an upper respiratory tract infection (URTI) weeks prior to her presentation rendering GBS secondary to the post viral URTI and AGE as the most likely diagnosis. Presence of thrombocytopenia was the only clue for dengue in this case.

  19. Seroepidemiology of Asymptomatic Dengue Virus Infection in Jeddah, Saudi Arabia

    PubMed Central

    Jamjoom, Ghazi A.; Azhar, Esam I.; Kao, Moujahid A.; Radadi, Raja M.

    2016-01-01

    BACKGROUND Although virologically confirmed dengue fever has been recognized in Jeddah, Saudi Arabia, since 1994, causing yearly outbreaks, no proper seroepidemiologic studies on dengue virus have been conducted in this region. Such studies can define the extent of infection by this virus and estimate the proportion that may result in disease. The aim of this study was to measure the seroprevalence of past dengue virus infection in healthy Saudi nationals from different areas in the city of Jeddah and to investigate demographic and environmental factors that may increase exposure to infection. METHODS Sera were collected from 1984 Saudi subjects attending primary health care centers in six districts of Jeddah. These included general patients of various ages seeking routine vaccinations, antenatal care or treatment of different illnesses excluding fever or suspected dengue. A number of blood donors were also tested. Serum samples were tested by enzyme immunoassay (EIA) for IgG antibodies to dengue viruses 1, 2, 3, 4. A questionnaire was completed for each patient recording various anthropometric data and factors that may indicate possible risk of exposure to mosquito bites and dengue infection. Patients with missing data and those who reported a history of dengue fever were excluded from analysis, resulting in a sample of 1939 patients to be analyzed. RESULTS The overall prevalence of dengue virus infection as measured by anti-dengue IgG antibodies from asymptomatic residents in Jeddah was 47.8% (927/1939) and 37% (68/184) in blood donors. Infection mostly did not result in recognizable disease, as only 19 of 1956 subjects with complete information (0.1%) reported having dengue fever in the past. Anti dengue seropositivity increased with age and was higher in males than females and in residents of communal housing and multistory buildings than in villas. One of the six districts showed significant increase in exposure rate as compared to the others. Availability of

  20. Structure and Function of the Non-Structural Protein of Dengue Virus and its Applications in Antiviral Therapy.

    PubMed

    Xie, Qian; Zhang, Bao; Yu, JianHai; Wu, Qinghua; Yang, Fangji; Cao, Hong; Zhao, Wei

    2017-01-01

    Dengue fever, a type of global and tropical infectious disease, and its prevention has become a challenging issue worldwide. Antibody-dependent enhancement effects and the virus pathogenic mechanism have not yet been fully elucidated, hindering the development of dengue fever prevention and suitable drug treatment. There is currently no specific prevention and therapy in clinical trials, however, in recent years, studies have focused on the pathogenesis and treatment of dengue. Research focusing on dengue virus nonstructural protein in special drugs for the prevention and control of dengue fever is a new progress leading to improved understanding regarding the prevention and control of dengue fever and suitable drugs for the treatment. The main challenges regarding the structure of dengue virus nonstructural protein and the drugs for antiviral therapy are summarized in this paper.

  1. Latest developments and future directions in dengue vaccines

    PubMed Central

    Thisyakorn, Chule

    2014-01-01

    Dengue is a mosquito-borne disease which is currently an expanding global health problem. The disease is caused by four closely related viruses, the dengue virus. There are no specific dengue therapeutics and prevention is currently limited to vector control measures. Development of an effective tetravalent dengue vaccine would therefore represent a major advance in the control of the disease and is considered a high public health priority. While a licensed dengue vaccine is not yet available, the scope and intensity of dengue vaccine development has increased dramatically in the last decade. The uniqueness of the dengue viruses and the spectrum of disease resulting from infection have made dengue vaccine development difficult. Several vaccine candidates are currently being evaluated in clinical studies. The candidate currently at the most advanced clinical development stage, a live-attenuated tetravalent vaccine based on chimeric yellow fever dengue virus, has progressed to phase III efficacy studies. Several other live-attenuated vaccines, as well as subunit, DNA and purified inactivated vaccine candidates, are at earlier stages of clinical development. Additional technological approaches, such as virus-vectored and virus-like particle-based vaccines, are under evaluation in preclinical studies. PMID:24757522

  2. Agent-based modeling to simulate the dengue spread

    NASA Astrophysics Data System (ADS)

    Deng, Chengbin; Tao, Haiyan; Ye, Zhiwei

    2008-10-01

    In this paper, we introduce a novel method ABM in simulating the unique process for the dengue spread. Dengue is an acute infectious disease with a long history of over 200 years. Unlike the diseases that can be transmitted directly from person to person, dengue spreads through a must vector of mosquitoes. There is still no any special effective medicine and vaccine for dengue up till now. The best way to prevent dengue spread is to take precautions beforehand. Thus, it is crucial to detect and study the dynamic process of dengue spread that closely relates to human-environment interactions where Agent-Based Modeling (ABM) effectively works. The model attempts to simulate the dengue spread in a more realistic way in the bottom-up way, and to overcome the limitation of ABM, namely overlooking the influence of geographic and environmental factors. Considering the influence of environment, Aedes aegypti ecology and other epidemiological characteristics of dengue spread, ABM can be regarded as a useful way to simulate the whole process so as to disclose the essence of the evolution of dengue spread.

  3. Meteorologically Driven Simulations of Dengue Epidemics in San Juan, PR

    PubMed Central

    Morin, Cory W.; Monaghan, Andrew J.; Hayden, Mary H.; Barrera, Roberto; Ernst, Kacey

    2015-01-01

    Meteorological factors influence dengue virus ecology by modulating vector mosquito population dynamics, viral replication, and transmission. Dynamic modeling techniques can be used to examine how interactions among meteorological variables, vectors and the dengue virus influence transmission. We developed a dengue fever simulation model by coupling a dynamic simulation model for Aedes aegypti, the primary mosquito vector for dengue, with a basic epidemiological Susceptible-Exposed-Infectious-Recovered (SEIR) model. Employing a Monte Carlo approach, we simulated dengue transmission during the period of 2010–2013 in San Juan, PR, where dengue fever is endemic. The results of 9600 simulations using varied model parameters were evaluated by statistical comparison (r2) with surveillance data of dengue cases reported to the Centers for Disease Control and Prevention. To identify the most influential parameters associated with dengue virus transmission for each period the top 1% of best-fit model simulations were retained and compared. Using the top simulations, dengue cases were simulated well for 2010 (r2 = 0.90, p = 0.03), 2011 (r2 = 0.83, p = 0.05), and 2012 (r2 = 0.94, p = 0.01); however, simulations were weaker for 2013 (r2 = 0.25, p = 0.25) and the entire four-year period (r2 = 0.44, p = 0.002). Analysis of parameter values from retained simulations revealed that rain dependent container habitats were more prevalent in best-fitting simulations during the wetter 2010 and 2011 years, while human managed (i.e. manually filled) container habitats were more prevalent in best-fitting simulations during the drier 2012 and 2013 years. The simulations further indicate that rainfall strongly modulates the timing of dengue (e.g., epidemics occurred earlier during rainy years) while temperature modulates the annual number of dengue fever cases. Our results suggest that meteorological factors have a time-variable influence on dengue transmission relative to other important

  4. Meteorologically Driven Simulations of Dengue Epidemics in San Juan, PR.

    PubMed

    Morin, Cory W; Monaghan, Andrew J; Hayden, Mary H; Barrera, Roberto; Ernst, Kacey

    2015-08-01

    Meteorological factors influence dengue virus ecology by modulating vector mosquito population dynamics, viral replication, and transmission. Dynamic modeling techniques can be used to examine how interactions among meteorological variables, vectors and the dengue virus influence transmission. We developed a dengue fever simulation model by coupling a dynamic simulation model for Aedes aegypti, the primary mosquito vector for dengue, with a basic epidemiological Susceptible-Exposed-Infectious-Recovered (SEIR) model. Employing a Monte Carlo approach, we simulated dengue transmission during the period of 2010-2013 in San Juan, PR, where dengue fever is endemic. The results of 9600 simulations using varied model parameters were evaluated by statistical comparison (r2) with surveillance data of dengue cases reported to the Centers for Disease Control and Prevention. To identify the most influential parameters associated with dengue virus transmission for each period the top 1% of best-fit model simulations were retained and compared. Using the top simulations, dengue cases were simulated well for 2010 (r2 = 0.90, p = 0.03), 2011 (r2 = 0.83, p = 0.05), and 2012 (r2 = 0.94, p = 0.01); however, simulations were weaker for 2013 (r2 = 0.25, p = 0.25) and the entire four-year period (r2 = 0.44, p = 0.002). Analysis of parameter values from retained simulations revealed that rain dependent container habitats were more prevalent in best-fitting simulations during the wetter 2010 and 2011 years, while human managed (i.e. manually filled) container habitats were more prevalent in best-fitting simulations during the drier 2012 and 2013 years. The simulations further indicate that rainfall strongly modulates the timing of dengue (e.g., epidemics occurred earlier during rainy years) while temperature modulates the annual number of dengue fever cases. Our results suggest that meteorological factors have a time-variable influence on dengue transmission relative to other important

  5. Epidemiological Trends of Dengue Disease in Colombia (2000-2011): A Systematic Review

    PubMed Central

    Villar, Luis Angel; Rojas, Diana Patricia; Besada-Lombana, Sandra; Sarti, Elsa

    2015-01-01

    A systematic literature review was conducted to describe the epidemiology of dengue disease in Colombia. Searches of published literature in epidemiological studies of dengue disease encompassing the terms “dengue”, “epidemiology,” and “Colombia” were conducted. Studies in English or Spanish published between 1 January 2000 and 23 February 2012 were included. The searches identified 225 relevant citations, 30 of which fulfilled the inclusion criteria defined in the review protocol. The epidemiology of dengue disease in Colombia was characterized by a stable “baseline” annual number of dengue fever cases, with major outbreaks in 2001–2003 and 2010. The geographical spread of dengue disease cases showed a steady increase, with most of the country affected by the 2010 outbreak. The majority of dengue disease recorded during the review period was among those <15 years of age. Gaps identified in epidemiological knowledge regarding dengue disease in Colombia may provide several avenues for future research, namely studies of asymptomatic dengue virus infection, primary versus secondary infections, and under-reporting of the disease. Improved understanding of the factors that determine disease expression and enable improvement in disease control and management is also important. PMID:25790245

  6. Health Beliefs and Practices Related to Dengue Fever: A Focus Group Study

    PubMed Central

    Wong, Li Ping; AbuBakar, Sazaly

    2013-01-01

    Background This qualitative study aimed to provide an in-depth understanding of the meaning of dengue fever (DF) amongst people living in a dengue endemic region, dengue prevention and treatment-seeking behaviours. The Health Belief Model was used as a framework to explore and understand dengue prevention behaviours. Methods A total of 14 focus group discussions were conducted with 84 Malaysian citizens of different socio-demographic backgrounds between 16th December, 2011 and 12th May, 2012. Results The study revealed that awareness about DF and prevention measures were high. The pathophysiology of dengue especially dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS) were rarely known; as a result, it was seen as deadly by some but was also perceived as easily curable by others without a basis of understanding. Young adults and elderly participants had a low perception of susceptibility to DF. In general, the low perceived susceptibility emerged as two themes, namely a perceived natural ability to withstand infection and a low risk of being in contact with the dengue virus vector, Aedes spp. mosquitoes. The barriers to sustained self-prevention against dengue prevention that emerged in focus groups were: i) lack of self-efficacy, ii) lack of perceived benefit, iii) low perceived susceptibility, and iv) unsure perceived susceptibility. Low perceived benefit of continued dengue prevention practices was a result of lack of concerted action against dengue in their neighborhood. Traditional medical practices and home remedies were widely perceived and experienced as efficacious in treating DF. Conclusion Behavioural change towards attaining sustainability in dengue preventive practices may be enhanced by fostering comprehensive knowledge of dengue and a change in health beliefs. Wide use of unconventional therapy for DF warrants the need to enlighten the public to limit their reliance on unproven alternative treatments. PMID:23875045

  7. [Dengue vaccines. A reality for Argentina?].

    PubMed

    Orellano, Pablo W; Salomón, Oscar D

    2016-01-01

    Dengue outbreaks have occurred yearly in Argentina since 1998. A number of candidate vaccines have been tested in endemic countries. The most advanced one was licensed in three countries of Latin America for children over 9 years of age. In the present article the benefits and drawbacks of these vaccines as well as the challenges for the implementation of a vaccination strategy in Argentina are discussed. Furthermore, a risk stratification strategy with new criteria and a multidisciplinary vision is suggested as a possible path for the assessment of the pertinence of a vaccination program in areas showing the highest risk of dengue transmission and/or for people at the greatest risk of developing severe dengue. It is also suggested that the definition regarding the status of endemicity should take into account the local realities. Finally, this paper proposes a broad discussion on the evidences, the expected impact and instrumental aspects that would be involved in the incorporation of a dengue vaccine, marketed or in development, into the national immunization program, and especially which subpopulation should be targeted for the immunization strategy to be cost-effective.

  8. Dengue in India

    PubMed Central

    Gupta, Nivedita; Srivastava, Sakshi; Jain, Amita; Chaturvedi, Umesh C.

    2012-01-01

    Dengue virus belongs to family Flaviviridae, having four serotypes that spread by the bite of infected Aedes mosquitoes. It causes a wide spectrum of illness from mild asymptomatic illness to severe fatal dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS). Approximately 2.5 billion people live in dengue-risk regions with about 100 million new cases each year worldwide. The cumulative dengue diseases burden has attained an unprecedented proportion in recent times with sharp increase in the size of human population at risk. Dengue disease presents highly complex pathophysiological, economic and ecologic problems. In India, the first epidemic of clinical dengue-like illness was recorded in Madras (now Chennai) in 1780 and the first virologically proved epidemic of dengue fever (DF) occurred in Calcutta (now Kolkata) and Eastern Coast of India in 1963-1964. During the last 50 years a large number of physicians have treated and described dengue disease in India, but the scientific studies addressing various problems of dengue disease have been carried out at limited number of centres. Achievements of Indian scientists are considerable; however, a lot remain to be achieved for creating an impact. This paper briefly reviews the extent of work done by various groups of scientists in this country. PMID:23041731

  9. Expanded dengue syndrome: subacute thyroiditis and intracerebral hemorrhage

    PubMed Central

    2012-01-01

    Background Although most symptomatic dengue infections follow an uncomplicated course, complications and unusual manifestations are increasingly being reported due to rising disease burden. Expanded dengue syndrome is a new entity added into World Health Organization (WHO) classification system to incorporate this wide spectrum of unusual manifestations. We report a case of expanded dengue syndrome with subacute thyroiditis and intracerebral hemorrhage. This is the first case report of thyroiditis in dengue infection. Case presentation A 20 years old man presented with fever, myalgias, arthralgias, retro-orbital pain, vomiting and gum bleeding during a large dengue outbreak in Lahore, Pakistan. On 7th day of illness patient became afebrile, but he developed severe headaches, unconsciousness followed by altered behavior. On 9th day of illness patient developed painful neck swelling accompanied by fever, tremors, palpitations, hoarseness of voice and odynophagia. Examination revealed acutely swollen, tender thyroid gland along with features of hyperthyroidism. Laboratory evaluation revealed stable hematocrit, thrombocytopenia and leukopenia. Patient had seroconverted for anti-dengue IgM antibodies on the 10th day of illness. A non-contrast Computed Tomogram (CT) of the brain showed right frontal lobe hematoma. Thyroid profile showed increased free T3 and T4 and low TSH. Technetium thyroid scan showed reduced tracer uptake. He was diagnosed as having subacute thyroiditis and treated with oral prednisolone and propranolol. Follow up CT brain showed resolving hematoma. Patient’s recovery was uneventful. Conclusion Subacute thyroiditis may develop during the course of dengue fever and should be included as a manifestation of expanded dengue syndrome. It should be suspected in patients with dengue fever who develop painful thyroid swelling and clinical features of hyperthyroidism. PMID:23033818

  10. Rainfall, abundance of Aedes aegypti and dengue infection in Selangor, Malaysia.

    PubMed

    Li, C F; Lim, T W; Han, L L; Fang, R

    1985-12-01

    An epidemio-meteorotropic analytical study of Selangor, in the Southwest coast of Peninsular Malaysia, examines the monthly incidence of dengue for the period 1973-1982 to assess possible quantitative association with the monthly rainfall. The relationships between rainfall, abundance of A. aegypti and dengue infection during 1982 in Jinjang, a dengue-prone area in Selangor, were also examined. A quantitative association between rainfall and the number of dengue cases was found during the first wet period. The lag time between the onset of heavy rain and dengue outbreak was about two to three months. A 120% increase in the number of dengue cases was observed when the monthly rainfall was 300 mm or more. Positive associations were seen between the incidence of dengue and the Aedes house index and the Breteau index in Jinjang. The relationships between these three variables and rainfall suggest that the latter might have exerted its effect on dengue infection partly through the creation of more breeding sites for A. aegypti. Assessment of the importance of A. aegypti in the transmission of dengue in this locality was not possible because of the lack of adjustment for A. albopictus, the other known vector of dengue in the state, and for social and other environmental factors influencing infection rates. In spite of this and the interpretational problems common in aggregate studies, the present analyses have provided relatively strong statistical evidence of an association between rainfall and dengue outbreaks in Selangor, thereby indicating that it is a factor worthy of careful surveillance and monitoring.

  11. An outbreak of HBV and HCV infection in a paediatric oncology ward: epidemiological investigations and prevention of further spread.

    PubMed

    Dumpis, Uga; Kovalova, Zanna; Jansons, Juris; Cupane, Liene; Sominskaya, Irina; Michailova, Marija; Karayiannis, Peter; Gardovska, Dace; Viazov, Sergey; Ross, Stefan; Roggendorf, Michael; Pumpens, Paul

    2003-03-01

    Hospital-acquired hepatitis B (HBV) and C virus (HCV) infections continue to occur despite increased awareness of this problem among the medical community. One hundred six patients were infected in a haematology oncology ward for children, over the time period 1996 to 2000. Serum samples from 45 such patients and 3 from infected medical personnel were used for nucleic acid amplification. HBV core, as well as HCV core and hypervariable region 1 (HVR1) nucleotide sequences, were analysed by phylogenetic tree analysis, in order to characterise the epidemiological pattern of viral transmission on the ward. Samples from 32 patients were positive for HBV-DNA or HCV-RNA by PCR. Ten patients were positive for both markers. Seventeen out of twenty-three HCV core gene sequences were found to be evolutionarily related and clustered separately from other local sequences in the phylogenetic tree, indicating nosocomial transmission. This was confirmed by analysis of HVR1 gene sequences. One nurse and one physician from the ward were HCV RNA positive, but their HCV sequences were not related evolutionarily to those of the patient cluster. Fifteen out of nineteen HBV core gene sequences were also clustered together and were positioned separately in the relevant tree. Epidemiological investigation excluded a common source infection and indicated that spread of infection was most likely due to inappropriate infection control measures on the ward. No obvious risk factors for transmission were identified during the retrospective survey in patients with related sequences, except use of multidose vials for saline and poor staff compliance with routine hand hygiene procedures. The preventive measures that were introduced reduced the incidence of infection significantly. No new cases of HBV infection and only three anti-HCV seroconversions occurred over a period of 19 months. The introduction and maintenance of strict prevention measures over a 2 year period, combined with HBV vaccination

  12. An optimal control problem arising from a dengue disease transmission model.

    PubMed

    Aldila, Dipo; Götz, Thomas; Soewono, Edy

    2013-03-01

    An optimal control problem for a host-vector Dengue transmission model is discussed here. In the model, treatments with mosquito repellent are given to adults and children and those who undergo treatment are classified in treated compartments. With this classification, the model consists of 11 dynamic equations. The basic reproductive ratio that represents the epidemic indicator is obtained from the largest eigenvalue of the next generation matrix. The optimal control problem is designed with four control parameters, namely the treatment rates for children and adult compartments, and the drop-out rates from both compartments. The cost functional accounts for the total number of the infected persons, the cost of the treatment, and the cost related to reducing the drop-out rates. Numerical results for the optimal controls and the related dynamics are shown for the case of epidemic prevention and outbreak reduction strategies.

  13. First Evidence of Simultaneous Circulation of Three Different Dengue Virus Serotypes in Africa

    PubMed Central

    Caron, Melanie; Grard, Gilda; Paupy, Christophe; Mombo, Illich Mamfred; Bikie Bi Nso, Branly; Kassa Kassa, Fabrice Roland; Nkoghe, Dieudonne; Leroy, Eric Maurice

    2013-01-01

    Gabon, in Central Africa, was affected for the first time in 2007 and then in 2010 by simultaneous outbreaks of chikungunya and Dengue serotype 2 (DENV-2) viruses. Through the national surveillance of dengue-like syndromes between 2007 and 2010, we observed continuous circulation of DENV-2 in a southward movement. This rapid spread of DENV-2 was associated with the emergence of DENV-1 in 2007 and DENV-3 in 2010. Interestingly, we detected six DENV-2 infected patients with hemorrhagic signs during the second outbreak in 2010. Although these cases do not meet all standard WHO criteria for severe Dengue with hemorrhage (formerly DHF), this is the first report of several dengue fever cases associated with hemorrhagic signs during a simultaneous circulation of different DENV serotypes in Africa. Together, these findings suggest that DENV is becoming more widely established on this continent and that DHF will likely become a serious public-health problem in the near future. PMID:24205075

  14. Control of Aedes aegypti Breeding: A Novel Intervention for Prevention and Control of Dengue in an Endemic Zone of Delhi, India

    PubMed Central

    Nagpal, B. N.; Gupta, Sanjeev Kumar; Shamim, Arshad; Vikram, Kumar; Srivastava, Aruna; Tuli, N. R.; Saxena, Rekha; Singh, Himmat; Singh, V. P.; Bhagat, V. N.; Yadav, N. K.; Valecha, Neena

    2016-01-01

    Background and objective The study is based on hypothesis that whether continuous entomological surveillance of Ae. aegypti and simultaneous appropriate interventions in key containers during non-transmission (December–May) months would have any impact on breeding of Aedes and dengue cases during the following transmission months (June–November). The impact of the surveillance and intervention measures undertaken during non-transmission months were assessed by entomological indicators namely container index (CI), house index (HI), pupal index (PI) and breteau index (BI). Methods A total of 28 localities of West Zone of Delhi with persistent dengue endemicity were selected for the study. Out of these localities, 20 were included in study group while other 8 localities were in control group. IEC and various Aedes breeding control activities were carried out in study group in both non-transmission and transmission season whereas control group did not have any such interventions during non-transmission months as per guidelines of MCD. These activities were undertaken by a team of investigators from NIMR and SDMC, Delhi. In control group, investigators from NIMR carried out surveillance activity to monitor the breeding of Aedes mosquito in localities. Results Comparison of baseline data revealed that all indices in control and study group of localities were comparable and statistically non-significant (p>0.05). In both study and control groups, indices were calculated after pooling data on seasonal basis, i.e., transmission and non-transmission months for both years. The test of significance conducted on all the four indices, i.e., HI, PI, CI, and BI, revealed a significant difference (p<0.05) between the study group and control group during transmission and non-transmission months except in HI. Due to consistent intervention measures undertaken in non-transmission months in study group, reduction in CI, HI, BI and PI was observed 63%, 62%, 64% and 99% respectively

  15. Assessing the interest to participate in a dengue vaccine efficacy trial among residents of Puerto Rico.

    PubMed

    Pérez-Guerra, Carmen L; Rodríguez-Acosta, Rosa L; Soto-Gómez, Eunice; Zielinski-Gutierrez, Emily; Peña-Orellana, Marisol; Santiago, Luis M; Rivera, Reinaldo; Cruz, R Rhode; Ramírez, Viani; Tomashek, Kay M; Dayan, Gustavo

    2012-07-01

    Dengue, endemic in Puerto Rico, is a major public health problem. Vaccines are thought the best means to prevent dengue because vector control alone has been largely ineffective. We implemented qualitative studies in 2006 and 2010 to determine the acceptability of conducting placebo-controlled dengue vaccine efficacy trials in Puerto Rican children. Key informant interviews and focus groups with parents and children were conducted in municipalities with high dengue incidence. We used structured open-ended questions to determine motivators and attitudes regarding vaccine trial participation. Knowledge about dengue risk and prevention, and knowledge, attitudes, and beliefs regarding vaccines and vaccine trials were assessed. Using grounded theory, we conducted content analysis and established categories and sub-categories of participant responses. All participants were knowledgeable about dengue prevention and perceived children as most affected age groups. Participants were aware of vaccines benefits and they thought a vaccine could prevent dengue. However, most would not allow their children to participate in a placebo-controlled vaccine trial. Barriers included lack of trust in new vaccines and vaccine trial procedures; fear of developing dengue or side effects from the vaccine and lack of information about candidate dengue vaccines. Participants thought information, including results of previous trials might overcome barriers to participation. Motivators for participation were altruism, protection from dengue, free medical attention, and compensation for transportation and participation. Parents would consider children participation if accurate vaccine trial information is provided.

  16. Dengue 4 Vaccine Development

    DTIC Science & Technology

    1987-09-01

    CopU~1C FftE 0~AD( ) DENGUE 4 VACCINE DEVELOPMENT Lf 0, to ANNUAL AND FINAL REPORT0 by 0Nyven J. Marchette, Ph.D. September 1, 1987 (For the period 1... Dengue 4 Vaccine Development 12. PERSONAL AUTHOR(S) Nyven Marchette. Ph.D. 13a. TYPE OF REPORT T COVERED 114. DATE OF REPORT (Year, Month, Day) 15. PAGE...necessary and identi’fy by block number) FIELD GROUP SUB-GROUP Key words: Virus, arbovirus, dengue , dengue -4, vaccinej attenuation, immunity, RAI

  17. Dengue virus serotype 4 in a highly susceptible population in Southeast Brazil.

    PubMed

    Amâncio, Frederico F; Ferraz, Marcela L; Almeida, Maria Cristina de M; Pessanha, José Eduardo M; Iani, Felipe C M; Fraga, Gabriela L; Lambertucci, José Roberto; Carneiro, Mariângela

    2014-01-01

    In Minas Gerais, Brazil, almost 500,000 dengue fever cases were reported to the State Surveillance System between November 2012 and July 2013. An analysis of the laboratory-confirmed cases revealed a higher age-specific incidence in adults and a higher case fatality rate in people aged ≥50. Dengue virus serotypes 1 and 4 (the latter of which is an emerging serotype in Brazil) were responsible for the outbreak.

  18. Model-informed risk assessment for Zika virus outbreaks in the Asia-Pacific regions.

    PubMed

    Teng, Yue; Bi, Dehua; Xie, Guigang; Jin, Yuan; Huang, Yong; Lin, Baihan; An, Xiaoping; Tong, Yigang; Feng, Dan

    2017-02-09

    Recently, Zika virus (ZIKV) has been recognized as a significant threat to global public health. The disease was present in large parts of the Americas, the Caribbean, and also the western Pacific area with southern Asia during 2015 and 2016. However, little is known about the factors affecting the transmission of ZIKV. We used Gradient Boosted Regression Tree models to investigate the effects of various potential explanatory variables on the spread of ZIKV, and used current with historical information from a range of sources to assess the risks of future ZIKV outbreaks. Our results indicated that the probability of ZIKV outbreaks increases with vapor pressure, the occurrence of Dengue virus, and population density but decreases as health expenditure, GDP, and numbers of travelers. The predictive results revealed the potential risk countries of ZIKV infection in the Asia-Pacific regions between October 2016 and January 2017. We believe that the high-risk conditions would continue in South Asia and Australia over this period. By integrating information on eco-environmental, social-economical, and ZIKV-related niche factors, this study estimated the probability for locally acquired mosquito-borne ZIKV infections in the Asia-Pacific region and improves the ability to forecast, and possibly even prevent, future outbreaks of ZIKV.

  19. Hyperferritinaemia in Dengue Virus Infected Patients Is Associated with Immune Activation and Coagulation Disturbances

    PubMed Central

    Pannuti, Cláudio S.; Brouns, Rosalba M.; van den Berg, Riemsdijk W. A.; van den Ham, Henk-Jan; Martina, Byron E. E.; Osterhaus, Albert D. M. E.; Netea, Mihai G.; Meijers, Joost C. M.; van Gorp, Eric C. M.; Kallas, Esper G.

    2014-01-01

    Background During a dengue outbreak on the Caribbean island Aruba, highly elevated levels of ferritin were detected in dengue virus infected patients. Ferritin is an acute-phase reactant and hyperferritinaemia is a hallmark of diseases caused by extensive immune activation, such as haemophagocytic lymphohistiocytosis. The aim of this study was to investigate whether hyperferritinaemia in dengue patients was associated with clinical markers of extensive immune activation and coagulation disturbances. Methodology/Principal Findings Levels of ferritin, standard laboratory markers, sIL-2R, IL-18 and coagulation and fibrinolytic markers were determined in samples from patients with uncomplicated dengue in Aruba. Levels of ferritin were significantly increased in dengue patients compared to patients with other febrile illnesses. Moreover, levels of ferritin associated significantly with the occurrence of viraemia. Hyperferritinaemia was also significantly associated with thrombocytopenia, elevated liver enzymes and coagulation disturbances. The results were validated in a cohort of dengue virus infected patients in Brazil. In this cohort levels of ferritin and cytokine profiles were determined. Increased levels of ferritin in dengue virus infected patients in Brazil were associated with disease severity and a pro-inflammatory cytokine profile. Conclusions/Significance Altogether, we provide evidence that ferritin can be used as a clinical marker to discriminate between dengue and other febrile illnesses. The occurrence of hyperferritinaemia in dengue virus infected patients is indicative for highly active disease resulting in immune activation and coagulation disturbances. Therefore, we recommend that patients with hyperferritinaemia are monitored carefully. PMID:25299654

  20. [Lessons learned in the control of Aedes aegypti to address dengue and the emergency of chikungunya in Iquitos, Peru].

    PubMed

    Vilcarromero, Stalin; Casanova, Wilma; Ampuero, Julia S; Ramal-Asayag, Cesar; Siles, Crystyan; Díaz, Gloria; Durand, Salomón; Celis-Salinas, Juan C; Astete, Helvio; Rojas, Percy; Vásquez-La Torre, Gabriela; Marín, Johan; Bazán, Isabel; Alegre, Yuri; Morrison, Amy C; Rodriguez-Ferrucci, Hugo

    2015-01-01

    Dengue has affected Iquitos since 1990 causing outbreaks of major impact on public health and for this reason great efforts have been made for its temporal control. Currently, with the expansion of the chikungunya virus in the Americas and the threat of the emergence of the virus in Iquitos, we reflect on lessons learned by way of the activities undertaken in the area of vector control; epidemiological surveillance, diagnosis and clinical management during periods of outbreaks of dengue, in a way that will allow us to better face the threat of an outbreak of chikungunya virus in the largest city in the Peruvian Amazon.

  1. Evolutionary Analysis of Dengue Serotype 2 Viruses Using Phylogenetic and Bayesian Methods from New Delhi, India

    PubMed Central

    Afreen, Nazia; Naqvi, Irshad H.; Broor, Shobha; Ahmed, Anwar; Kazim, Syed Naqui; Dohare, Ravins; Kumar, Manoj; Parveen, Shama

    2016-01-01

    Dengue fever is the most important arboviral disease in the tropical and sub-tropical countries of the world. Delhi, the metropolitan capital state of India, has reported many dengue outbreaks, with the last outbreak occurring in 2013. We have recently reported predominance of dengue virus serotype 2 during 2011–2014 in Delhi. In the present study, we report molecular characterization and evolutionary analysis of dengue serotype 2 viruses which were detected in 2011–2014 in Delhi. Envelope genes of 42 DENV-2 strains were sequenced in the study. All DENV-2 strains grouped within the Cosmopolitan genotype and further clustered into three lineages; Lineage I, II and III. Lineage III replaced lineage I during dengue fever outbreak of 2013. Further, a novel mutation Thr404Ile was detected in the stem region of the envelope protein of a single DENV-2 strain in 2014. Nucleotide substitution rate and time to the most recent common ancestor were determined by molecular clock analysis using Bayesian methods. A change in effective population size of Indian DENV-2 viruses was investigated through Bayesian skyline plot. The study will be a vital road map for investigation of epidemiology and evolutionary pattern of dengue viruses in India. PMID:26977703

  2. Evolutionary Analysis of Dengue Serotype 2 Viruses Using Phylogenetic and Bayesian Methods from New Delhi, India.

    PubMed

    Afreen, Nazia; Naqvi, Irshad H; Broor, Shobha; Ahmed, Anwar; Kazim, Syed Naqui; Dohare, Ravins; Kumar, Manoj; Parveen, Shama

    2016-03-01

    Dengue fever is the most important arboviral disease in the tropical and sub-tropical countries of the world. Delhi, the metropolitan capital state of India, has reported many dengue outbreaks, with the last outbreak occurring in 2013. We have recently reported predominance of dengue virus serotype 2 during 2011-2014 in Delhi. In the present study, we report molecular characterization and evolutionary analysis of dengue serotype 2 viruses which were detected in 2011-2014 in Delhi. Envelope genes of 42 DENV-2 strains were sequenced in the study. All DENV-2 strains grouped within the Cosmopolitan genotype and further clustered into three lineages; Lineage I, II and III. Lineage III replaced lineage I during dengue fever outbreak of 2013. Further, a novel mutation Thr404Ile was detected in the stem region of the envelope protein of a single DENV-2 strain in 2014. Nucleotide substitution rate and time to the most recent common ancestor were determined by molecular clock analysis using Bayesian methods. A change in effective population size of Indian DENV-2 viruses was investigated through Bayesian skyline plot. The study will be a vital road map for investigation of epidemiology and evolutionary pattern of dengue viruses in India.

  3. Complete nucleotide sequence analysis of a Dengue-1 virus isolated on Easter Island, Chile.

    PubMed

    Cáceres, C; Yung, V; Araya, P; Tognarelli, J; Villagra, E; Vera, L; Fernández, J

    2008-01-01

    Dengue-1 viruses responsible for the dengue fever outbreak in Easter Island in 2002 were isolated from acute-phase sera of dengue fever patients. In order to analyze the complete genome sequence, we designed primers to amplify contiguous segments across the entire sequence of the viral genome. RT-PCR products obtained were cloned, and complete nucleotide and deduced amino acid sequences were determined. This report constitutes the first complete genetic characterization of a DENV-1 isolate from Chile. Phylogenetic analysis shows that an Easter Island isolate is most closely related to Pacific DENV-1 genotype IV viruses.

  4. Oral receptivity of Aedes aegypti from Cape Verde for yellow fever, dengue, and chikungunya viruses.

    PubMed

    Vazeille, Marie; Yébakima, André; Lourenço-de-Oliveira, Ricardo; Andriamahefazafy, Barrysson; Correira, Artur; Rodrigues, Julio Monteiro; Veiga, Antonio; Moreira, Antonio; Leparc-Goffart, Isabelle; Grandadam, Marc; Failloux, Anna-Bella

    2013-01-01

    At the end of 2009, 21,313 cases of dengue-3 virus (DENV-3) were reported in the islands of Cape Verde, an archipelago located in the Atlantic Ocean 570 km from the coast of western Africa. It was the first dengue outbreak ever reported in Cape Verde. Mosquitoes collected in July 2010 in the city of Praia, on the island of Santiago, were identified morphologically as Aedes aegypti formosus. Using experimental oral infections, we found that this vector showed a moderate ability to transmit the epidemic dengue-3 virus, but was highly susceptible to chikungunya and yellow fever viruses.

  5. Aedes larval population dynamics and risk for dengue epidemics in Malaysia.

    PubMed

    Rohani, A; Suzilah, I; Malinda, M; Anuar, I; Mohd Mazlan, I; Salmah Maszaitun, M; Topek, O; Tanrang, Y; Ooi, S C; Rozilawati, H; Lee, H L

    2011-08-01

    Early detection of a dengue outbreak is an important first step towards implementing effective dengue interventions resulting in reduced mortality and morbidity. A dengue mathematical model would be useful for the prediction of an outbreak and evaluation of control measures. However, such a model must be carefully parameterized and validated with epidemiological, ecological and entomological data. A field study was conducted to collect and analyse various parameters to model dengue transmission and outbreak. Dengue prone areas in Kuala Lumpur, Pahang, Kedah and Johor were chosen for this study. Ovitraps were placed outdoor and used to determine the effects of meteorological parameters on vector breeding. Vector population in each area was monitored weekly for 87 weeks. Weather stations, consisting of a temperature and relative humidity data logger and an automated rain gauge, were installed at key locations in each study site. Correlation and Autoregressive Distributed Lag (ADL) model were used to study the relationship among the variables. Previous week rainfall plays a significant role in increasing the mosquito population, followed by maximum humidity and temperature. The secondary data of rainfall, temperature and humidity provided by the meteorological department showed an insignificant relationship with the mosquito population compared to the primary data recorded by the researchers. A well fit model was obtained for each locality to be used as a predictive model to foretell possible outbreak.

  6. Next generation dengue vaccines: A review of the preclinical development pipeline.

    PubMed

    Vannice, Kirsten S; Roehrig, John T; Hombach, Joachim

    2015-12-10

    Dengue represents a significant and growing public health problem across the globe, with approximately half of the world's population at risk. The increasing and expanding burden of dengue has highlighted the need for new tools to prevent dengue, including development of dengue vaccines. Recently, the first dengue vaccine candidate was evaluated in Phase 3 clinical trials, and other vaccine candidates are under clinical evaluation. There are also a number of candidates in preclinical development, based on diverse technologies, with promising results in animal models and likely to move into clinical trials and could eventually be next-generation dengue vaccines. This review provides an overview of the various technological approaches to dengue vaccine development with specific focus on candidates in preclinical development and with evaluation in non-human primates.

  7. DengueME: A Tool for the Modeling and Simulation of Dengue Spatiotemporal Dynamics.

    PubMed

    de Lima, Tiago França Melo; Lana, Raquel Martins; de Senna Carneiro, Tiago Garcia; Codeço, Cláudia Torres; Machado, Gabriel Souza; Ferreira, Lucas Saraiva; de Castro Medeiros, Líliam César; Davis Junior, Clodoveu Augusto

    2016-09-15

    The prevention and control of dengue are great public health challenges for many countries, particularly since 2015, as other arboviruses have been observed to interact significantly with dengue virus. Different approaches and methodologies have been proposed and discussed by the research community. An important tool widely used is modeling and simulation, which help us to understand epidemic dynamics and create scenarios to support planning and decision making processes. With this aim, we proposed and developed DengueME, a collaborative open source platform to simulate dengue disease and its vector's dynamics. It supports compartmental and individual-based models, implemented over a GIS database, that represent Aedes aegypti population dynamics, human demography, human mobility, urban landscape and dengue transmission mediated by human and mosquito encounters. A user-friendly graphical interface was developed to facilitate model configuration and data input, and a library of models was developed to support teaching-learning activities. DengueME was applied in study cases and evaluated by specialists. Other improvements will be made in future work, to enhance its extensibility and usability.

  8. DengueME: A Tool for the Modeling and Simulation of Dengue Spatiotemporal Dynamics †

    PubMed Central

    de Lima, Tiago França Melo; Lana, Raquel Martins; de Senna Carneiro, Tiago Garcia; Codeço, Cláudia Torres; Machado, Gabriel Souza; Ferreira, Lucas Saraiva; de Castro Medeiros, Líliam César; Davis Junior, Clodoveu Augusto

    2016-01-01

    The prevention and control of dengue are great public health challenges for many countries, particularly since 2015, as other arboviruses have been observed to interact significantly with dengue virus. Different approaches and methodologies have been proposed and discussed by the research community. An important tool widely used is modeling and simulation, which help us to understand epidemic dynamics and create scenarios to support planning and decision making processes. With this aim, we proposed and developed DengueME, a collaborative open source platform to simulate dengue disease and its vector’s dynamics. It supports compartmental and individual-based models, implemented over a GIS database, that represent Aedes aegypti population dynamics, human demography, human mobility, urban landscape and dengue transmission mediated by human and mosquito encounters. A user-friendly graphical interface was developed to facilitate model configuration and data input, and a library of models was developed to support teaching-learning activities. DengueME was applied in study cases and evaluated by specialists. Other improvements will be made in future work, to enhance its extensibility and usability. PMID:27649226

  9. Mining local climate data to assess spatiotemporal dengue fever epidemic patterns in French Guiana

    PubMed Central

    Flamand, Claude; Fabregue, Mickael; Bringay, Sandra; Ardillon, Vanessa; Quénel, Philippe; Desenclos, Jean-Claude; Teisseire, Maguelonne

    2014-01-01

    Objective To identify local meteorological drivers of dengue fever in French Guiana, we applied an original data mining method to the available epidemiological and climatic data. Through this work, we also assessed the contribution of the data mining method to the understanding of factors associated with the dissemination of infectious diseases and their spatiotemporal spread. Methods We applied contextual sequential pattern extraction techniques to epidemiological and meteorological data to identify the most significant climatic factors for dengue fever, and we investigated the relevance of the extracted patterns for the early warning of dengue outbreaks in French Guiana. Results The maximum temperature, minimum relative humidity, global brilliance, and cumulative rainfall were identified as determinants of dengue outbreaks, and the precise intervals of their values and variations were quantified according to the epidemiologic context. The strongest significant correlations were observed between dengue incidence and meteorological drivers after a 4–6-week lag. Discussion We demonstrated the use of contextual sequential patterns to better understand the determinants of the spatiotemporal spread of dengue fever in French Guiana. Future work should integrate additional variables and explore the notion of neighborhood for extracting sequential patterns. Conclusions Dengue fever remains a major public health issue in French Guiana. The development of new methods to identify such specific characteristics becomes crucial in order to better understand and control spatiotemporal transmission. PMID:24549761

  10. Distribution, seasonal variation & dengue transmission prediction in Sisaket, Thailand

    PubMed Central

    Wongkoon, S.; Jaroensutasinee, M.; Jaroensutasinee, K.

    2013-01-01

    Background & objectives: Environmental factors including weather variables may play a significant role in the transmission of dengue. This study investigated the effect of seasonal variation on the abundance of Aedes aegypti and Ae. albopictus larvae and explored the impact of weather variability on dengue transmission in Sisaket, Thailand. Methods: The monthly mosquito larval surveys were carried out in urban and rural areas in Sisaket, Thailand from January to December 2010. Data on monthly-reported cases of dengue fever over the period 2004-2010 were obtained from the Ministry of Public Health. Weather data over the same period were obtained from the Thai Meteorological Department. Chi-square test was used to find the differences relating to seasonal variability, areas of study, and mosquito species factors using entomological survey data. Time series Poisson regression analysis was performed using data on monthly weather variables and dengue cases. Results: There were more Ae. aegypti larvae per household than Ae. albopictus larvae in the winter and rainy seasons. More Aedes larvae per household were found in the rainy season than in the winter and summer seasons. Relative humidity at a lag of one month and rainy days in the current month were significant predictors of dengue incidence in Sisaket. Interpretation & conclusions: Increased rain during the current month and less humidity during the previous month might trigger a higher incidence of dengue epidemic in Sisaket. The present findings suggest that the dengue incidence corresponds with the number of Aedes larvae. The seasonal patterns of dengue outbreaks coincide with the rainy season. PMID:24135179

  11. Evaluation of the National Notifiable Diseases Surveillance System for Dengue Fever in Taiwan, 2010–2012

    PubMed Central

    McKerr, Caoimhe; Lo, Yi-Chun; Edeghere, Obaghe; Bracebridge, Sam

    2015-01-01

    Background In Taiwan, around 1,500 cases of dengue fever are reported annually and incidence has been increasing over time. A national web-based Notifiable Diseases Surveillance System (NDSS) has been in operation since 1997 to monitor incidence and trends and support case and outbreak management. We present the findings of an evaluation of the NDSS to ascertain the extent to which dengue fever surveillance objectives are being achieved. Methodology We extracted the NDSS data on all laboratory-confirmed dengue fever cases reported during 1 January 2010 to 31 December 2012 to assess and describe key system attributes based on the Centers for Disease Control and Prevention surveillance evaluation guidelines. The system’s structure and processes were delineated and operational staff interviewed using a semi-structured questionnaire. Crude and age-adjusted incidence rates were calculated and key demographic variables were summarised to describe reporting activity. Data completeness and validity were described across several variables. Principal Findings Of 5,072 laboratory-confirmed dengue fever cases reported during 2010–2012, 4,740 (93%) were reported during July to December. The system was judged to be simple due to its minimal reporting steps. Data collected on key variables were correctly formatted and usable in > 90% of cases, demonstrating good data completeness and validity. The information collected was considered relevant by users with high acceptability. Adherence to guidelines for 24-hour reporting was 99%. Of 720 cases (14%) recorded as travel-related, 111 (15%) had an onset >14 days after return, highlighting the potential for misclassification. Information on hospitalization was missing for 22% of cases. The calculated PVP was 43%. Conclusions/Significance The NDSS for dengue fever surveillance is a robust, well maintained and acceptable system that supports the collection of complete and valid data needed to achieve the surveillance objectives. The

  12. Molecular characterization of dengue viruses circulating during 2009-2012 in Uttar Pradesh, India.

    PubMed

    Mishra, Gitika; Jain, Amita; Prakash, Om; Prakash, Shantanu; Kumar, Rashmi; Garg, Ravindra K; Pandey, Nidhi; Singh, Mastan

    2015-01-01

    Dengue is the most rapidly spreading mosquito-borne viral disease in the world; in India it has taken endemic proportion implicating all the four known dengue virus serotypes. Dengue infection is caused by a small, single stranded RNA virus comprising of four antigenically distinct virus serotypes designated as dengue virus type 1-4 (DENV-1-4). On the basis of genomic variations, each serotype is classified further into its genotypes. Epidemiological studies have shown that the emergence of a newer dengue serotype/genotype after an interval always leads to a major outbreak; therefore a continuous epidemiological surveillance is needed to monitor the epidemiology of dengue viruses. The present study was planned to identify the serotype/genotype of dengue viruses circulating in Uttar Pradesh, India. Of 433 dengue suspected patients, tested by reverse transcriptase PCR (RT-PCR), 136 were positive for dengue virus RNA. Of these, DENV-1, 2, and 3 were detected in 26 (19.1%), 77 (56.6%), and 33 (24.3%) patients, respectively. Of 136 RT-PCR positive samples, 24 samples were sequenced to identify their genotypes. For sequencing C-prM gene junction of dengue virus genome was chosen. Phylogenetic analysis of sequenced dengue strains revealed that all the 12 DENV-1 strains were genotype III, all the eight DENV-2 strains were genotype IV (Cosmopolitan genotype) and among four DENV-3 strains, three were genotype III and one was genotype I. In conclusion, the co-circulation of multiple dengue virus serotypes and genotypes is alarming in U.P., India.

  13. Impediments of reporting dengue cases in India.

    PubMed

    Das, Sushmita; Sarfraz, Asim; Jaiswal, Nitesh; Das, Pradeep

    2017-03-02

    Dengue has emerged as one of the most important mosquito-borne, fatal flaviviral disease, apparently expanding as a global health problem. An estimated 3.6 billion people are at risk for dengue, with 50 million infections per year occurring across 100 countries globally. The annual number of dengue fever cases in India is many times higher than it is officially reported. This under reporting would play a major role in the government's decision-making. Underestimating of the disease in India encumbers its people from taking preventive measures, discourages efforts to ensnare the sources of the disease and deliberates efforts for vaccine research. In this article, we highlight the probable impediments of under reporting leading to its impact on national and global public health and also offer key remedies to effectively address the issues across the clinics to the community level.

  14. Tackling dengue fever: Current status and challenges.

    PubMed

    Nedjadi, Taoufik; El-Kafrawy, Sherif; Sohrab, Sayed S; Desprès, Philippe; Damanhouri, Ghazi; Azhar, Esam

    2015-12-09

    According to recent statistics, 96 million apparent dengue infections were estimated worldwide in 2010. This figure is by far greater than the WHO prediction which indicates the rapid spread of this disease posing a growing threat to the economy and a major challenge to clinicians and health care services across the globe particularly in the affected areas.This article aims at bringing to light the current epidemiological and clinical status of the dengue fever. The relationship between genetic mutations, single nucleotide polymorphism (SNP) and the pathophysiology of disease progression will be put into perspective. It will also highlight the recent advances in dengue vaccine development.Thus far, a significant progress has been made in unraveling the risk factors and understanding the molecular pathogenesis associated with the disease. However, further insights in molecular features of the disease and the development of animal models will enormously help improving the therapeutic interventions and potentially contribute to finding new preventive measures for population at risk.

  15. Dengue vaccine: local decisions, global consequences

    PubMed Central

    López-Gatell, Hugo; Alpuche-Aranda, Celia M; Santos-Preciado, José I

    2016-01-01

    Abstract As new vaccines against diseases that are prevalent in low- and middle-income countries gradually become available, national health authorities are presented with new regulatory and policy challenges. The use of CYD-TDV – a chimeric tetravalent, live-attenuated dengue vaccine – was recently approved in five countries. Although promising for public health, this vaccine has only partial and heterogeneous efficacy and may have substantial adverse effects. In trials, children who were aged 2–5 years when first given CYD-TDV were seven times more likely to be hospitalized for dengue, in the third year post-vaccination, than their counterparts in the control group. As it has not been clarified whether this adverse effect is only a function of age or is determined by dengue serostatus, doubts have been cast over the long-term safety of this vaccine in seronegative individuals of any age. Any deployment of the vaccine, which should be very cautious and only considered after a rigorous evaluation of the vaccine’s risk–benefit ratio in explicit national and subnational scenarios, needs to be followed by a long-term assessment of the vaccine’s effects. Furthermore, any implementation of dengue vaccines must not weaken the political and financial support of preventive measures that can simultaneously limit the impacts of dengue and several other mosquito-borne pathogens. PMID:27821888

  16. Dengue vaccine: local decisions, global consequences.

    PubMed

    López-Gatell, Hugo; Alpuche-Aranda, Celia M; Santos-Preciado, José I; Hernández-Ávila, Mauricio

    2016-11-01

    As new vaccines against diseases that are prevalent in low- and middle-income countries gradually become available, national health authorities are presented with new regulatory and policy challenges. The use of CYD-TDV - a chimeric tetravalent, live-attenuated dengue vaccine - was recently approved in five countries. Although promising for public health, this vaccine has only partial and heterogeneous efficacy and may have substantial adverse effects. In trials, children who were aged 2-5 years when first given CYD-TDV were seven times more likely to be hospitalized for dengue, in the third year post-vaccination, than their counterparts in the control group. As it has not been clarified whether this adverse effect is only a function of age or is determined by dengue serostatus, doubts have been cast over the long-term safety of this vaccine in seronegative individuals of any age. Any deployment of the vaccine, which should be very cautious and only considered after a rigorous evaluation of the vaccine's risk-benefit ratio in explicit national and subnational scenarios, needs to be followed by a long-term assessment of the vaccine's effects. Furthermore, any implementation of dengue vaccines must not weaken the political and financial support of preventive measures that can simultaneously limit the impacts of dengue and several other mosquito-borne pathogens.

  17. The Role of Imported Cases and Favorable Meteorological Conditions in the Onset of Dengue Epidemics

    PubMed Central

    Shang, Chuin-Shee; Wen, Tzai-Hung; Tsai, Kun-Hsien

    2010-01-01

    Background Travelers who acquire dengue infection are often routes for virus transmission to other regions. Nevertheless, the interplay between infected travelers, climate, vectors, and indigenous dengue incidence remains unclear. The role of foreign-origin cases on local dengue epidemics thus has been largely neglected by research. This study investigated the effect of both imported dengue and local meteorological factors on the occurrence of indigenous dengue in Taiwan. Methods and Principal Findings Using logistic and Poisson regression models, we analyzed bi-weekly, laboratory-confirmed dengue cases at their onset dates of illness from 1998 to 2007 to identify correlations between indigenous dengue and imported dengue cases (in the context of local meteorological factors) across different time lags. Our results revealed that the occurrence of indigenous dengue was significantly correlated with temporally-lagged cases of imported dengue (2–14 weeks), higher temperatures (6–14 weeks), and lower relative humidity (6–20 weeks). In addition, imported and indigenous dengue cases had a significant quantitative relationship in the onset of local epidemics. However, this relationship became less significant once indigenous epidemics progressed past the initial stage. Conclusions These findings imply that imported dengue cases are able to initiate indigenous epidemics when appropriate weather conditions are present. Early detection and case management of imported cases through rapid diagnosis may avert large-scale epidemics of dengue/dengue hemorrhagic fever. The deployment of an early-warning surveillance system, with the capacity to integrate meteorological data, will be an invaluable tool for successful prevention and control of dengue, particularly in non-endemic countries. PMID:20689820

  18. Antibodies targeting dengue virus envelope domain III are not required for serotype-specific protection or prevention of enhancement in vivo.

    PubMed

    Williams, Katherine L; Wahala, Wahala M P B; Orozco, Susana; de Silva, Aravinda M; Harris, Eva

    2012-07-20

    The envelope (E) protein of dengue virus (DENV) is composed of three domains (EDI, EDII, EDIII) and is the main target of neutralizing antibodies. Many monoclonal antibodies that bind EDIII strongly neutralize DENV. However in vitro studies indicate that anti-EDIII antibodies contribute little to the neutralizing potency of human DENV-immune serum. In this study, we assess the role of anti-EDIII antibodies in mouse and human DENV-immune serum in neutralizing or enhancing DENV infection in mice. We demonstrate that EDIII-depleted human DENV-immune serum was protective against homologous DENV infection in vivo. Although EDIII-depleted DENV-immune mouse serum demonstrated decreased neutralization potency in vitro, reduced protection in some organs, and enhanced disease in vivo, administration of increased volumes of EDIII-depleted serum abrogated these effects. These data indicate that anti-EDIII antibodies contribute to protection and minimize enhancement when present, but can be replaced by neutralizing antibodies targeting other epitopes on the dengue virion.

  19. Outbreak Column 16: Cognitive errors in outbreak decision making

    PubMed Central

    2015-01-01

    During outbreaks, decisions must be made without all the required information. People, including infection prevention and control teams (IPCTs), who have to make decisions during uncertainty use heuristics to fill the missing data gaps. Heuristics are mental model short cuts that by-and-large enable us to make good decisions quickly. However, these heuristics contain biases and effects that at times lead to cognitive (thinking) errors. These cognitive errors are not made to deliberately misrepresent any given situation; we are subject to heuristic biases when we are trying to perform optimally. The science of decision making is large; there are over 100 different biases recognised and described. Outbreak Column 16 discusses and relates these heuristics and biases to decision making during outbreak prevention, preparedness and management. Insights as to how we might recognise and avoid them are offered.

  20. Enhanced performance of an innovative dengue IgG/IgM rapid diagnostic test using an anti-dengue EDI monoclonal antibody and dengue virus antigen

    PubMed Central

    Lee, Jihoo; Kim, Young-Eun; Kim, Hak-Yong; Sinniah, Mangalam; Chong, Chom-Kyu; Song, Hyun-Ok

    2015-01-01

    High levels of anti-dengue IgM or IgG can be detected using numerous rapid diagnostic tests (RDTs). However, the sensitivity and specificity of these tests are reduced by changes in envelope glycoprotein antigenicity that inevitably occur in limited expression systems. A novel RDT was designed to enhance diagnostic sensitivity. Dengue viruses cultured in animal cells were used as antigens to retain the native viral coat protein. Monoclonal antibodies (mAbs) were then developed, for the first time, against domain I of envelope glycoprotein (EDI). The anti-dengue EDI mAb was employed as a capturer, and EDII and EDIII, which are mainly involved in the induction of neutralizing antibodies in patients, were fully available to bind to anti-dengue IgM or IgG in patients. A one-way automatic blood separation device prevented reverse migration of plasma and maximize the capture of anti-dengue antibodies at the test lines. A clinical evaluation in the field proved that the novel RDT (sensitivities of 96.5% and 96.7% for anti-dengue IgM and IgG) is more effective in detecting anti-dengue antibodies than two major commercial tests (sensitivities of 54.8% and 82% for SD BIOLINE; 50.4% and 75.3% for PanBio). The innovative format of RDT can be applied to other infectious viral diseases. PMID:26655854

  1. Testing the impact of virus importation rates and future climate change on dengue activity in Malaysia using a mechanistic entomology and disease model.

    PubMed

    Williams, C R; Gill, B S; Mincham, G; Mohd Zaki, A H; Abdullah, N; Mahiyuddin, W R W; Ahmad, R; Shahar, M K; Harley, D; Viennet, E; Azil, A; Kamaluddin, A

    2015-10-01

    We aimed to reparameterize and validate an existing dengue model, comprising an entomological component (CIMSiM) and a disease component (DENSiM) for application in Malaysia. With the model we aimed to measure the effect of importation rate on dengue incidence, and to determine the potential impact of moderate climate change (a 1 °C temperature increase) on dengue activity. Dengue models (comprising CIMSiM and DENSiM) were reparameterized for a simulated Malaysian village of 10 000 people, and validated against monthly dengue case data from the district of Petaling Jaya in the state of Selangor. Simulations were also performed for 2008-2012 for variable virus importation rates (ranging from 1 to 25 per week) and dengue incidence determined. Dengue incidence in the period 2010-2012 was modelled, twice, with observed daily weather and with a 1 °C increase, the latter to simulate moderate climate change. Strong concordance between simulated and observed monthly dengue cases was observed (up to r = 0·72). There was a linear relationship between importation and incidence. However, a doubling of dengue importation did not equate to a doubling of dengue activity. The largest individual dengue outbreak was observed with the lowest dengue importation rate. Moderate climate change resulted in an overall decrease in dengue activity over a 3-year period, linked to high human seroprevalence early on in the simulation. Our results suggest that moderate reductions in importation with control programmes may not reduce the frequency of large outbreaks. Moderate increases in temperature do not necessarily lead to greater dengue incidence.

  2. An update on the incidence of dengue gaining strength in Saudi Arabia and current control approaches for its vector mosquito

    PubMed Central

    2014-01-01

    Background The cases of dengue reported earlier in the late 1990s from the Kingdom of Saudi Arabia (KSA) occurred in the cities of Jeddah and Makkah. Although the kingdom has ample financial resources to establish effective control measures for the dengue vector, numerous cases of dengue occur and fluctuate in numbers from year to year. This necessitates a serious review of the current vector control strategies being practiced in order to identify the existing shortcomings. This short report provides an update on epidemiology of dengue in KSA (specifically in cities of Jeddah and Makkah) with a critical look at the current vector control strategies. Findings In 2013, 4411 cases of dengue were reported, with 8 cases of mortality. This number of dengue incidence was four times higher compared to 2012. In 2013, the highest number of 1272 dengue cases was reported in May, while the lowest number (37) of cases was reported in September. Conclusions It is evident that the control strategies of the dengue vector presently employed are inadequate. There seems to be serious deficiencies in following proper scientific procedures during field application(s) of control materials against the vector as is evident by the increases in the number of dengue cases as well as frequent outbreaks of the vector mosquito populations. In this review, some specific suggestions are made to draw attention to the relevant KSA authorities of the possible reasons behind unsuccessful control results and as to how to improve the strategy of dengue vector control in the kingdom. PMID:24890567

  3. Phylogenetic reconstruction of dengue virus type 2 in Colombia

    PubMed Central

    2012-01-01

    Background Dengue fever is perhaps the most important viral re-emergent disease especially in tropical and sub-tropical countries, affecting about 50 million people around the world yearly. In Colombia, dengue virus was first detected in 1971 and still remains as a major public health issue. Although four viral serotypes have been recurrently identified, dengue virus type 2 (DENV-2) has been involved in the most important outbreaks during the last 20 years, including 2010 when the fatality rate highly increased. As there are no major studies reviewing virus origin and genotype distribution in this country, the present study attempts to reconstruct the phylogenetic history of DENV-2 using a sequence analysis from a 224 bp PCR-amplified product corresponding to the carboxyl terminus of the envelope (E) gene from 48 Colombian isolates. Results As expected, the oldest isolates belonged to the American genotype (subtype V), but the strains collected since 1990 represent the American/Asian genotype (subtype IIIb) as previously reported in different American countries. Interestingly, the introduction of this genotype coincides with the first report of dengue hemorrhagic fever in Colombia at the end of 1989 and the increase of cases during the next years. Conclusion After replacement of the American genotype, several lineages of American/Asian subtype have rapidly spread all over the country evolving in new clades. Nevertheless, the direct association of these new variants in the raise of lethality rate observed during the last outbreak has to be demonstrated. PMID:22405440

  4. Emergence of traveling waves in the spreading of dengue fever

    NASA Astrophysics Data System (ADS)

    Bianco, Simone; Faatz, Andrea; Cummings, Derek; Shaw, Leah

    2010-03-01

    Dengue fever is a multistrain mosquito-borne subtropical disease that exhibits complex oscillatory outbreaks. Epidemiological data from Thailand displays traveling waves of infection originating in Bangkok, the largest population center (Cummings et al., Nature 427: 344, 2004). We present a multistrain metapopulation model in which traveling wave like behavior results from migration coupling between heterogeneous regions. The region with the highest effective person-to-person contact rate leads the dynamics. A stochastic version of the model will also be presented.

  5. Modelling dengue epidemic spreading with human mobility

    NASA Astrophysics Data System (ADS)

    Barmak, D. H.; Dorso, C. O.; Otero, M.

    2016-04-01

    We explored the effect of human mobility on the spatio-temporal dynamics of Dengue with a stochastic model that takes into account the epidemiological dynamics of the infected mosquitoes and humans, with different mobility patterns of the human population. We observed that human mobility strongly affects the spread of infection by increasing the final size and by changing the morphology of the epidemic outbreaks. When the spreading of the disease is driven only by mosquito dispersal (flight), a main central focus expands diffusively. On the contrary, when human mobility is taken into account, multiple foci appear throughout the evolution of the outbreaks. These secondary foci generated throughout the outbreaks could be of little importance according to their mass or size compared with the largest main focus. However, the coalescence of these foci with the main one generates an effect, through which the latter develops a size greater than the one obtained in the case driven only by mosquito dispersal. This increase in growth rate due to human mobility and the coalescence of the foci are particularly relevant in temperate cities such as the city of Buenos Aires, since they give more possibilities to the outbreak to grow before the arrival of the low-temperature season. The findings of this work indicate that human mobility could be the main driving force in the dynamics of vector epidemics.

  6. Dengue Baidu Search Index data can improve the prediction of local dengue epidemic: A case study in Guangzhou, China

    PubMed Central

    Liu, Tao; Zhu, Guanghu; Lin, Hualiang; Zhang, Yonghui; He, Jianfeng; Deng, Aiping; Peng, Zhiqiang; Xiao, Jianpeng; Rutherford, Shannon; Xie, Runsheng; Zeng, Weilin; Li, Xing; Ma, Wenjun

    2017-01-01

    Background Dengue fever (DF) in Guangzhou, Guangdong province in China is an important public health issue. The problem was highlighted in 2014 by a large, unprecedented outbreak. In order to respond in a more timely manner and hence better control such potential outbreaks in the future, this study develops an early warning model that integrates internet-based query data into traditional surveillance data. Methodology and principal findings A Dengue Baidu Search Index (DBSI) was collected from the Baidu website for developing a predictive model of dengue fever in combination with meteorological and demographic factors. Generalized additive models (GAM) with or without DBSI were established. The generalized cross validation (GCV) score and deviance explained indexes, intraclass correlation coefficient (ICC) and root mean squared error (RMSE), were respectively applied to measure the fitness and the prediction capability of the models. Our results show that the DBSI with one-week lag has a positive linear relationship with the local DF occurrence, and the model with DBSI (ICC:0.94 and RMSE:59.86) has a better prediction capability than the model without DBSI (ICC:0.72 and RMSE:203.29). Conclusions Our study suggests that a DSBI combined with traditional disease surveillance and meteorological data can improve the dengue early warning system in Guangzhou. PMID:28263988

  7. Environmental risk factors and hotspot analysis of dengue distribution in Pakistan

    NASA Astrophysics Data System (ADS)

    Khalid, Bushra; Ghaffar, Abdul

    2015-11-01

    This study is an attempt to find out the factors responsible for sudden dengue outbreak in different cities of Pakistan during 2011. For this purpose, spatio-temporal distribution of dengue in Islamabad, Rawalpindi, Lahore, and Karachi has been taken into account. According to the available data, the factors responsible for this spread includes climate covariates like rainfall, temperature, and wind speed; social covariates like population, and area of locality, and environmental risk factors like drainage pattern and geo-hydrological conditions. Reported dengue cases from localities and Shuttle Radar Topography Mission (SRTM) 90 m digital elevation model (DEM) of study areas have been processed for hotspots, regression model and stream density in the localities of high dengue incidence. The relationship of daily dengue incidence with climate covariates during the months of July-October of the study year is analyzed. Results show that each dry spell of 2-4 days provides suitable conditions for the development and survival of dengue vectors during the wet months of July and August in the areas of high stream density and population. Very few cases have been reported in July while higher number of cases reported in the months of August, September, until late October. Hotspot analysis highlights the areas of high dengue incidence while regression analysis shows the relationship between the population and the areas of localities with the dengue incidence.

  8. Assessment of optimal strategies in a two-patch dengue transmission model with seasonality

    PubMed Central

    Lee, Chang Hyeong; Lee, Sunmi

    2017-01-01

    Emerging and re-emerging dengue fever has posed serious problems to public health officials in many tropical and subtropical countries. Continuous traveling in seasonally varying areas makes it more difficult to control the spread of dengue fever. In this work, we consider a two-patch dengue model that can capture the movement of host individuals between and within patches using a residence-time matrix. A previous two-patch dengue model without seasonality is extended by adding host demographics and seasonal forcing in the transmission rates. We investigate the effects of human movement and seasonality on the two-patch dengue transmission dynamics. Motivated by the recent Peruvian dengue data in jungle/rural areas and coast/urban areas, our model mimics the seasonal patterns of dengue outbreaks in two patches. The roles of seasonality and residence-time configurations are highlighted in terms of the seasonal reproduction number and cumulative incidence. Moreover, optimal control theory is employed to identify and evaluate patch-specific control measures aimed at reducing dengue prevalence in the presence of seasonality. Our findings demonstrate that optimal patch-specific control strategies are sensitive to seasonality and residence-time scenarios. Targeting only the jungle (or endemic) is as effective as controlling both patches under weak coupling or symmetric mobility. However, focusing on intervention for the city (or high density areas) turns out to be optimal when two patches are strongly coupled with asymmetric mobility. PMID:28301523

  9. Temporal Correlations Between Mosquito-Based Dengue Virus Surveillance Measures or Indoor Mosquito Abundance and Dengue Case Numbers in Mérida City, México

    PubMed Central

    EISEN, LARS; GARCÍA-REJÓN, JULIÁN E.; GÓMEZ-CARRO, SALVADOR; VÁSQUEZ, MARÍA DEL ROSARIO NÁJERA; KEEFE, THOMAS J.; BEATY, BARRY J.; LOROÑO-PINO, MARÍA ALBA

    2014-01-01

    Surveillance of dengue virus (DENV) in Aedes (Stegomyia) aegypti (L.) females is of potential interest because human DENV infections are commonly asymptomatic, which decreases the effectiveness of dengue case surveillance to provide early warning of building outbreaks. Our primary aim was to examine if mosquito-based virological measures – monthly percentages of examined Ae. aegypti females infected with DENV or examined homes from which ≥1 DENV-infected Ae. aegypti female was collected – are correlated with reported dengue cases in the same or subsequent months within study neighborhoods in Mérida City, México. The study encompassed ~30 neighborhoods in the southern and eastern parts of the city. Mosquitoes were collected monthly over a 15-month period within study homes (average of 145 homes examined per month); this produced ~5,800 Ae. aegypti females subsequently examined for DENV RNA. Although monthly dengue case numbers in the study neighborhoods varied more than 100-fold during the study period, we did not find statistically significant positive correlations between monthly data for mosquito-based DENV surveillance measures and reported dengue cases in the same or subsequent months. Monthly average temperature, rainfall, and indoor abundance of Ae. aegypti females were positively correlated (P ≤ 0.001) with dengue case numbers in subsequent months with lag times of 3–5, 2, and 1–2 months, respectively. However, because dengue outbreak risk is strongly influenced by serotype-specific susceptibility of the human population to DENV, the value of weather conditions and entomological indices to predict outbreaks is very limited. Potential ways to improve the sensitivity of mosquito-based DENV surveillance are discussed. PMID:25118425

  10. Monoclonal Antibodies for Dengue Virus prM Glycoprotein Protect Mice against Lethal Dengue Infection

    DTIC Science & Technology

    1989-09-15

    Nile virus and a prelysozomal endosome prM glycoprotein of dengue virus can also be required for viral replication . PrM Mabs 2H2 protective against...tech- bodies can prevent lethal alphavirus encepha- niques to preserve immunogenicity, to deter- litis. Nature 297: 70-72. UI:82173237 mine whether

  11. Outbreak of Nosocomial Listeriosis — Texas, 2010

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background: Invasive listeriosis is a potentially fatal foodborne disease caused by Listeria monocytogenes. In February 2010, a listeriosis cluster was identified in Texas. We investigated to confirm the outbreak, identify the source, and prevent additional infections. Methods: All clinical isol...

  12. Reappearance of chikungunya, formerly called dengue, in the Americas.

    PubMed

    Halstead, Scott B

    2015-04-01

    After an absence of ≈200 years, chikungunya returned to the American tropics in 2013. The virus is maintained in a complex African zoonotic cycle but escapes into an urban cycle at 40- to 50-year intervals, causing global pandemics. In 1823, classical chikungunya, a viral exanthem in humans, occurred on Zanzibar, and in 1827, it arrived in the Caribbean and spread to North and South America. In Zanzibar, the disease was known as kidenga pepo, Swahili for a sudden cramp-like seizure caused by an evil spirit; in Cuba, it was known as dengue, a Spanish homonym of denga. During the eighteenth century, dengue (present-day chikungunya) was distinguished from breakbone fever (present-day dengue), another febrile exanthem. In the twentieth century, experiments resulted in the recovery and naming of present-day dengue viruses. In 1952, chikungunya virus was recovered during an outbreak in Tanzania, but by then, the virus had lost its original name to present-day dengue viruses.

  13. Reappearance of Chikungunya, Formerly Called Dengue, in the Americas

    PubMed Central

    2015-01-01

    After an absence of ≈200 years, chikungunya returned to the American tropics in 2013. The virus is maintained in a complex African zoonotic cycle but escapes into an urban cycle at 40- to 50-year intervals, causing global pandemics. In 1823, classical chikungunya, a viral exanthem in humans, occurred on Zanzibar, and in 1827, it arrived in the Caribbean and spread to North and South America. In Zanzibar, the disease was known as kidenga pepo, Swahili for a sudden cramp-like seizure caused by an evil spirit; in Cuba, it was known as dengue, a Spanish homonym of denga. During the eighteenth century, dengue (present-day chikungunya) was distinguished from breakbone fever (present-day dengue), another febrile exanthem. In the twentieth century, experiments resulted in the recovery and naming of present-day dengue viruses. In 1952, chikungunya virus was recovered during an outbreak in Tanzania, but by then, the virus had lost its original name to present-day dengue viruses. PMID:25816211

  14. Virulence Markers of Dengue Viruses

    DTIC Science & Technology

    1990-02-20

    Soawy Ca saoouj Virulence Markers of Dengue Viruses (U) 12. PCIRSONAL AUTHORS) James L. Hardy, Ph.D. and Srisakul C. Kliks, Ph.D. 13a. TYPE Of REPORT...17. COSATI COOLS I& S UBiJECT TERMS0,G ’-mPJ!’ iwin.. - fl OV nu0a mef) FIELD I GROUP SUS-GROUIP Dengue viruses, dengue hemorrhagic fever, virulence...serotypes of dengue virus vary from mild forms i.e. pyrexia of unknown origin (PUO) and dengue fever (DF) to severe forms i.e. dengue hemorrhagic fever and

  15. Rhombencephalitis associated with Dengue fever.

    PubMed

    Verma, Rajesh; Bharti, Kavita; Mehta, Mannan; Bansod, Amrit

    2016-05-01

    Dengue infection is gradually disseminating throughout the world in alarming proportions. It is a arbovirus infection,transmitted by aedes mosquitoes. It is a multi-systemic disorder associated with varied neurological complications. There is increased trend of development of neurological complications in dengue fever. The neurological complications arising due to dengue infection can be categorized into central and neuromuscular complications. The central nervous system disorders reported with dengue fever are encephalopathy,encephalitis and myelitis.Here we report a case of rhombencephalitis associated with dengue fever. The literature does not mention rhombencephalitis occurring with dengue illness.

  16. Value of routine dengue diagnosis in endemic countries

    PubMed Central

    Ayukekbong, James Ayukepi; Oyero, Olufunmilayo G; Nnukwu, Samuel Ekpesu; Mesumbe, Henry Nzike; Fobisong, Cajetang Nkong

    2017-01-01

    Dengue is one of the most common arthropod-borne viral diseases in humans and it is a leading cause of illness and death in the tropical and subtropical regions of the world. It is thought to account for 400 million cases annually among approximately 3.97 billion people at risk of infection in 128 endemic countries. Despite the global prevalence of the disease, the availability of a vaccine is limited in most countries in the endemic areas. Most endemic countries in South America, South East Asia and Africa serve as attractive touristic sites for people from non-endemic countries who become infected and export the virus to dengue-free regions. Dengue fever typically resembles malaria and in endemic countries most cases of dengue are treated as presumptive malaria. Consequently, routine dengue diagnosis among persons with fever will offer early treatment and reduce the burden of the disease. Also, routine testing among travellers from endemic countries will reduce importation and prevent the geographical expansion of dengue. In this essay, we seek to highlight the usefulness of routine dengue testing in endemic countries. PMID:28239567

  17. Dengue infection in neotropical forest mammals.

    PubMed

    de Thoisy, Benoît; Lacoste, Vincent; Germain, Adeline; Muñoz-Jordán, Jorge; Colón, Candimar; Mauffrey, Jean-François; Delaval, Marguerite; Catzeflis, François; Kazanji, Mirdad; Matheus, Séverine; Dussart, Philippe; Morvan, Jacques; Setién, Alvaro Aguilar; Deparis, Xavier; Lavergne, Anne

    2009-04-01

    In South America, dengue is the arbovirus-transmitted disease with the highest incidence. Unlike other arboviruses, wild mammals have no confirmed role in the cycle of dengue in the neotropics, although serological studies have suggested a possible secondary amplification cycle involving mammals other than nonhuman primates. In French Guiana, where all four serotypes (DENV-1, DENV-2, DENV-3, DENV-4) are present, the disease is endemic with outbreak events. To determine whether wild mammals can be infected by DENV, rodents, marsupials, and bats were captured over several periods, from 2001 to 2007, at two sites. The first location is a secondary forest surrounded by an urban area where dengue is endemic. The second location is a forest edge site where the disease has not yet emerged. A total of 10,000 trap-nights were performed and 616 mammals were captured. RNAs representing the four DENV serotypes were detected at both sites by reverse-transcriptase polymerase chain reaction in the livers and/or sera of 92 mammals belonging to 14 out of 32 species distributed among all the orders investigated: Rodentia (33 positive/146 tested), Marsupialia (40/318), and Chiroptera (19/152). Sequence analyses of a portion of the capsid and premembrane junction revealed that mammal strains of DENV-1, DENV-2, DENV-3, and DENV-4 had only 92.6%, 89%, 95%, and 95.8% identity, respectively, with strains circulating in the human population during the same periods. Regarding DENV-2, strains related (99% identity) to those responsible for an epidemic event in humans in French Guiana concurrent to the capture sessions were also evidenced, suggesting that wild mammals in edge habitats can be infected by circulating human strains. Our results demonstrate, for the first time, that neotropical wild mammals can be infected with dengue virus. The question of whether mammals maintain DENV in enzootic cycles and can play a role in its reemergence in human populations remains to be answered.

  18. Dengue hemorrhagic fever

    MedlinePlus

    ... a severe, potentially deadly infection spread by some mosquitos. Causes Four different dengue viruses are known to ... occurs when a person is bitten by a mosquito that is infected with the virus. The mosquito ...

  19. Dengue shock syndrome

    PubMed Central

    Sudulagunta, Sreenivasa Rao; Sodalagunta, Mahesh Babu; Sepehrar, Mona; Bangalore Raja, Shiva Kumar; Nataraju, Aravinda Settikere; Kumbhat, Mounica; Sathyanarayana, Deepak; Gummadi, Siddharth; Burra, Hemanth Kumar

    2016-01-01

    Dengue fever is a mosquito-borne arthropod-borne viral (arboviral) tropical disease in humans affecting 50–528 million people worldwide. The acute abdominal complications of dengue fever are acute appendicitis, acute pancreatitis, acute acalculous cholecystitis and non-specific peritonitis. Acute pancreatitis with new onset diabetes in dengue shock syndrome (DSS) is very rarely reported. We describe a case of 30-year-old man admitted in intensive care unit and was diagnosed with DSS with RT-PCR, NS1 antigen and dengue IgM antibody being positive. Abdominal ultrasound and computerized tomography confirmed acute pancreatitis. Patient required insulin after recovery. Diabetes mellitus caused by DSS is under-reported and lack of awareness may increase mortality and morbidity. PMID:28031845

  20. [Urbanization and dengue ecology].

    PubMed

    Tauil, P L

    2001-01-01

    Demographic changes occurring in underdeveloped countries due to intense rural-urban migration since the 1960s have resulted in overcrowded cities with multiple deficiencies, particularly in housing and basic sanitation. Some 20% of the population in large and medium-sized cities live in slums or under similar conditions. Lack of regular water supply and public garbage collection foster the proliferation of potential breeding sites for Aedes aegypti (the main mosquito vector for dengue), including precarious reservoirs for potable water and disposable recipients which accumulate water, like used cans and plastic and glass bottles. Modern industries also produce large volumes of disposable materials. Propagation of the dengue virus and the spread of dengue vectors are favored by the high intensity, frequency, and speed of private and public transportation. Such factors can help explain the re-emergence of dengue, the most important arbovirus in the world today, affecting thousands of people each year.

  1. A climate-based spatiotemporal prediction for dengue fever epidemics: a case study in southern Taiwan

    NASA Astrophysics Data System (ADS)

    Yu, H.-L.; Yang, S.-J.; Lin, Y.-C.

    2012-04-01

    Dengue Fever (DF) has been identified by the World Health organization (WHO) as one of the most serious vector-borne infectious diseases in tropical and sub-tropical areas. DF has been one of the most important epidemics in Taiwan which occur annually especially in southern Taiwan during summer and autumn. Most DF studies have focused mainly on temporal DF patterns and its close association with climatic covariates, whereas few studies have investigated the spatial DF patterns (spatial dependence and clustering) and composite space-time effects of the DF epidemics. The present study proposes a spatio-temporal DF prediction approach based on stochastic Bayesian Maximum Entropy (BME) analysis. Core and site-specific knowledge bases are considered, including climate and health datasets under conditions of uncertainty, space-time dependence functions, and a Poisson regression model of climatic variables contributing to DF occurrences in southern Taiwan during 2007, when the highest number of DF cases was recorded in the history of Taiwan epidemics (over 2000). The obtained results show that the DF outbreaks in the study area are highly influenced by climatic conditions. Furthermore, the analysis can provide the required "one-week-ahead" outbreak warnings based on spatio-temporal predictions of DF distributions. Therefore, the proposed analysis can provide the Taiwan Disease Control Agency with a valuable tool to timely identify, control, and even efficiently prevent DF spreading across space-time.

  2. Development of a novel DNA SynCon tetravalent dengue vaccine that elicits immune responses against four serotypes.

    PubMed

    Ramanathan, Mathura P; Kuo, Yuan-Chia; Selling, Bernard H; Li, Qianjun; Sardesai, Niranjan Y; Kim, J Joseph; Weiner, David B

    2009-10-30

    The increased transmission and geographic spread of dengue fever (DF) and its most severe presentations, dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS), make it one of the most important mosquito-borne viral disease of humans. Four distinct serotypes of dengue viruses are transmitted to humans through the bites of the mosquitoes. Currently there is no vaccine or antiviral drug against DV infections. Cross-protection between dengue virus serotypes is limited and antibody dependent enhancement (ADE) contributes significantly to the severity of the disease. The major challenge is to induce a broad durable immune response against all four serotypes of dengue virus simultaneously while avoiding the possible exacerbation of risk of developing the severe forms of disease through incomplete or modified responses. In order to address this worldwide concern, we present a synthetic consensus (SynCon) human codon optimized DNA vaccine that elicits immunity against all four dengue serotypes. We cloned consensus DIII domain of E protein from all serotypes and expressed them as a single open reading frame in a mammalian expression vector, called pDV-U-DIII (dengue-vaccine universal). In mice, this dengue-universal construct elicits significant level of anti-DIII antibody that neutralizes all four dengue subtypes and prevents cell death induced by dengue infection. This is the first SynCon DNA vaccine that provides tetravalent immunity against all four serotypes of dengue virus.

  3. Arterial Hypertension and Skin Allergy Are Risk Factors for Progression from Dengue to Dengue Hemorrhagic Fever: A Case Control Study

    PubMed Central

    Teixeira, Maria Glória; Paixão, Enny S.; Costa, Maria da Conceição N.; Cunha, Rivaldo V.; Pamplona, Luciano; Dias, Juarez P.; Figueiredo, Camila A.; Figueiredo, Maria Aparecida A.; Blanton, Ronald; Morato, Vanessa; Barreto, Maurício L.; Rodrigues, Laura C.

    2015-01-01

    Background Currently, knowledge does not allow early prediction of which cases of dengue fever (DF) will progress to dengue hemorrhagic fever (DHF), to allow early intervention to prevent progression or to limit severity. The objective of this study is to investigate the hypothesis that some specific comorbidities increase the likelihood of a DF case progressing to DHF. Methods A concurrent case-control study, conducted during dengue epidemics, from 2009 to 2012. Cases were patients with dengue fever that progressed to DHF, and controls were patients of dengue fever who did not progress to DHF. Logistic regression was used to estimate the association between DHF and comorbidities. Results There were 490 cases of DHF and 1,316 controls. Among adults, progression to DHF was associated with self-reported hypertension (OR = 1.6; 95% CI 1.1-2.1) and skin allergy (OR = 1.8; 95% CI 1.1-3.2) with DHF after adjusting for ethnicity and socio-economic variables. There was no statistically significant association between any chronic disease and progression to DHF in those younger than 15 years. Conclusions Physicians attending patients with dengue fever should keep those with hypertension or skin allergies in health units to monitor progression for early intervention. This would reduce mortality by dengue. PMID:25996882

  4. Scabies: Prevention and Control

    MedlinePlus

    ... Diagnostic Assistance [DPDx] Error processing SSI file Prevention & Control Recommend on Facebook Tweet Share Compartir When a ... avoid outbreaks. Institutional outbreaks can be difficult to control and require a rapid, aggressive, and sustained response. ...

  5. Safety Testing of Dengue-1 and Dengue-3 Seeds for Human Challenges, Unattenuated. Dengue Virus Type 4

    DTIC Science & Technology

    1988-07-01

    o AD SAFETY TESTING OF DENGUE -1 AND DENGUE -3 SEEDS FOR HUMAN CHALLENGES, UNATTENUATED; DENGUE VIRUS TYPE 4 PHASE REPORT LOUIS POTASHELECTE - OCT 0...Classification) (U) Safety Testing of Dengue -] and Dengue -3 Seeds for Human Challenges, Unattenuated 12. PERSONAL AUTHOR(S) Potash, Louis 13a. TYPE OF REPORT...SUBJECT TERMS (Continue on reverse of necesary and identify by block number) FIELD GROUP SUB-GROUP,, \\" 06 13 Dengue -1; Dengue -3;’ epatitis A Viral

  6. Dengue vaccines for travelers.

    PubMed

    Wilder-Smith, Annelies; Deen, Jacqueline L

    2008-07-01

    Dengue is an arthropod-borne infection caused by a flavivirus and spread by the Aedes mosquitoes. Many of the countries where dengue is endemic are popular tourist destinations and the disease is an increasingly important problem encountered by international travelers. Personal protection against the day-feeding dengue vectors is problematic, indicating the urgent need for a dengue vaccine. This review discusses the challenges of vaccine development, current vaccine strategies and the prospects for the availability of a vaccine for travelers in the future. Cost-effectiveness studies will need to take into account many factors, including the attack rate of dengue in travelers, the proportion of travelers who will need hospitalization, the cost of altered travel itineraries, the cost of the vaccine, duration of travel, destination and season. To be licensed as a travelers' vaccine, vaccine trials must address safety, immunogenicity, duration of protection, schedules and boosters in adults (in particular in immunologically naive adults), trials that may differ from those conducted in endemic countries. Vaccine schedules with long intervals would be a major obstacle to the uptake of the vaccine by travelers. Enhanced reactogenicity or interference with immunization must be effectively excluded for travelers with prior or concurrent vaccination against other flaviviruses, such as yellow fever or Japanese encephalitis. Licensing dengue as a travelers' vaccine poses unique challenges beyond the development of a vaccine for the endemic population.

  7. Stochastic epidemic outbreaks: why epidemics are like lasers

    NASA Astrophysics Data System (ADS)

    Schwartz, Ira B.; Billings, Lora

    2004-05-01

    Many diseases, such as childhood diseases, dengue fever, and West Nile virus, appear to oscillate randomly as a function of seasonal environmental or social changes. Such oscillations appear to have a chaotic bursting character, although it is still uncertain how much is due to random fluctuations. Such bursting in the presence of noise is also observed in driven lasers. In this talk, I will show how noise can excite random outbreaks in simple models of seasonally driven outbreaks, as well as lasers. The models for both population dynamics will be shown to share the same class of underlying topology, which plays a major role in the cause of observed stochastic bursting.

  8. The citrus flavanone naringenin impairs dengue virus replication in human cells

    PubMed Central

    Frabasile, Sandra; Koishi, Andrea Cristine; Kuczera, Diogo; Silveira, Guilherme Ferreira; Verri, Waldiceu Aparecido; Duarte dos Santos, Claudia Nunes; Bordignon, Juliano

    2017-01-01

    Dengue is one of the most significant health problems in tropical and sub-tropical regions throughout the world. Nearly 390 million cases are reported each year. Although a vaccine was recently approved in certain countries, an anti-dengue virus drug is still needed. Fruits and vegetables may be sources of compounds with medicinal properties, such as flavonoids. This study demonstrates the anti-dengue virus activity of the citrus flavanone naringenin, a class of flavonoid. Naringenin prevented infection with four dengue virus serotypes in Huh7.5 cells. Additionally, experiments employing subgenomic RepDV-1 and RepDV-3 replicon systems confirmed the ability of naringenin to inhibit dengue virus replication. Antiviral activity was observed even when naringenin was used to treat Huh7.5 cells 24 h after dengue virus exposure. Finally, naringenin anti-dengue virus activity was demonstrated in primary human monocytes infected with dengue virus sertoype-4, supporting the potential use of naringenin to control dengue virus replication. In conclusion, naringenin is a suitable candidate molecule for the development of specific dengue virus treatments. PMID:28157234

  9. The citrus flavanone naringenin impairs dengue virus replication in human cells.

    PubMed

    Frabasile, Sandra; Koishi, Andrea Cristine; Kuczera, Diogo; Silveira, Guilherme Ferreira; Verri, Waldiceu Aparecido; Duarte Dos Santos, Claudia Nunes; Bordignon, Juliano

    2017-02-03

    Dengue is one of the most significant health problems in tropical and sub-tropical regions throughout the world. Nearly 390 million cases are reported each year. Although a vaccine was recently approved in certain countries, an anti-dengue virus drug is still needed. Fruits and vegetables may be sources of compounds with medicinal properties, such as flavonoids. This study demonstrates the anti-dengue virus activity of the citrus flavanone naringenin, a class of flavonoid. Naringenin prevented infection with four dengue virus serotypes in Huh7.5 cells. Additionally, experiments employing subgenomic RepDV-1 and RepDV-3 replicon systems confirmed the ability of naringenin to inhibit dengue virus replication. Antiviral activity was observed even when naringenin was used to treat Huh7.5 cells 24 h after dengue virus exposure. Finally, naringenin anti-dengue virus activity was demonstrated in primary human monocytes infected with dengue virus sertoype-4, supporting the potential use of naringenin to control dengue virus replication. In conclusion, naringenin is a suitable candidate molecule for the development of specific dengue virus treatments.

  10. A Large Scale Biorational Approach Using Bacillus thuringiensis israeliensis (Strain AM65-52) for Managing Aedes aegypti Populations to Prevent Dengue, Chikungunya and Zika Transmission

    PubMed Central

    Pruszynski, Catherine A.; Hribar, Lawrence J.; Mickle, Robert; Leal, Andrea L.

    2017-01-01

    Background Aedes aegypti is a container-inhabiting mosquito and a vector of dengue, chikungunya, and Zika viruses. In 2009 several cases of autochthonous dengue transmission were reported in Key West, Florida, USA prompting a comprehensive response to control A. aegypti. In Key West, larvae of this mosquito develop in containers around human habitations which can be numerous and labor intensive to find and treat. Aerial applications of larvicide covering large areas in a short time can be an efficient and economical method to control A. aegypti. Bacillus thuringiensis israelensis (Bti) is a bacterial larvicide which is highly target specific and appropriate for wide area spraying over urban areas, but to date, there are no studies that evaluate aerial spraying of Bti to control container mosquitoes like A. aegypti. Methodology This paper examines the effectiveness of aerial larvicide applications using VectoBac® WG, a commercially available Bti formulation, for A. aegypti control in an urban setting in the USA. Droplet characteristics and spray drop deposition were evaluated in Key West, Florida, USA. The mortality of A. aegypti in containers placed under canopy in an urban environment was also evaluated. Efficacy of multiple larvicide applications on adult female A. aegypti population reduction was compared between an untreated control and treatment site. Conclusions Droplet characteristics showed that small droplets can penetrate through dense canopy to reach small containers. VectoBac WG droplets reached small containers under heavy canopy in sufficient amounts to cause > 55% mortality on all application days and >90% mortality on 3 of 5 application days while controls had <5% mortality. Aerial applications of VectoBac WG caused significant decrease in adult female populations throughout the summer and during the 38th week (last application) the difference in adult female numbers between untreated and treated sites was >50%. Aerial larvicide applications using

  11. Detection of dengue virus in platelets isolated from dengue patients.

    PubMed

    Noisakran, Sansanee; Gibbons, Robert V; Songprakhon, Pucharee; Jairungsri, Aroonroong; Ajariyakhajorn, Chuanpis; Nisalak, Ananda; Jarman, Richard G; Malasit, Prida; Chokephaibulkit, Kulkanya; Perng, Guey Chuen

    2009-03-01

    Though thrombocytopenia or dysfunction of platelets is common in dengue virus infection, the role of platelets has not been established. We enrolled 33 hospitalized children with serologically confirmed dengue virus infection. Blood specimens were collected during hospitalization. Platelets and plasma were isolated from the whole blood. Detection of dengue virus in plasma and platelets was carried out by RT-PCR with primers that can differentiate different dengue serotypes simultaneously, and by electron transmission microscopy (EM). Dengue viral RNA was detected in the platelets and plasma by conventional RT-PCR. A significantly higher percentage of dengue viral RNA was detected in platelets than in plasma (p = 0.03). Platelets isolated 5 days after onset of fever were most likely positive for viral RNA. Concurrent infection or co-circulation with multiple dengue serotypes was observed in 12% of patients. Infrequently, negative-stranded dengue viral RNA was detected in platelets and in plasma. Importantly, EM confirmed the presence of dengue viral-like particles inside platelets prepared from dengue patients. Our findings suggest the presence of dengue virus in platelets may be associated with the dysfunction of platelets observed in dengue patients.

  12. Prediction of High Incidence of Dengue in the Philippines

    PubMed Central

    Buczak, Anna L.; Baugher, Benjamin; Babin, Steven M.; Ramac-Thomas, Liane C.; Guven, Erhan; Elbert, Yevgeniy; Koshute, Phillip T.; Velasco, John Mark S.; Roque, Vito G.; Tayag, Enrique A.; Yoon, In-Kyu; Lewis, Sheri H.

    2014-01-01

    Background Accurate prediction of dengue incidence levels weeks in advance of an outbreak may reduce the morbidity and mortality associated with this neglected disease. Therefore, models were developed to predict high and low dengue incidence in order to provide timely forewarnings in the Philippines. Methods Model inputs were chosen based on studies indicating variables that may impact dengue incidence. The method first uses Fuzzy Association Rule Mining techniques to extract association rules from these historical epidemiological, environmental, and socio-economic data, as well as climate data indicating future weather patterns. Selection criteria were used to choose a subset of these rules for a classifier, thereby generating a Prediction Model. The models predicted high or low incidence of dengue in a Philippines province four weeks in advance. The threshold between high and low was determined relative to historical incidence data. Principal Findings Model accuracy is described by Positive Predictive Value (PPV), Negative Predictive Value (NPV), Sensitivity, and Specificity computed on test data not previously used to develop the model. Selecting a model using the F0.5 measure, which gives PPV more importance than Sensitivity, gave these results: PPV = 0.780, NPV = 0.938, Sensitivity = 0.547, Specificity = 0.978. Using the F3 measure, which gives Sensitivity more importance than PPV, the selected model had PPV = 0.778, NPV = 0.948, Sensitivity = 0.627, Specificity = 0.974. The decision as to which model has greater utility depends on how the predictions will be used in a particular situation. Conclusions This method builds prediction models for future dengue incidence in the Philippines and is capable of being modified for use in different situations; for diseases other than dengue; and for regions beyond the Philippines. The Philippines dengue prediction models predicted high or low incidence of dengue four weeks in advance of

  13. WHO Dengue Case Classification 2009 and its usefulness in practice: an expert consensus in the Americas

    PubMed Central

    Horstick, Olaf; Martinez, Eric; Guzman, Maria Guadalupe; Martin, Jose Luis San; Ranzinger, Silvia Runge

    2015-01-01

    Introduction: In 2009, the new World Health Organization (WHO) dengue case classification – dengue/severe dengue (D/SD) – was introduced, replacing the 1997 WHO dengue case classification: dengue fever/dengue haemorrhagic fever/dengue shock syndrome (DF/DHF/DSS). Methods: A 2-day expert consensus meeting in La Habana/Cuba aimed to (1) share the experiences from Pan American Health Organization (PAHO) member states when applying D/SD, (2) present national and local data using D/SD, and (3) agree with the presented evidence on a list of recommendations for or against the use of D/SD for PAHO, and also globally. Results: Eight key questions were discussed, concluding: (1) D/SD is useful describing disease progression because it considers the dynamic nature of the disease, (2) D/SD helps defining dengue cases correctly for clinical studies, because it defines more precisely disease severity and allows evaluating dynamically the progression of cases, (3) D/SD describes correctly all clinical forms of severe dengue. Further standards need to be developed regionally, especially related to severe organ involvement, (4) D/SD allows for pathophysiological research identifying – in a sequential manner – the clinical manifestations of dengue related to pathophysiological events, (5) the warning signs help identifying early cases at risk of shock (children and adults), pathophysiology of the warning signs deserves further studies, (6) D/SD helps treating individual dengue cases and also the reorganization of health-care services for outbreak management, (7) D/SD helps diagnosing dengue, in presumptive diagnosis and follow-up of the disease, because of its high sensitivity and high negative predictive value (NPV), and (8) there is currently no update of the International Disease Classification10 (ICD10) to include the new classification of dengue (D/SD); therefore, there are not enough experiences of epidemiological reporting. Once D/SD has been implemented in

  14. Seasonal Distribution and Climatic Correlates of Dengue Disease in Dhaka, Bangladesh.

    PubMed

    Morales, Ivonne; Salje, Henrik; Saha, Samir; Gurley, Emily S

    2016-06-01

    Dengue has been regularly reported in Dhaka, Bangladesh, since a large outbreak in 2000. However, to date, we have limited information on the seasonal distribution of dengue disease and how case distribution correlates with climate. Here, we analyzed dengue cases detected at a private diagnostic facility in Dhaka during 2010-2014. We calculated Pearson cross-correlation coefficients to examine the relationship between the timing of cases and both rainfall and temperature. There were 2,334 cases diagnosed during the study period with 76% over the age of 15 years. Cases were reported in every month of the study; however, 90% of cases occurred between June and November. Increases in rainfall were correlated with increases in cases 2 months later (correlation of 0.7). The large proportion of adult cases is consistent with substantial population susceptibility and suggests Dhaka remains at risk for outbreaks. Although cases occurred year-round, public health preparedness should be focused during peak months.

  15. Health Economics of Dengue: A Systematic Literature Review and Expert Panel's Assessment

    PubMed Central

    Beatty, Mark E.; Beutels, Philippe; Meltzer, Martin I.; Shepard, Donald S.; Hombach, Joachim; Hutubessy, Raymond; Dessis, Damien; Coudeville, Laurent; Dervaux, Benoit; Wichmann, Ole; Margolis, Harold S.; Kuritsky, Joel N.

    2011-01-01

    Dengue vaccines are currently in development and policymakers need appropriate economic studies to determine their potential financial and public health impact. We searched five databases (PubMed, EMBASE, LILAC, EconLit, and WHOLIS) to identify health economics studies of dengue. Forty-three manuscripts were identified that provided primary data: 32 report economic burden of dengue and nine are comparative economic analyses assessing various interventions. The remaining two were a willingness-to-pay study and a policymaker survey. An expert panel reviewed the existing dengue economic literature and recommended future research to fill information gaps. Although dengue is an important vector-borne disease, the economic literature is relatively sparse and results have often been conflicting because of use of inconsistent assumptions. Health economic research specific to dengue is urgently needed to ensure informed decision making on the various options for controlling and preventing this disease. PMID:21363989

  16. Dengue vaccine: an update on recombinant subunit strategies.

    PubMed

    Martin, J; Hermida, L

    2016-03-01

    Dengue is an increasing public health problem worldwide, with the four serotypes of the virus infecting over 390 million people annually. There is no specific treatment or antiviral drug for dengue, and prevention is largely limited to controlling the mosquito vectors or disrupting the human-vector contact. Despite the considerable progress made in recent years, an effective vaccine against the virus is not yet available. The development of a dengue vaccine has been hampered by many unique challenges, including the need to ensure the absence of vaccine-induced enhanced severity of disease. Recombinant protein subunit vaccines offer a safer alternative to other vaccine approaches. Several subunit vaccine candidates are presently under development, based on different structural and non-structural proteins of the virus. Novel adjuvants or immunopotentiating strategies are also being tested to improve their immunogenicity. This review summarizes the current status and development trends of subunit dengue vaccines.

  17. Observations on Hospitalized Dengue Patients

    DTIC Science & Technology

    1987-01-01

    DENGUE PATIENTS IN MANILA Carman. R. Min oto* be" S. Siqpo Ommon D. Leus** Curds G. Ibyes* INTRODUCION to the Hospital of Infant Jesus between October...31, 1983 and March 31, 1984: Criteria for the diagnosis of dengue Dengue hemorrhagic fever (DHF) has been recognized infection were based on the...titer of later sample < 1:640. DHF epidemic.4𔃿 Since that time, there have only been a few- was differentiated from dengue fever (DF), and DHF was

  18. Use of Insecticide-Treated House Screens to Reduce Infestations of Dengue Virus Vectors, Mexico

    PubMed Central

    Manrique-Saide, Pablo; Che-Mendoza, Azael; Barrera-Perez, Mario; Guillermo-May, Guillermo; Herrera-Bojorquez, Josue; Dzul-Manzanilla, Felipe; Gutierrez-Castro, Cipriano; Lenhart, Audrey; Vazquez-Prokopec, Gonzalo; Sommerfeld, Johannes; McCall, Philip J.; Kroeger, Axel

    2015-01-01

    Dengue prevention efforts rely on control of virus vectors. We investigated use of insecticide-treated screens permanently affixed to windows and doors in Mexico and found that the screens significantly reduced infestations of Aedes aegypti mosquitoes in treated houses. Our findings demonstrate the value of this method for dengue virus vector control. PMID:25625483

  19. Dengue vaccine: come let's fight the menace.

    PubMed

    Chawla, Sumit; Sahoo, Soumya Swaroop; Singh, Inderjeet; Verma, Madhur; Gupta, Vikas; Kumari, Sneh

    2015-01-01

    Although dengue has a global distribution, the World Health Organization (WHO) South-East Asia region together with Western Pacific region bears nearly 75% of the current global disease burden. Globally, the societal burden has been estimated to be approximately 528 to 1300 disability-adjusted life years (DALY) per million to populations in endemic regions Dengue is believed to infect 50 to 100 million people worldwide a year with half a million life-threatening infections requiring hospitalization, resulting in approximately 12,500 to 25,000 deaths. Despite being known for decades and nearly half the world's population is at risk for infection with as many as 100 million cases occurring annually, the pitiable state is that we still have no antiviral drugs to treat it and no vaccines to prevent it. In recent years, however, the development of dengue vaccines has accelerated dramatically in tandem with the burgeoning dengue problem with a rejuvenated vigour. However, recent progress in molecular-based vaccine strategies, as well as a renewed commitment by the World Health Organization (WHO) to co-ordinate global efforts on vaccine development, finally provides hope that control of this serious disease may be at hand. Today, several vaccines are in various stages of advanced development, with clinical trials currently underway on 5 candidate vaccines. Trials in the most advanced stages are showing encouraging preliminary data, and the leading candidate could be licensed as early as 2015.

  20. Community Willingness to Participate in a Dengue Study in Aceh Province, Indonesia

    PubMed Central

    Anwar, Samsul; Bustaman, Aslam; Radiansyah, Arsil; Angraini, Pradiba; Fasli, Riny; Salwiyadi, Salwiyadi; Bastian, Reza Akbar; Oktiviyari, Ade; Akmal, Imaduddin; Iqbalamin, Muhammad; Adil, Jamalul; Henrizal, Fenni; Darmayanti, Darmayanti; Pratama, Rovy; Fajar, Jonny Karunia; Setiawan, Abdul Malik; Imrie, Allison; Kuch, Ulrich; Groneberg, David Alexander; Sasmono, R. Tedjo; Dhimal, Meghnath; Müller, Ruth

    2016-01-01

    Background Dengue virus infection is the most rapidly spreading vector-borne disease in the world. Essential research on dengue virus transmission and its prevention requires community participation. Therefore, it is crucial to understand the factors that are associated with the willingness of communities in high prevalence areas to participate in dengue research. The aim of this study was to explore factors associated with the willingness of healthy community members in Aceh province, Indonesia, to participate in dengue research that would require phlebotomy. Methodology/Principal Findings A community-based cross-sectional study was carried out in nine regencies and municipalities of Aceh from November 2014 to March 2015. Interviews using a set of validated questionnaires were conducted to collect data on demography, history of dengue infection, socioeconomic status, and knowledge, attitude and practice regarding dengue fever. Two-step logistic regression and Spearman’s rank correlation (rs) analysis were used to assess the influence of independent variables on dependent variables. Among 535 participants, less than 20% had a good willingness to participate in the dengue study. The factors associated with good willingness to participate were being female, working as a civil servant, private employee or entrepreneur, having a high socioeconomic status and good knowledge, attitude and practice regarding dengue. Good knowledge and attitude regarding dengue were positive independent predictors of willingness to participate (OR: 2.30 [95% CI: 1.36–3.90] and 3.73 [95% CI: 2.24–6.21], respectively). Conclusion/Significance The willingness to participate in dengue research is very low among community members in Aceh, and the two most important associated factors are knowledge and attitude regarding dengue. To increase participation rate, efforts to improve the knowledge and attitude of community members regarding dengue fever and dengue-related research is required

  1. The maximum potential market for dengue drugs V 1.0.

    PubMed

    Dow, Geoffrey; Mora, Eric

    2012-11-01

    Drugs offer a complementary approach to vaccines for preventing the progression of symptoms and onset of the severe manifestations of dengue. Despite the rapid maturation of the research and development infrastructure for dengue drugs and the increasing frequency of dengue inhibitors reported in the scientific literature, the potential size of the market for dengue drugs has not been articulated. In the present work, extrapolating from publicly available information, we explored the economi