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Sample records for prevent dengue outbreaks

  1. Dengue disease outbreak detection.

    PubMed

    Dayama, Pankaj; Sampath, Kameshwaran

    2014-01-01

    Early detection of outbreak of a disease may help in timely and effective public health interventions. Our motivation for this work is to assist EHD planning officer to analyze the incidence data and based on it declare whether there is an outbreak or not. In this paper, we develop ensemble of multiple techniques for detecting dengue disease outbreak. These techniques are applied to dengue incidence data from Singapore and results are summarized.

  2. Mediational Effects of Self-Efficacy Dimensions in the Relationship between Knowledge of Dengue and Dengue Preventive Behaviour with Respect to Control of Dengue Outbreaks: A Structural Equation Model of a Cross-Sectional Survey

    PubMed Central

    Isa, Affendi; Loke, Yoon K.; Smith, Jane R.; Papageorgiou, Alexia; Hunter, Paul R.

    2013-01-01

    Background Dengue fever is endemic in Malaysia, with frequent major outbreaks in urban areas. The major control strategy relies on health promotional campaigns aimed at encouraging people to reduce mosquito breeding sites close to people's homes. However, such campaigns have not always been 100% effective. The concept of self-efficacy is an area of increasing research interest in understanding how health promotion can be most effective. This paper reports on a study of the impact of self-efficacy on dengue knowledge and dengue preventive behaviour. Methods and Findings We recruited 280 adults from 27 post-outbreak villages in the state of Terengganu, east coast of Malaysia. Measures of health promotion and educational intervention activities and types of communication during outbreak, level of dengue knowledge, level and strength of self-efficacy and dengue preventive behaviour were obtained via face-to-face interviews and questionnaires. A structural equation model was tested and fitted the data well (χ2 = 71.659, df = 40, p = 0.002, RMSEA = 0.053, CFI = 0.973, TLI = 0.963). Mass media, local contact and direct information-giving sessions significantly predicted level of knowledge of dengue. Level and strength of self-efficacy fully mediated the relationship between knowledge of dengue and dengue preventive behaviours. Strength of self-efficacy acted as partial mediator in the relationship between knowledge of dengue and dengue preventive behaviours. Conclusions To control and prevent dengue outbreaks by behavioural measures, health promotion and educational interventions during outbreaks should now focus on those approaches that are most likely to increase the level and strength of self-efficacy. PMID:24086777

  3. Impact of a Dengue Outbreak Experience in the Preventive Perceptions of the Community from a Temperate Region: Madeira Island, Portugal

    PubMed Central

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

    2015-01-01

    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 Island. 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

  4. 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

  5. Leptospirosis during dengue outbreak, Bangladesh.

    PubMed

    LaRocque, Regina C; Breiman, Robert F; Ari, Mary D; Morey, Roger E; Janan, Firdous Ara; Hayes, John Mosely; Hossain, M Anowar; Brooks, W Abdullah; Levett, Paul N

    2005-05-01

    We collected acute-phase serum samples from febrile patients at 2 major hospitals in Dhaka, Bangladesh, during an outbreak of dengue fever in 2001. A total of 18% of dengue-negative patients tested positive for leptospirosis. The case-fatality rate among leptospirosis patients (5%) was higher than among dengue fever patients (1.2%).

  6. First outbreak of dengue hemorrhagic fever, Bangladesh.

    PubMed

    Rahman, Mahbubur; Rahman, Khalilur; Siddque, A K; Shoma, Shereen; Kamal, A H M; Ali, K S; Nisaluk, Ananda; Breiman, Robert F

    2002-07-01

    During the first countrywide outbreak of dengue hemorrhagic fever in Bangladesh, we conducted surveillance for dengue at a hospital in Dhaka. Of 176 patients, primarily adults, found positive for dengue, 60.2% had dengue fever, 39.2% dengue hemorrhagic fever, and 0.6% dengue shock syndrome. The Dengue virus 3 serotype was detected in eight patients.

  7. The 2006 dengue outbreak in Delhi, India.

    PubMed

    Sinha, N; Gupta, N; Jhamb, R; Gulati, S; Kulkarni Ajit, V

    2008-12-01

    Dengue is a worldwide condition spread throughout the tropical and subtropical zones between 30 degrees north and 40 degrees south. It is endemic in South East Asia, the pacific, East and West Africa, the Caribbean and the Americas. Dengue outbreaks are occurring almost every three yearly in Delhi for the last 12 years. The latest outbreak was in the year 2006, which started late in August, peaked in the month of October and lasted till late November. We describe here the clinical, hematological and biochemical data of 70 patients of dengue fever diagnosed as per WHO criteria in Lok Nayak Hospital, New Delhi during this outbreak. Hematological parameters were estimated by automated counter and dengue serology was done by capture ELISA technique. The results displayed widespread effect of dengue fever on hematological and biochemical profile. Some of our patients also had atypical dengue manifestations. These results suggest that dengue fever is a major public health problem which can lead to significant morbidity and can even be fatal at times. All efforts should be made to prevent it.

  8. 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

  9. 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

  10. Dissecting Japan's Dengue Outbreak in 2014.

    PubMed

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

    2016-02-01

    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.

  11. 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.

  12. An outbreak of dengue fever in Yap State.

    PubMed

    Durand, Mark A; Bel, Martin; Ruwey, Ignathia; Marfel, Maria; Yug, Laurence; Ngaden, Victor

    2005-09-01

    Between May and December 2004,Yap State experienced an outbreak of Dengue Fever, type 1 with a final total of 658 recorded clinically compatible cases, including 42 hospitalisations and 12 cases of dengue haemorrhagic fever/shock syndrome. There were no fatalities. Lessons learned from this outbreak include: the importance maintaining a high index of suspicion and on-site diagnostic capability for dengue fever, the importance of prompt in-service training for health care workers, the danger posed to neighbors by local lapses in outbreak prone disease surveillance and the utility of the Pacific Public Health Surveillance Network in responding to such diseases, the importance of active disease surveillance in outer island populations, and the importance of instituting preventive measures against the nosocomial spread of dengue fever.

  13. Dengue Prevention

    MedlinePlus

    ... Compartir This photograph shows a mother applying mosquito repellent to her child's skin in order to prevent ... the lights are on. To protect yourself, use repellent on your skin while indoors or out. When ...

  14. Severe dengue outbreak in Yunnan, China, 2013.

    PubMed

    Zhang, Fu-Chun; Zhao, Hui; Li, Li-Hua; Jiang, Tao; Hong, Wen-Xin; Wang, Jian; Zhao, Ling-Zhai; Yang, Hui-Qin; Ma, De-Hong; Bai, Chun-Hai; Shan, Xi-Yun; Deng, Yong-Qiang; Qin, Cheng-Feng

    2014-10-01

    In recent decades, the impact of dengue has increased both geographically and in intensity, and this disease is now a threat to approximately half of the world's population. An unexpected large outbreak of dengue fever was reported in Xishuangbanna Dai Autonomous Prefecture, Yunnan Province, China, in 2013. This was the first autochthonous outbreak with a significant proportion of severe dengue cases in mainland China in a decade. According to the 2009 World Health Organization guidelines, half of the 136 laboratory confirmed cases during the epidemic were severe dengue. The clinical presentation included severe haemorrhage (such as massive vaginal and gastrointestinal bleeding), severe plasma leakage (such as pleural effusion, ascites, or hypoproteinaemia), and organ involvement (such as myocarditis and lung impairment); 21 cases eventually deteriorated to shock. During this outbreak, all severe cases occurred in adults, among whom about 43% had co-morbid conditions. Nucleic acid detection and virus isolation confirmed dengue virus serotype 3 (DENV-3) to be the pathogenic agent of this outbreak. Phylogenetic analyses of envelope gene sequences showed that these DENV-3 isolates belonged to genotype II. This finding is of great importance to understand the circulation of DENV and predict the risk of severe disease in mainland China. Here, we provide a brief report of the epidemiology, clinical manifestations, and aetiology of this dengue fever outbreak, and characterize DENV strains isolated from clinical specimens.

  15. Severe Dengue Fever Outbreak in Taiwan.

    PubMed

    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.

  16. 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

  17. 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.

  18. 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. PMID:26922851

  19. 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.

  20. 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.

  1. 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.

  2. Dengue disease outbreak definitions are implicitly variable.

    PubMed

    Brady, Oliver J; Smith, David L; Scott, Thomas W; Hay, Simon I

    2015-06-01

    Infectious diseases rarely exhibit simple dynamics. Outbreaks (defined as excess cases beyond response capabilities) have the potential to cause a disproportionately high burden due to overwhelming health care systems. The recommendations of international policy guidelines and research agendas are based on a perceived standardised definition of an outbreak characterised by a prolonged, high-caseload, extra-seasonal surge. In this analysis we apply multiple candidate outbreak definitions to reported dengue case data from Brazil to test this assumption. The methods identify highly heterogeneous outbreak characteristics in terms of frequency, duration and case burden. All definitions identify outbreaks with characteristics that vary over time and space. Further, definitions differ in their timeliness of outbreak onset, and thus may be more or less suitable for early intervention. This raises concerns about the application of current outbreak guidelines for early warning/identification systems. It is clear that quantitatively defining the characteristics of an outbreak is an essential prerequisite for effective reactive response. More work is needed so that definitions of disease outbreaks can take into account the baseline capacities of treatment, surveillance and control. This is essential if outbreak guidelines are to be effective and generalisable across a range of epidemiologically different settings.

  3. Dengue disease outbreak definitions are implicitly variable

    PubMed Central

    Brady, Oliver J.; Smith, David L.; Scott, Thomas W.; Hay, Simon I.

    2015-01-01

    Infectious diseases rarely exhibit simple dynamics. Outbreaks (defined as excess cases beyond response capabilities) have the potential to cause a disproportionately high burden due to overwhelming health care systems. The recommendations of international policy guidelines and research agendas are based on a perceived standardised definition of an outbreak characterised by a prolonged, high-caseload, extra-seasonal surge. In this analysis we apply multiple candidate outbreak definitions to reported dengue case data from Brazil to test this assumption. The methods identify highly heterogeneous outbreak characteristics in terms of frequency, duration and case burden. All definitions identify outbreaks with characteristics that vary over time and space. Further, definitions differ in their timeliness of outbreak onset, and thus may be more or less suitable for early intervention. This raises concerns about the application of current outbreak guidelines for early warning/identification systems. It is clear that quantitatively defining the characteristics of an outbreak is an essential prerequisite for effective reactive response. More work is needed so that definitions of disease outbreaks can take into account the baseline capacities of treatment, surveillance and control. This is essential if outbreak guidelines are to be effective and generalisable across a range of epidemiologically different settings. PMID:25979287

  4. Dengue fever outbreak in Lahore.

    PubMed

    Hassan, Usman; Loya, Asif; Mehmood, Muhammad Tariq; Nazeer, Hammad; Sultan, Faisal

    2013-03-01

    Dengue fever has now affected all the major cities of country. About 41,354 patients underwent antibody screening for dengue fever from Shaukat Khanum Memorial Cancer Hospital, Lahore, during the epidemic period (October 1st 2010 to December 20th 2010). Out of them, 1294 (3.1%) patients were positive for IgM antibodies, and 124 (0.3%) for IgG antibodies. A total of 722 (1.7%) patients were borderline positive for IgM antibodies and 108 (0.26%) were borderline positive for IgG antibodies. Dengue fever has emerged as a global problem over the last 5 years. It has also hit Lahore badly especially after the floods in 2010. High index of suspicion should be there in case of related symptoms.

  5. 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

  6. Implication of vaccination against dengue for Zika outbreak

    PubMed Central

    Tang, Biao; Xiao, Yanni; Wu, Jianhong

    2016-01-01

    Zika virus co-circulates with dengue in tropical and sub-tropical regions. Cases of co-infection by dengue and Zika have been reported, the implication of this co-infection for an integrated intervention program for controlling both dengue and Zika must be addressed urgently. Here, we formulate a mathematical model to describe the transmission dynamics of co-infection of dengue and Zika with particular focus on the effects of Zika outbreak by vaccination against dengue among human hosts. Our analysis determines specific conditions under which vaccination against dengue can significantly increase the Zika outbreak peak, and speed up the Zika outbreak peak timing. Our results call for further study about the co-infection to direct an integrated control to balance the benefits for dengue control and the damages of Zika outbreak. PMID:27774987

  7. Dengue fever outbreak in a recreation club, Dhaka, Bangladesh.

    PubMed

    Wagatsuma, Yukiko; Breiman, Robert F; Hossain, Anowar; Rahman, Mahbubur

    2004-04-01

    An outbreak of dengue fever occurred among employees of a recreation club in Bangladesh. Occupational transmission was characterized by a 12% attack rate, no dengue among family contacts, and Aedes vectors in club areas. Early recognition of the outbreak likely limited its impact.

  8. [Dengue fever: outbreak in southern Europe?].

    PubMed

    Durand, Jean-Paul; Couissinier-Paris, Patricia; Tolou, Hugues

    2003-09-15

    Epidemiology of dengue fever is changing dramatically. The worldwide incidence is rising and clinical symptoms are worsening. Reports describing forms associated with haemorrhages or shock syndrome involving both children and adults are increasingly frequent in regions beyond Southeast Asia where the first cases were observed. Many mechanisms could be implicated in these changes, including modifications of the virus, host, vector, or socio-economic factors. The new facilities in the laboratory diagnostic (MAC-ELISA; molecular biology), the commercialization of these assays allow not only assessment of morbidity and mortality in endemic areas and early detection of epidemic outbreaks but also evaluation of socio-economic impact and effectiveness of control measures. Now, the efficiency of the fight must be better, otherwise dengue will grow up during this new century.

  9. Epidemiology and characteristics of the dengue outbreak in Guangdong, Southern China, in 2014.

    PubMed

    Huang, L; Luo, X; Shao, J; Yan, H; Qiu, Y; Ke, P; Zheng, W; Xu, B; Li, W; Sun, D; Cao, D; Chen, C; Zhuo, F; Lin, X; Tang, F; Bao, B; Zhou, Y; Zhang, X; Li, H; Li, J; Wan, D; Yang, L; Chen, Y; Zhong, Q; Gu, X; Liu, J; Huang, L; Xie, R; Li, X; Xu, Y; Luo, Z; Liao, M; Wang, H; Sun, L; Li, H; Lau, G W; Duan, C

    2016-02-01

    Dengue is a rapidly spreading mosquito-borne disease caused by the dengue virus (DENV) and has emerged as a severe public health problem around the world. Guangdong, one of the southern Chinese provinces, experienced a serious outbreak of dengue in 2014, which was believed to be the worst dengue epidemic in China over the last 20 years. To better understand the epidemic, we collected the epidemiological data of the outbreak and analyzed 14,594 clinically suspected dengue patients from 25 hospitals in Guangdong. Dengue cases were then laboratory-confirmed by the detection of DENV non-structural protein 1 (NS1) antigen and/or DENV RNA. Afterwards, clinical manifestations of dengue patients were analyzed and 93 laboratory-positive serum specimens were chosen for the DENV serotyping and molecular analysis. Our data showed that the 2014 dengue outbreak in Guangdong had spread to 20 cities and more than 45 thousand people suffered from dengue fever. Of 14,594 participants, 11,387 were definitively diagnosed. Most manifested with a typical non-severe clinical course, and 1.96 % developed to severe dengue. The strains isolated successfully from the serum samples were identified as DENV-1. Genetic analyses revealed that the strains were classified into genotypes I and V of DENV-1, and the dengue epidemic of Guangdong in 2014 was caused by indigenous cases and imported cases from the neighboring Southeast Asian countries of Malaysia and Singapore. Overall, our study is informative and significant to the 2014 dengue outbreak in Guangdong and will provide crucial implications for dengue prevention and control in China and elsewhere. PMID:26700953

  10. Epidemiology and characteristics of the dengue outbreak in Guangdong, Southern China, in 2014.

    PubMed

    Huang, L; Luo, X; Shao, J; Yan, H; Qiu, Y; Ke, P; Zheng, W; Xu, B; Li, W; Sun, D; Cao, D; Chen, C; Zhuo, F; Lin, X; Tang, F; Bao, B; Zhou, Y; Zhang, X; Li, H; Li, J; Wan, D; Yang, L; Chen, Y; Zhong, Q; Gu, X; Liu, J; Huang, L; Xie, R; Li, X; Xu, Y; Luo, Z; Liao, M; Wang, H; Sun, L; Li, H; Lau, G W; Duan, C

    2016-02-01

    Dengue is a rapidly spreading mosquito-borne disease caused by the dengue virus (DENV) and has emerged as a severe public health problem around the world. Guangdong, one of the southern Chinese provinces, experienced a serious outbreak of dengue in 2014, which was believed to be the worst dengue epidemic in China over the last 20 years. To better understand the epidemic, we collected the epidemiological data of the outbreak and analyzed 14,594 clinically suspected dengue patients from 25 hospitals in Guangdong. Dengue cases were then laboratory-confirmed by the detection of DENV non-structural protein 1 (NS1) antigen and/or DENV RNA. Afterwards, clinical manifestations of dengue patients were analyzed and 93 laboratory-positive serum specimens were chosen for the DENV serotyping and molecular analysis. Our data showed that the 2014 dengue outbreak in Guangdong had spread to 20 cities and more than 45 thousand people suffered from dengue fever. Of 14,594 participants, 11,387 were definitively diagnosed. Most manifested with a typical non-severe clinical course, and 1.96 % developed to severe dengue. The strains isolated successfully from the serum samples were identified as DENV-1. Genetic analyses revealed that the strains were classified into genotypes I and V of DENV-1, and the dengue epidemic of Guangdong in 2014 was caused by indigenous cases and imported cases from the neighboring Southeast Asian countries of Malaysia and Singapore. Overall, our study is informative and significant to the 2014 dengue outbreak in Guangdong and will provide crucial implications for dengue prevention and control in China and elsewhere.

  11. 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

  12. The 2003 outbreak of Dengue fever in Delhi, India.

    PubMed

    Singh, N P; Jhamb, Rajat; Agarwal, S K; Gaiha, M; Dewan, Richa; Daga, M K; Chakravarti, Anita; Kumar, Shailesh

    2005-09-01

    Dengue fever (DF) and Dengue hemorrhagic fever (DHF) are widespread in Southeast Asia. An outbreak of DF/DHF in Delhi in 2003 started during September, reached its peak in October-November, and lasted until early December. This study describes the clinical and laboratory data of the 185 cases of DF/DHF admitted to Lok Nayak Hospital, New Delhi. The mean age of the patients was 26 +/- 10 years. Fever was present in all the cases with an average duration of fever being 4.5 +/- 1.2 days with headache (61.6%), backache, (57.8%), vomiting (50.8%) and abdominal pain (21%) being the other presenting complaints. Hemorrhagic manifestations in the form of a positive tourniquet test (21%), gum bleeding and epistaxis (40%), hematemesis (22%), skin rashes (20%) and melena (14%) were also observed. Hepatomegaly and splenomegaly were observed in 10% and 5% of cases, respectively. Laboratory investigations revealed thrombocytopenia (with a platelet count of < 100,000/microl) in about 61.39% of cases, Leukopenia (WBC <3,000/mm2) and hemoconcentration (Hct >20% of expected for age and sex) were found in 68% and 52% of the cases, respectively. The mortality rate was 2.7%. Despite widespread measures taken to control outbreaks of DF, it caused major outbreaks. More stringent measures in the form of vector control, improved sanitation and health education are needed to decrease morbidity, mortality and health care costs caused by a preventable disease.

  13. Factors Associated with Larval Control Practices in a Dengue Outbreak Prone Area

    PubMed Central

    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. PMID:25309602

  14. 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

  15. 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

  16. Space-time analysis of the dengue spreading dynamics in the 2004 Tartagal outbreak, Northern Argentina.

    PubMed

    Rotela, Camilo; Fouque, Florence; Lamfri, Mario; Sabatier, Phillipe; Introini, Virginia; Zaidenberg, Mario; Scavuzzo, Carlos

    2007-07-01

    The spreading dynamic of the 2004 dengue fever outbreak that occurred in Tartagal, Northwestern Argentina, was investigated. A total of 487 suspected dengue cases were recorded and geo-referenced. Maps of daily cases were generated for the 109 days of the outbreak. The epidemic affected the majority of the city within 11 days. The age-distribution of the cases was different from the population age-distribution. The spatio-temporal clustering of the cases was analyzed using Knox test concept. Results of the space and time geo-referencing of the cases showed outbreak spotlights and spreading patterns that could be related to entomologic and epidemiologic factors. An environmental risk prediction model was developed based on a synthetic multi-band image created from LandSat 5 TM satellite image. The potential and limitations of remote sensing data and spatial statistics as landscape epidemiology tools for a dengue surveillance strategy and prevention are discussed.

  17. Myanmar dengue outbreak associated with displacement of serotypes 2, 3, and 4 by dengue 1.

    PubMed

    Thu, Hlaing Myat; Lowry, Kym; Myint, Thein Thein; Shwe, Than Nu; Han, Aye Maung; Khin, Kyu Kyu; Thant, Kyaw Zin; Thein, Soe; Aaskov, John

    2004-04-01

    In 2001, Myanmar (Burma) had its largest outbreak of dengue-15,361 reported cases of dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS), including 192 deaths. That year, 95% of dengue viruses isolated from patients were serotype 1 viruses belonging to two lineages that had diverged from an earlier, now extinct, lineage sometime before 1998. The ratio of DHF to DSS cases in 2001 was not significantly different from that in 2000, when 1,816 cases of DHF/DSS were reported and dengue 1 also was the most frequently isolated serotype. However, the 2001 ratio was significantly higher than that in 1998 (also an outbreak year) and in 1999, when all four serotypes were detected and serotypes 1, 2, and 3 were recovered in similar numbers. The large number of clinical cases in 2001 may have been due, in part, to a preponderance of infections with dengue 1 viruses.

  18. 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.

  19. The first major outbreak of dengue hemorrhagic fever in Delhi, India.

    PubMed

    Dar, L; Broor, S; Sengupta, S; Xess, I; Seth, P

    1999-01-01

    India An outbreak of dengue hemorrhagic fever/dengue shock syndrome (DHS/DSS) occurred in 1996 in India in and near Delhi. The cause was confirmed as dengue virus type 2, by virus cultivation and indirect immunofluorescence with type-specific monoclonal antibodies. This is the largest such outbreak reported from India, indicating a serious resurgence of dengue virus infection.

  20. Molecular Characterization of Two Major Dengue Outbreaks in Costa Rica.

    PubMed

    Soto-Garita, Claudio; Somogyi, Teresita; Vicente-Santos, Amanda; Corrales-Aguilar, Eugenia

    2016-07-01

    Dengue virus (DENV) (Flavivirus, Flaviviridae) is a reemerging arthropod-borne virus with a worldwide circulation, transmitted mainly by Aedes aegypti and Aedes albopictus mosquitoes. Since the first detection of its main transmitting vector in 1992 and the invasion of DENV-1 in 1993, Costa Rica has faced dengue outbreaks yearly. In 2007 and 2013, Costa Rica experienced two of the largest outbreaks in terms of total and severe cases. To provide genetic information about the etiologic agents producing these outbreaks, we conducted phylogenetic analysis of viruses isolated from human samples. A total of 23 DENV-1 and DENV-2 sequences were characterized. These analyses signaled that DENV-1 genotype V and DENV-2 American/Asian genotype were circulating in those outbreaks. Our results suggest that the 2007 and 2013 outbreak viral strains of DENV-1 and DENV-2 originated from nearby countries and underwent in situ microevolution. PMID:27139442

  1. Predicting Dengue Fever Outbreaks in French Guiana Using Climate Indicators

    PubMed Central

    Adde, Antoine; Roucou, Pascal; Mangeas, Morgan; Ardillon, Vanessa; Desenclos, Jean-Claude; Rousset, Dominique; Girod, Romain; Briolant, Sébastien; Quenel, Philippe; Flamand, Claude

    2016-01-01

    Background Dengue fever epidemic dynamics are driven by complex interactions between hosts, vectors and viruses. Associations between climate and dengue have been studied around the world, but the results have shown that the impact of the climate can vary widely from one study site to another. In French Guiana, climate-based models are not available to assist in developing an early warning system. This study aims to evaluate the potential of using oceanic and atmospheric conditions to help predict dengue fever outbreaks in French Guiana. Methodology/Principal Findings Lagged correlations and composite analyses were performed to identify the climatic conditions that characterized a typical epidemic year and to define the best indices for predicting dengue fever outbreaks during the period 1991–2013. A logistic regression was then performed to build a forecast model. We demonstrate that a model based on summer Equatorial Pacific Ocean sea surface temperatures and Azores High sea-level pressure had predictive value and was able to predict 80% of the outbreaks while incorrectly predicting only 15% of the non-epidemic years. Predictions for 2014–2015 were consistent with the observed non-epidemic conditions, and an outbreak in early 2016 was predicted. Conclusions/Significance These findings indicate that outbreak resurgence can be modeled using a simple combination of climate indicators. This might be useful for anticipating public health actions to mitigate the effects of major outbreaks, particularly in areas where resources are limited and medical infrastructures are generally insufficient. PMID:27128312

  2. An outbreak of dengue virus at Rio de Janeiro--1986.

    PubMed

    Schatzmayr, H G; Nogueira, R M; Travassos da Rosa, A P

    1986-01-01

    Dengue virus type 1 has been isolated in Aedes albopictus cell strain, from sera of patients living in the Nova Iguaçu county, by Rio de Janeiro. The clinical picture was characterized by fever, headache, retrobulbar pain, backache, pains in the muscles and the joints and prostration. Studies in paired sera confirmed the presence of recent infection by dengue virus type 1. The outbreak reached adjacent areas, including Rio de Janeiro city (May, 1986).

  3. Dengue outbreak in an Indo-Myanmar boarder area: epidemiological aspects and risk factors.

    PubMed

    Khan, S A; Dutta, P; Borah, J; Chowdhury, P; Doloi, P K; Mahanta, J

    2013-09-01

    During October 2007, a large outbreak of suspected dengue fever (DF) was reported in Moreh township, Manipur: the first widespread outbreak in Northeast India. A cross sectional study was carried out in Moreh. The information on outbreak was collected and then described in time, place and person characteristics to arrive at aetiological hypotheses. Two hundred and eighty two serum samples were collected. Ninety one samples were reported positive for acute infection with dengue virus. Co-circulation of all the four dengue virus serotypes (1-4) and concurrent infection of 2 & 3, 1 & 3, and 1 & 4 serotypes was found. Predominant clinical features of the patients were fever (100%), headache (39%), vomiting (9.8%) and joint pain (4.16%). Haemorrhagic manifestation was recorded in one patient who subsequently died. Entomological surveys revealed profuse breeding of Aedes mosquitoes in all the affected municipal wards with high HI (37.5-71.43%), CI (53.84-86.95%) and BI (80-208.33%). Presence of IgM antibody, co-circulation of all the serotypes and concurrent infection with more than one serotype in the same individual confirmed the outbreak due to dengue virus infection. Preventive and control measures undertaken following the epidemiological investigation helped in controlling the outbreak.

  4. Dengue haemorrhagic fever (DHF) outbreak in Calcutta--1990.

    PubMed

    Bhattacharjee, N; Mukherjee, K K; Chakravarti, S K; Mukherjee, M K; De, P N; Sengupta, M; Banik, G B; Bhowmick, P; Sinha, S K; Chakraborty, M S

    1993-03-01

    An outbreak of Dengue Haemorrhagic Fever (DHF) occurred in Calcutta between September and December, 1990. Children and young adults were the major victims. Haemorrhagic manifestations and shocks were the main features in most of the hospitalised cases. Five mouse pathogenic agents were isolated from 105 acute cases and all were identified as DEN-3. HI and CF test with 55 paired sera revealed evidence of dengue infection in 33 (60 per cent) and flavivirus group reaction including dengue in 17 (30.9 per cent). It was for the first time, that DEN-3 was considered to be the etiologic agent for DHF in Calcutta.

  5. Outbreak of dengue Fever in central China, 2013.

    PubMed

    Huang, Xue Yong; Ma, Hong Xia; Wang, Hai Feng; DU, Yan Hua; Su, Jia; Li, Xing Le; Tang, Xiao Yan; Ma, Hong Peng; Zu, Bing Can; Zhang, Qiao Hong; Chen, Hao Min; Xu, Bian Li

    2014-11-01

    In 2013, the first dengue fever (DF) outbreak in central China was reported in the central of Henan province, northern temperate regions, although they have been sequentially recorded in Southern China. 106 suspected DF cases were reported and 73 patients were confirmed dengue virus type 3 (DEN-3) infections. 62/392 (15.8%) local health persons showed DEN antibodies positive. To this day Henan is the northernmost province in China which has been reported about outbreak of DF and what is important is that it warns us the endemic range of DF has been expanded geographically in China.

  6. Experience in adult population in dengue outbreak in Delhi.

    PubMed

    Tripathi, B K; Gupta, B; Sinha, R S; Prasad, S; Sharma, D K

    1998-03-01

    A dengue outbreak has recently hit the Indian capital. We studied the clinical profile of adult patients. Five hundred and sixty patients of dengue infection were admitted in a specially created ward according to the criteria laid down by WHO. Haematemesis (28.28%), epistaxis (26.78%) and malena (14.28%) were some of the common presentations. Similarly lymphadenopathy, especially cervical (30.89%), palatal rashes (26.96%) and hepatomegaly (23.75%) were the most commonly encountered findings on physical examination. Most of the cases were of dengue fever with haemorrhage and only 2.5% cases were classified under dengue haemorrhagic fever or dengue shock syndrome. The average hospital stay was 3.4 days but only 9.8 hours in the eleven patients who died, suggesting their late arrival in preterminal situation giving little time for resuscitation. Thrombocytopenia was not a feature and only 12.85% patients had platelet count less than 70,000/cmm. Most of the patients who were admitted with thrombocytopenia, showed normalization in their platelet counts in next few days. Serological examination demonstrated evidence of recent dengue infection in 41.17% patients. Few patients required blood or platelet concentrate transfusion. Eleven patients died, three due to DIC, one of intracranial haemorrhage and seven due to massive gastric haemorrhage. Rest of the patients recovered completely. Thus we can conclude that recent outbreak in Delhi was of dengue fever with haemorrhage and mortality was very low in patients who came early to the hospital.

  7. An outbreak of dengue fever in Veerannapet village, Cherial Mandal, of Warangal district, Andhra Pradesh.

    PubMed

    Kamal, S; Jain, S K; Patnaik, S K; Lal, S

    2005-12-01

    An epidemiological and entomological investigation was carried out in Veerannapet village, Cherial Mandal of Warangal district, Andhra Pradesh. The study showed that all age groups and both the sexes were affected with the disease. Fever and bodyache was the first presenting feature, which was self-limiting and lasted for 4-5 days. Of the 19 Serum Samples tested, 17 showed high titre to Dengue antigen with 10 showing diagnostic titre. Five samples were positive for IgM antibodies to dengue virus. Larval surveys indicates high Breteau index (30.40%), House index (23.20%) and Container index (9.17%). The clinico-epidemiological and entomological investigation indicates present episode of fever outbreak is due to dengue fever. Strengthening and intensification of surveillance along with educating the community is recommended for prevention of outbreak.

  8. Characteristics of a dengue hemorrhagic fever outbreak in 2001 in Kaohsiung.

    PubMed

    Lai, Ping-Chang; Lee, Susan Shin-Jung; Kao, Chih-Hsiang; Chen, Yao-Shen; Huang, Chun-Kai; Lin, Wei-Ru; Wann, Shue-Ren; Lin, Hsi-Hsun; Yen, Muh-Yong; Liu, Yung-Ching

    2004-10-01

    A dengue outbreak occurred in Kaohsiung City starting in July in 2001. We studied the clinical profile of all patients admitted to Kaohsiung Veterans General Hospital during this outbreak from July 2001 to January 2002. A total of 25 cases of clinically suspected dengue fever were treated during this period, and 13 of them were confirmed by laboratory results (13/25; 52%). Eleven of the 25 patients (11/25; 44%) were admitted. The mean age of the patients with laboratory confirmation of infection was 53 years (range, 7 to 85 years). Headache (7/13; 53.8%), bone pain (8/13; 61.5%), myalgia (10/13; 76.9%), abdominal pain (7/13; 53.8%), and skin rash (9/13; 69.2%) were the most common presentations. A high proportion of patients were classified as having dengue hemorrhagic fever (DHF) [6/13; 46.2%] and 2 of these patients had dengue shock syndrome (DSS) based on the World Health Organization criteria. Pretibial petechia (6/13; 46.1%), gastrointestinal bleeding (6/13; 46.1%), and hemoptysis (4/13; 30.8%) were the most common hemorrhagic manifestations. The average hospital stay was 7.1 days. Thrombocytopenia was very common and 84.6% patients had a platelet count less than 100,000/mm3. Monocytosis was found in all patients. Few patients required blood or platelet concentrate transfusion. The 2 patients who developed DSS both survived. All patients recovered completely without any obvious sequela. In conclusion, there was a high percentage of DHF among patients in the dengue outbreak in 2001. Increasing rates of DHF compared to previous reports from Taiwan may be a sign of hyperendemicity (multiple serotypes present) of the dengue virus in Kaohsiung City and its greater likelihood elsewhere in Taiwan. Prevention and control of both dengue fever and DHF have thus become increasingly important.

  9. An outbreak of dengue fever in rural areas of northern India.

    PubMed

    Kumar, A; Sharma, S K; Padbidri, V S; Thakare, J P; Jain, D C; Datta, K K

    2001-12-01

    During the past few decades, epidemics of dengue fever are causing concern in several South-East Asian countries including India. The rural areas of Hissar district of Haryana state, situated about 170 km North-West of Delhi, experienced an outbreak of febrile illness during July-August 1996. A total of 13 villages in eight affected primary health centres reported fever cases. The clinical, epidemiological and entomological findings indicated that the present episode was due to dengue fever. The aetiological agent of the current outbreak, the DEN-2 virus, was isolated from 12 acute-phase sera specimens. Though, in the recent past outbreaks have been reported from the rural areas of southern and western India, the present episode is the first outbreak being reported from the rural areas of northern India. The increasing frequency of dengue fever outbreaks in rural areas of various Indian states reflects the changing life style of the rural population as a result of urbanization process and calls for a suitable prevention and control policy based on strengthened surveillance, appropriate health education to the community coupled with proper training of health personnel.

  10. Detecting and Responding to a Dengue Outbreak: Evaluation of Existing Strategies in Country Outbreak Response Planning

    PubMed Central

    Kroeger, Axel; Runge-Ranzinger, Silvia; O'Dempsey, Tim

    2013-01-01

    Background. Dengue outbreaks are occurring with increasing frequency and intensity. Evidence-based epidemic preparedness and effective response are now a matter of urgency. Therefore, we have analysed national and municipal dengue outbreak response plans. Methods. Thirteen country plans from Asia, Latin America and Australia, and one international plan were obtained from the World Health Organization. The information was transferred to a data analysis matrix where information was extracted according to predefined and emerging themes and analysed for scope, inconsistencies, omissions, and usefulness. Findings. Outbreak response planning currently has a considerable number of flaws. Outbreak governance was weak with a lack of clarity of stakeholder roles. Late timing of responses due to poor surveillance, a lack of combining routine data with additional alerts, and lack of triggers for initiating the response weakened the functionality of plans. Frequently an outbreak was not defined, and early response mechanisms based on alert signals were neglected. There was a distinct lack of consideration of contextual influences which can affect how an outbreak detection and response is managed. Conclusion. A model contingency plan for dengue outbreak prediction, detection, and response may help national disease control authorities to develop their own more detailed and functional context specific plans. PMID:24222774

  11. Clinical profile of dengue during 2005 outbreak in Kolkata and predictive markers of dengue haemorrhagic fever.

    PubMed

    Ghosh, Sanat Kumar; De, Saumyen; Sarkar, Uttam; Ghosh, Mausumi; Chatterjee, Mrinal Kanti; Samanta, Sandip

    2011-11-01

    Epidemics of dengue outbreak are frequent in south-east Asian countries. Dengue is a major cause of morbidity and mortality in this region. This prospective observational study was done at Dr BC Roy Memorial for Children during the outbreak in 2005 in Kolkata to know the clinical pattern of dengue cases and to find the possible markers of development of dengue hemorrhagic fever. Two hundred and eighty seropositive cases of dengue were included in the study. Among paediatric population, 5 to 10 years age group was most commonly affected. One-sixth of the cases were from villages indicating the extension of the epidemic in rural areas. Abrupt onset of high fever, non-purulent conjunctival injection, erythematous lips, flushed appearance, myalgia, arthralgia, headache and thrombocytopenia were the predominant features. Rhinitis and pharyngitis were rarely found. Prolonged fever more than 7 days, flushed appearance, pharyngeal congestion, shock evidence, serous effusion, bleeding manifestations, thrombocytopenia, elevated liver enzymes and elevated PCV were associated with development of dengue haemorrhagic fever and dengue shock syndrome.

  12. A hypothesis for the 2007 dengue outbreak in Singapore.

    PubMed

    Massad, E; Coutinho, F A B; Ma, S; Burattini, M N

    2010-07-01

    A previous mathematical model explaining dengue in Singapore predicted a reasonable outbreak of about 6500 cases for 2006 and a very mild outbreak with about 2000 cases for 2007. However, only 3051 cases were reported in 2006 while more than 7800 were reported in the first 44 weeks of 2007. We hypothesized that the combination of haze with other local sources of particulate matter had a significant impact on mosquito life expectancy, significantly increasing their mortality rate. To test the hypothesis a mathematical model based on the reproduction number of dengue fever and aimed at comparing the impact of several possible alternative control strategies was proposed. This model also aimed at contributing to the understanding of the causes of dengue resurgence in Singapore in the last decade. The model's simulation demonstrated that an increase in mosquito mortality in 2006 and either a reduction in mortality or an increase in the carrying capacity of mosquitoes in 2007 explained the patterned observed in Singapore. Based on the model's simulation we concluded that the fewer than expected number of dengue cases in Singapore in 2006 was caused by an increase in mosquito mortality due to the disproportionate haze affecting the country that year and that particularly favourable environmental conditions in 2007 propitiated mosquitoes with a lower mortality rate, which explains the greater than expected number of dengue cases in 2007. Whether our hypothesis is plausible or not should be debated further.

  13. Dengue Risk among Visitors to Hawaii during an Outbreak

    PubMed Central

    Smith, Carrie E.; Tom, Tammy; Sasaki, Jed; Ayers, Tracy

    2005-01-01

    Despite the high rates of dengue in many tropical destinations frequented by tourists, limited information is available on the risk for infection among short-term visitors. We retrospectively surveyed 4,000 persons who arrived in Hawaii during the peak of the 2001–2002 dengue outbreak and collected follow-up serologic test results for those reporting denguelike illness. Of 3,064 visitors who responded, 94 (3%) experienced a denguelike illness either during their trip or within 14 days of departure; 34 of these persons were seen by a physician, and 2 were hospitalized. Twenty-seven visitors with denguelike illness provided a serum specimen; all specimens were negative for anti-dengue immunoglobulin G antibodies. The point estimate of dengue incidence was zero infections per 358 person-days of exposure with an upper 95% confidence limit of 3.0 cases per person-year. Thus, the risk for dengue infection for visitors to Hawaii during the outbreak was low. PMID:15890133

  14. Epidemiological aspects of an outbreak of dengue fever/dengue haemorrhagic fever in Singapore.

    PubMed

    Goh, K T; Ng, S K; Chan, Y C; Lim, S J; Chua, E C

    1987-09-01

    A nation-wide outbreak of 260 cases of DF/DHF with 1 death occurred in Singapore from Apr-Sept 1986. The outbreak originated from 3 separate foci of transmission at the western, south-eastern and north-eastern parts of the island and then spread to other dengue receptive urban and suburban areas. The morbidity rate was highest in young male Chinese adults between 15 and 24 years of age. The outbreak was rapidly brought under control through destruction of adult Aedes mosquitoes, surveys and source reduction of larval breeding habitats, health education and to a certain extent law enforcement. The Aedes population was high in the main foci of transmission although the overall house index was only 1.1. Other factors which could have precipitated the outbreak included waning herd immunity of the human population and continuous introduction of dengue virus into the country.

  15. Impact of vector control on a dengue fever outbreak in Trinidad, West Indies, in 1998.

    PubMed

    Chadee, Dave D; Williams, Fiona L R; Kitron, Uriel D

    2005-08-01

    In 1998, Trinidad experienced its first major outbreak of dengue haemorrhagic fever. Data from the Trinidad Public Health Laboratory, the National Surveillance Unit and Insect Vector Control Division, Ministry of Health, Trinidad and Tobago were analysed to determine the impact of vector control measures on the dengue outbreak. Geographical Information Systems (GIS)/Global Positioning Systems (GPS) were used to map cases and to distinguish epidemiological clusters. The Aedes aegypti population densities were higher than the 5% transmission threshold in all counties. The spatial distribution of dengue fever cases was significantly correlated with the heavily populated east-west corridor in the north and several distinctly separate clusters in the western part of the island. The temporal distribution patterns showed significantly more dengue fever cases occurring during the rainy season than during the dry season. This study documents the importance of vector control in the prevention of dengue transmission since no vaccine is currently available, and emphasizes the urgent need to understand better the environmental factors which contribute to the proliferation of this disease vector Ae. aegypti. PMID:16045461

  16. Impact of vector control on a dengue fever outbreak in Trinidad, West Indies, in 1998.

    PubMed

    Chadee, Dave D; Williams, Fiona L R; Kitron, Uriel D

    2005-08-01

    In 1998, Trinidad experienced its first major outbreak of dengue haemorrhagic fever. Data from the Trinidad Public Health Laboratory, the National Surveillance Unit and Insect Vector Control Division, Ministry of Health, Trinidad and Tobago were analysed to determine the impact of vector control measures on the dengue outbreak. Geographical Information Systems (GIS)/Global Positioning Systems (GPS) were used to map cases and to distinguish epidemiological clusters. The Aedes aegypti population densities were higher than the 5% transmission threshold in all counties. The spatial distribution of dengue fever cases was significantly correlated with the heavily populated east-west corridor in the north and several distinctly separate clusters in the western part of the island. The temporal distribution patterns showed significantly more dengue fever cases occurring during the rainy season than during the dry season. This study documents the importance of vector control in the prevention of dengue transmission since no vaccine is currently available, and emphasizes the urgent need to understand better the environmental factors which contribute to the proliferation of this disease vector Ae. aegypti.

  17. Evaluation of the performance of a dengue outbreak detection tool for China.

    PubMed

    Zhang, Honglong; Li, Zhongjie; Lai, Shengjie; Clements, Archie C A; Wang, Liping; Yin, Wenwu; Zhou, Hang; Yu, Hongjie; Hu, Wenbiao; Yang, Weizhong

    2014-01-01

    An outbreak detection and response system, using time series moving percentile method based on historical data, in China has been used for identifying dengue fever outbreaks since 2008. For dengue fever outbreaks reported from 2009 to 2012, this system achieved a sensitivity of 100%, a specificity of 99.8% and a median time to detection of 3 days, which indicated that the system was a useful decision tool for dengue fever control and risk-management programs in China.

  18. Dengue virus type 1 clade replacement in recurring homotypic outbreaks

    PubMed Central

    2013-01-01

    Background Recurring dengue outbreaks occur in cyclical pattern in most endemic countries. The recurrences of dengue virus (DENV) infection predispose the population to increased risk of contracting the severe forms of dengue. Understanding the DENV evolutionary mechanism underlying the recurring dengue outbreaks has important implications for epidemic prediction and disease control. Results We used a set of viral envelope (E) gene to reconstruct the phylogeny of DENV-1 isolated between the periods of 1987–2011 in Malaysia. Phylogenetic analysis of DENV-1 E gene revealed that genotype I virus clade replacements were associated with the cyclical pattern of major DENV-1 outbreaks in Malaysia. A total of 9 non-conservative amino acid substitutions in the DENV-1 E gene consensus were identified; 4 in domain I, 3 in domain II and 2 in domain III. Selection pressure analyses did not reveal any positively selected codon site within the full length E gene sequences (1485 nt, 495 codons). A total of 183 (mean dN/dS = 0.0413) negatively selected sites were found within the Malaysian isolates; neither positive nor negative selection was noted for the remaining 312 codons. All the viruses were cross-neutralized by the respective patient sera suggesting no strong support for immunological advantage of any of the amino acid substitutions. Conclusion DENV-1 clade replacement is associated with recurrences of major DENV-1 outbreaks in Malaysia. Our findings are consistent with those of other studies that the DENV-1 clade replacement is a stochastic event independent of positive selection. PMID:24073945

  19. Outbreak of dengue in Mumbai and predictive markers for dengue shock syndrome.

    PubMed

    Shah, Ira; Deshpande, G C; Tardeja, P N

    2004-10-01

    An alarming rise of dengue has been seen in Mumbai during the post-monsoon season. We undertook this prospective study in the pediatric wards and pediatric intensive care unit of B. J. Wadia Hospital for Children between 27 August 2003 and 10 October 2003 to determine the clinical features, laboratory abnormalities, and outcome of children affected with dengue and to determine the predictive markers for dengue shock syndrome. Fifty-one suspected dengue cases were tested for positivity of dengue by determination of dengue IgM antibodies by ELISA test. These positive cases were analysed for common clinical features, laboratory derangements, and outcome. Patients were subdivided into three subgroups: dengue fever (DF), dengue hemorrhagic fever (DHF), and dengue shock syndrome (DSS) as per WHO classification. Predictive markers for DSS were also determined. Thirty-nine patients had a positive dengue IgM titre, 20 patients had DHF, 18 patients had DSS, and one patient had DF The mean age of presentation was 4.9 years. Fever, hepatomegaly, vomiting, bleeding tendencies, erythematous rash, thrombocytopenia, elevated liver enzymes, and deranged PT and PTT were the predominant clinical and laboratory features. Predictive markers for DSS were younger age at onset, altered sensorium, paralytic ileus, and significantly deranged PT. Patients with DSS also had a longer recovery period and required more supportive management in the form of component therapy and ionotropic support. All three patients who died belonged to the DSS subgroup with case fatality rate for DSS being 16.6 per cent. None of the patients in the DHF or DF subgroup died. Endemicity of dengue fever is on the rise in Mumbai with increased incidence among children. Appropriate investigations, strict monitoring and prompt supportive management can reduce mortality in dengue. Predictive markers of DSS can reduce the mortality if promptly treated. Also prevention of transmission by mosquito control and maintaining

  20. 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 ...

  1. 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...

  2. Culture-amplified detection of dengue virus from serum in an outbreak of dengue fever.

    PubMed

    Gleeson, F; McBride, J; Norton, R

    1999-02-01

    An outbreak of dengue type 2 occurred in North Queensland, Australia, between December 1996 and April 1997. Culture of serum in the Aedes albopictus C6/36 cell line with detection using immunofluorescent staining was compared with a culture-amplified detection system using an immunoperoxidase staining method in a microtiter plate format. A total of 374 serum specimens from individuals during the outbreak were tested. Ninety-five specimens were positive using immunofluorescence and ninety-two were positive using the immunoperoxidase method (sensitivity 91.6%; specificity 98.2%). The immunoperoxidase method is quicker, easier to perform, and does not require the use of an immunofluorescent microscope. The method is more suited to the processing of large numbers of specimens in an outbreak and could be used in endemic areas with limited virological resources.

  3. The 1996 outbreak of dengue hemorrhagic fever in Delhi, India.

    PubMed

    Anuradha, S; Singh, N P; Rizvi, S N; Agarwal, S K; Gur, R; Mathur, M D

    1998-09-01

    A major outbreak of dengue hemorrhagic fever (DHF) affected more than 10,000 people in Delhi and neighboring areas in 1996. The outbreak started in September, peaked in October to November and lasted till early December. The clinical and laboratory data of 515 adult patients admitted to Lok Nayak Hospital, New Delhi were reviewed. Fever (100%), myalgias and malaise (96%), abdominal pain (10.2%) and vomiting (8.7%) were the prominent presenting features. Hemorrhagic manifestations were seen in all patients- a positive tourniquet test (21.2%), scattered petechial rash (23.07%), confluent rash (2.7%), epistaxis (38.4%), gum bleeds (28.06%) and hematemesis (22.86%) being the major bleeding manifestations. Hepatomegaly was observed in 96% of the patients. Laboratory investigations revealed thrombocytopenia, hemoconcentration and leukopenia. Serological confirmation with a microcapture ELISA technic was done in 143/515 patients. The mortality rate was 6.6% and, multiple bleeding manifestations, severe thrombocytopenia, hypoproteinemia and dengue shock syndrome (DSS) were associated with a higher mortality.

  4. Vaccines and immunization strategies for dengue prevention.

    PubMed

    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

  5. Dengue and dengue-like outbreaks in the past: the case of the Macau epidemic fever of 1874.

    PubMed

    Buchillet, Dominique

    2012-07-01

    Historical sources abound in references to outbreaks of a disease resembling dengue fever. Medical observers reported on its rapid onset and great expansion in the population, the diversity and changeability of its clinical features and its overall mildness. In 1874, an epidemic disease with fever, rash and rheumatic pains as main symptoms broke out in the Portuguese colony of Macau, South China. It was similar to the epidemic disease which swept the colony 2 years before during the socalled dengue pandemic of 1870-1873. The 1874 epidemic disease was variously labeled by local physicians, including dengue fever. In his report on the disease, Dr. Lúcio Augusto da Silva, hence at the head of the health services of Macau, discussed on the nature of the epidemic febrile disease. Here, I review the data on the 1874 epidemic outbreak and put them in the context of historical dengue-like outbreaks. A possible Chikungunya etiology of the disease is postulated.

  6. 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.

  7. 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

  8. 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.

  9. [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.

  10. Slow platelet recovery pattern during the 2011 dengue outbreak: a preliminary report.

    PubMed

    Gooneratne, L; Wimalachandra, M; Wijerathna, J; Karunathunga, N; Jayasinghe, S

    2014-06-01

    During the 2011 dengue outbreak, health care providers in Colombo, Sri Lanka noticed a slow rise in platelet counts in patients recovering from dengue fever when compared to the 2010 outbreak. This study was carried out to confirm this observation. The platelet recovery rates of two groups of patients from 2010 and 2011 (n=28 and n=25 respectively) were computed and compared. The platelet recovery rates, of patients from the 2011 outbreak were found to be slower than the platelet recovery rates of patients from the 2010 outbreak (p value=0.0089).

  11. Four dengue virus serotypes found circulating during an outbreak of dengue fever and dengue haemorrhagic fever in Jakarta, Indonesia, during 2004.

    PubMed

    Suwandono, Agus; Kosasih, Herman; Nurhayati; Kusriastuti, Rita; Harun, Syahrial; Ma'roef, Chairin; Wuryadi, Suharyono; Herianto, Bambang; Yuwono, Djoko; Porter, Kevin R; Beckett, Charmagne G; Blair, Patrick J

    2006-09-01

    Periodic outbreaks of dengue have emerged in Indonesia since 1968, with the severity of resulting disease increasing in subsequent years. In early 2004, a purported dengue outbreak erupted across the archipelago, with over 50,000 cases and 603 deaths reported. To confirm the disease aetiology and to provide an epidemiological framework of this epidemic, an investigation was conducted in ten hospitals within the capital city of Jakarta. Clinical and laboratory findings were determined from a cohort of 272 hospitalised patients. Exposure to dengue virus was determined in 180 (66.2%) patients. When clinically assessed, 100 (55.6%) of the 180 patients were classified as having dengue fever (DF), 31 (17.2%) as DF with haemorrhagic manifestations and 49 (27.2%) as dengue haemorrhagic fever (DHF). Evidence from haemagglutination inhibition assays suggested that 33/40 (82.5%) of those with DHF from which laboratory evidence was available suffered from a secondary dengue infection. All four dengue viruses were identified upon viral isolation, with DEN-3 being the most predominant serotype recovered, followed by DEN-4, DEN-2 and DEN-1. In summary, the 2004 outbreak of dengue in Jakarta, Indonesia, was characterised by the circulation of multiple virus serotypes and resulted in a relatively high percentage of a representative population of hospitalised patients developing DHF.

  12. Ongoing outbreak of dengue type 1 in the Autonomous Region of Madeira, Portugal: preliminary report.

    PubMed

    Sousa, C A; Clairouin, M; Seixas, G; Viveiros, B; Novo, M T; Silva, A C; Escoval, M T; Economopoulou, A

    2012-01-01

    Following the identification of two autochthonous cases of dengue type 1 on 3 October 2012, an outbreak of dengue fever has been reported in Madeira, Portugal. As of 25 November, 1,891 cases have been detected on the island where the vector Aedes aegypti had been established in some areas since 2005. This event represents the first epidemic of dengue fever in Europe since 1928 and concerted control measures have been initiated by local health authorities.

  13. Serodiagnosis of dengue during an outbreak at a tertiary care hospital in Delhi.

    PubMed

    Gupta, Ekta; Dar, Lalit; Narang, Priyanka; Srivastava, V K; Broor, Shobha

    2005-01-01

    Dengue, an important human arboviral infection, is endemic in many parts of India. Outbreaks are now reported quite frequently from different parts of the country. We report here findings of serological investigation of serum samples received during a recent outbreak of dengue infection in Delhi from September to November 2003. Acute phase serum samples from suspected cases of dengue infection (including dengue fever, dengue haemorrhagic fever and dengue shock syndrome) of duration 5 days, were tested for dengue specific IgM antibodies by enzyme linked immuno sorbant assay (ELISA). Of the 874 serum samples tested, 456 (52.3% ) were positive for dengue specific IgM antibodies. The maximum number of positive cases was reported in October, peaking in second and third week. Patients in the age group of 21-30 yr accounted for 34.2 per cent of positive cases. This outbreak was less severe as compared to the previous 1996 outbreak and showed a shift towards an older age group.

  14. 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

  15. 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.

  16. Seroepidemiological survey among schoolchildren during the 2000-2001 dengue outbreak of Ratchaburi Province, Thailand.

    PubMed

    Tuntaprasart, Walairut; Barbazan, Philippe; Nitatpattana, Narong; Rongsriyam, Yupha; Yoksan, Sutee; Gonzalez, Jean Paul

    2003-09-01

    From August 2000 to 2001, a dengue outbreak occurred in Mueang district, Ratchaburi Province, Thailand. About 800 cases of dengue infection were reported, and among them, 49.5% were clinically diagnosed as dengue hemorrhagic fever according to the WHO criteria. During the outbreak, the incidence rate of dengue infection in Hin Gong subdistrict was 2.9 per 1,000 population. A seroepidemiological survey was conducted among primary schoolchildren from July 2000 to June 2001, to monitor dengue transmission. In a baseline survey, 283 children were surveyed for dengue antibody and 71% were IgG seropositive. In June 2001, the rate of dengue infection showed an increase of 8.8% with 8.0% among immune children and 10.3% among naive schoolchildren. Among 283 schoolchildren, 90 were followed up 3 times, in September and December 2000, and June 2001. An increase in the rate of seroconversion was observed in the period September to December 2000, while the peak dengue outbreaks in the dry season occurred in February 2001. Serosurveys among schoolchildren appear to be early warning system, and can be advantageous in early dengue control actions, in order to break the chain of transmission before an impending epidemic.

  17. [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.

  18. Use of a Rapid Test for Diagnosis of Dengue during Suspected Dengue Outbreaks in Resource-Limited Regions.

    PubMed

    Hunsperger, Elizabeth A; Sharp, Tyler M; Lalita, Paul; Tikomaidraubuta, Kini; Cardoso, Yolanda Rebello; Naivalu, Taina; Khan, Aalisha Sahu; Marfel, Maria; Hancock, W Thane; Tomashek, Kay M; Margolis, Harold S

    2016-08-01

    Dengue is major public health problem, globally. Timely verification of suspected dengue outbreaks allows for public health response, leading to the initiation of appropriate clinical care. Because the clinical presentation of dengue is nonspecific, dengue diagnosis would benefit from a sensitive rapid diagnostic test (RDT). We evaluated the diagnostic performance of an RDT that detects dengue virus (DENV) nonstructural protein 1 (NS1) and anti-DENV IgM during suspected acute febrile illness (AFI) outbreaks in four countries. Real-time reverse transcription-PCR and anti-DENV IgM enzyme-linked immunosorbent assay were used to verify RDT results. Anti-DENV IgM RDT sensitivity and specificity ranged from 55.3 to 91.7% and 85.3 to 98.5%, respectively, and NS1 sensitivity and specificity ranged from 49.7 to 92.9% and 22.2 to 89.0%, respectively. Sensitivity varied by timing of specimen collection and DENV serotype. Combined test results moderately improved the sensitivity. The use of RDTs identified dengue as the cause of AFI outbreaks where reference diagnostic testing was limited or unavailable. PMID:27225409

  19. Origin of dengue type 3 viruses associated with the dengue outbreak in Dhaka, Bangladesh, in 2000 and 2001.

    PubMed

    Podder, Goutam; Breiman, Robert F; Azim, Tasnim; Thu, Hlaing Myat; Velathanthiri, Niluka; Mai, Le Quynh; Lowry, Kym; Aaskov, John G

    2006-02-01

    Dengue and dengue hemorrhagic fever re-emerged in Bangladesh in 2000 and 2001 and nearly all viruses isolated were dengue type 3. Phylogenetic analyses of the envelope genes of examples of these viruses indicated that they were most closely related to recently emerged dengue type 3 viruses from neighboring Thailand and Myanmar but distinct from those from India and Sri Lanka. Since this strain of dengue virus type 3 had not been associated with unusual patterns of disease in Thailand or Myanmar, it suggested that the outbreak in Bangladesh was due to local factors after the introduction of viruses from countries to the east rather than to the evolution of an unusually virulent strain of virus in Bangladesh.

  20. Risk factors associated with an outbreak of dengue fever/dengue haemorrhagic fever in Hanoi, Vietnam.

    PubMed

    Toan, D T T; Hoat, L N; Hu, W; Wright, P; Martens, P

    2015-06-01

    Dengue fever/dengue haemorrhagic fever (DF/DHF) appears to be emerging in Hanoi in recent years. A case-control study was performed to investigate risk factors for the development of DF/DHF in Hanoi. A total of 73 patients with DF/DHF and 73 control patients were included in the study. The risk factor analysis indicated that living in rented housing, living near uncovered sewers, and living in a house discharging sewage directly into to ponds were all significantly associated with DF/DHF. People living in rented houses were 2·2 times more at risk of DF/DHF than those living in their own homes [adjusted odds ratio (aOR) 2·2, 95% confidence interval (CI) 1·1-4·6]. People living in an unhygienic house, or in a house discharging sewage directly to the ponds were 3·4 times and 4·3 times, respectively, more likely to be associated with DF/DHF (aOR 3·4, 95% CI 1-11·7; aOR 4·3, 95% CI 1·1-16·9). These results contribute to the understanding of the dynamics of dengue transmission in Hanoi, which is needed to implement dengue prevention and control programmes effectively and efficiently.

  1. Surveillance of Aedes albopictus Skuse breeding preference in selected dengue outbreak localities, peninsular Malaysia.

    PubMed

    Rozilawati, H; Tanaselvi, K; Nazni, W A; Mohd Masri, S; Zairi, J; Adanan, C R; Lee, H L

    2015-03-01

    Entomological surveillance was conducted in order to determine the abundance and to evaluate any changes of biological vectors or ecology, especially in the dengue outbreak areas. The abundance and breeding preference of Aedes albopictus and Aedes aegypti were conducted in selected dengue outbreak localities in three states of peninsular Malaysia namely Selangor, Federal Territory of Kuala Lumpur, and Penang Island using ovitraps and larval survey method. It was determined that Ae. albopictus was predominant in most of the localities and found to breed more outdoor than indoor. A wide range of breeding foci were recorded in this study. It was also determined that ovitrap method was more effective to detect the presence of Aedes mosquitoes when the larval survey was at low rate of infestation. The abundance of Ae. albopictus in dengue outbreak localities emphasis that the vector control programme should also target this species together with the primary dengue vector, Ae. aegypti. PMID:25801254

  2. Dengue outbreaks in Guánica-Ensenada and Villalba, Puerto Rico, 1972-1973.

    PubMed

    Rymzo, W T; Cline, B L; Kemp, G E; Sather, G E; Craven, P C

    1976-01-01

    Epidemics of dengue fever occurring in Puerto Rico in 1963 to 1964 and 1969 were caused by dengue-3 and dengue-2 (DN-2) viruses, respectively, but endemic dengue transmission has never been documented on the Island. Since the 1969 epidemic, a surveillance system has detected DN-2 activity on the Island during each of the years 1970 through 1973, which suggests endemic persistence of the virus. This report describes the investigation of localized outbreaks of DN-2 in Guanica-Ensenada (1972) and Villalba (1973), and presents epidemiological, serological, and virological data from the outbreaks. Analysis of geographic distribution of dengue activity in Puerto Rico in recent years indicates that the DN-2 transmission in 1970 to 1973 may represent a long tail-off of the 1969 epidemic rather than the emergence of a truly endemic situation.

  3. 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.

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

    PubMed

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

    2009-01-01

    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.

  5. Molecular Characterization and Viral Origin of the First Dengue Outbreak in Xishuangbanna, Yunnan Province, China, 2013.

    PubMed

    Guo, Xiaofang; Yang, Henglin; Wu, Chao; Jiang, Jinyong; Fan, Jianhua; Li, Hongbin; Zhu, Jin; Yang, Zhonghua; Li, Yuanyuan; Zhou, Hongning; Zhang, Jiusong

    2015-08-01

    In August 2013, Xishuangbanna, Yunnan Province, China, had its first dengue outbreak. Dengue virus (DENV) RNA detection in sera or viral isolates revealed that all 222 autochthonous patients detected and three Chinese travelers from Laos (imported cases) were positive for DENV-3 serotype, while DENV-1 and DENV-4 were detected in travelers from Myanmar and Thailand during the outbreak. For 33 suspected dengue cases collected before the outbreak, two imported cases from Laos and nine residents living in Laos (Laotian cases) were positive for DENV-3. Further, a random subset of 33 positive cases for DENV-3 was sequenced for the full envelope gene of DENV. Phylogenetic analysis showed that all of the 25 autochthonous cases sequenced were grouped into the same clade, genotype II of DENV-3, with imported cases from Laos and Laotian cases. These results suggest that the genotype II of DENV-3 was associated with the outbreak and may have originated from the virus circulating in Laos.

  6. 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

  7. 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

  8. 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.

  9. The distinct distribution and phylogenetic characteristics of dengue virus serotypes/genotypes during the 2013 outbreak in Yunnan, China: Phylogenetic characteristics of 2013 dengue outbreak in Yunnan, China.

    PubMed

    Wang, Binghui; Yang, Henglin; Feng, Yue; Zhou, Hongning; Dai, Jiejie; Hu, Yunzhang; Zhang, Li; Wang, Yajuan; Baloch, Zulqarnain; Xia, Xueshan

    2016-01-01

    Since 2000, sporadic imported cases of dengue fever were documented almost every year in Yunnan Province, China. Unexpectedly, a large-scale outbreak of dengue virus (DENV) infection occurred from August to December 2013, with 1538 documented cases. In the current study, 81 dengue-positive patient samples were collected from Xishuangbanna, the southernmost prefecture of the Yunnan province, and 23 from Dehong, the westernmost prefecture of the Yunnan province. The full-length envelope genes were amplified and sequenced. Phylogenetic analysis revealed that nine strains (39.1%) and 14 strains (60.9%) from the Dehong prefecture were classified as genotype I of DENV-1 and Asian I genotype of DENV-2, respectively. All strains from Xishuangbanna were identified as genotype II of DENV-3. Bayesian coalescent analysis indicates that the outbreak originated from bordering southeastern Asian countries. These three epidemic genotypes were predicted to originate in Thailand and then migrate into Yunnan through different routes.

  10. Tetravalent Dengue Vaccine: A Review in the Prevention of Dengue Disease.

    PubMed

    Scott, Lesley J

    2016-09-01

    Tetravalent, live-attenuated, dengue vaccine (Dengvaxia(®); CYD-TDV) is the first vaccine approved for the prevention of dengue disease caused by dengue virus (DENV) serotypes 1-4 in individuals aged 9-45 or 9-60 years living in high dengue endemic areas. This narrative review discusses the immunogenicity, protective efficacy, reactogenicity and safety of CYD-TDV in the prevention of dengue disease. In Latin American and Asian phase 3 trials in children and adolescents (n > 30,000), the recommended three-dose CYD-TDV regimen was efficacious in preventing virologically-confirmed dengue (VCD) during the period from 28 days after the last dose (month 13) to month 25, meeting the primary endpoint criteria. Protective efficacy against VCD in the respective individual trials was 60.8 and 56.5 % (primary analysis). During the 25-month active surveillance phase, CYD-TDV also provided protective efficacy against VCD, severe dengue, any grade of dengue haemorrhagic fever and VCD-related hospitalization in children aged 9 years and older. CYD-TDV was generally well tolerated, with no safety concerns identified after up to 4 years' follow-up (i.e. from post dose 1) in ongoing long-term studies. Based on evidence from the dengue clinical trial program, the WHO SAGE recommended that countries with high dengue endemicity consider introducing CYD-TDV as part of an integrated disease prevention strategy to lower disease burden. Pharmacoeconomic considerations will be pivotal to implementing dengue vaccination prevention strategies in these countries. The availability of a dengue vaccine is considered essential if the 2012 WHO global strategy targets for reducing the burden of dengue disease by 2020 are to be attained. Hence, CYD-TDV represents a major advance for the prevention of dengue disease in high dengue endemic regions. PMID:27506852

  11. Unusual manifestations in dengue outbreak 2009, Delhi, India.

    PubMed

    Jhamb, Rajat; Kumar, Ashok; Ranga, G S; Rathi, Nitin

    2010-12-01

    Epidemics of Dengue fever (DF) and Dengue hemorrhagic fever (DHF) are common in Southeast Asia. DF is defined & classified according to WHO criteria. Variable clinical manifestations of DF & DHF have been described in earlier studies. But some patients present with unusual clinical features and clinical profile not classifiable according to the present WHO criteria. Some of these complications if not recognized early and treated properly can even prove fatal. So this study was done to describe various clinical features in Dengue fever with special emphasis on unusual manifestations. This study was conducted at University College of Medical Sciences and associated Guru Teg Bahadur hospital; a tertiary care hospital, located in East Delhi in India. It was a retrospective study of 76 patients of probable DF; including 4 cases of DHF (according to WHO classification); 60 males & 16 females above 12 years of age admitted in medical wards of Guru Teg Bahadur hospital in an outbreak of DF which occurred during September-December 2009. The data obtained was analyzed to see clinical and laboratory profile of DF/DHF with special emphasis on unusual manifestations. The mean age of the patients was 28 +/- 9.6 years. Fever was present in all the cases with an average duration of fever being 5.47 +/- 2.2 days with body ache, (84.2%), vomiting (61.8%), abdominal pain (51.3%) and headache (19.7%) being the other presenting complaints. Hemorrhagic manifestations in the form of gum bleeding and epistaxis (35.5%), positive tourniquet test (27.6%); skin rashes (15.8%), melena (15.8%) and hematemesis (5.26%) were also present. In our study a fair no of patients presented with unusual symptoms like pain in abdomen 39 (51.3%), nausea 32 (42.1%), & vomiting 47 (61.8%), which is higher than that reported previous outbreak. Of the 39 patients who presented with abdominal pain; ultrasonography of abdomen was done in 25 patients. Fifteen (38%) of these were found to have acalculous

  12. Epidemiological and Virological Characterizations of the 2014 Dengue Outbreak in Guangzhou, China

    PubMed Central

    Wang, Jian; Hong, Wen-Xin; Zhao, Ling-Zhai; Deng, Yong-Qiang; Qiu, Shuang; Zhang, Yu; Cai, Wei-Ping; Cao, Wu-Chun; Qin, Cheng-Feng

    2016-01-01

    Dengue used to be recognized as an imported and sporadic disease in China. Since June 2014, an unexpected large dengue outbreak has attacked Guangzhou, China, resulting in more than 40,000 cases. Among the 1,942 laboratory-confirmed hospitalized dengue cases, 121 were diagnosed as severe dengue according to the 2009 WHO guideline, and 2 patients finally died. Laboratory diagnosis and virus isolation demonstrated that the majority (96%) cases were caused by dengue virus serotype 1 (DENV-1), and the others by serotype 2 (DENV-2). 14 DENV strains were isolated from the sera of acute-phase dengue patients during this outbreak, and the complete envelope (E) gene of 12 DENV-1 strains and two DENV-2 strains were determined using RT-PCR assay. Phylogenetic analysis based on the E gene revealed the DENV-1 strains isolated during the outbreak belonged to genotype I and V, respectively. These isolates formed three clades. DENV-2 isolates were assigned to the same clade belonging to genotype cosmopolitan. These strains isolated in 2014 were closely related to the isolates obtained from the same province, Guangdong, in 2013. No amino acid mutations known to increase virulence were identified throughout the E protein of isolates in 2014. These results indicate that dengue is turning into endemic in Guangdong, China, and extensive seroepidemiological investigation and mosquito control measures are critically needed in the future. PMID:27257804

  13. Maiden outbreaks of dengue virus 1 genotype III in rural central India.

    PubMed

    Barde, P V; Kori, B K; Shukla, M K; Bharti, P K; Chand, G; Kumar, G; Ukey, M J; Ali, N A; Singh, N

    2015-01-01

    Dengue is regarded as the most important arboviral disease. Although sporadic cases have been reported, serotypes responsible for outbreaks have not been identified from central India over the last 20 years. We investigated two outbreaks of febrile illness, in August and November 2012, from Korea district (Chhattisgarh) and Narsinghpur district (Madhya Pradesh), respectively. Fever and entomological surveys were conducted in the affected regions. Molecular and serological tests were conducted on collected serum samples. Dengue-specific amplicons were sequenced and phylogenetic analyses were performed. In Korea and Narsinghpur districts 37·3% and 59% of cases were positive, respectively, for dengue infection, with adults being the worst affected. RT-PCR confirmed dengue virus serotype 1 genotype III as the aetiology. Ninety-six percent of infections were primary. This is the first time that dengue virus 1 outbreaks have been documented from central India. Introduction of the virus into the population and a conducive mosquitogenic environment favouring increased vector density caused the outbreak. Timely diagnosis and strengthening vector control measures are essential to avoid future outbreaks.

  14. 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.

  15. 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.

  16. 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. PMID:27366770

  17. 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. PMID:27215933

  18. A focal, rapidly-controlled outbreak of dengue fever in two suburbs in Townsville, north Queensland, 2001.

    PubMed

    Hills, Susan L; Piispanen, John P; Humphreys, Jan L; Foley, Peter N

    2002-01-01

    In April-May 2001 an outbreak of dengue fever occurred in two suburbs in Townsville, north Queensland. This was the first outbreak in the Townsville region since a very large outbreak in 1992-1993. Notification delays resulted in late detection of the outbreak. Once recognised, control measures were implemented and rapid control was achieved. Dengue serotype 2 was the causative virus and 9 cases of dengue fever were documented. The approach to management of dengue fever outbreaks and vector control strategies have been improved and refined in the years since the 1992-1993 outbreak. These measures, in addition to favourable weather conditions, were likely to have contributed to the successful containment of this outbreak.

  19. Dengue-3 outbreak in Paraguay: investigations using capillary blood samples on filter paper.

    PubMed

    Matheus, Severine; Meynard, Jean-Baptiste; Lavergne, Anne; Girod, Romain; Moua, David; Labeau, Bhety; Dussart, Philippe; Lacoste, Vincent; Deparis, Xavier

    2008-11-01

    During a dengue-3 outbreak in Paraguay at the beginning of 2007, capillary blood samples absorbed onto filter papers were collected from 44 suspected cases. These samples were subjected to three molecular and serologic tests, and 31 of the 44 samples gave a positive result by at least one of the techniques used. Molecular analyses detected the dengue-3 serotype in 22 patients and additionally the dengue-2 serotype in two patients. Therefore two different serotypes were co-circulating during this outbreak. Overall, this study validates the use of dried-blood samples for field screening investigations. Indeed, all types of laboratory studies of dengue were possible with samples consisting of a few drops of dried blood from finger pricks.

  20. Clinical & virological study of dengue fever outbreak in Jalore city, Rajasthan 1985.

    PubMed

    Chouhan, G S; Rodrigues, F M; Shaikh, B H; Ilkal, M A; Khangaro, S S; Mathur, K N; Joshi, K R; Vaidhye, N K

    1990-11-01

    An epidemic of acute febrile illness caused by dengue virus occurred in Jalore town, in south-west Rajasthan, in April and May, 1985. Most patients had classical signs and symptoms of dengue fever or had only a mild atypical febrile illness. A few patients had in addition haemorrhagic manifestations/shock or encephalitis. Virological studies (carried out by the National Institute of Virology, Pune) showed that dengue type 3 virus was the main etiological agent. This is the first reported outbreak of dengue in the arid zone in western Rajasthan, that occurred in summer (April-May) in contrast to other parts of India, where such outbreaks are commonly reported after the rains (between August and November).

  1. Epidemiological and entomological investigation in dengue outbreak area of Ahmedabad district.

    PubMed

    Joshi, P T; Pandya, A P; Anjan, J K

    2000-03-01

    Epidemiological and Entomological investigations conducted in seven affected villages of Sanand and Viramgam Talukas of Ahmedabad district revealed that all age groups and both the genders were affected. 33.33% blood samples of patients showed seropositivity suggesting dengue infection Similarly, Dengue virus antigen was detected in 7 Females Ae. aegypti out of 2 Males and 26 Females tested by indirect immunofluroscent technique. Aedes aegypti population measured by various parameters i.e. Premise index (32.16%), Receptacle index (26.15%) and infested receptacle index (0.36%) were above the critical limit. Aedes aegypti population is susceptible to 5% Malathion. The findings suggest the fever outbreak was of dengue. Co-related evidences indicated the possible role of dengue 2 virus in the outbreak.

  2. 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

  3. A potential risk assessment of a dengue outbreak in north central Texas, USA. (Part 1 of 2): Abundance and temporal variation of dengue vectors.

    PubMed

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

    2009-06-01

    In response to three imported dengue cases in north central Texas as well as increased case numbers in Texas and adjoining Mexican states in 2005, the authors assessed the potential risk of a dengue outbreak in north central Texas by investigating abundance and temporal variation of dengue vectors in 2006. Dengue vector abundance was monitored from 54 sites in Dallas County, Texas, from June to November 2006, using oviposition traps. Both dengue vectors--the yellow fever mosquito, Aedes aegypti, and the Asian tiger mosquito, Aedes albopictus--were present. Of the two, Ae. albopictus was more abundant and its abundance appeared to be positively affected by temperature and precipitation. Potential risk of a dengue outbreak was predicted based on the abundance and temporal variation of dengue vectors and a long-term trend of breeding season precipitation and warmer winter temperatures.

  4. 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. PMID:27031524

  5. 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.

  6. Dengue outbreak associated with multiple serotypes--Puerto Rico, 1998.

    PubMed

    1998-11-13

    Dengue is an acute viral disease caused by any of the four dengue virus serotypes (DEN-1, DEN-2, DEN-3, and DEN-4). The principal mosquito vector is Aedes aegypti, which has a worldwide distribution in tropical and many subtropical areas. All four virus serotypes produce a similar illness characterized by fever, headache, myalgias, arthralgias, rash, nausea and vomiting and induce life-long immunity that is specific to the infecting serotype. A small proportion of infected persons may develop the severe form of disease, dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS), but with early diagnosis and proper supportive management, fatality rates may be <1%. This report summarizes an epidemic of dengue in Puerto Rico in 1998 associated with multiple dengue serotypes.

  7. Outbreak of dengue fever in rural areas of Parbhani district of Maharashtra (India).

    PubMed

    Mehendale, S M; Risbud, A R; Rao, J A; Banerjee, K

    1991-01-01

    Outbreak of dengue fever in Chikalthana, Pimpalgaon and Waloor villages in Parbhani district of Maharashtra (India) were investigated. Clinically, the illness was typical of dengue fever except for the absence of maculopapular rash. A total of 42 acute, 14 late acute, 73 convalescent and 19 sera from contacts were collected. Of the 15 virus isolates, 12 were identified as dengue virus type 2 and 1 as dengue virus type 1. Serological tests confirmed the etiological role of dengue virus in the outbreak. House-to-house survey was carried out in Chikalthana and Pimpalgaon villages. Overall, 15.09 per cent of the surveyed population was affected during the outbreak and attack rate was higher at Pimpalgaon. A tendency of water storage was observed in the households and concomitant entomological studies proved Aedes aegypti breeding. Higher prevalence of dengue fever was noted among larger families and in families that had two or more patients, the commonest duration between the first and the last patient was often less than 5 days.

  8. Dengue outbreak in Delhi in 2009: study of laboratory and clinical parameters.

    PubMed

    Chakravarti, Anita; Suresh, Kumar; Neha; Shweta; Malik, Sonia

    2012-09-01

    Dengue infection is endemic in India with frequent epidemics of Dengue Fever/Dengue Hemorrhagic Fever. The outbreaks vary in the commonest serotype in circulation during that period, predominant laboratory findings and clinical manifestations. This study was carried during the outbreak of dengue in Delhi in 2009. Clinical assessment and laboratory investigations were performed and severity of the disease with clinical, haematological parameters and serotypes were correlated. Of 107 patients included in the study, 64 (59.8%) were positive by ELISA. These 64 patients were tested by RT-PCR and 7 were found to be positive. DEN-2 and DEN-4 serotypes were isolated. There was a decreasing trend in mean age of patients with severity of infection. The outbreak was milder as compared to earlier ones in regards of number of cases presenting with clinical manifestations of bleeding. A considerable number of patients presented with unusual findings, namely, ascites, pleural effusion, myocarditis, cholecystitis and pancreatitis. There was no statistically significant difference either in platelet count between various groups or comparison of bleeding with severity of thrombocytopenia. This study provides an insight into the clinico-laboratory findings of the outbreak of dengue in 2009.

  9. 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.

  10. Characterization of the dengue outbreak in Nuevo Leon state, Mexico, 2010.

    PubMed

    Leduc-Galindo, D; Gloria-Herrera, U; Rincón-Herrera, U; Ramos-Jiménez, J; Garcia-Luna, S; Arellanos-Soto, D; Mendoza-Tavera, N; Tavitas-Aguilar, I; Garcia-Garcia, E; Galindo-Galindo, E; Villarreal-Perez, J; Fernandez-Salas, I; Santiago, G A; Muñoz-Jordan, J; Rivas-Estilla, A M

    2015-04-01

    We studied serotypes circulating dengue virus (DENV) cases, entomological Breteau index, rain-fall index and epidemiology of groups affected during the 2010 outbreak in Nuevo Leon, Mexico. From 2,271 positive cases, 94% were dengue classic and 6% dengue hemorrhagic fever; DENV1 was mainly isolated (99%) (Central-American lineage of American-African-genotype). We found correlation between two environmental phenomena (Increment of rainfall and vector-indexes) (p ≤ 0.05) with epidemiological, clinical and risk of DENV-1 ongoing transmission.

  11. 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…

  12. A data-driven epidemiological prediction method for dengue outbreaks using local and remote sensing data

    PubMed Central

    2012-01-01

    Background Dengue is the most common arboviral disease of humans, with more than one third of the world’s population at risk. Accurate prediction of dengue outbreaks may lead to public health interventions that mitigate the effect of the disease. Predicting infectious disease outbreaks is a challenging task; truly predictive methods are still in their infancy. Methods We describe a novel prediction method utilizing Fuzzy Association Rule Mining to extract relationships between clinical, meteorological, climatic, and socio-political data from Peru. These relationships are in the form of rules. The best set of rules is automatically chosen and forms a classifier. That classifier is then used to predict future dengue incidence as either HIGH (outbreak) or LOW (no outbreak), where these values are defined as being above and below the mean previous dengue incidence plus two standard deviations, respectively. Results Our automated method built three different fuzzy association rule models. Using the first two weekly models, we predicted dengue incidence three and four weeks in advance, respectively. The third prediction encompassed a four-week period, specifically four to seven weeks from time of prediction. Using previously unused test data for the period 4–7 weeks from time of prediction yielded a positive predictive value of 0.686, a negative predictive value of 0.976, a sensitivity of 0.615, and a specificity of 0.982. Conclusions We have developed a novel approach for dengue outbreak prediction. The method is general, could be extended for use in any geographical region, and has the potential to be extended to other environmentally influenced infections. The variables used in our method are widely available for most, if not all countries, enhancing the generalizability of our method. PMID:23126401

  13. [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.

  14. 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

  15. 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

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

    PubMed

    Rezza, Giovanni

    2014-12-01

    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

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

    PubMed

    Rezza, Giovanni

    2014-12-01

    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.

  18. Ongoing outbreak of dengue serotype-3 in Solomon Islands, January to May 2013

    PubMed Central

    Joshua, Cynthia; Sio, Alison; Shortus, Matthew; Dalipanda, Tenneth; Durski, Kara; Musto, Jennie; Puiahi, Elliot; Dofai, Alfred; Aaskov, John; Cao-Lormeau, Van Mai; Musso, Didier; Dutta, Nick; Fleisch, Juliet; Nilles, Eric

    2013-01-01

    Methods Enhanced dengue surveillance was implemented in the capital, Honiara, and in the provinces. This included training health staff on dengue case definitions, data collection and reporting. Vector surveillance was also conducted. Results From 3 January to 15 May 2013, 5254 cases of suspected dengue were reported (101.8 per 10 000 population), including 401 hospitalizations and six deaths. The median age of cases was 20 years (range zero to 90), and 86% were reported from Honiara. Both Aedes aegyti and Aedes albopictus were identified in Honiara. Outbreak response measures included clinical training seminars, vector control activities, implementation of diagnostic and case management protocols and a public communication campaign. Discussion This was the first large dengue outbreak documented in Solomon Islands. Factors that may have contributed to this outbreak include a largely susceptible population, the presence of a highly efficient dengue vector in Honiara, a high-density human population with numerous breeding sites and favourable weather conditions for mosquito proliferation. Although the number of cases has plateaued since 1 April, continued enhanced nationwide surveillance and response activities are necessary. PMID:24319611

  19. 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. PMID:25144749

  20. 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.

  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. Discriminable roles of Aedes aegypti and Aedes albopictus in establishment of dengue outbreaks in Taiwan.

    PubMed

    Yang, Chao-Fu; Hou, Jion-Nun; Chen, Tien-Huang; Chen, Wei-June

    2014-02-01

    Aedes aegypti and Aedes albopictus were reported to be significant as vectors of dengue fever. In Taiwan, the latter is distributed throughout the island while the former appears only south of the Tropic of Cancer; i.e., 23.5°N. In the past decade, there were five outbreaks with over 1000 cases of dengue fever in Taiwan. Without exception, these outbreaks all occurred in the south where the two Aedes mosquitoes are sympartic. According to the Center for Disease Control of Taiwan, imported cases are thought to provide the seeds of dengue outbreaks every year. Mostly, the number of imported cases is greater in northern island, probably due to a larger population of travelers and imported workers from endemic countries. Looking at the example in 2002, northern, central, and southern parts of Taiwan reported 28, 11, and 13 imported cases, respectively. However, 54, 21, and 5309 total cases were confirmed in the corresponding regions over the entire year, indicating a significant skew of case distributions. A hypothesis is thus inspired that the existence of Ae. aegypti is a prerequisite to initiate a dengue outbreak, while participation of Ae. albopictus expands or maintains the scale until the de novo herd immunity reaches high level.

  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. Surface water areas significantly impacted 2014 dengue outbreaks in Guangzhou, China.

    PubMed

    Tian, Huaiyu; Huang, Shanqian; Zhou, Sen; Bi, Peng; Yang, Zhicong; Li, Xiujun; Chen, Lifan; Cazelles, Bernard; Yang, Jing; Luo, Lei; Jing, Qinlong; Yuan, Wenping; Pei, Yao; Sun, Zhe; Yue, Tianxiang; Kwan, Mei-Po; Liu, Qiyong; Wang, Ming; Tong, Shilu; Brownstein, John S; Xu, Bing

    2016-10-01

    Dengue transmission in urban areas is strongly influenced by a range of biological and environmental factors, yet the key drivers still need further exploration. To better understand mechanisms of environment-mosquito-urban dengue transmission, we propose an empirical model parameterized and cross-validated from a unique dataset including viral gene sequences, vector dynamics and human dengue cases in Guangzhou, China, together with a 36-year urban environmental change maps investigated by spatiotemporal satellite image fusion. The dengue epidemics in Guangzhou are highly episodic and were not associated with annual rainfall over time. Our results indicate that urban environmental changes, especially variations in surface area covered by water in urban areas, can substantially alter the virus population and dengue transmission. The recent severe dengue outbreaks in Guangzhou may be due to the surge in an artificial lake construction, which could increase infection force between vector (mainly Aedes albopictus) and host when urban water area significantly increased. Impacts of urban environmental change on dengue dynamics may not have been thoroughly investigated in the past studies and more work needs to be done to better understand the consequences of urbanization processes in our changing world. PMID:27336234

  5. Surface water areas significantly impacted 2014 dengue outbreaks in Guangzhou, China.

    PubMed

    Tian, Huaiyu; Huang, Shanqian; Zhou, Sen; Bi, Peng; Yang, Zhicong; Li, Xiujun; Chen, Lifan; Cazelles, Bernard; Yang, Jing; Luo, Lei; Jing, Qinlong; Yuan, Wenping; Pei, Yao; Sun, Zhe; Yue, Tianxiang; Kwan, Mei-Po; Liu, Qiyong; Wang, Ming; Tong, Shilu; Brownstein, John S; Xu, Bing

    2016-10-01

    Dengue transmission in urban areas is strongly influenced by a range of biological and environmental factors, yet the key drivers still need further exploration. To better understand mechanisms of environment-mosquito-urban dengue transmission, we propose an empirical model parameterized and cross-validated from a unique dataset including viral gene sequences, vector dynamics and human dengue cases in Guangzhou, China, together with a 36-year urban environmental change maps investigated by spatiotemporal satellite image fusion. The dengue epidemics in Guangzhou are highly episodic and were not associated with annual rainfall over time. Our results indicate that urban environmental changes, especially variations in surface area covered by water in urban areas, can substantially alter the virus population and dengue transmission. The recent severe dengue outbreaks in Guangzhou may be due to the surge in an artificial lake construction, which could increase infection force between vector (mainly Aedes albopictus) and host when urban water area significantly increased. Impacts of urban environmental change on dengue dynamics may not have been thoroughly investigated in the past studies and more work needs to be done to better understand the consequences of urbanization processes in our changing world.

  6. Description of a large island-wide outbreak of dengue in Puerto Rico, 2007.

    PubMed

    Tomashek, Kay M; Rivera, Aidsa; Muñoz-Jordan, Jorge L; Hunsperger, Elizabeth; Santiago, Luis; Padro, Oscar; Garcia, Enid; Sun, Wellington

    2009-09-01

    Dengue is a mosquito-borne viral disease that affects 40% of the world's population. Nearly four million U.S. citizens live in dengue-endemic areas; the most affected population resides in Puerto Rico. Data from a dengue surveillance system were used to describe all suspected cases reported in Puerto Rico in 2007. Rates of infection per 10,000 residents were calculated by age, sex, and residence. Rates and clinical outcomes were compared with those from outbreaks in 1994-1995 and 1998. In 2007, 10,508 suspected cases were reported; 52.5% persons were hospitalized, 31.8% reported hemorrhage, 2.2% had dengue hemorrhage fever, and 44 died. A total of 3,293 (33.0%) of processed specimens were laboratory positive for dengue virus (DENV); DENV-3 (1,342, 61.7%) and DENV-2 (677, 31.1%) were detected most often. The overall incidence of laboratory-positive dengue was 8.6 infections per 10,000 population. Rates were highest among persons 10-14 years of age (19.0), followed by persons 15-19 years of age (17.9) and infants (10.9). Higher rates of hospitalization and hemorrhage were reported in 2007 than in 1994-1995 or 1998. United States citizens residing in Puerto Rico are at risk of acquiring dengue. Data suggest that the severity is worsening, and persons 10-19 years of age and infants continue to be most affected.

  7. Dengue hemorrhagic fever outbreak in children in Port Sudan.

    PubMed

    Malik, Amal; Earhart, Kenneth; Mohareb, Emad; Saad, Magdi; Saeed, Mubarak; Ageep, Ali; Soliman, Atef

    2011-03-01

    Dengue fever (DF)/dengue hemorrhagic fever (DHF) has emerged as a global public health problem with countries in Asia and the Pacific sharing more than 70% of the disease burden. In 2004-2005 a total of 312 cases admitted to Pediatric and Sea Port Hospitals in Port Sudan were clinically diagnosed as DHF. The mortality rate recorded was 3.8% (n=12). Of the cases 73.4% were patients 5-15 years of age. A total of 91.2% of cases were admitted during May and June 2005 with 49.4% residing in the eastern region of Port Sudan. Dengue shock syndrome was observed in 37 of 312 (11.9%). All patients had thrombocytopenia with platelets count ranged from <100,000 to <150,000 cell/mm³. Of the 40 sera tested using RAPID-cassette test in the Khartoum Central Public Health Lab, 36 (90%) were dengue IgM positive. A subset of these sera (n=23) were sent to NAMRU-3 and confirmed by IgM-capture ELISA; 9 of 23 were PCR positive for dengue serotype 3.

  8. 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

  9. Field epidemiology of an outbreak of dengue fever in Charters Towers, Queensland: are insect screens protective?

    PubMed

    Murray-Smith, S; Weinstein, P; Skelly, C

    1996-10-01

    Between March and July 1993 a dengue virus epidemic swept through Charters Towers, a rural North Queensland mining community of 10,000. This clearly delineated outbreak provided an ideal opportunity to carry out one of the few field epidemiological studies of dengue in Australia. The epicurve was consistent with that of a point source outbreak, 18 weeks in duration and peaking at four weeks. A basic reproduction number for the dengue epidemic of 1.99 indicates a similar rate of spread to that found in dengue epidemics overseas. A female-to-male sex ratio of 1.7:1 was obtained for the 238 cases identified. An age- and sex-matched retrospective case-control study showed that cases were significantly more likely to live in unscreened houses than were controls (McNemar chi 2 = 56.1 df, P < 0.0001). Despite being generally accepted, an association between insect screens and a reduced incidence of mosquito-borne diseases has not previously been demonstrated in Australia. We speculate that unscreened housing facilitates the initial spread of a dengue epidemic.

  10. 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. PMID:26503276

  11. 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

  12. 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.

  13. 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

  14. 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

  15. Lessons learned during dengue outbreaks in the United States, 2001-2011.

    PubMed

    Adalja, Amesh A; Sell, Tara Kirk; Bouri, Nidhi; Franco, Crystal

    2012-04-01

    Since 2001, three autochthonous dengue fever outbreaks have occurred in the United States: in Hawaii (2001); Brownsville, Texas (2005); and southern Florida (2009-2011). We sought to characterize and describe the response to these outbreaks from the perspectives of public health and vector control officials. By conducting a medical literature review through PubMed and news media searches through Google, we identified persons involved in managing each outbreak; 26 persons then participated in qualitative, semistructured interviews. After analyzing the 3 outbreaks, we found the following prominent themes in the response efforts: timely detection of illness; communication of up-to-date, correct information; and development of a rapid response that engages the community. We therefore recommend that public health authorities involve the clinical and laboratory community promptly, provide accurate information, and engage the local community in vector control and case identification and reporting.

  16. Clinical observations of virologically confirmed dengue fever in the 1987 outbreak in southern Taiwan.

    PubMed

    Liu, H W; Ho, T L; Hwang, C S; Liao, Y H

    1989-01-01

    Fifty-nine virologically confirmed cases of dengue fever were clinically studied during the 1987 outbreak in southern Taiwan. Viral isolation and serologic studies indicated that type 1 dengue was the cause. Dengue fever has not been on the island of Taiwan for 42 years and nearly all the population under 42 years of age is susceptible. Most patients under age 42 experience primary infection while those over 42 years old experience secondary infection. The majority of 59 cases studied were females in the 21-30-year age group. Classic signs and symptoms ere fever, headache, muscle pain, joint pain, nausea and vomiting, and skin rash. Approximately 80% of the patients had leukopenia (less than 5,000/mm3) and thrombocytopenia (less than 50,000/mm3) and 90% experienced mild to moderate elevation of serum glutamic oxaloacetic transaminase. Hemorrhagic manifestations occurred in 25.4% of patients. No patients under observation in this study developed hypotension or died.

  17. [Clinical features of dengue fever in children during the outbreak in Santiago de Cuba].

    PubMed

    Vargas Caballero, M E; Aguirre Portuondo, T M; Palacios Serrano, H

    2001-01-01

    A study of the dengue outbreak occurred from January to November 1997 in Santiago de Cuba municipality was performed to characterize the clinical picture of the patients. The sample was taken from those patients presenting with clinical and epidemiological elements and positive IgM determination serological test. Seventy-seven patients were confirmed as having dengue virus 2 infection whose clinical-humoral characteristic was dengue fever predominantly present in school boys. The clinical picture was given by fever headache, retrorbitary pain, osteomioarticular pain as the most common symptom and by exanthema as a prevailing sign. Most of bleedings occurred on the 2nd day and the most frequent hemorrhagic manifestation was positive tourniquet test.

  18. The first reported outbreak of dengue hemorrhagic fever in Irian Jaya, Indonesia.

    PubMed

    Richards, A L; Bagus, R; Baso, S M; Follows, G A; Tan, R; Graham, R R; Sandjaja, B; Corwin, A L; Punjabi, N

    1997-07-01

    During the months of September 1993 through February 1994, an outbreak of hemorrhagic fever occurred in the city of Jayapura, the provincial capital of Irian Jaya, Indonesia. Seventy-two patients (age range = 1-41 years) with suspected dengue hemorrhagic fever (DHF) were enrolled into the outbreak investigation conducted during October-November 1993. The pediatric patient population consisted of 36 individuals ages 1-12 years of age with a similar male to female ratio. From clinical histories obtained from the children diagnosed with DHF (n = 23), the predominant complaints were fever (100%), headache (96.7%), vomiting (47.8%), abdominal pain (39.1%), back/bone pain (39.1%), cough (39.1%), sore throat (21.7%), convulsions (17.4%), and eye pain (13.0%). Clinical findings of the same pediatric patients included a positive tourniquet test result (100%), thrombocytopenia (100%), hemoconcentration (100%), skin petechiae (43.5%), epistaxis (39.1%), and maculopapular rash (26%). All four of the children diagnosed with DHF grade IV had hepatomegaly, pleural effusion, ascites, cold perspiration, and confusion. Serologic data demonstrated that a majority (46 of 70, 68.7%) of the individuals assessed did not have significant levels of IgM specific for dengue viruses at the time of their admission. However, the nine successful dengue virus isolations were only from these serononreactive cases (19.6%). From the other patients assessed, 11.4% had a primary (or first exposure) serologic response to dengue virus antigen (predominantly IgM); 17.1% had a secondary (or subsequent exposure) serologic response to the same dengue antigens (predominantly IgG response) and 5.7% (four adults) had indeterminate serologic data that could not differentiate between reactivity to dengue or Japanese encephalitis virus antigen preparations. Virus culture of blood samples produced nine dengue virus isolates: DEN- 1 (2), DEN-2 (1), and DEN-3 (6). Japanese encephalitis and influenza viruses were not

  19. Predominance of the DEN-3 genotype during the recent dengue outbreak in Bangladesh.

    PubMed

    Aziz, M M; Hasan, K N; Hasanat, M A; Siddiqui, M A; Salimullah, M; Chowdhury, A K; Ahmed, Moslehuddin; Alam, M N; Hassan, M S

    2002-03-01

    A recent outbreak of dengue in Bangladesh was marked by many fatal complications. As clinical virulence varies among the genotypes of dengue virus, a study was conducted to investigate the molecular genotypes of dengue in Bangladesh. Reverse transcription polymerase chain reaction was used to determine viral genotypes using oligonucleotide generic primers that produce a 511 bp product. The resulting product was typed by nested PCR with strain-specific primers, yielding 482 (DEN-1), 119 (DEN-2), 290 (DEN-3) and 392 (DEN-4), visualized on UV transilluminator after electrophoresis on 2% agarose gel stained with ethidium bromide. Of 45 clinically diagnosed dengue patients (mean age 28 years; male/female 30/15), 19 (42.2%) had detectable viral RNA in their blood. However, during the first 5 days of fever in 30 patients, the frequency was 60% (18/30), implying that the sooner serum is drawn after the fever, the greater the chances of detecting viral RNA. DEN-3 was detected in all except 2 patients who were infected with DEN-2. DEN-2 (two cases) and DEN-4 (one case) were present as co-infections with DEN-3. All of the patients presented with fever, anorexia and vomiting; many had headache and general body ache; a few had a rash. About a quarter had suffered episodes of bleeding, while ascites, pleural effusion and CNS symptoms were found in a few patients Patients positive for viral RNA were also positive for anti-dengue IgM (p=0.007) in subsequent sampling. The study suggests the predominance of DEN-3 infection with occasional co-infection with other types, during the recent outbreak of dengue in Bangladesh.

  20. 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.

  1. 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

  2. Dengue outbreak in a hilly state of Arunachal Pradesh in Northeast India.

    PubMed

    Khan, Siraj A; Dutta, Prafulla; Topno, Rashmee; Soni, Monika; Mahanta, Jagadish

    2014-01-01

    Dengue has been reported from plains as well as hilly regions of India including some parts of Northeast India. In July-August 2012, outbreak of fever with unknown origin (FUO) indicative of Dengue was reported in Pasighat, East Siang district of Arunachal Pradesh (AP) state. Serum samples (n = 164) collected from patients from Health Training and Research Centre General Hospital, Pasighat, were tested for NS1 antigen and IgM antibodies. NS1-positive samples were analyzed by RT-PCR assay and entomological surveys were carried out. The majority of suspected cases reported NS1 antigen positivity. Females and young adults were mostly affected. The majority of the amplified NS1-positive samples showed Dengue serotype 3 infection. Aedes (Stegomyia) albopictus, known as semiurban breeding mosquitoes, was the only potential vector species identified from the affected areas of Pasighat which single handedly contributed to the outbreak. Thus, the present work identifies Dengue as an emerging arboviral infection in hilly state of AP along with a looming risk of its spread to neighbouring areas.

  3. [Molecular and serological diagnosis of a dengue outbreak in Coro, Falcón state, Venezuela].

    PubMed

    Moros, Zoila Caridad; Abad, María Jesús; Arsenak, Miriam; Martínez, Dilia; Cierco, Maria Magdalena; Costagliola, Asunta; Urbina, Leyda; Taylor, Peter; Liprandi, Ferdinando; Pujol, Flor Helene

    2003-09-01

    Dengue virus (DV) is responsible for a spectrum of diseases, from a self-limited fever disease (DF, dengue fever) to the more severe forms of hemorrhagic fever/dengue shock syndrome (DHF/DSS). The aim of this study was the serological and molecular confirmation of an outbreak of dengue in Falcon state, Venezuela. A total of 54 sera from patients with clinical diagnosis of DV infection were analyzed by an enzyme immunoassays developed in Venezuela (ELISA -IgM e -IgG) and by PCR. From them, 78% exhibited DV infection (PCR+ y/o IgM+), 48% exhibited viremia by PCR and 57% were positive to IgM. An interesting observation was the high percent (76%) of patients with past or secondary infection (IgG positive), which included all the patients exhibiting clinical symptoms of DHF (n = 8). From the PCR positive sera, serotype 1 was found in 27%, serotype 2 in 54% and serotype 4 in 19%. No serotype 3 was found circulating in this population, although this serotype was already circulating in the nearby island of Aruba. The combination of serological and molecular methods allow us to obtain a fairly precise information of this outbreak.

  4. 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.

  5. 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.

  6. 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

  7. Outbreak of dengue fever in Palau, Western Pacific: risk factors for infection.

    PubMed

    Ashford, David A; Savage, Harry M; Hajjeh, Rana A; McReady, Jill; Bartholomew, David M; Spiegel, Richard A; Vorndam, Vance; Clark, Gary G; Gubler, Duane G

    2003-08-01

    Between January and June 1995, an outbreak of dengue fever occurred in Palau, an island nation of 32,000 inhabitants in the Western Pacific. To determine the magnitude of this outbreak and to determine modifiable risk factors to guide control strategies, we established active surveillance at the national hospital and private clinics, reviewed available clinical records, and conducted serologic and entomologic surveys. Between January 1 and July 1, 1995, 817 case-patients with acute febrile illness with body or joint aches and one of the following: headache, rash, nausea, vomiting, or hemorrhagic manifestations presented to health facilities in Palau. The epidemic peaked in the second week of April 1995. Of 338 case-patients tested, 254 (75%) had positive serologic results by an IgM capture enzyme-linked immunosorbent assay. Dengue 4 virus was isolated from 78 (51%) of 154 serum samples tested. Blood samples collected during a cross-sectional survey were tested for IgM antibody and yielded an attack ratio of 27% (95% confidence interval = 23-31%). Potential vectors included the introduced species Aedes aegypti and Ae. albopictus, and the native species Ae. hensilli. Significant risk factors (P < or = 0.05) for infection included age < 20 years, the presence of food or water pans for animals on the property, taro farming, the presence of Ae. aegypti on the property, and presence of Ae. scutellaris group mosquitoes (Ae. Hensilli, Ae. albopictus, and a native species). This was the first outbreak of dengue 4 virus in the Western Pacific, and the first documented epidemic of dengue in Palau since 1988.

  8. Dengue Epidemiology

    MedlinePlus

    ... the southern U. S., dengue is endemic in northern Mexico, and the U.S. population has no immunity, the ... south Texas in 2005. (Dengue Hemorrhagic Fever - U.S.- Mexico Border, 2005 ) A small dengue outbreak occurred in ...

  9. Best Practices in Dengue Surveillance: A Report from the Asia-Pacific and Americas Dengue Prevention Boards

    PubMed Central

    Beatty, Mark E.; Stone, Amy; Fitzsimons, David W.; Hanna, Jeffrey N.; Lam, Sai Kit; Vong, Sirenda; Guzman, Maria G.; Mendez-Galvan, Jorge F.; Halstead, Scott B.; Letson, G. William; Kuritsky, Joel; Mahoney, Richard; Margolis, Harold S.

    2010-01-01

    Background Dengue fever is a virus infection that is spread by the Aedes aegypti mosquito and can cause severe disease especially in children. Dengue fever is a major problem in tropical and sub-tropical regions of the world. Methodology/Principal Findings We invited dengue experts from around the world to attend meetings to discuss dengue surveillance. We reviewed literature, heard detailed reports on surveillance programs, and shared expert opinions. Results Presentations by 22 countries were heard during the 2.5 day meetings. We describe the best methods of surveillance in general, the stakeholders in dengue surveillance, and the steps from mosquito bite to reporting of a dengue case to explore how best to carry out dengue surveillance. We also provide details and a comparison of the dengue surveillance programs by the presenting countries. Conclusions/Significance The experts provided recommendations for achieving the best possible data from dengue surveillance accepting the realities of the real world (e.g., limited funding and staff). Their recommendations included: (1) Every dengue endemic country should make reporting of dengue cases to the government mandatory; (2) electronic reporting systems should be developed and used; (3) at minimum dengue surveillance data should include incidence, hospitalization rates, deaths by age group; (4) additional studies should be completed to check the sensitivity of the system; (5) laboratories should share expertise and data; (6) tests that identify dengue virus should be used in patients with fever for four days or less and antibody tests should be used after day 4 to diagnose dengue; and (7) early detection and prediction of dengue outbreaks should be goals for national surveillance systems. PMID:21103381

  10. Characteristics of a Dengue Outbreak in a Remote Pacific Island Chain – Republic of the Marshall Islands, 2011–2012

    PubMed Central

    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. PMID

  11. Multiple Sources of Infection and Potential Endemic Characteristics of the Large Outbreak of Dengue in Guangdong in 2014

    PubMed Central

    Shen, Shu-Qun; Wei, Hai-Xia; Fu, Yong-Hang; Zhang, Hao; Mo, Qing-Yi; Wang, Xiao-Jun; Deng, Sheng-Qun; Zhao, Wei; Liu, Yu; Feng, Xiao-Shuang; Chen, Wei; Peng, Hong-Juan

    2015-01-01

    A large outbreak of dengue, with the most documented cases, occurred in Guangdong China in 2014. Epidemiological studies and phylogenetic analysis of the isolated dengue virus (DENV) showed this outbreak was attributed to multiple sources and caused by at least two genotypes of DENV-1 (Genotypes I and III) and two genotypes of DENV-2 (Cosmopolitan and Asian I Genotypes). A retrospective review and phylogenetic analysis of DENV isolated in Guangdong showed that DENV-1 Genotype I strains were reported continuously during 2004–2014, Genotype III strains were reported during 2009–2014 ; DENV-2 Cosmopolitan and Asian I Genotype strains were reported continuously during 2012–2014. At least 45,171 cases were reported in this outbreak, with 65.9% of the patients in the 21–55-year-old group. A trend toward a decrease in the daily newly emerged cases lagged by approximately 20 days compared with the mosquito density curve. Several epidemiological characteristics of this outbreak and the stably sustained serotypes and genotypes of DENV isolated in Guangdong suggest that Guangdong has been facing a threat of transforming from a dengue epidemic area to an endemic area. The high temperature, drenching rain, rapid urbanization, and pandemic of dengue in Southeast Asia may have contributed to this large outbreak of dengue. PMID:26593240

  12. Cardiac complications of a dengue fever outbreak in Sri Lanka, 2005.

    PubMed

    Kularatne, S A M; Pathirage, M M K; Kumarasiri, P V R; Gunasena, S; Mahindawanse, S I

    2007-08-01

    A high incidence of cardiac complications was observed in an outbreak of dengue fever at General Hospital, Peradeniya, Sri Lanka, in 2005. This report describes 120 serologically confirmed dengue fever patients who presented during the outbreak. Seventy-five (62.5%) of these patients had electrocardiogram changes (T inversion, ST depression, bundle branch blocks) and were assigned to the 'cardiac group' (50 females, 25 males; median age 34 years, range 13-76). These patients were more susceptible to fatigue, dyspnoea, low peripheral oxygen saturation in room air (P=0.001), chest pain (P=0.001) and flushing of skin (P=0.05) than 45 (37.5%) patients who had normal electrocardiograms and made up the 'non-cardiac group'. In the cardiac group there were 31 primary and 44 secondary dengue patients. In the cardiac group, 17 (23%) patients had hypotension and 58 (77%) developed tachycardia and bradycardia (P<0.001) compared to four (9%) in the non-cardiac group, suggestive of significant cardiac dysfunction. There was no correlation between pulse rate and body temperature: cardiac group (r=0.05; P=0.63); non-cardiac group (r=0.11, P=0.46). RT-PCR detected DEN-3 in three cardiac patients.

  13. A Household Serosurvey to Estimate the Magnitude of a Dengue Outbreak in Mombasa, Kenya, 2013

    PubMed Central

    Ellis, Esther M.; Neatherlin, John C.; Delorey, Mark; Ochieng, Melvin; Mohamed, Abdinoor Haji; Mogeni, Daniel Ondari; Hunsperger, Elizabeth; Patta, Shem; Gikunju, Stella; Waiboic, Lilian; Fields, Barry; Ofula, Victor; Konongoi, Samson Limbaso; Torres-Velasquez, Brenda; Marano, Nina; Sang, Rosemary; Margolis, Harold S.; Montgomery, Joel M.; Tomashek, Kay M.

    2015-01-01

    Dengue appears to be endemic in Africa with a number of reported outbreaks. In February 2013, several individuals with dengue-like illnesses and negative malaria blood smears were identified in Mombasa, Kenya. Dengue was laboratory confirmed and an investigation was conducted to estimate the magnitude of local transmission including a serologic survey to determine incident dengue virus (DENV) infections. Consenting household members provided serum and were questioned regarding exposures and medical history. RT-PCR was used to identify current DENV infections and IgM anti-DENV ELISA to identify recent infections. Of 1,500 participants from 701 households, 210 (13%) had evidence of current or recent DENV infection. Among those infected, 93 (44%) reported fever in the past month. Most (68, 73%) febrile infected participants were seen by a clinician and all but one of 32 participants who reportedly received a diagnosis were clinically diagnosed as having malaria. Having open windows at night (OR = 2.3; CI: 1.1–4.8), not using daily mosquito repellent (OR = 1.6; CI: 1.0–2.8), and recent travel outside of Kenya (OR = 2.5; CI: 1.1–5.4) were associated with increased risk of DENV infection. This survey provided a robust measure of incident DENV infections in a setting where cases were often unrecognized and misdiagnosed. PMID:25923210

  14. A household serosurvey to estimate the magnitude of a dengue outbreak in Mombasa, Kenya, 2013.

    PubMed

    Ellis, Esther M; Neatherlin, John C; Delorey, Mark; Ochieng, Melvin; Mohamed, Abdinoor Haji; Mogeni, Daniel Ondari; Hunsperger, Elizabeth; Patta, Shem; Gikunju, Stella; Waiboic, Lilian; Fields, Barry; Ofula, Victor; Konongoi, Samson Limbaso; Torres-Velasquez, Brenda; Marano, Nina; Sang, Rosemary; Margolis, Harold S; Montgomery, Joel M; Tomashek, Kay M

    2015-04-01

    Dengue appears to be endemic in Africa with a number of reported outbreaks. In February 2013, several individuals with dengue-like illnesses and negative malaria blood smears were identified in Mombasa, Kenya. Dengue was laboratory confirmed and an investigation was conducted to estimate the magnitude of local transmission including a serologic survey to determine incident dengue virus (DENV) infections. Consenting household members provided serum and were questioned regarding exposures and medical history. RT-PCR was used to identify current DENV infections and IgM anti-DENV ELISA to identify recent infections. Of 1,500 participants from 701 households, 210 (13%) had evidence of current or recent DENV infection. Among those infected, 93 (44%) reported fever in the past month. Most (68, 73%) febrile infected participants were seen by a clinician and all but one of 32 participants who reportedly received a diagnosis were clinically diagnosed as having malaria. Having open windows at night (OR = 2.3; CI: 1.1-4.8), not using daily mosquito repellent (OR = 1.6; CI: 1.0-2.8), and recent travel outside of Kenya (OR = 2.5; CI: 1.1-5.4) were associated with increased risk of DENV infection. This survey provided a robust measure of incident DENV infections in a setting where cases were often unrecognized and misdiagnosed.

  15. 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. PMID:25453329

  16. 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.

  17. Bleeding outcome during a dengue outbreak in 2005 in the East-coast region of Peninsular Malaysia: a prospective study.

    PubMed

    Fariz-Safhan, M N; Tee, H P; Abu Dzarr, G A; Sapari, S; Lee, Y Y

    2014-06-01

    During a dengue outbreak in 2005 in the East-coast region of Peninsular Malaysia, one of the worst hit areas in the country at that time, we undertook a prospective study. We aimed to describe the bleeding outcome and changes in the liver and hematologic profiles that were associated with major bleeding outcome during the outbreak. All suspected cases of dengue admitted into the only referral hospital in the region during the outbreak were screened for WHO 2002 criteria and serology. Liver function, hematologic profile and severity of bleeding outcome were carefully documented. The association between symptoms, liver and hematologic impairments with the type of dengue infection (classical vs. hemorrhagic) and bleeding outcome (major vs. non-major) was tested. Dengue fever was confirmed in 183 cases (12.5/100,000 population) and 144 cases were analysed. 59.7% were dengue hemorrhagic fever, 3.5% were dengue shock syndrome and there were 3 in-hospital deaths. Major bleeding outcome (gastrointestinal bleeding, intracranial bleeding or haemoptysis) was present in 14.6%. Elevated AST, ALT and bilirubin were associated with increasing severity of bleeding outcome (all P < 0.05). Platelet count and albumin level were inversely associated with increasing severity of bleeding outcome (both P < 0.001). With multivariable analysis, dengue hemorrhagic fever was more likely in the presence of abdominal pain (OR 1.1, 95% CI 0.02- 1.6) and elevated AST (OR 1.0, 95% CI 1.0-1.1) but the presence of pleural effusion (OR 5.8, 95% CI: 1.1-29.9) and elevated AST (OR 1.008, 95% CI: 1.005-1.01) predicted a severe bleeding outcome. As a conclusion, the common presence of a severe hemorrhagic form of dengue fever may explain the rising death toll in recent outbreaks and the worst impairment in liver and hematologic profiles was seen in major bleeding outcome. PMID:25134895

  18. Bleeding outcome during a dengue outbreak in 2005 in the East-coast region of Peninsular Malaysia: a prospective study.

    PubMed

    Fariz-Safhan, M N; Tee, H P; Abu Dzarr, G A; Sapari, S; Lee, Y Y

    2014-06-01

    During a dengue outbreak in 2005 in the East-coast region of Peninsular Malaysia, one of the worst hit areas in the country at that time, we undertook a prospective study. We aimed to describe the bleeding outcome and changes in the liver and hematologic profiles that were associated with major bleeding outcome during the outbreak. All suspected cases of dengue admitted into the only referral hospital in the region during the outbreak were screened for WHO 2002 criteria and serology. Liver function, hematologic profile and severity of bleeding outcome were carefully documented. The association between symptoms, liver and hematologic impairments with the type of dengue infection (classical vs. hemorrhagic) and bleeding outcome (major vs. non-major) was tested. Dengue fever was confirmed in 183 cases (12.5/100,000 population) and 144 cases were analysed. 59.7% were dengue hemorrhagic fever, 3.5% were dengue shock syndrome and there were 3 in-hospital deaths. Major bleeding outcome (gastrointestinal bleeding, intracranial bleeding or haemoptysis) was present in 14.6%. Elevated AST, ALT and bilirubin were associated with increasing severity of bleeding outcome (all P < 0.05). Platelet count and albumin level were inversely associated with increasing severity of bleeding outcome (both P < 0.001). With multivariable analysis, dengue hemorrhagic fever was more likely in the presence of abdominal pain (OR 1.1, 95% CI 0.02- 1.6) and elevated AST (OR 1.0, 95% CI 1.0-1.1) but the presence of pleural effusion (OR 5.8, 95% CI: 1.1-29.9) and elevated AST (OR 1.008, 95% CI: 1.005-1.01) predicted a severe bleeding outcome. As a conclusion, the common presence of a severe hemorrhagic form of dengue fever may explain the rising death toll in recent outbreaks and the worst impairment in liver and hematologic profiles was seen in major bleeding outcome.

  19. 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.

  20. 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

  1. 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.

  2. Who Is Vulnerable to Dengue Fever? A Community Survey of the 2014 Outbreak in Guangzhou, China

    PubMed Central

    Chen, Bin; Yang, Jun; Luo, Lei; Yang, Zhicong; Liu, Qiyong

    2016-01-01

    Unprecedented dengue fever (DF) outbreaks impel China to develop useful disease control strategies. Integrated vector management (IVM) focuses on identifying vulnerable populations and interrupting human–vector contact; however, vulnerable populations have not been clearly identified in China. We conducted a case-control study during the initial stage of the 2014 DF outbreak in Guangzhou, China to assess risk factors for DF infection. Cases were randomly sampled from the National Notifiable Infectious Disease Reporting Information System (NNIDRIS). Controls were healthy individuals recruited from 17 DF infected communities through cluster sampling. A structured questionnaire on demographics, knowledge, practices, and living environment was administered to participants (165 cases; 492 controls). Logistic regression models identified characteristics of vulnerable populations. Awareness of dengue (OR = 0.08, 95% CI = 0.04–0.17), removing trash and stagnant water from around the residence (OR = 0.02, 95% CI = 0.00–0.17), and using mosquito repellent oils (OR = 0.36, 95% CI = 0.16–0.81) were protective factors. Living in an old flat or shed (OR = 2.38, 95% CI = 1.18–4.79) was a risk factor. Coils and bed nets were not protective due to incorrect knowledge of use. Using mosquito repellent oils and other protective measures can reduce vulnerability to DF infection. PMID:27428986

  3. Who Is Vulnerable to Dengue Fever? A Community Survey of the 2014 Outbreak in Guangzhou, China.

    PubMed

    Chen, Bin; Yang, Jun; Luo, Lei; Yang, Zhicong; Liu, Qiyong

    2016-01-01

    Unprecedented dengue fever (DF) outbreaks impel China to develop useful disease control strategies. Integrated vector management (IVM) focuses on identifying vulnerable populations and interrupting human-vector contact; however, vulnerable populations have not been clearly identified in China. We conducted a case-control study during the initial stage of the 2014 DF outbreak in Guangzhou, China to assess risk factors for DF infection. Cases were randomly sampled from the National Notifiable Infectious Disease Reporting Information System (NNIDRIS). Controls were healthy individuals recruited from 17 DF infected communities through cluster sampling. A structured questionnaire on demographics, knowledge, practices, and living environment was administered to participants (165 cases; 492 controls). Logistic regression models identified characteristics of vulnerable populations. Awareness of dengue (OR = 0.08, 95% CI = 0.04-0.17), removing trash and stagnant water from around the residence (OR = 0.02, 95% CI = 0.00-0.17), and using mosquito repellent oils (OR = 0.36, 95% CI = 0.16-0.81) were protective factors. Living in an old flat or shed (OR = 2.38, 95% CI = 1.18-4.79) was a risk factor. Coils and bed nets were not protective due to incorrect knowledge of use. Using mosquito repellent oils and other protective measures can reduce vulnerability to DF infection. PMID:27428986

  4. Who Is Vulnerable to Dengue Fever? A Community Survey of the 2014 Outbreak in Guangzhou, China.

    PubMed

    Chen, Bin; Yang, Jun; Luo, Lei; Yang, Zhicong; Liu, Qiyong

    2016-01-01

    Unprecedented dengue fever (DF) outbreaks impel China to develop useful disease control strategies. Integrated vector management (IVM) focuses on identifying vulnerable populations and interrupting human-vector contact; however, vulnerable populations have not been clearly identified in China. We conducted a case-control study during the initial stage of the 2014 DF outbreak in Guangzhou, China to assess risk factors for DF infection. Cases were randomly sampled from the National Notifiable Infectious Disease Reporting Information System (NNIDRIS). Controls were healthy individuals recruited from 17 DF infected communities through cluster sampling. A structured questionnaire on demographics, knowledge, practices, and living environment was administered to participants (165 cases; 492 controls). Logistic regression models identified characteristics of vulnerable populations. Awareness of dengue (OR = 0.08, 95% CI = 0.04-0.17), removing trash and stagnant water from around the residence (OR = 0.02, 95% CI = 0.00-0.17), and using mosquito repellent oils (OR = 0.36, 95% CI = 0.16-0.81) were protective factors. Living in an old flat or shed (OR = 2.38, 95% CI = 1.18-4.79) was a risk factor. Coils and bed nets were not protective due to incorrect knowledge of use. Using mosquito repellent oils and other protective measures can reduce vulnerability to DF infection.

  5. [Laboratory diagnosis and symptoms of dengue, during an outbreak in the Ribeirão Preto region, SP, Brazil].

    PubMed

    Figueiredo, L T; Owa, M A; Carlucci, R H; de Oliveira, L

    1992-01-01

    A dengue type 1 outbreak started in the Ribeirao Preto Region, North of Sao Paulo State, Brazil, in November of 1990. About 3500 dengue cases were confirmed by blood tests until February of 1991. The Virus Research Unit of The Faculty of Medicine of Ribeirao Preto-Sao Paulo State University, studied 502 dengue suspect cases. The serologic diagnosis of dengue type 1 was confirmed by haemagglutination inhibition test (HAI) in 19% of the cases. Diagnosis was done later by using an enzyme immuno assay on infected cultured cells (EIA-ICC) which discriminated IgG and IgM dengue, antibodies. EIA-ICC was less sensitive (89%) but more effective than HAI. EIA-ICC is a simple technique. It dispenses a second serum sample for diagnosis and it can be completed in about 5 hours. Dengue virus was isolated from the blood of 21 patients by inoculation in culture of mosquito C6/36 cells. The isolated virus were identified by indirect immunofluorescent test, by using an antisera pool to the flavivirus family and dengue type specific monoclonal antibodies. The dengue most frequent symptoms in 71 patients were observed: fever (90%), myalgias (57%) and arthralgias (41%).

  6. Underrecognition of Leptospirosis During a Dengue Fever Outbreak in Hawaii, 2001–2002

    PubMed Central

    Ellis, Tania; Imrie, Allison; Katz, Alan R.

    2008-01-01

    Abstract During the 10-year period from 1997 through 2006, the reported mean annual incidence rate of leptospirosis in the state of Hawaii was 3.3/100,000 with a range of 22–60 infections reported each year. Because the clinical presentation is highly variable, however, leptospirosis illness is challenging to recognize and may be underdiagnosed. To assess whether the incidence may be substantially higher than reported figures indicate, we retrospectively studied the prevalence of anti-Leptospira IgM antibodies among specimens obtained over a 12-month period (May 2001 to April 2002) from patients presenting with febrile illness during a dengue fever outbreak in Hawaii. Of 1206 patients testing negative or indeterminate for dengue, 54 (4.5%; 95% confidence interval: 3.3%–5.7%) were positive for anti-Leptospira IgM antibodies using a commercially available dipstick enzyme-linked immunosorbent assay (ELISA). The most common clinical symptoms reported by laboratory-positive leptospirosis patients were fever (92%), headache (88%), and myalgia (83%). Three clinical symptoms were significantly less common among persons laboratory positive for leptospirosis when compared with the 122 patients who had been diagnosed with dengue fever during the outbreak: rash (p < 0.0001), chills (p = 0.05), and petechiae (p = 0.0005). Laboratory-positive leptospirosis infections were identified in persons exposed on each of the 5 most populous islands and illness onsets spanned a 10-month period, reflecting an endemic pattern of disease. If added to the figures obtained via routine passive surveillance, the number of leptospirosis infections identified through this study would more than double the annual incidence rate for Hawaii during 2001. These findings indicate that many leptospiral infections in Hawaii go undiagnosed. Physicians should maintain a high index of suspicion for leptospirosis when assessing patients presenting with acute febrile illness among residents and visitors to

  7. Underrecognition of leptospirosis during a dengue fever outbreak in Hawaii, 2001-2002.

    PubMed

    Ellis, Tania; Imrie, Allison; Katz, Alan R; Effler, Paul V

    2008-08-01

    During the 10-year period from 1997 through 2006, the reported mean annual incidence rate of leptospirosis in the state of Hawaii was 3.3/100,000 with a range of 22-60 infections reported each year. Because the clinical presentation is highly variable, however, leptospirosis illness is challenging to recognize and may be underdiagnosed. To assess whether the incidence may be substantially higher than reported figures indicate, we retrospectively studied the prevalence of anti-Leptospira IgM antibodies among specimens obtained over a 12-month period (May 2001 to April 2002) from patients presenting with febrile illness during a dengue fever outbreak in Hawaii. Of 1206 patients testing negative or indeterminate for dengue, 54 (4.5%; 95% confidence interval: 3.3%-5.7%) were positive for anti-Leptospira IgM antibodies using a commercially available dipstick enzyme-linked immunosorbent assay (ELISA). The most common clinical symptoms reported by laboratory-positive leptospirosis patients were fever (92%), headache (88%), and myalgia (83%). Three clinical symptoms were significantly less common among persons laboratory positive for leptospirosis when compared with the 122 patients who had been diagnosed with dengue fever during the outbreak: rash (p < 0.0001), chills (p = 0.05), and petechiae (p = 0.0005). Laboratory-positive leptospirosis infections were identified in persons exposed on each of the 5 most populous islands and illness onsets spanned a 10-month period, reflecting an endemic pattern of disease. If added to the figures obtained via routine passive surveillance, the number of leptospirosis infections identified through this study would more than double the annual incidence rate for Hawaii during 2001. These findings indicate that many leptospiral infections in Hawaii go undiagnosed. Physicians should maintain a high index of suspicion for leptospirosis when assessing patients presenting with acute febrile illness among residents and visitors to Hawaii.

  8. Dengue Prevention and 35 Years of Vector Control in Singapore

    PubMed Central

    Goh, Kee-Tai; Gubler, Duane J.

    2006-01-01

    After a 15-year period of low incidence, dengue has reemerged in Singapore in the past decade. We identify potential causes of this resurgence. A combination of lowered herd immunity, virus transmission outside the home, an increase in the age of infection, and the adoption of a case-reactive approach to vector control contribute to the increased dengue incidence. Singapore's experience with dengue indicates that prevention efforts may not be sustainable. For renewed success, Singapore needs to return to a vector control program that is based on carefully collected entomologic and epidemiologic data. Singapore's taking on a leadership role in strengthening disease surveillance and control in Southeast Asia may also be useful in reducing virus importation. PMID:16707042

  9. Simultaneous outbreaks of dengue, chikungunya and Zika virus infections: diagnosis challenge in a returning traveller with nonspecific febrile illness

    PubMed Central

    Moulin, E.; Selby, K.; Cherpillod, P.; Kaiser, L.; Boillat-Blanco, N.

    2016-01-01

    Zika virus is an emerging flavivirus that is following the path of dengue and chikungunya. The three Aedes-borne viruses cause simultaneous outbreaks with similar clinical manifestations which represents a diagnostic challenge in ill returning travellers. We report the first Zika virus infection case imported to Switzerland and present a diagnostic algorithm. PMID:27006779

  10. Simultaneous outbreaks of dengue, chikungunya and Zika virus infections: diagnosis challenge in a returning traveller with nonspecific febrile illness.

    PubMed

    Moulin, E; Selby, K; Cherpillod, P; Kaiser, L; Boillat-Blanco, N

    2016-05-01

    Zika virus is an emerging flavivirus that is following the path of dengue and chikungunya. The three Aedes-borne viruses cause simultaneous outbreaks with similar clinical manifestations which represents a diagnostic challenge in ill returning travellers. We report the first Zika virus infection case imported to Switzerland and present a diagnostic algorithm.

  11. 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

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

    PubMed

    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

    2016-02-01

    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.

  13. Exploratory space-time analysis of reported dengue cases during an outbreak in Florida, Puerto Rico, 1991-1992.

    PubMed

    Morrison, A C; Getis, A; Santiago, M; Rigau-Perez, J G; Reiter, P

    1998-03-01

    The spatial and temporal distributions of dengue cases reported during a 1991-1992 outbreak in Florida, Puerto Rico (population = 8,689), were studied by using a Geographic Information System. A total of 377 dengue cases were identified from a laboratory-based dengue surveillance system and georeferenced by their residential addresses on digital zoning and U.S. Geological Survey topographic maps. Weekly case maps were generated for the period between June and December 1991, when 94.2% of the dengue cases were reported. The temporal evolution of the epidemic was rapid, affecting a wide geographic area within seven weeks of the first reported cases of the season. Dengue cases were reported in 217 houses; of these 56 (25.8%) had between two and six reported cases. K-function analysis was used to characterize the spatial clustering patterns for all reported dengue cases (laboratory-positive and indeterminate) and laboratory-positive cases alone, while the Barton and David and Knox tests were used to characterize spatio-temporal attributes of dengue cases reported during the 1991-1992 outbreak. For both sets of data significant case clustering was identified within individual households over short periods of time (three days or less), but in general, the cases had spatial pattern characteristics much like the population pattern as a whole. The rapid temporal and spatial progress of the disease within the community suggests that control measures should be applied to the entire municipality, rather than to the areas immediately surrounding houses of reported cases. The potential for incorporating Geographic Information System technologies into a dengue surveillance system and the limitations of using surveillance data for spatial studies are discussed. PMID:9546405

  14. [Genetic relatedness of the dengue 3 virus isolated in the outbreak of dengue hemorrhagic fever in Nicaragua, 1994].

    PubMed

    Guzmán, M G; Rosario, D; Muné, M; Alvarez, M; Rodríguez, R; Kourí, G

    1996-01-01

    It is reported the isolation of 2 dengue strains, 3 in samples from Nicaraguan patients suffering from dengue with hemorrhagic manifestations, which showed the reintroduction of this serotype in the region after being 17 years out of circulation. It is also reported the genetic characterization of the isolated strain, which, according to its classification, belongs to the group of dengue 2 strains isolated in Southeast Asi and which have been associated to hemorrhagic dengue. These results suggest the origin of this strain.

  15. Evolution of dengue virus type 2 during two consecutive outbreaks with an increase in severity in southern Taiwan in 2001-2002.

    PubMed

    Chen, Hui-Ling; Lin, Su-Ru; Liu, Hsin-Fu; King, Chwan-Chuen; Hsieh, Szu-Chia; Wang, Wei-Kung

    2008-10-01

    To investigate viral determinants and evolution linked to outbreak with increased severity, we examined dengue virus type 2 (DENV-2) sequences from plasma of 31 patients (14 dengue fever, 17 dengue hemorrhagic fever, DHF) continuously during the 2001 and 2002 outbreaks in southern Taiwan, in which both the total cases and proportion of DHF cases increased. Analysis of envelope (E) and full-genome sequences between viruses of the two outbreaks revealed 5 nucleotide changes in E, NS1, NS4A, and NS5 genes. None was identical to those reported in the DENV-2 outbreak in Cuba in 1997, suggesting viral determinants linked to severe outbreak are genotype dependent. Compared with previous reports of lineage turnover years apart, our findings that the 2002 viruses descended from a minor variant of the 2001 viruses in less than 6 months was novel, and may represent a mechanism of evolution of DENV from one outbreak to another.

  16. Risk factors associated with an outbreak of dengue fever in a favela in Fortaleza, north-east Brazil.

    PubMed

    Heukelbach, J; de Oliveira, F A; Kerr-Pontes, L R; Feldmeier, H

    2001-08-01

    To increase the effectiveness of ongoing anti-dengue control measures, we conducted a case-control study in a favela in Fortaleza (north-east Brazil) during an outbreak of dengue fever. Cases were defined according to the national guidelines for dengue control as well as based on the detection of IgM-dengue antibodies, and 34 cases and 34 controls were investigated. Significant risk factors were: living in a street perpendicular to the beach on which the favela is situated (P < 0.0001), an interval > 30 days since the last visit of the vector control agent (P=0.001), receptacles in the garden or courtyard (P=0.001), plants with temporary water pools on the property, gutter to collect rainwater, uncovered water storage container (all P=0.02), and no waste collection (P=0.03). Socio-economic variables were not associated with dengue fever. The probable starting point of the epidemic was an uncovered water tank on the roof of the house adjacent to the index case. From there, the outbreak spread uphill parallel to the prevailing direction of the wind. Thus, the chronological and spatial evolution of the epidemic could have been forecast after the first cases had occurred. This example of investigative epidemiology in an operational setting shows that targeted intervention leading to increased effectiveness of control measures is possible.

  17. [Outbreak of classical fever of dengue caused by serotype 2 in Araguaiana, Tocantins, Brazil].

    PubMed

    Vasconcelos, P F; Travassos da Rosa, E S; Travassos da Rosa, J F; de Freitas, R B; Dégallier, N; Rodrigues, S G; Travassos da Rosa, A P

    1993-01-01

    We report the first outbreak of dengue fever caused by dengue 2 (DEN 2) in Araguaina, Tocantins State. Four hundred people of 74 families, living at S. João, Araguaina Sul and Neblina districts were questioned and then bled, in order to obtain sera to test for anti-dengue antibodies. If a person was sick, a small quantity of blood was collected for virus isolation. The main clinical picture of disease was characterized by fever, headache, myalgias, arthralgias and skin rash. Were obtained 1,105 (56 females and 45 males of Culex quinquefasciatus and 567 females and 437 males of Aedes aegypti) mosquitoes from larvae collected in Araguaina. The females of Aedes aegypti obtained from larvae were allowed to feed on 8 febrile patients. The diagnosis of infection was made by both virus isolation into Aedes albopictus (C6/36) cells, and serology, by Hemagglutination-inhibition (HI) and IgM capture ELISA (MAC ELISA). No virus was isolated from mosquitoes. Although five strains of DEN 2 were obtained from humans, and another 111 infections were diagnosed serologically (IgM positive). The positivity rate of the samples was 27.75% (111 of 400), while that of the families was 66.2% (45 of 72), where at least one member of the each family was infected. It was also detected 26.1% of asymptomatic infections. All age groups were affected. Therefore, the infection was more frequent in females (33.5%) than males (23.8%).(ABSTRACT TRUNCATED AT 250 WORDS)

  18. 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

  19. Genetic characterization of dengue virus serotypes causing concurrent infection in an outbreak in Ernakulam, Kerala, South India.

    PubMed

    Anoop, M; Issac, Aneesh; Mathew, Thomas; Philip, Sairu; Kareem, Nabeel Abdul; Unnikrishnan, R; Sreekumar, E

    2010-08-01

    Dengue fever, a mosquito-borne viral infection, causes significant morbidity and has become endemic in the Indian subcontinent. Virus strains currently circulating in many parts of the country are not well studied at the molecular level. In the present study, genetic characterization of virus strains from a dengue outbreak that occurred in and around a tertiary care hospital in Ernakulam, Kerala in the year 2008 has been reported. By reverse transcription polymerase chain reaction (RT-PCR), 37 out of 75 (49.3%) clinically suspected cases were positive for dengue viral RNA. Among these, 21 (56.8%) samples showed concurrent infection with multiple serotypes of the virus. Majority of the combined infections were caused by dengue serotype 2 and 3. Co-infections with type 1 and 2 in two patients, and type 1, 2 and 3 in one patient were also observed. The core-pre-Membrane (CprM) junction nucleotide sequencing and phylogenetic analysis revealed that the type 1 strains were related to the viral strains reported from Delhi-2001 and Gwalior-2002 dengue outbreaks, while the type 2 strains were related to the strains from Gwalior-2001 epidemic. Sequences of type 3 strains did not show clear relation to any of the previous Indian isolates, and in the phylogenetic analysis, they formed a distinct lineage within the Indian type 3 strains. This study indicates hyperendemicity of dengue in the region with the presence of multiple serotypes and high rates of co-infection, and local genomic evolution of the viral strains involved in this outbreak.

  20. Epidemiology and vector efficiency during a dengue fever outbreak in Cixi, Zhejiang Province, China.

    PubMed

    Yang, Tianci; Lu, Liang; Fu, Guiming; Zhong, Shi; Ding, Gangqiang; Xu, Rong; Zhu, Guangfeng; Shi, Nanfeng; Fan, Feilong; Liu, Qiyong

    2009-06-01

    An emigrant worker returning from Southeast Asia triggered the outbreak of a DF epidemic in Zhejiang province, China, in October, 2004. Eighty-three cases, mainly young and middle-aged people between 20 and 50 (78.3%), were reported in the area of Cixi. There were no obvious occupational patterns. The majority of cases were female, with a sex ratio of 1:1.86 (m:f). The dengue virus (DENV) strains from the epidemic area were isolated and identified as DENV-1, which belongs to Asian strain 1. According to the epidemiological investigation, the incidence of DF had no relationship to temperature, humidity, or precipitation, and the Breteau index of larvae showed a clear relationship only with the House Index and Container Index. Recent dengue problems in the town have been associated with the complex social factors and hygienic conditions for endemic villagers and immigrant workers. Some hygienic measures should be taken by the local government to reduce the risk of mosquito-borne disease. These measures should aim to eliminate the breeding sites of the vector Aedes albopictus in indoor and outdoor containers filled with rainwater and thus reducing the risk of DF transmission.

  1. Inapparent infection during an outbreak of dengue fever in Southeastern China.

    PubMed

    Sun, Jimin; Luo, Shuying; Lin, Junfen; Chen, Jinhua; Hou, Juan; Fu, Tao; Lv, Huakun; Chen, Zhiping; Cong, Liming; Ling, Feng; Chai, Chengliang; Zhang, Yanjun; Mao, Haiyan; Yan, Juying; Lu, Yiyu; Liu, Qiyong; Song, Xiuping; Lu, Liang

    2012-12-01

    Dengue fever (DF) is often asymptomatic in endemic areas. Asymptomatic infection during a DF outbreak in China, where DF is not endemic, has not been reported until now. In this study a total of 365 subjects from 6 villages were recruited from October 4-7, 2009. Overall, 102 subjects (27.95%) were positive for dengue virus (DENV) IgM, and 14 subjects (3.84%) were positive for DENV IgG and IgM. In different age groups, seropositive rates varied from 12.50% to 50.00% for DENV IgM, and from 0% to 11.76% for DENV IgG. Seroprevalence of DENV IgM was significantly higher than that of DENV IgG. Seroprevalence rates of DENV IgM differed among different villages. However, the seroprevalence of DENV IgM was not statistically significantly different among gender and age groups. Asymptomatic DF infection is prevalent in non-endemic areas.

  2. 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.

  3. 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

  4. 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

  5. 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

  6. 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.

  7. 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.

  8. Dengue/DHF: an emerging disease in India.

    PubMed

    Sharma, S N; Raina, V K; Kumar, A

    2000-09-01

    Dengue/DHF is an emergent disease in India and some parts of country are endemic and periodically contributing annual outbreaks of dengue/DHF. Dengue infection manifests as undifferentiated fever, dengue haemorrhagic fever (DHF) which leads to hospitalization large number of people in a localized area. There is high mortality and morbidity associated with the onset of each dengue outbreak leading to great socio-economic impact. The prevention and control of dengue outbreak depends upon the proper monitoring of the disease case through disease surveillance so as to ensure timely management of cases. Vector surveillance helps in the proper and timely implementation of emergency control measures against dengue vector i.e. Aedes aegypti. There is an urgent need for an effective diagnostic strategy for early diagnosis to shorten the illness duration, hospitalization time and the associated complications.

  9. Unusual and rare manifestations of dengue during a dengue outbreak in a tertiary care hospital in South India.

    PubMed

    Neeraja, M; Iakshmi, V; Teja, V D; Lavanya, Vanjari; Priyanka, E N; Subhada, K; Parida, M M; Dash, P K; Sharma, Sashi; Rao, P V L; Reddy, Gopal

    2014-07-01

    Dengue is the most rapidly spreading mosquito-borne viral disease in the world, and as a larger proportion of the population is being affected, more unusual manifestations are being reported. Very few studies have documented unusual manifestations of dengue in South India. This prospective study was undertaken from July 2011 to June 2013 to document rare manifestations of dengue fever in 175 hospitalized patients. The clinical diagnosis was confirmed by the detection of NS1Ag, dengue IgM, or IgG by ELISA and/or a RT-PCR and CDC real-time PCR for dengue virus (DENV) RNA. The daily profiles of the hematological and biochemical investigations were followed and recorded. Unusual and rare manifestations of dengue were documented for 115 patients (66 %). Hepatitis was observed in 70 % of the cases. Pleural effusion was seen in 11 %, acute renal failure in 10 %, neurological complications such as encephalitis in 7.4 %, myocarditis in 9 %, and bleeding gastric ulcers in 3.4 % of the cases. DENV serotype 2 was more prevalent in patients with unusual manifestations of dengue in our study. The WHO classification system does not include unusual and rare manifestations; hence, it is essential to be aware of these manifestations and closely monitor them for better clinical management and outcome of patients.

  10. A program for prevention and control of epidemic dengue and dengue hemorrhagic fever in Puerto Rico and the U.S. Virgin Islands.

    PubMed

    Gubler, D J; Casta-Valez, A

    1991-01-01

    The ongoing resurgence of Aedes aegypti in the Americas--abetted by poor mosquito control, urbanization, and increased air travel--has led to dengue hyperendemicity, more frequent dengue epidemics, and the emergence of dengue hemorrhagic fever (DHF). This article describes a program developed to cope with this situation that emphasizes disease prevention rather than general mosquito control measures.

  11. 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

  12. Entomological investigations during outbreaks of dengue fever in certain villages in Maharashtra state.

    PubMed

    Ilkal, M A; Dhanda, V; Hassan, M M; Mavale, M; Mahadev, P V; Shetty, P S; Guttikar, S N; Banerjee, K

    1991-05-01

    Outbreaks of dengue (DEN) fever are reported from 22 villages in five districts in the state of Maharashtra. DEN viral antigen was detected by indirect immunofluorescence test in 34 of 375 female Aedes aegypti mosquitoes collected from 8 villages. DEN types 2 and 3 were identified among the 16 strains that were isolated. None of the 64 male mosquitoes showed the presence of viral antigen; 281 males and 323 females reared from field collected larvae were also found negative. Indoor spraying of DDT in the affected villages produced a drastic reduction in Ae. aegypti catches. No viral antigen was detected in mosquitoes caught subsequent to the spray. With the introduction of water supply through taps, which is often inadequate, people are compelled to store water for domestic purposes, which favours an increase in Ae. aegypti breeding. In view of changing rural ecology associated with the development process, continued surveillance of the spread of Ae. aegypti as well as the diseases borne by this vector are recommended.

  13. Complete Genome Sequencing of Dengue Virus Type I from Zhuhai City, China.

    PubMed

    Chen, Chao; Wei, Quande

    2016-01-01

    The detection and successful typing of dengue virus (DENV) from patients with suspected dengue fever are important for stopping outbreaks and preventing the recurrence of this virus. In this study, we reported complete genomic sequences of DENV-1 isolated from Zhuhai patients, providing basic information for future epidemic dengue disease detection. PMID:26868388

  14. 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.

  15. 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...

  16. Biting Density and Distribution of Aedes albopictus during the September 2014 Outbreak of Dengue Fever in Yoyogi Park and the Vicinity of Tokyo Metropolis, Japan.

    PubMed

    Tsuda, Yoshio; Maekawa, Yoshihide; Ogawa, Kohei; Itokawa, Kentaro; Komagata, Osamu; Sasaki, Toshinori; Isawa, Haruhiko; Tomita, Takashi; Sawabe, Kyoko

    2016-01-01

    A total of 160 autochthonous dengue cases transmitted by Aedes albopictus were reported between August and October of 2014 in Tokyo Metropolis, Japan. Ae. albopictus is a medically important vector of dengue virus, which has expanded its geographic distribution in temperate regions. Understanding the distribution and biting density of Ae. albopictus during the 2014 dengue outbreak in Tokyo is important to evaluate the epidemic risks of dengue fever in other highly populated cities in Europe and Asia. Of the 160 patients, 134 visited the same park (Yoyogi Park) located in central Tokyo. Mosquitoes infected with dengue virus were collected from this park, suggesting that it was the exclusive location for the transmission of dengue. This study aimed to collect referential data to estimate the transmission threshold of dengue virus in terms of biting density of Ae. albopictus and determined high transmission risk areas of dengue virus in Yoyogi Park and its vicinity. The overall mean density of biting Ae. albopictus (7.13/man/8 min) was sufficiently high for successful transmission of dengue virus, and areas with biting densities higher than the overall mean density were classified as high risk areas for the transmission of dengue virus in Yoyogi Park.

  17. Entomological observations on dengue vector mosquitoes following a suspected outbreak of dengue in certain parts of Nagaland with a note on their susceptibility to insecticides.

    PubMed

    Dutta, P; Khan, S A; Khan, A M; Sharma, C K; Mahanta, J

    2004-04-01

    Three species of Aedes viz., Aedes albopictus, Aedes aegypti and Aedes annandalei were detected from different breeding sources in and around human habitats during entomological study conducted following an outbreak suspected to be of dengue (which occurred during, 1994) in parts of Medziphema PHC area of Nagaland in two different points of time ie., in the year, 1994 and, 2000. The potential dengue vector, Aedes albopictus showed high preponderance by breeding in all types of containers searched with high Breteau Index (BI) value of 85.0 and 72.72 recorded in, 1994 and, 2000 respectively whereas the BI value for other potential vector, Aedes aegypti was recorded low (4.9) in the year, 1994 with a substantial increase (31.81) in, 2000. The change in ecosystem along with the process of urbanization has facilitated the growth of these dengue vector mosquitoes in the area of investigation. Adults of both Aedes aegypti and Aedes albopictus were found to be susceptible to DDT, dieldrin and malathion in insecticide bioassay carried out using WHO test kit.

  18. Novel concept on antiviral strategies to dengue.

    PubMed

    Lo, Yu-Chih; Perng, Guey Chuen

    2016-06-01

    Recent evidence has revealed that asymptomatic and/or persistent dengue virus (DENV) infections play a role in the cycling pattern of dengue outbreaks. These findings add a new dimension to the continually evolving search for effective prevention strategies in dengue. Disappointing outcomes of clinical trials in anti-dengue modalities have become commonplace. These failures may result from confounding variables and/or unresolved scientific issues that surround dengue, including the replication cycle of DENV in a natural setting, the target cells and reservoir for viral replication in vivo, and the effect of asymptomatic/persistent carriers in the dissemination of dengue. This article sets forth to address these issues using the most updated information available in the literature and to propose a novel antiviral strategy for the prevention and control of dengue. PMID:27284691

  19. The north Indian dengue outbreak 2006: a retrospective analysis of intensive care unit admissions in a tertiary care hospital.

    PubMed

    Chandralekha; Gupta, Pratyush; Trikha, Anjan

    2008-02-01

    Dengue fever (DF), dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS) have emerged as public health problems of international concern. During a dengue outbreak in north India in October 2006, more than 10000 patients presented to hospital with fever. We retrospectively analysed the presenting features, treatment given and the outcome of patients admitted to the Intensive Care Unit (ICU), All India Institute of Medical Sciences (AIIMS): a tertiary care hospital in New Delhi. A total of 72 critically ill patients were referred for admission to the ICU. The common symptoms were fever (100%), myalgia (40%) and gastrointestinal bleed. Menorrhagia and haematuria were seen as the sole presenting features in many females. Treatment consisted of bed rest, oxygen therapy, intensive monitoring, antipyretics, platelet transfusions, hydration and electrolyte correction. On average, six units of platelets were required per patient. The average duration of stay in the ICU was 3 d. There were eight deaths. Adequate hydration and platelet replacement with transfusions, especially apheresis platelets to a target level above 60000 platelets/mm3, were effective means of combating the disease.

  20. Dengue: an emerging disease in Nepal.

    PubMed

    Pun, S B

    2011-01-01

    Dengue is an acute infectious disease caused by dengue viruses and transmitted by the Aedes species of mosquito. The rapid global spread of the dengue virus into new areas has begun to attract more research attention. A series of dengue fever outbreaks in several districts of Nepal has been recently observed. The evidence of all four serotypes (DEN - 1 - 4) could be a consequence of a sudden resurgence of a more severe dengue disease in Nepal. Health care providers need to become familiar with the disease to prevent or control the possibility of future outbreaks. The clinical features, diagnosis, treatment, epidemiological patterns and challenges of dengue virus infection in Nepal will be discussed here.

  1. Dengue in French Guiana, 1965-1993.

    PubMed

    Fouque, F; Reynes, J M; Moreau, J P

    1995-06-01

    While it seems likely that dengue fever (DF) has existed in French Guiana for at least one century, data on outbreaks are sketchy before temporary eradication of the dengue vector mosquito Aedes aegypti and its reestablishment in the early 1960s. Dengue cases were serologically confirmed for the first time in 1965, and since then dengue epidemics have occurred at two to six year intervals, the most important occurring in 1968-1969, 1970, 1972, 1976, 1982, 1986, and 1992. Three of the four dengue virus serotypes (dengue-1, dengue-2, and dengue-4) have been implicated in these outbreaks. During the 1992 epidemic, which appears to have begun in 1991 and extended into 1993, cases of dengue hemorrhagic fever (DHF) were confirmed for the first time. In all, at least 40 DHF cases and several deaths were associated with this epidemic. This development has raised considerable concern about the public health threat posed by DHF in French Guiana. Such concern is only heightened by the fact that while vector control is the sole means of preventing or combating dengue outbreaks, it has proved difficult to maintain vector populations at low levels with the control measures currently employed.

  2. Absence of impact of aerial malathion treatment on Aedes aegypti during a dengue outbreak in Kingston, Jamaica.

    PubMed

    Castle, T; Amador, M; Rawlins, S; Figueroa, J P; Reiter, P

    1999-02-01

    During an outbreak of dengue fever in Jamaica from October to December 1995, a study was carried out to determine the impact of aerial ultra-low volume malathion treatment on adult Aedes aegypti. This was done by monitoring oviposition rates of the vector in three urban communities in Kingston and by exposing caged mosquitoes both directly and indirectly to the aerial malathion treatment. The insecticide was delivered at a rate of 219 mL/ha between 7:10 a.m. and 8:45 a.m. The results of the study clearly showed that the insecticide application was ineffective in interfering with Aedes aegypti oviposition, and adult mosquitoes held in cages inside dwellings were largely unaffected. Consequently, this type of intervention seemed to have little significant impact in arresting or abating dengue transmission.

  3. Clinico-epidemiological profile of an outbreak of dengue fever in rural area of Ambajogai Mandai, District Beed.

    PubMed

    Vedpathak, V L; Soundale, S G; Lakde, R N; Deo, D S; Khadilkar, H A

    2011-03-01

    A clinico-epidemiological study of fever cases was carried out in three villages of Ambajogai Mandal, Beed, Maharashtra. Out of 123 fever cases studied, most common affected age group was 21-45 years with more number of females i.e. 55.28%. The patients mainly presented with fever and joint pain with no any evidence of haemorrhagic manifestation. Of the 36 blood samples tested 03 samples were found positive for IgM antibodies to dengue virus. Larval survey showed highest breeding preference in domestic water container like earthen pots. Entomological indices were found out to be higher as house index 19.76%; container index 19.02%; Breteau index 22.31%. Clinico-epidemiological, laboratory and entomological investigations indicate present episode of fever outbreak was due to dengue fever. It demands for strengthening the surveillance activity and alert reporting of peripheral health staff along with IEC activities for community participation and involvement of other departments.

  4. 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.

  5. Characteristics of children hospitalized with dengue fever in an outbreak in Rio de Janeiro, Brazil.

    PubMed

    Giraldo, Diana; Sant'Anna, Clemax; Périssé, André Reynaldo Santos; March, Maria de Fatima Pombo; Souza, Ana Paula; Mendes, Analucia; Bonfim, Marcia; Hofer, Cristina B

    2011-10-01

    During a dengue epidemic in Rio de Janeiro in 2007-2008 the Instituto de Puericultura e Pediatria Martagão Gesteira Hospital was a reference for admitted children. The World Health Organization (WHO) considered several manifestations as warning signs of severe dengue This is a retrospective cohort study of all children admitted with dengue fever. Clinical variables considered warning signs by WHO were evaluated in the multivariate analysis, to investigate if they were independently associated with severe dengue. One hundred and eighty one children were admitted, aged from 4 months to 15 years; 30 were classified as severe dengue. Abdominal pain (OR=2.63, 95% CI 1.06-6.53) and lethargy (OR=3.40, 95% CI 1.45-7.99) were independently associated with severe dengue.

  6. 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... ...

  7. Dengue.

    PubMed

    Halstead, Scott B

    2007-11-10

    The four dengue viruses are transmitted in tropical countries that circle the globe. All can cause syndromes that are self-limited or severe. The common severe syndrome--dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS)--is characterised by sudden vascular permeability generated by cytokines released when T cells attack dengue-infected cells. Dengue 1 virus became prevalent in Hawaii where it was transmitted by Aedes albopictus, producing a classic virgin soil epidemic, with clinical disease seen largely in adults. In Cuba and Singapore, sequential dengue infections at long intervals produced unusually severe disease in adults. Evidence suggests that enhancing and cross-reactive neutralising antibodies regulate dengue epidemics and disease severity. Classic DHF/DSS arises during initial dengue infections in infants with low circulating amounts of maternal dengue antibodies, an observation that precludes an exclusive causal role for secondary T-cell responses. Here, I review and discuss data on clinical diagnosis and pathophysiology of vascular permeability and coagulopathy, parenteral treatment of DHF/DSS, and new laboratory tests.

  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. 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

  10. Molecular characterization and clinical evaluation of dengue outbreak in 2002 in Bangladesh.

    PubMed

    Islam, Mohammed Alimul; Ahmed, Muzahed Uddin; Begum, Nasima; Chowdhury, Naseem Akhtar; Khan, Afjal Hossain; Parquet, Maria del Carmen; Bipolo, Sophie; Inoue, Shingo; Hasebe, Futoshi; Suzuki, Yasuo; Morita, Kouichi

    2006-04-01

    During the febrile illness epidemic in Bangladesh in 2002, 58 people died out of the 6,132 affected. Two hundred hospitalized patients were analyzed clinically, serologically and virologically to determine the features of this dengue infection. Among the 10- to 70-year-old age group of the 200 clinically suspected dengue patients, 100 (50%) were confirmed as dengue cases by virus isolation and dengue IgM-capture ELISA. Of the 100 dengue-confirmed cases, the mean age was 29.0 (+/-12.4). The possible dengue secondary infection rate determined by Flavivirus IgG-indirect ELISA was 78% in 2002. Eight dengue virus strains were isolated, representing the first dengue virus isolation in the country, and all of the strains were dengue virus type-3 (DEN-3). Sequence data for the envelope gene of the DEN-3 Bangladeshi isolates were used in a phylogenetic comparison with DEN-3 from other countries. A phylogenetic analysis revealed that all 8 strains of DEN-3 were clustered within a well-supported independent sub-cluster of genotype II and were closely related to the Thai isolates from the 1990s. Therefore, it is likely that the currently circulating DEN-3 viruses entered Bangladesh from neighboring countries.

  11. Outbreak of febrile illness due to dengue virus type 3 in Calcutta during 1983.

    PubMed

    Mukherjee, K K; Chakravarti, S K; Dey, P N; Dey, S; Chakraborty, M S

    1987-01-01

    An epidemic of dengue fever broke out in Calcutta between July and August 1983. Persons of all age groups were affected with a preponderance of young adults. Haemorrhagic manifestations and shock were not observed. Virus was isolated from 4 acute phase sera and identified as dengue type 3 (DEN-3), the first isolation of DEN-3 virus in Calcutta. Serotesting with 9 paired blood samples established dengue infection in 7 and a flavivirus group reaction in 2. Examination of 36 single sera revealed presumptive dengue infection in 15 and a flavivirus group reaction in 17, while the remaining 4 were negative to all flavivirus antigens.

  12. Beliefs about the prevention of dengue and other febrile illnesses in Mérida, Mexico.

    PubMed

    Winch, P; Lloyd, L; Godas, M D; Kendall, C

    1991-12-01

    A series of open interviews and a survey were conducted in several neighbourhoods in the city of Mérida, Mexico to find out whether poor response to government dengue control programmes might be related to the explanatory models about dengue and its prevention held by community members. Dengue was grouped by informants with other mild febrile illnesses, all of which were thought to be inevitable and capable of converting into more serious illnesses. Although vector control personnel think of prevention in terms of eliminating the larval habitats of mosquito vectors, the form of prevention most commonly described involved looking after oneself once sick, so that mild fevers do not evolve into serious fevers. Due to the prevalence of this different model of prevention, it is argued that simple messages about dengue may be misinterpreted. Vector control programmes need to take into account local models of febrile illnesses and their prevention in order to be effective.

  13. 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

  14. Current emerging situation of dengue in India.

    PubMed

    Mariappan, Thiruppathi

    2013-07-01

    Outbreaks of dengue fever (DF) have been reported from various countries. Although DF has been endemic in India from the nineteenth century, dengue haemorrhagic fever (DHF) was first reported in 1987. The first major widespread epidemic of DHF and dengue shock syndrome (DSS) was reported in 1996 with four serotypes reported to be in co-circulation. In 2012 an outbreak occurred in India during which a total of 47,029 DF cases and 242 deaths were reported - three times higher than the previous year. Twelve states reported a large number of cases, including Tamil Nadu which recorded 12,264 from various districts. We discuss methods of prevention and control.

  15. 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. PMID:27191223

  16. 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.

  17. 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

  18. 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

  19. Use of a geographic information system for defining spatial risk for dengue transmission in Bangladesh: role for Aedes albopictus in an urban outbreak.

    PubMed

    Ali, Mohammad; Wagatsuma, Yukiko; Emch, Michael; Breiman, Robert F

    2003-12-01

    We used conventional and spatial analytical tools to characterize patterns of transmission during a community-wide outbreak of dengue fever and dengue hemorrhagic fever in Dhaka, Bangladesh in 2000. A comprehensive household-level mosquito vector survey and interview was conducted to obtain data on mosquito species and breeding as well as illness consistent with dengue. Clusters of dengue illnesses and high-density vector populations were observed in a distinct sector of the city. Dengue clusters are less identifiable in areas further away from major hospitals, suggesting that proximity to hospitals determines whether cases of dengue are diagnosed. Focusing on those areas relatively close to hospitals, we found a spatial association between dengue clusters and vector populations. Households reporting a recent dengue illness were more likely to have Aedes albopictus larvae present in the home when compared with households not reporting cases. Households reporting a recent dengue illness were also more likely to have a neighbor with Ae. albopictus present in the home. In contrast, the presence of Aedes aegypti within the premises as well as the homes of neighbors (within 50 meters) was not associated with dengue illness. Given that the breeding habitats for Ae. albopictus are somewhat distinct from those of Ae. aegypti, the findings of this study have implications for control of dengue transmission in this urban setting where much of the focus has been on indoor mosquito breeding and transmission. Public health officials may find the disease-environment map useful for planning targeted interventions because it displays areas where transmission is most intense.

  20. An outbreak of dengue virus serotype 1 infection in Cixi, Ningbo, People's Republic of China, 2004, associated with a traveler from Thailand and high density of Aedes albopictus.

    PubMed

    Xu, Guozhang; Dong, Hongjun; Shi, Nanfeng; Liu, Shijian; Zhou, Aiming; Cheng, Zhihua; Chen, Guohua; Liu, Jianyi; Fang, Ting; Zhang, Hongwei; Gu, Chunying; Tan, Xiaojie; Ye, Jianjie; Xie, Shuyun; Cao, Guangwen

    2007-06-01

    Autochthonous dengue infections have not been reported in Ningbo, People's Republic of China since 1929. In August-October 2004, an outbreak of dengue fever was confirmed in Xiaolin, Cixi, Ningbo. Of 83 cases reported, 68 were laboratory confirmed. Fifty-three percent (34 of 64) of the cases had IgM antibodies to dengue virus. Dengue virus serotype-1 was isolated from two cases. The outbreak was linked to a traveler who returned from Thailand. Phylogenetic analysis showed that the Ningbo isolate was closely associated to strains from Thailand. Prevalence of dengue-specific IgG in asymptomatic residents was significantly higher in the epidemic-stricken area than in a control area. High density of Aedes albopictus, which resulted from waterlogging caused by Typhoon Rananim and lifestyle of local residents, was responsible for rapid spread of the virus. Eradication of mosquito infestation might interrupt transmission. This outbreak underscores the importance of maintaining surveillance and control of potential vectors for the control of emerging infectious diseases.

  1. 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

  2. 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.

  3. Serological aspects of Dengue fever and its correlation with clinical features in a recent febrile outbreak.

    PubMed

    Chatterjee, T K; Nayak, K; Som, S; Chatterjee, S; Chaudhuris, N; Mukherjee, B

    2007-01-01

    The study was done to assess correlation between serology and clinical features of Dengue fever at Burdwan Medical College, where after clinical examination, blood samples were processed by E.I.A. Of 139 cases, mostly between 1 to 20 years, Male-Female ratio was 80:59. Bleeding manifestation was observed only in 3 cases, and Lymphadenopathy, Myocarditis were uncommon features. Few patients have biphasic temperature. Fever and severity of symptoms did not have correlation. Patients' blood was examined for Dengue viruses, with only 44.6% positivity. Correlation exists between illness duration and antibody titer. [r = 0.41; (P < 0.01)]. Fever other, than Dengue also exhibited similar symptoms, but optical density in EIA test was less. As high fever with similar symptoms may be due to causes other than Dengue, thorough search for other viral infection namely Chikungunya should be done in endemic areas also.

  4. An insular outbreak of dengue fever in a rural south Indian village.

    PubMed

    Norman, G; Theodre, A; Joseph, A

    1991-09-01

    In mid 1990, an epidemic of fever affected a single village in Kaniyambadi Block, South India. The illness was characterized by a fever of approximately five days duration, accompanied by headache, chills, sweating and muscle pain. The overall attack rate was 22.5 per cent. The attack rate was uniform across the various age groups and between the sexes. Testing of the acute and convalescent serum samples obtained from cases showed a serological response to dengue virus. The Aedes house index in the village was found to be 36 per cent with toilets serving as active breeding sites. Adjacent villages studied showed similarly high rates of Aedes prevalence, although no cases of the same fever were seen. Since previous exposure to dengue increases the risk for epidemics of dengue hemorrhagic fever and dengue shock syndrome, health education on methods of Aedes control is continuing.

  5. An outbreak of type 2 dengue fever in the Seychelles, probably transmitted by Aedes albopictus (Skuse).

    PubMed

    Metselaar, D; Grainger, C R; Oei, K G; Reynolds, D G; Pudney, M; Leake, C J; Tukei, P M; D'Offay, R M; Simpson, D I

    1980-01-01

    Between December 1976 and September 1977 the Seychelles group of islands in the Indian Ocean was struck by an extensive epidemic of dengue fever. The peak of the epidemic was in the last week of February. Type 2 dengue virus was isolated from patients and mosquitos. Aedes albopictus was the sole vector. The clinical picture was that of classical dengue. Haemorrhagic fever and the shock syndrome were not observed.Absenteeism from schools and offices, anamnestic questioning, and prevalence of antibodies in sera collected after the epidemic was over, indicated that approximately 75% of the population had been infected. Serological evidence was obtained of an epidemic of dengue in the islands more than 40 years earlier. This was confirmed by archival records.

  6. Clinical intervention and molecular characteristics of a dengue hemorrhagic fever outbreak in Timor Leste, 2005.

    PubMed

    Kalayanarooj, Siripen; Rimal, Hem Sagar; Andjaparidze, Alex; Vatcharasaevee, Varunee; Nisalak, Ananda; Jarman, Richard G; Chinnawirotpisan, Piyawan; Mammen, Mammen P; Holmes, Edward C; Gibbons, Robert V

    2007-09-01

    In response to a January 2005 report of dengue hemorrhagic fever (DHF) in Timor Leste, the World Health Organization sent a team to assist the National Hospital Guido Valadares (NHGV) in Dili with clinical case management and diagnostic support. The hospital reported 67 admissions including 8 deaths (case fatality rate approximately 12%) over the previous weeks with case histories clinically compatible with DHF. During the intervention, an additional 44 suspected dengue patients were admitted to the pediatric ward of NHGV. Among 41 patients with clinical diagnoses of dengue fever or DHF, 38 (93%) were laboratory confirmed. Although cause and effect cannot be definitely attributed, the case fatality rate decreased to 3.6% after the intervention with education about dengue management strategies.

  7. Development and Evaluation of an in-House IgM-Capture ELISA for the Detection of Chikungunya and Its Application to a Dengue Outbreak Situation in Kenya in 2013.

    PubMed

    Wasonga, Caroline; Inoue, Shingo; Kimotho, James; Morita, Kouichi; Ongus, Juliette; Sang, Rosemary; Musila, Lillian

    2015-01-01

    Chikungunya (CHIK) is a mosquito-borne viral disease. In the 2004 CHIK outbreak in Kenya, diagnosis was delayed because of the lack of accurate diagnostics. Therefore, this study aimed to develop and evaluate an in-house IgM-capture enzyme linked immunosorbent assay (ELISA) (in-house ELISA) for the detection of chikungunya virus (CHIKV) infections. Anti-CHIKV antibodies were raised in rabbits, purified and conjugated to horseradish peroxidase. These anti-CHIKV antibodies and cell-culture derived antigen were used to develop the ELISA. To validate the in-house ELISA, 148 patient sera from the 2005 Comoros CHIK outbreak were tested with centers for disease control and prevention (CDC) IgM-capture ELISA (CDC ELISA) and focus reduction neutralization test (FRNT) as reference assays. The in-house ELISA had a sensitivity of 97.6% and specificity of 81.3% compared to the CDC ELISA and a sensitivity of 91.1% and specificity of 96.7% compared to FRNT. Furthermore, 254 clinically suspected dengue patient samples from Eastern Kenya, collected in 2013, were tested for CHIKV IgM using the in-house ELISA. Out of the 254 samples, 26 (10.2%) were IgM positive, and of these 26 samples, 17 were further analyzed by FRNT and 14 (82.4%) were positive. The in-house ELISA was able to diagnose CHIKV infection among suspected dengue cases in the 2013 outbreak.

  8. Natural transmission of dengue virus serotype 3 by Aedes albopictus (Skuse) during an outbreak in Havelock Island: Entomological characteristics.

    PubMed

    Sivan, Arun; Shriram, A N; Sugunan, A P; Anwesh, Maile; Muruganandam, N; Kartik, C; Vijayachari, P

    2016-04-01

    From May to June 2014, an outbreak of dengue virus (DENV) illness occurred in the Havelock Island, South Andaman. Entomological investigations were undertaken during the peak of the outbreak, from 26th May-4th June, to identify the primary vector(s) involved in the transmission so that appropriate public health measures could be implemented. Adult mosquitoes were collected by BG-Sentinel traps in houses and neighborhoods of clinically ill patients. Water holding containers were inspected for the presence of mosquito larvae and pupae. Adult mosquitoes were analyzed by RT-PCR for the presence of nucleic acids of DENV and CHIKV. A total of 498 mosquitoes were collected and processed in 27 pools. The species composition comprised of 58.3% Aedes albopictus, 7.5% Aedes aegypti and 4.2% Aedes edwardsi and 3.1% constituted others. Two A. albopictus pools were found to be positive for DENV RNA. Sequencing of the RT PCR 511 base pair amplicon positive samples showed homology with DENV-3, suggesting that serotype-3 was responsible for the outbreak and A. albopictus was the primary vector responsible. This was supported by high container (10.1%), premise (25.4%) and Breteau (27.9) indices, with miscellaneous receptacles (2.4%), tree holes (1.2%) and discarded tires (1.2%) registering relatively higher container indices. This is the first report of detection of DENV in A. albopictus from Andaman and Nicobar Islands. PMID:26780552

  9. 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. PMID:24681813

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

    PubMed Central

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

    2012-01-01

    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. PMID:22668443

  11. 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.

  12. 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.

  13. Dengue haemorrhagic fever outbreak in October-November 1996 in Ludhiana, Punjab, India.

    PubMed

    Kaur, H; Prabhakar, H; Mathew, P; Marshalla, R; Arya, M

    1997-07-01

    An epidemic of haemorrhagic fever broke out in Ludhiana in October and November 1996. Persons of all age groups were affected with preponderance of young adults. Haemorrhagic manifestations like rashes, epistaxis, bleeding from the gums and haematemesis were observed. The cause of fever was investigated. Serum samples collected at random from 71 patients were tested by ELISA for dengue types 1-4 IgM antibodies. These were positive in 96.7 per cent of cases. Immunoblot testing for IgM and IgG for all serotypes of dengue virus were positive in 90.2 and 73.2 per cent of the serum samples respectively. The haemorrhagic fever was serologically proven to be due to dengue virus.

  14. 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.

  15. Vaccines for the prevention of neglected diseases--dengue fever.

    PubMed

    Pang, Tikki

    2003-06-01

    Dengue and dengue hemorrhagic fever have spread to all tropical areas of the developing world, but still remain largely neglected diseases. Several promising vaccine candidates in the form of live attenuated and chimeric vaccines have been developed and are currently in human clinical trials. However, significant practical, logistic, and scientific challenges remain before these vaccines can widely and safely be applied to vulnerable populations. Vector control, community education and public health measures must be pursued in parallel with vaccine development.

  16. [The risk of urban yellow fever outbreaks in Brazil by dengue vectors. Aedes aegypti and Aedes albopictus].

    PubMed

    Mondet, B; da Rosa, A P; Vasconcelos, P F

    1996-01-01

    Urban yellow fever (YF) epidemics have disappeared from Brazil since about 50 years, but a selvatic cycle still exist. In many States, cases are more or less numerous each year. Ae. aegypti was eradicated in 1954, re-appeared temporarily in 1967, and then definitively in 1976-1977. Ae. aegypti is a vector of yellow few (YF), but also of dengue, whose first cases were reported in 1982. Today, dengue is endemic in many regions. A second Flavivirus vector, Aedes albopictus is present since about ten years in some States, from which Säo Paulo. The analysis of the YF cases between 1972 and 1994 allowed us to determine the epidemiologic regions. In the first region, the endemic area, the YF virus is circulating "silently" among monkeys, and the emergence of human cases is rare. In the second region, the epidemic area, some epizootics occur in a more or less cyclic way, and human cases can be numerous. Nevertheless, these outbreaks are considered "selvatic" epidemics, as long as Ae. aegypti is not concerned. From the Amazonian region, the virus moves forward along the forest galleries of the Amazone tributaries, from North to South. Actually, dengue epidemics appear in quite all States, and reflect the geographical distribution of Ae. aegypti. Recently, Ae. aegypti was found in the southern part of the Pará State, in the Carajás region considered to be the source of the main YF epidemics. In another hand, Ae. albopictus is now increasing its distribution area, specially in the suburban zones. The ecology of this potential vector, which seems to have a great adaptative capacity, give this vector an intermediate position between the forest galleries, where the YF virus circulates, and the agglomerations infested with Ae. aegypti. Since a few years, the possibility of urban YF is threatening Brazil, it is more and more predictable and we must survey very carefully the epidemiological situation in some regions of the country.

  17. 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

  18. Dengue Fever

    MedlinePlus

    ... Search Button Leading research to understand, treat, and prevent infectious, immunologic, and allergic diseases NIAID Home Health & ... NIAID News & Events Volunteer NIAID > Health & Research Topics > Dengue Fever > Understanding Dengue Fever Understanding Cause Transmission Symptoms ...

  19. Prevention and control of meningococcal outbreaks: The emerging role of serogroup B meningococcal vaccines.

    PubMed

    Oviedo-Orta, Ernesto; Ahmed, Sohail; Rappuoli, Rino; Black, Steven

    2015-07-17

    Recently an investigational meningococcal B vaccine has been used in two college outbreaks in the US. This is the first time that a meningococcal B vaccine has been used for outbreak control in the US. However, strain specific vaccines for meningococcal B outbreaks have been developed in Norway, Cuba and to control a large prolonged outbreak in New Zealand. Although meningococcal disease is mostly endemic and baseline rates in the US have fallen over the past decade, outbreaks are not uncommon in the US and globally. In an outbreak, disease risk can rise 1000 fold or more and such outbreaks can last a decade or longer causing significant morbidity and mortality. Here we review the evolution of several serogroup B outbreaks, and, when applicable, the development and impact of meningococcal B vaccines to control these outbreaks. Prior to the availability of "broad spectrum" meningococcal B vaccines, vaccines developed to control meningococcal B outbreaks were strain specific. With the development of two newly licensed meningococcal B vaccines - a four component meningococcal B vaccine (Bexsero, Novartis) and the two component fHBP vaccine (Trumenba, Pfizer) that target a broad array of meningococcal B strains, there is now the potential to prevent outbreaks and as well as to shorten the delay between identification of an outbreak and availability of a vaccine.

  20. [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.

  1. 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. PMID:18368236

  2. Strengthening the perception-assessment tools for dengue prevention: a cross-sectional survey in a temperate region (Madeira, Portugal)

    PubMed Central

    2014-01-01

    Background Community participation is mandatory in the prevention of Dengue outbreaks. Taking public views into account is crucial to guide more effective planning and quicker community participation in preventing campaigns. This study aims to assess community perceptions of Madeira population in order to explore their involvement in the A. aegypti’s control and reinforce health-educational planning. Due to the lack of accurate methodologies for measuring perception, a new tool to assess the community’s perceptions was built. Methods A cross-sectional survey was performed in the Island’s aegypti-infested area, exploring residents’ perceptions regarding most critical community behaviour: aegypti-source reduction and their domestic aegypti-breeding sites. A novel tool defining five essential topics which underlie the source reduction’s awareness and accession was built, herein called Essential-Perception (EP) analysis. Results Of 1276 individuals, 1182 completed the questionnaire (92 · 6%). EP-Score analysis revealed that community’s perceptions were scarce, inconsistent and possibly incorrect. Most of the population (99 · 6%) did not completely understood the five essential topics explored. An average of 54 · 2% of residents only partially understood each essential topic, revealing inconsistencies in their understanding. Each resident apparently believed in an average of four false assumptions/myths. Significant association (p<0.001) was found between both the EP-Score level and the domestic presence of breeding sites, supporting the validity of this EP-analysis. Aedes aegypti’s breeding sites, consisting of décor/leisure containers, presented an atypical pattern of infestation comparing with dengue prone regions. Conclusions The studied population was not prepared for being fully engaged in dengue prevention. Evidences suggest that EP-methodology was efficient and accurate in assessing the community perception and its compliance to

  3. Can hematocrit and platelet determination on admission predict shock in hospitalized children with dengue hemorrhagic fever? A clinical observation from a small outbreak.

    PubMed

    Wiwanitkit, Viroj; Manusvanich, Pornake

    2004-01-01

    Dengue infection is a major public health problem, affecting children in the Southeast Asia region. In Thailand, the dengue hemorrhagic fever is still a major infectious disease among the children with up to two to three epidemics per year. Hemoconcentration accompanied by platelet depletion are the predominant laboratory signs of dengue hemorrhagic fever. Findings from 23 hospitalized patients with dengue hemorrhafic fever in a small outbreak in a provincial hospital in Thailand are reported. The question if hematocrit and platelet determination on admission can predict shock in hospitalized children with dengue hemorrhagic fever was studied. The data from the discharge summary of these patients were studied, focusing on the admission hematology laboratory data. Regression analysis was used to test the correlation between the admission hematology laboratory data (hematocrit, white blood cell count, and platelet) and the focused outcome (shock or no shock). Of these 23 patients, shock did not develop in 19, and shock developed in four. There was no significant difference in admission hematology laboratory data between both groups (p < 0.05). The regression analysis revealed no significant correlation between the studied hematology laboratory data and the focused outcome (p > 0.05). It means that the three studied investigations on admission cannot predict shock in our hospitalized dengue hemorrhagic cases. From this study, it can imply that closed monitoring of dengue hemorrhagic patients is necessary. The general practitioner cannot rely on the admission hematology laboratory data to predict shock in these patients. Additionally, it might confirm that, although dengue infection can be fatal, with proper supportive treatment, especially hospitalization and hydration for severe cases, the outcome is very good.

  4. 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.

  5. Molecular identification of the first local dengue fever outbreak in Shenzhen city, China: a potential imported vertical transmission from Southeast Asia?

    PubMed

    Yang, F; Guo, G Z; Chen, J Q; Ma, H W; Liu, T; Huang, D N; Yao, C H; Zhang, R L; Xue, C F; Zhang, L

    2014-02-01

    A suspected dengue fever outbreak occurred in 2010 at a solitary construction site in Shenzhen city, China. To investigate this epidemic, we used serological, molecular biological, and bioinformatics techniques. Of nine serum samples from suspected patients, we detected seven positive for dengue virus (DENV) antibodies, eight for DENV-1 RNA, and three containing live viruses. The isolated virus, SZ1029 strain, was sequenced and confirmed as DENV-1, showing the highest E-gene homology to D1/Malaysia/36000/05 and SG(EHI)DED142808 strains recently reported in Southeast Asia. Further phylogenetic tree analysis confirmed their close relationship. At the epidemic site, we also detected 14 asymptomatic co-workers (out of 291) positive for DENV antibody, and DENV-1-positive mosquitoes. Thus, we concluded that DENV-1 caused the first local dengue fever outbreak in Shenzhen. Because no imported case was identified, the molecular fingerprints of the SZ1029 strain suggest this outbreak may be due to vertical transmission imported from Southeast Asia.

  6. Dengue Fever

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Dengue Fever” will be included in “Health Information for International Travel, 2007-2008” which will be published by the U.S. Centers for Disease Control and Prevention. Dengue and dengue hemorrhagic fever are viral diseases transmitted by Aedes mosquitoes. The disease is found in tropical and s...

  7. 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

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

    PubMed

    Cheng, Qu; Jing, Qinlong; Spear, Robert C; Marshall, John M; Yang, Zhicong; Gong, Peng

    2016-02-01

    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.

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

    PubMed

    Cheng, Qu; Jing, Qinlong; Spear, Robert C; Marshall, John M; Yang, Zhicong; Gong, Peng

    2016-02-01

    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

  10. 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

  11. 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...

  12. 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

  13. 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

  14. Dengue outbreak in Karachi, Pakistan, 2006: experience at a tertiary care center.

    PubMed

    Khan, E; Siddiqui, J; Shakoor, S; Mehraj, V; Jamil, B; Hasan, R

    2007-11-01

    This is the first report of the largest epidemic of dengue hemorrhagic fever (DHF) virus infection (2006) with IgM-confirmed cases from Karachi, Pakistan. Medical records of 172 IgM-positive patients were reviewed retrospectively for demographic, clinical and laboratory data. Patients were categorized into dengue fever (DF) and DHF according to the WHO severity grading scale. The mean+/-SD age of the patients was 25.9+/-12.8 years, 55.8% were males and the hemoconcentration was recorded in a small number of patients [10 (7.0%)]. Male gender [odds ratio (OR)=14.7, P=0.003), positive history of vomiting (OR=4.3, P=0.047), thrombocytopenia at presentation (OR=225.2, P<0.001) and monocytosis (OR=5.8, P=0.030) were independently associated with DHF, but not with DF. Five cases (2.9%) had a fatal outcome, with a male-to-female ratio of 1:4. Three were from a pediatric group (<15 years). Pulmonary hemorrhages, disseminated intravascular coagulation and cerebral edema preceded death in these patients. The results have highlighted significant findings, such as adult susceptibility to DHF, pronounced abdominal symptoms and lack of hemoconcentration at time of presentation in the study population. These findings may play an important role in the case definitions of future studies from this part of the world.

  15. Dengue fever: a risk to travelers.

    PubMed

    Karp, B E

    1997-07-01

    An outbreak of dengue fever occurred among a small group of Maryland and Pennsylvania residents following a trip to the British Virgin Islands in January 1996. Dengue fever is a mosquito-borne viral illness that occurs primarily in tropical urban areas. Most dengue infections are benign and self-limited, but some produce severe and fatal hemorrhagic disease. Although dengue is not endemic in the continental United States, travelers may acquire the infection during visits to the tropics. Physicians should consider dengue in the differential diagnosis of a patient with a febrile illness and a history of recent travel to a tropical area. Travelers to endemic areas should be advised to take precautions to prevent mosquito bites.

  16. 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 Central

    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. PMID:25127366

  17. 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.

  18. Unique impacts of HBV co-infection on clinical and laboratory findings in a recent dengue outbreak in China.

    PubMed

    Tang, Yangbo; Kou, Zhihua; Tang, Xiaoping; Zhang, Fuchun; Yao, Xian; Liu, Shengyong; Jin, Xia

    2008-08-01

    High prevalence of hepatitis B virus (HBV) infection in China offers a unique setting to examine HBV's influence on the presentation of dengue fever. In 398 patients admitted for suspected dengue fever, 89% (353/398) were positive for dengue IgM antibodies. Among dengue-infected patients, 8% (29/353) had chronic HBV co-infection. Only dengue virus serotype 1 was identified by virus isolation and reverse transcriptase-polymerase chain reaction assays. No case of dengue hemorrhagic fever/dengue shock syndrome was diagnosed. In addition to routine clinical tests, interleukin 2 (IL-2), IL-4, IL-6, IL-10, interferon gamma (IFNgamma), and tumor necrosis factor alpha (TNFalpha) levels were measured in the sera of 95% (334/353) of dengue-infected subjects as well as controls. Surprisingly, HBV/dengue co-infected patients made less IL-6 (P < 0.05) and TNFalpha (P < 0.05) than patients with only dengue infection. Similar levels of IL-4, IL-10, and IFNgamma were found in both groups. Thus, HBV co-infection seems to alter the cytokine production pattern when patients contract dengue infection.

  19. Prospective study of the duration and magnitude of viraemia in children hospitalised during the 1996-1997 dengue-2 outbreak in French Polynesia.

    PubMed

    Murgue, B; Roche, C; Chungue, E; Deparis, X

    2000-04-01

    The magnitude and duration of viraemia in children admitted to the hospital with dengue was studied during a dengue 2 outbreak in French Polynesia in 1996-1997. Forty-nine patients from whom at least 3 plasma samples were available were included in the study. Based on analysis of IgG-ELISA and haemagglutination inhibition assay, 21 of these were primary and 28 were secondary infections. According to World Health Organization criteria, 42 were dengue fever and 7 were dengue haemorrhagic fever. Virus was detectable by reverse transcription-PCR in all patients for at least the first 3 days of the onset of fever, but was never detected after the 6th day (mean duration = 4.4 days). Plasma virus titers ranged from 1.7-5.6 Log(10) TCID(50)/ml. A significant difference was not observed in the magnitude and duration of viraemia in patients with primary versus secondary infections. The severity of the illness, however, was correlated with both criteria.

  20. 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.

  1. Syphilis outbreak in Walsall, UK: lessons for control and prevention.

    PubMed

    Arumainayagam, J; Pallan, M J; Buckley, E; Pugh, R N; White, D G; Morrall, I A; Morris, C; Chandramani, S

    2007-01-01

    An assessment of risk-taking behaviour among men who have sex with men (MSM) attending a sauna venue was undertaken, using a standardized questionnaire, after which outreach screening was introduced targeting MSM. The epidemiology of the continuing outbreak of syphilis was reviewed to determine the factors driving the outbreak and assess the benefit of continuing outreach screening. Findings among the 163 respondents at the sauna included a high rate of casual sex and a tendency not to disclose HIV status. Over 12 months, 51 cases of early syphilis were recorded. Our review showed a decline in incidence in MSM after outreach screening, but an increase in heterosexual spread. Given the frequent anonymous nature of syphilis transmission, traditional contact tracing is ineffective. Outreach screening is required at gay venues and other community settings to target at-risk populations.

  2. Dengue haemorrhagic fever and the dengue shock syndrome in India.

    PubMed

    Lall, R; Dhanda, V

    1996-01-01

    The clinical spectrum of dengue fever ranges from asymptomatic infection through severe haemorrhage and sudden fatal shock. Increased capillary permeability is the diagnostic feature of dengue haemorrhagic fever (DHF). The pathophysiology of DHF/dengue shock syndrome (DSS) is related to sequential infection with different serotypes of the virus, variations in virus virulence, interaction of the virus with environmental or host factors and a combination of various risk factors. Infection due to low virulence strains is assumed to be the reason for the infrequent incidence of serious dengue disease in India. Since all four serotypes of the dengue virus have been implicated in various outbreaks in this country and several outbreaks of DHF/DSS have been recorded since the first report in 1963, further epidemics of the disease are likely. The situation is aggravated by the recent emergence of DHF/DSS in Sri Lanka. In view of the potential of this disease to spread, effective preventive and control measures should be a priority.

  3. Dengue in the deserts: Search and Destroy Operations

    PubMed Central

    Cariappa, M.P.; Bansal, A.S.; Dutt, Manohar; Reddy, K.P.

    2014-01-01

    Dengue, a viral disease transmitted by the Aedes mosquito has the potential to cause outbreaks in urban settings. Planned and coordinated actions including entomological surveillance need to be undertaken at the community level, through synergized efforts by all partners and stakeholders. The experience of conducting such a Task Force based action plan for prevention and control of dengue, in a desert township is highlighted in this study. PMID:25609869

  4. 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

  5. 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. PMID:26424605

  6. [Epidemiology of dengue and hemorrhagic dengue in Santiago, Cuba 1997].

    PubMed

    Valdés, L; Guzmán, M G; Kourí, G; Delgado, J; Carbonell, I; Cabrera, M V; Rosario, D; Vázquez, S

    1999-07-01

    A dengue epidemic that Cuba reported in 1997 registered more than 500,000 cases of dengue fever produced by viral serotype 1. In 1981, there was an epidemic of dengue hemorrhagic fever produced by serotype 2 of the virus. This time 344,203 clinical cases were reported, 10,312 of which were severe cases of hemorrhagic fever that led to 158 fatalities (101 of them among children). The reintroduction of dengue, and specifically of dengue viral serotype 2 (Jamaica genotype), was quickly detected in January 1997 through an active surveillance system with laboratory confirmation of cases in the municipality of Santiago de Cuba, in the province of the same name. The main epidemiological features of this outbreak are reported in this paper. A total of 3,012 cases were reported and serologically confirmed. These included 205 cases classified as dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS), 12 of which were case fatalities (all among adults). Secondary infection with dengue virus was one of the most important risk factors for DHF/DSS. Ninety-eight percent of the DHF/DSS cases and 92% of the fatal cases had contracted a secondary infection. It was the first time dengue hemorrhagic fever was documented as a secondary infection 16 to 20 years after initial infection. Belonging to the white racial group was another important risk factor for DHF/DSS, as had been observed during the 1981 epidemic. During the most recent epidemic it was demonstrated that the so called "fever alert" is not useful for early detection of an epidemic. Measures taken by the country's public health officials prevented spread of the epidemic to other municipalities plagued by Aedes aegypti.

  7. 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.

  8. Dengue type 2 outbreak in the south of the state of Bahia, Brazil: laboratorial and epidemiological studies.

    PubMed

    Nogueira, R M; Miagostovich, M P; Schatzmayr, H G; Moraes, G C; Cardoso, M A; Ferreira, J; Cerqueira, V; Pereira, M

    1995-01-01

    During March 1994 cases of a exanthematic acute disease were reported in the municipalities of Itagemirim, Eunápolis and Belmonte, state of Bahia. Dengue fever was confirmed by serology (MAC-ELISA) and by dengue virus type 2 isolation, genotype Jamaica. Signs and symptoms of classic dengue fever were observed with a high percentual of rash (73.8%) and pruritus (50.5%). Major haemorrhagic manifestations were unfrequent and only bleeding gum was reported. Dengue virus activity spreaded rapidly to important tourism counties like Porto Seguro, Ilhéus, Santa Cruz de Cabrália, Prado, Alcobaça and others, representing a risk for the spreading of dengue virus into the country and abroad.

  9. Invited commentary: Dengue lessons from Cuba.

    PubMed

    Vaughn, D W

    2000-11-01

    An 18-year interval between a dengue virus type 1 outbreak in 1977-1979 and a dengue virus type 2 outbreak in 1997 in Santiago de Cuba, Cuba, provided a unique opportunity to evaluate risk factors for dengue disease. All patients with symptomatic dengue, including 205 cases of dengue hemorrhagic fever and 12 deaths, were adults born before the dengue virus type 1 epidemic, and nearly all (98%) experienced secondary dengue virus infections. In contrast, almost all of those who seroconverted without illness (97%) experienced primary dengue virus infection. This provides epidemiologic support for the immune enhancement theory of dengue pathogenesis. The Cuban experience suggests that immune enhancement can be seen even 20 years after the primary dengue virus infection. It also supports the contention that primary infections with dengue virus type 2 (and dengue virus type 4) are largely subclinical. These observations have implications for dengue vaccine development based on live-attenuated viruses.

  10. 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. PMID:26936670

  11. Dengue and dengue hemorrhagic fever.

    PubMed

    Gubler, D J

    1998-07-01

    Dengue fever, a very old disease, has reemerged in the past 20 years with an expanded geographic distribution of both the viruses and the mosquito vectors, increased epidemic activity, the development of hyperendemicity (the cocirculation of multiple serotypes), and the emergence of dengue hemorrhagic fever in new geographic regions. In 1998 this mosquito-borne disease is the most important tropical infectious disease after malaria, with an estimated 100 million cases of dengue fever, 500,000 cases of dengue hemorrhagic fever, and 25,000 deaths annually. The reasons for this resurgence and emergence of dengue hemorrhagic fever in the waning years of the 20th century are complex and not fully understood, but demographic, societal, and public health infrastructure changes in the past 30 years have contributed greatly. This paper reviews the changing epidemiology of dengue and dengue hemorrhagic fever by geographic region, the natural history and transmission cycles, clinical diagnosis of both dengue fever and dengue hemorrhagic fever, serologic and virologic laboratory diagnoses, pathogenesis, surveillance, prevention, and control. A major challenge for public health officials in all tropical areas of the world is to develop and implement sustainable prevention and control programs that will reverse the trend of emergent dengue hemorrhagic fever.

  12. [First case of dengue hemorrhagic fever with shock syndrome in Martinique].

    PubMed

    Mansuy, J M; Delor, R; Mehdaoui, H; Elizabeth, L

    1996-01-01

    Since mid 95, many Caribbean islands and America's countries suffer from a new outbreak of an epidemic of dengue fever and dengue haemorrhagic fever. Until today, no case of dengue haemorrhagic fever was reported in Martinique (FWI) in spite of the high prevalence of dengue fever in the island. The first identified case asserts the severity of illness. In Martinique, these arbovirosis is often underestimated. Nowadays, the disease prevention must become one of the principal targets of the medical corporation and the Public Health Authorities. Consequently, epidemiologic survey and principally vector's control must be reinforced.

  13. Influence of environmental conditions on asynchronous outbreaks of dengue disease and increasing vector population in Kaohsiung, Taiwan.

    PubMed

    Lai, Li-Wei

    2011-04-01

    The objective of this study was to clarify the associations between dengue vectors and the number of dengue fever admissions. We statistically analyzed the daily meteorological and sea surface temperature (SST) data obtained from 13 monitoring stations for 2002-2007, the daily number of dengue fever admissions to hospitals, as well as the Breteau index (BI) values obtained from the Taiwan Centres for Disease Control for the 38 political districts of metropolitan Kaohsiung. It was found that hot and wet environmental conditions were caused by warm SSTs together with the weather patterns that cause typhoons and high-pressure areas in the tropical Pacific Ocean. The conditions clearly contribute to an increase in the BI. Synoptic weather patterns still remain an important factor in determining the growth of dengue vectors, particularly in rural areas, although public health programs and improved environmental sanitation can also reduce the threat of the disease.

  14. Studies on community knowledge and behavior following a dengue epidemic in Chennai city, Tamil Nadu, India.

    PubMed

    Ashok Kumar, V; Rajendran, R; Manavalan, R; Tewari, S C; Arunachalam, N; Ayanar, K; Krishnamoorthi, R; Tyagi, B K

    2010-08-01

    In 2001, a major dengue outbreak was recorded in Chennai city, with 737 cases (90%) out of a total of 861 cases recorded from Tamil Nadu state. A KAP survey was carried out to assess the community knowledge, attitude and practice on dengue fever (DF), following the major dengue outbreak in 2001. A pre- tested, structured questionnaire was used for data collection. The multistage cluster sampling method was employed and 640 households (HHs) were surveyed. Among the total HHs surveyed, 34.5% of HHs were aware of dengue and only 3.3% of HHs knew that virus is the causative agent for DF. Majority of the HHs (86.5%) practiced water storage and only 3% of them stored water more than 5 days. No control measures were followed to avoid mosquito breeding in the water holding containers by majority of HHs (65%). Sixty percent of HHs did not know the biting behaviour of dengue vector mosquitoes. The survey results indicate that the community knowledge was very poor on dengue, its transmission, vector breeding sources, biting behavior and preventive measures. The lack of basic knowledge of the community on dengue epidemiology and vector bionomics would be also a major cause of increasing trend of dengue in this highly populated urban environment. There is an inevitable need to organize health education programmes about dengue disease to increase community knowledge and also to sensitize the community to participate in integrated vector control programme to resolve the dengue problem.

  15. Preventing diseases and outbreaks at child care centers using an education, evaluation, and inspection method.

    PubMed

    Wagner, Jordan; Clodfelter, Sharon

    2014-03-01

    From 2005 to 2008, Washoe County, Nevada, child care centers experienced an increase in illnesses from communicable disease outbreaks. The number of ill children and caregivers from these outbreaks went from 26 in 2005 to 266 in 2008, an increase of 923%. A clear need to reverse this trend existed. Therefore, in 2009 Washoe County strengthened its regulations for child care facilities by adding numerous communicable disease prevention standards. In addition, in 2009 a two-year education, evaluation, and inspection program was implemented at Washoe County child care centers. Following the implementation of this program, a decline occurred in the number of illnesses. The number of ill children and caregivers from outbreaks went from 266 in 2008 to 13 in 2011, a decrease of 95%.

  16. 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

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

    PubMed

    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

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

    PubMed

    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.

  19. 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.

  20. Laboratory-based dengue fever surveillance in Tamil Nadu, India.

    PubMed

    Victor, T John; Malathi, M; Asokan, R; Padmanaban, P

    2007-08-01

    Dengue fever and dengue haemorrhagic fever (DF/DHF) have become a serious public health problem in many parts of India in recent years. Several vertical national programmes for communicable diseases, which include vector-borne diseases such as malaria and filariasis have been in operation for over five decades in India. The remarkable increase in dengue fever and DHF related deaths during the last decade has necessitated an effective surveillance system to detect the cases and adopt appropriate control measures against dengue vectors. Although the existence of all the four serotypes of dengue virus was proved as early as in 1960s, it was only after 1990, several outbreaks of DF/DHF were reported in Tamil Nadu. Further, dengue, once considered as urban problem has now penetrated into rural areas also, due to various changes in the environment. The geographic spread, increase in number of cases, reporting system, laboratory diagnosis, monitoring of vector density and investigation of outbreaks in Tamil Nadu during the last decade are comprehensively documented and discussed here to further strengthen the surveillance network to prevent possible major outbreaks of DF/DHF.

  1. [Dengue and chikungunya acquired during travel in the tropics].

    PubMed

    van Aart, Carola J C; Braks, Marieta A H; Hautvast, Jeannine L A; de Mast, Quirijn; Tostmann, Alma

    2015-01-01

    The global incidence of dengue and chikungunya has greatly increased over recent decades, partly due to the increase of geographic distribution of both vectors. These infections are endemic to the tropics and subtropics, however autochthonous transmission and outbreaks have been described in non-endemic areas. Currently, there is a large chikungunya outbreak in the western hemisphere which started in the Caribbean. Chikungunya had not previously been endemic to this region. Both arboviral infections are important causes of fever in Dutch travellers returning from tropical destinations. The clinical presentations of dengue and chikungunya overlap; both are characterised by high fever and arthralgia. Bleeding and plasma leakage are potentially life-threatening complications of dengue, while persistent arthralgia typifies chikungunya. The prevention of mosquito bites, by using protective clothing and insect repellents, is the only way to prevent infection. No vaccine is yet available.

  2. [Dengue and chikungunya acquired during travel in the tropics].

    PubMed

    van Aart, Carola J C; Braks, Marieta A H; Hautvast, Jeannine L A; de Mast, Quirijn; Tostmann, Alma

    2015-01-01

    The global incidence of dengue and chikungunya has greatly increased over recent decades, partly due to the increase of geographic distribution of both vectors. These infections are endemic to the tropics and subtropics, however autochthonous transmission and outbreaks have been described in non-endemic areas. Currently, there is a large chikungunya outbreak in the western hemisphere which started in the Caribbean. Chikungunya had not previously been endemic to this region. Both arboviral infections are important causes of fever in Dutch travellers returning from tropical destinations. The clinical presentations of dengue and chikungunya overlap; both are characterised by high fever and arthralgia. Bleeding and plasma leakage are potentially life-threatening complications of dengue, while persistent arthralgia typifies chikungunya. The prevention of mosquito bites, by using protective clothing and insect repellents, is the only way to prevent infection. No vaccine is yet available. PMID:25784059

  3. [The dengue fever in Mexico. Knowledge for improving the quality in health].

    PubMed

    Fajardo-Dolci, Germán; Meljem-Moctezuma, José; Vicente-González, Esther; Venegas-Páez, Francisco Vicente; Mazón-González, Betania; Aguirre-Gas, Héctor Gerardo

    2012-01-01

    Dengue is a systemic infectious disease of viral etiology, transmitted by Aedes mosquitoes. It causes between 50 and 100 million cases annually over 100 countries. In most of the cases it presents as influenza-like illness or undifferentiated fever and more than 500,000 patients develop dengue hemorrhagic fever. In America, dengue fever is considered the most important resurgent disease and its hemorrhagic form is becoming more relevant, especially given the steady increase in the number of deaths. The first outbreaks of dengue in America were described in 1635. Since the apparition of dengue hemorrhagic fever, in 1962, it has been considered a public health problem because half of the population lives in endemic areas. The purpose of this paper is to carry a briefly review of the epidemiology, clinical features, pathophysiology, prevention and treatment of dengue fever, as well as create recommendations in order to improve the quality of care and decrease mortality in these patients.

  4. [Dengue fever and dengue hemorrhagic fever].

    PubMed

    Fonsmark, L; Poulsen, A; Heegaard, E D

    2000-09-18

    Dengue virus is transmitted by mosquitoes and causes dengue fever/dengue haemorrhagic fever throughout the tropical areas of the world. There is an increasing incidence of dengue infections. Because of increasing travel activity, infection among Danes travelling abroad as well as imported cases are expected to be seen more frequently. In this review we describe the clinical manifestations, diagnosis, pathogenesis, treatment and prevention of the disease.

  5. 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…

  6. 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

  7. 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. PMID:24550728

  8. Spatial, environmental and entomological risk factors analysis on a rural dengue outbreak in Lundu District in Sarawak, Malaysia.

    PubMed

    Cheah, Whye Lian; Chang, Moh Seng; Wang, Yin Chai

    2006-06-01

    The objective of this study was to elucidate the association of various risk factors with dengue cases reported in Lundu district, Sarawak, by analyzing the interaction between environmental, entomological, socio-demographic factors. Besides conventional entomological, serological and house surveys, this study also used GIS technology to generate geographic and environmental data on Aedes albopictus and dengue transmission. Seven villages were chosen based on the high number of dengue cases reported. A total of 551 households were surveyed. An overall description of the socio-demographic background and basic facilities was presented together with entomological and geographical profiles. For serological and ovitrap studies, systematic random sampling was used. Serological tests indicated that 23.7% of the 215 samples had a history of dengue, either recent or previous infections. Two samples (0.9%) were confirmed by IgM ELISA and 49 samples (22.8%) had IgG responses. A total of 32,838 Aedes albopictus eggs were collected in 56 days of trapping. Cluster sampling was also done to determine whether any of the risk factors (entomological or geographical) were influenced by geographical location. These clusters were defined as border villages with East Kalimantan and roadside villages along Lundu/Biawas trunk road. The data collected were analyzed using SPSS version 10.01. Descriptive analysis using frequency, means, and median were used. To determine the association between variables and dengue cases reported, and to describe the differences between the two clusters of villages, two-sample t-test, and Pearson's Chi-Square were used. Accurate maps were produced with overlay and density function, which facilitates the map visualization and report generating phases. This study also highlights the use of differential Global Positioning System in mapping sites of 1m accuracy. Analysis of the data revealed there are significant differences in clusters of villages attributable

  9. 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.

  10. 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. PMID:26960530

  11. Dengue: a continuing global threat

    PubMed Central

    Guzman, Maria G.; Halstead, Scott B.; Artsob, Harvey; Buchy, Philippe; Farrar, Jeremy; Gubler, Duane J.; Hunsperger, Elizabeth; Kroeger, Axel; Margolis, Harold S.; Martínez, Eric; Nathan, Michael B.; Pelegrino, Jose Luis; Simmons, Cameron; Yoksan, Sutee; Peeling, Rosanna W.

    2014-01-01

    Dengue fever and dengue haemorrhagic fever are important arthropod-borne viral diseases. Each year, there are ~50 million dengue infections and ~500,000 individuals are hospitalized with dengue haemorrhagic fever, mainly in Southeast Asia, the Pacific and the Americas. Illness is produced by any of the four dengue virus serotypes. A global strategy aimed at increasing the capacity for surveillance and outbreak response, changing behaviours and reducing the disease burden using integrated vector management in conjunction with early and accurate diagnosis has been advocated. Antiviral drugs and vaccines that are currently under development could also make an important contribution to dengue control in the future. PMID:21079655

  12. Dengue: a continuing global threat.

    PubMed

    Guzman, Maria G; Halstead, Scott B; Artsob, Harvey; Buchy, Philippe; Farrar, Jeremy; Gubler, Duane J; Hunsperger, Elizabeth; Kroeger, Axel; Margolis, Harold S; Martínez, Eric; Nathan, Michael B; Pelegrino, Jose Luis; Simmons, Cameron; Yoksan, Sutee; Peeling, Rosanna W

    2010-12-01

    Dengue fever and dengue haemorrhagic fever are important arthropod-borne viral diseases. Each year, there are ∼50 million dengue infections and ∼500,000 individuals are hospitalized with dengue haemorrhagic fever, mainly in Southeast Asia, the Pacific and the Americas. Illness is produced by any of the four dengue virus serotypes. A global strategy aimed at increasing the capacity for surveillance and outbreak response, changing behaviours and reducing the disease burden using integrated vector management in conjunction with early and accurate diagnosis has been advocated. Antiviral drugs and vaccines that are currently under development could also make an important contribution to dengue control in the future.

  13. 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.

  14. 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.

  15. Health care-associated infection outbreak investigations by the Centers for Disease Control and Prevention, 1946-2005.

    PubMed

    Archibald, Lennox K; Jarvis, William R

    2011-12-01

    Since 1946, Centers for Disease Control and Prevention (CDC) personnel have investigated outbreaks of infections and adverse events associated with delivery of health care. CDC Epidemic Intelligence Service officers have led onsite investigations of these outbreaks by systematically applying epidemiology, statistics, and laboratory science. During 1946-2005, CDC Epidemic Intelligence Service officers conducted 531 outbreak investigations in facilities across the United States and abroad. Initially, the majority of outbreaks involved gastrointestinal tract infections; however, in later years, bloodstream, respiratory tract, and surgical wound infections predominated. Among pathogens implicated in CDC outbreak investigations, Staphylococcus aureus, Enterococcus species, Enterobacteriaceae, nonfermentative Gram-negative bacteria, or yeasts predominated, but unusual organisms (e.g., the atypical mycobacteria) were often included. Outbreak types varied and often were linked to transfer of colonized patients or health care personnel between facilities (multihospital outbreaks), national distribution of contaminated products, use of invasive medical devices, or variances in practices and procedures in health care environments (e.g., intensive care units, water reservoirs, or hemodialysis units). Through partnerships with health care facilities and local and state health departments, outbreaks were terminated and lives saved. Data from investigations invariably contributed to CDC-generated guidelines for prevention and control of health care-associated infections. PMID:22135394

  16. Dengue viral infection.

    PubMed

    Sarin, Y K; Singh, S; Singh, T

    1998-02-01

    Dengue viral infection produces a spectrum of disease. For example, mild dengue disease is characterized by biphasic fever, myalgia, arthralgia, leukopenia, and lymphadenopathy, while dengue hemorrhagic fever is an often fatal disease characterized by hemorrhages and shock syndrome. The disease, especially in its severe form, is seen more often among children than among adults. With focus upon India, dengue's etiology, epidemiology, pathology, pathogenesis of dengue hemorrhagic fever, clinical manifestations of both the mild and severe forms of dengue viral infection, diagnosis, differential diagnosis, treatment, prevention, and prognosis are discussed.

  17. 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

  18. 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.

  19. 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.

  20. Spatio-Temporal Tracking and Phylodynamics of an Urban Dengue 3 Outbreak in São Paulo, Brazil

    PubMed Central

    Mondini, Adriano; de Moraes Bronzoni, Roberta Vieira; Nunes, Silvia Helena Pereira; Chiaravalloti Neto, Francisco; Massad, Eduardo; Alonso, Wladimir J.; Lázzaro, Eduardo S. M.; Ferraz, Amena Alcântara; de Andrade Zanotto, Paolo Marinho; Nogueira, Maurício Lacerda

    2009-01-01

    The dengue virus has a single-stranded positive-sense RNA genome of ∼10.700 nucleotides with a single open reading frame that encodes three structural (C, prM, and E) and seven nonstructural (NS1, NS2A, NS2B, NS3, NS4A, NS4B, and NS5) proteins. It possesses four antigenically distinct serotypes (DENV 1–4). Many phylogenetic studies address particularities of the different serotypes using convenience samples that are not conducive to a spatio-temporal analysis in a single urban setting. We describe the pattern of spread of distinct lineages of DENV-3 circulating in São José do Rio Preto, Brazil, during 2006. Blood samples from patients presenting dengue-like symptoms were collected for DENV testing. We performed M-N-PCR using primers based on NS5 for virus detection and identification. The fragments were purified from PCR mixtures and sequenced. The positive dengue cases were geo-coded. To type the sequenced samples, 52 reference sequences were aligned. The dataset generated was used for iterative phylogenetic reconstruction with the maximum likelihood criterion. The best demographic model, the rate of growth, rate of evolutionary change, and Time to Most Recent Common Ancestor (TMRCA) were estimated. The basic reproductive rate during the epidemics was estimated. We obtained sequences from 82 patients among 174 blood samples. We were able to geo-code 46 sequences. The alignment generated a 399-nucleotide-long dataset with 134 taxa. The phylogenetic analysis indicated that all samples were of DENV-3 and related to strains circulating on the isle of Martinique in 2000–2001. Sixty DENV-3 from São José do Rio Preto formed a monophyletic group (lineage 1), closely related to the remaining 22 isolates (lineage 2). We assumed that these lineages appeared before 2006 in different occasions. By transforming the inferred exponential growth rates into the basic reproductive rate, we obtained values for lineage 1 of R0 = 1.53 and values for lineage 2 of R0

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

    PubMed

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

    2016-08-01

    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 such intervention called Mo-Buzz, a mobile-based crowdsource-driven socially mediated system developed to address gaps in dengue surveillance and education in Colombo, Sri Lanka. We conducted a 30-minute cross-sectional field survey (N = 404) among potential users of Mo-Buzz in Colombo. We examined individual, institutional, and cultural factors that influence their potential intention-to-use Mo-Buzz and assessed if these factors varied by demographic factors. Descriptive analysis revealed high perceived ease-of-use (PEOU; M = 3.81, SD = 0.44), perceived usefulness (PU; M = 4.01, SD = 0.48), and intention-to-use (PI; M = 3.91, SD = 0.46) among participants. Analysis of variance suggested participants in the 31 to 40 years age group reported highest PEOU, whereas the oldest group reported high perceived institutional efficacy (M = 3.59, SD = 0.64) and collectivistic tendencies. Significant differences (at the p < .05 level) were also found by education and income. Regression analysis demonstrated that PU, behavioral control, institutional efficacy, and collectivism were significant predictors of PI. We concluded that despite high overall PI, future adoption and use of Mo-Buzz will be shaped by a complex mix of factors at different levels of the public health ecology. Implications of study findings from theoretical and practical perspectives related to the future adoption of mobile-based participatory systems in public health are discussed and ideas for a future research agenda presented. PMID:26377525

  2. Pertussis (Whooping Cough) Outbreaks

    MedlinePlus

    ... questions about pertussis outbreaks... Resources and Publications Find articles about pertussis outbreaks and resources for outbreak response... Postexposure Antimicrobial Prophylaxis The primary objective of PEP should be to prevent death ...

  3. 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

  4. Dengue Virus and Japanese Encephalitis Virus Epidemiological Shifts in Nepal: A Case of Opposing Trends

    PubMed Central

    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

    2013-01-01

    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. PMID:23419366

  5. 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…

  6. Dengue encephalitis in French Guiana.

    PubMed

    Hommel, D; Talarmin, A; Deubel, V; Reynes, J M; Drouet, M T; Sarthou, J L; Hulin, A

    1998-01-01

    Thousands of cases of dengue fever (DF) and several cases of dengue haemorrhagic fever were recorded in French Guiana during the recent outbreak of dengue-2 virus (1991-1992) and in subsequent years. One case with clinical signs typical of classical DF with neurological complications is reported in this study. The neurological features (encephalitis) appeared during the acute phase, 2 days after the onset of fever. Dengue-2 virus was detected in both the cerebrospinal fluid and blood sample. This case was fatal. This first reported case of classical DF with encephalitis in French Guiana is a new demonstration of the potential neurovirulence of dengue viruses.

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

    PubMed

    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

  8. 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. PMID:26753672

  9. Ecologic and Sociodemographic Risk Determinants for Dengue Transmission in Urban Areas in Thailand

    PubMed Central

    Koyadun, Surachart; Butraporn, Piyarat; Kittayapong, Pattamaporn

    2012-01-01

    This study analyzed the association between household-level ecologic and individual-level sociodemographic determinants and dengue transmission in urban areas of Chachoengsao province, Thailand. The ecologic and sociodemographic variables were examined by univariate analysis and multivariate logistic regression. In the ecologic model, dengue risk was related to households situated in the ecotope of residential mixed with commercial and densely populated urban residential areas (RCDENPURA) (aOR = 2.23, P = 0.009), high historical dengue risk area (aOR = 2.06, P < 0.001), and presence of household window screens (aOR = 1.62, P = 0.023). In the sociodemographic model, the dengue risk was related to householders aged >45 years (aOR = 3.24, P = 0.003), secondary and higher educational degrees (aOR = 2.33, P = 0.013), household members >4 persons (aOR = 2.01, P = 0.02), and community effort in environmental management by clean-up campaign (aOR = 1.91, P = 0.035). It is possible that the preventive measures were positively correlated with dengue risk because these activities were generally carried out in particular households or communities following dengue experiences or dengue outbreaks. Interestingly, the ecotope of RCDENPURA and high historical dengue risk area appeared to be very good predictors of dengue incidences. PMID:23056042

  10. 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

    2016-01-01

    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. PMID:26732586

  11. 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.

  12. Dengue associated hemophagocytic lymphohistiocytosis: a case series.

    PubMed

    Pal, Priyankar; Giri, Prabhas Prasun; Ramanan, A V

    2014-06-01

    Hemophagocytic lymphohistiocytosis is a rare complication of dengue. We present 8 cases of dengue associated hemophagocytic lymphohistiocytosis diagnosed in our hospital during the dengue outbreak of 2012. All the cases were treated with a short (4 weeks) course of steroids along with supportive measures, and showed an excellent response.

  13. 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

  14. Laboratory Surveillance of Dengue in Argentina, 1995–2001

    PubMed Central

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

    2003-01-01

    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. PMID:12781019

  15. 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.

  16. 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

  17. 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.

  18. [Dengue outbreak by virus type 4 in French Polynesia. II. Preliminary biological observations on epidemiology and physiopathology of the disease (author's transl)].

    PubMed

    Parc, F; Tetaria, C; Pichon, G

    1981-01-01

    Authors report some accurate epidemiologic and physiopathologic data about dengue 4. Thanks to virus intrathoracic inoculation in Toxorhynchites amboinensis (Doleshall, 1857), 202 viral strains have been isolated from 633 sera samples. The incidence of the disease has decreased very early after immunization of the whole population and resulted in an eradication of dengue type 1 virus which was endemic in French Polynesia since 1976. Only one type of dengue virus seems to be tolerated in French Polynesian ecosystem in the same time. There is no crossing protection with dengue 1. Clinically, the picture has been the same in both new and previously infected by dengue 1 patients. Duration of viremia during the secondary dengue fever is not shorter than in the primary one. The hemagglutination inhibiting antibodies do not protect patients, but do not result in immune-complexes pathology.

  19. Investigating an outbreak of acute fever in Chuuk, Federated States of Micronesia

    PubMed Central

    Yichiro, Yoster; Otoko, Kasian; Heldart, Helden; Meyshine, Andita; Assito, Prisca; Pretrick, Moses; Souares, Yvan; Hancock, Thane; Durand, Mark; Roth, Adam

    2014-01-01

    Objective In September 2012, there was an unexpected increase of acute febrile illness (AFI) in Chuuk State of the Federated States of Micronesia. At the same time, dengue outbreaks were occurring in two of the Federated States of Micronesia’s other three states. The cause of AFI was suspected to be dengue; however, by the end of October, only one of 39 samples was positive for dengue. The objective of the investigation was to establish the cause of the outbreak. Methods A line list was created and data analysed by time, place, person and clinical features. Reported symptoms were compared with the published symptoms of several diagnoses and laboratory testing undertaken. Results Of the 168 suspected cases, 62% were less than 20 years of age and 60% were male. The clinical features of the cases were not typical for dengue but suggestive of respiratory illness. Nasopharyngeal swabs were subsequently collected and found to be positive for influenza. Public health measures were undertaken and the AFI returned to expected levels. Discussion Clinical diagnosis of acute febrile illness (AFI) can often be difficult and misleading. This can mean that opportunities for preventive measures early on in an outbreak are missed. In any outbreak, descriptive epidemiological analyses are valuable in helping to ascertain the cause of the outbreak. PMID:25685599

  20. 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

  1. 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

  2. Dengue and dengue haemorrhagic fever: Indian perspective.

    PubMed

    Chaturvedi, U C; Nagar, Rachna

    2008-11-01

    The relationship of this country with dengue has been long and intense. The ?rst recorded epidemic of clinically dengue-like illness occurred at Madras in 1780 and the dengue virus was isolated for the ?rst time almost simultaneously in Japan and Calcutta in 1943-1944. After the ?rst virologically proved epidemic of dengue fever along the East Coast of India in 1963-1964, it spread to allover the country.The ?rst full-blown epidemic of the severe form of the illness,the dengue haemorrhagic fever/dengue shock syndrome occurred in North India in 1996. Aedes aegypti is the vector for transmission of the disease. Vaccines or antiviral drugs are not available for dengue viruses; the only effective way to prevent epidemic degure fever/dengue haemorrhagic fever (DF/DHF) is to control the mosquito vector, Aedes aegypti and prevent its bite. This country has few virus laboratories and some of them have done excellent work in the area of molecular epidemiology,immunopathology and vaccine development. Selected work done in this country on the problems of dengue is presented here.

  3. Using simplified models to communicate the importance of prevention, detection and preparedness before a disease outbreak.

    PubMed

    McNab, B; Dubé, C; Alves, D

    2011-08-01

    Frontline farm workers and veterinary-policy-makers are arguably in the best positions to influence prevention, detection, and preparedness-for-control of farm animal diseases. It is important that such individuals make biologically sound decisions concerning the daily management and regulation of the health of animals. Such decisions should be based on a good understanding of key principles of disease spread and control. This paper summarises these principles, as described in previous publications, into simple models. These models may be used to communicate concepts to readers who may not have time to study more complex models. These models illustrate the relationship between the development of new disease cases (from existing cases, i.e., the reproductive ratio R) and (i) the duration of the period during which existing cases are available as infectious, (ii) contact rates, (iii) transmission rates and (iv) susceptibility. Understanding these concepts through models has great utility, facilitating better decisions for disease prevention, detection and preparedness-for-control, before an outbreak becomes unmanageable. These basic concepts apply to all animal species, including humans.

  4. Dengue fever: natural management.

    PubMed

    Qadir, Muhammad Imran; Abbas, Khizar; Tahir, Madeha; Irfan, Muhammad; Raza Bukhari, Syeda Fiza; Ahmed, Bilal; Hanif, Muhammad; Rasul, Akhtar; Ali, Muhammad

    2015-03-01

    Dengue fever is caused by the mosquito-borne dengue virus (DENV) serotypes 1-4, and is the most common arboviral infection of humans in subtropical and tropical regions of the world. Dengue virus infections can present with a spacious range of clinical signs, from a mild feverish illness to a life-threatening shock syndrome. Till now, there is no approved vaccine or drug against this virus. Therefore, there is an urgent need of development of alternative solutions for dengue. Several plant species have been reported with anti-dengue activity. Many herbal/natural drugs, most of which are commonly used as nutritional components, have been used as antiviral, larvicidal, mosquitocidal and mosquito repellents that may be used against dengue. The objective of this review article was to provide current approaches for the treatment and management/prevention of dengue fever by targeting viral proteins involved in replication cycle of the virus and different developmental stages of mosquito.

  5. Waterborne disease outbreaks in the United States of America: causes and prevention.

    PubMed

    Craun, G F

    1992-01-01

    National statistics on waterborne outbreaks in the United States of America show that 1,702 waterborne outbreaks with 542,018 cases of illness and 1,089 deaths have been reported. Almost all deaths prior to 1940 were due to typhoid fever; 9 deaths from other causes have occurred since 1971. During the past decade, 291 waterborne outbreaks were reported in community (43%) and noncommunity (33%) systems, and from the ingestion of contaminated water from recreational (14%) and individual (10%) water sources. Although several large waterborne outbreaks occurred during the past decade, most were in small communities. The number of illnesses per outbreak in noncommunity systems during the past decade is much larger than that reported during any previous period, and the magnitude of these outbreaks indicates the potential effect on the travelling, transient population. During 1981-1990, contaminated, untreated groundwater or inadequately disinfected groundwater was responsible for 43% of all reported waterborne outbreaks, and contaminated, untreated surface water or inadequately treated surface water was responsible for 24% of all reported outbreaks. The use of untreated groundwater has declined in importance as a cause of outbreaks, and more outbreaks are now caused by inadequate or interrupted disinfection of groundwater. The increased occurrence of outbreaks in disinfected groundwater systems may be due to (i) increased use of disinfection with little effort to reduce or eliminate sources of contamination, and (ii) not providing effective, continuous disinfection. In surface-water systems, outbreaks occur primarily because of inadequate or interrupted disinfection in systems that do not provide filtration, but a large increase in outbreaks has recently occurred in filtered systems.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Dengue vaccine.

    PubMed

    Simasathien, Sriluck; Watanaveeradej, Veerachai

    2005-11-01

    Dengue is an expanding health problem. About two-fifths of the world population are at risk for acquiring dengue with 50-100 million cases of acute febrile illness yearly including about 500,000 cases of DHF/DSS. No antiviral drugs active against the flavivirus exist. Attempts to control mosquito vector has been largely unsuccessful. Vaccination remains the most hopeful preventive measure. Dengue vaccine has been in development for more than 30 years, yet none has been licensed. The fact that enhancing antibody from previous infection and high level of T cell activation during secondary infection contribute to immunopathology of DHF, the vaccine must be able to induce protective response to four dengue serotypes simultaneously. Inactivated vaccine is safe but needs a repeated booster thus, development is delayed. Tetravalent live attenuated vaccine and chimeric vaccine using yellow fever or dengue viruses as a backbone are being carried out in human trials. DNA vaccine and subunit vaccine are being carried out in animal trials.

  7. The risk of dengue hemorrhagic fever (DHF) outbreak based on vector density in Kurau, Riau province, Indonesia.

    PubMed

    Mangara, S G; Sukmono; Kusumadiharja, J; Suroso, T; Sutjipto, H

    2000-01-01

    It is known that in Padang, Rantau, Rangsang, Merbau and Bengkalis islands, Riau Province, the deposit of oil was found in a huge quantity. The drilling concession belongs to Kondur Petroleum Company. To operate an exploitation, hundreds of workers not only Indonesian but also the workers from foreign countries come and go to that area. It was recorded that the workers from foreign countries come from Singapore, Malaysia, Thailand, The Philippines, Taiwan, Japan, Korea. United States of America and from France, Britain, Australia and Germany. These workers have a close interaction with about 50,00 local population distributed with a high concentration in some places. The high risk of DHF was determined since the significant density of Aedes aregypti larvae, the main vector of DHF, were found in Lukit, Mengkikip and Melibur, three locations of survey. Of 104 (53.3%) of 195 houses in these three survey locations were found positive for the larvae. Even though there were no positive of larvae in 65 houses in Lukit, in Melibur and Mengkikip, the House Index (HI) was 61.7% and 95.7%. Outside the houses 521 containers were examined in three locations of survey and 329 (63.1%) were positive for Ae. aegypti larvae. The highest number of containers positive for Ae. aegypti larvae were 213 (94.7%) out of 225 and found in Mengkikip. In Melibur, 114 (68.3%) out of 167 of containers were positive and in Lukit only 2 (1.56%) out of 129 containers were positive of Ae. aegypti larvae. These larvae density constitute a high risk of DHF outbreak, and unfortunately is supported by the rainfall situation recorded in Kurau and BZ Climatology Stations. It was recorded that all along the year, at least one day in a month there was the rain which the rainfall volume was 30 ml.

  8. The risk of dengue hemorrhagic fever (DHF) outbreak based on vector density in Kurau, Riau province, Indonesia.

    PubMed

    Mangara, S G; Sukmono; Kusumadiharja, J; Suroso, T; Sutjipto, H

    2000-01-01

    It is known that in Padang, Rantau, Rangsang, Merbau and Bengkalis islands, Riau Province, the deposit of oil was found in a huge quantity. The drilling concession belongs to Kondur Petroleum Company. To operate an exploitation, hundreds of workers not only Indonesian but also the workers from foreign countries come and go to that area. It was recorded that the workers from foreign countries come from Singapore, Malaysia, Thailand, The Philippines, Taiwan, Japan, Korea. United States of America and from France, Britain, Australia and Germany. These workers have a close interaction with about 50,00 local population distributed with a high concentration in some places. The high risk of DHF was determined since the significant density of Aedes aregypti larvae, the main vector of DHF, were found in Lukit, Mengkikip and Melibur, three locations of survey. Of 104 (53.3%) of 195 houses in these three survey locations were found positive for the larvae. Even though there were no positive of larvae in 65 houses in Lukit, in Melibur and Mengkikip, the House Index (HI) was 61.7% and 95.7%. Outside the houses 521 containers were examined in three locations of survey and 329 (63.1%) were positive for Ae. aegypti larvae. The highest number of containers positive for Ae. aegypti larvae were 213 (94.7%) out of 225 and found in Mengkikip. In Melibur, 114 (68.3%) out of 167 of containers were positive and in Lukit only 2 (1.56%) out of 129 containers were positive of Ae. aegypti larvae. These larvae density constitute a high risk of DHF outbreak, and unfortunately is supported by the rainfall situation recorded in Kurau and BZ Climatology Stations. It was recorded that all along the year, at least one day in a month there was the rain which the rainfall volume was 30 ml. PMID:11414442

  9. Dengue fever in the Indian Subcontinent: an overview.

    PubMed

    Raheel, Ummar; Faheem, Muhammad; Riaz, Mohammad Nasir; Kanwal, Naghmana; Javed, Farakh; Zaidi, Najam us Sahar Sadaf; Qadri, Ishtiaq

    2011-04-01

    The Indian Subcontinent has emerged as a scene of many mosquito-borne infectious diseases, including malaria and dengue fever. After the 1990s, the rate of malaria declined owing largely to preventive measures, but at the same time dengue fever (DF) and dengue hemorrhagic fever (DHF) were increasing in the region. Outbreaks were recorded in all countries of the Indian Subcontinent with India, Pakistan, Bangladesh and Sri Lanka on the forefront and suffering from the largest number of cases and deaths. We discuss annual cases of DF/DHF in these four countries and possible factors involved in DF outbreaks. We also discuss prevalent serotypes in this region where data suggest the emergence of DEN2 and DEN3 as the most dominant and lethal serotypes. Climate is an important factor influencing DF outbreaks, and rainfall, temperature and humidity play a pivotal role in DF outbreaks. Finally the economic impact of DF/DHF cases is discussed showing that direct and indirect economic loss due to DF/DHF reaches millions of USD each year.

  10. Dengue in children.

    PubMed

    Verhagen, Lilly M; de Groot, Ronald

    2014-11-01

    Dengue is a mosquito-borne viral disease of expanding geographical range and increasing incidence. The vast majority of dengue cases are children less than 15 years of age. Dengue causes a spectrum of illness from mild fever to severe disease with plasma leakage and shock. Infants and children with secondary heterologous dengue infections are most at risk for severe dengue disease. Laboratory diagnosis of dengue can be established within five days of disease onset by direct detection of viral components in serum. After day five, serologic diagnosis provides indirect evidence of dengue. Currently, no effective antiviral agents are available to treat dengue infection. Therefore, treatment remains supportive, with emphasis on close hematological monitoring, recognition of warning signs of severe disease and fluid-replacement therapy and/or blood transfusions when required. Development of a dengue vaccine is considered a high public health priority. A safe and efficacious dengue vaccine would also be important for travelers. This review highlights the current understanding of dengue in children, including its clinical manifestations, pathogenesis, diagnostic tests, management and prevention.

  11. 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

  12. 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

  13. 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.

  14. [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.

  15. [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. PMID:27120872

  16. The re-emergence of dengue in China.

    PubMed

    Ooi, Eng Eong

    2015-01-01

    The number of reports in the literature on dengue outbreaks in various parts of south China is increasing. This trend is likely contributed to by multiple factors, chief among which is the increase in trade and human movement in and out of China from the Southeast Asian region where dengue is firmly endemic. However, a holistic picture of dengue in China and how the public health authorities are responding to this global health challenge has been missing. In a research article published in BMC Medicine, Lai et al. have now filled this gap in knowledge by analysing statutorily mandated national dengue surveillance data from 1990 till 2014. They also conducted time series analyses to identify key drivers of dengue transmission in south China as well as from south China to the other parts of this vast and populous country. Their findings, as well as the description of surveillance and disease control activities in China, highlight urgent steps that need to be taken if China wishes to prevent itself from becoming another country that experiences large and frequent cycles of epidemic dengue.

  17. Dengue: a review.

    PubMed

    Rodriguez-Tan, R S; Weir, M R

    1998-10-01

    Millions of dengue cases occur worldwide each year. Most recently, an outbreak occurred in Texas. Though usually a nonspecific febrile illness that resolves with supportive therapy, the clinical spectrum ranges from asymptomatic to severe hemorrhage and sudden fatal shock. The potential exists for the introduction of dengue virus into other parts of the United States, and for secondary transmission in areas with vector mosquitoes, because of increased travel to and from regions of the Americas where dengue is endemic. The discovery of Aedes (Ae) albopictus strains adapted to temperate conditions makes this threat much greater. With global warming, a more rapid distribution of the Aedes species may occur, moving northward, encompassing larger population centers and leading to increased vectorborne diseases. Control of dengue currently requires control of the principal vector mosquitoes. Vaccine development continues, but at present the only way to avoid dengue in an area where it is endemic or epidemic is to use repellents and mosquito barriers. Lifesaving intervention and management of a patient with dengue and its complications depend upon a complete history, to include travel and physical examination with a high level of suspicion. Physicians and other health care providers should learn to recognize this disease. Once a person is infected, the key to survival is early diagnosis and appropriate treatment for the severe, life-threatening complications of dengue hemorrhagic fever and dengue shock syndrome.

  18. 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.

  19. 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

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

    PubMed

    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

  1. [Dengue in French Guiana. History and present status].

    PubMed

    Reynes, J M

    1996-01-01

    The evolution of dengue in French Guiana has the same trend as in most tropical American countries, with emergence of dengue hemorrhagic fever (DHF) and endemicity of the disease. During the 1940's, several dengue-like outbreaks were reported from French Guiana. Then, the only dengue vector, Aedes aegypti, was eradicated between 1950 and 1963, when it started to reinfest the country. By the end of the 1960's, new dengue epidemics with serological confirmation were described. After 1970, the first dengue strains were isolated, firstly dengue-2 strains, then dengue-1 and dengue-4 strains. Between 1970 and 1990, several dengue outbreaks struck French Guiana with 2 to 6 years intervals. In July 1991, started the first DHF outbreak in French Guiana which spread in all the most important towns until October 1992. About 3,000 cases were reported, that is almost 3% of the population, from which about 1/3 had serological confirmation; more than 300 people were hospitalized and some 80 with hemorrhages. Finally 6 deaths were reported, 5 of which had hemorrhages but could not be included into DHF cases according to WHO criteria. The dengue-2 strain responsible for this outbreak is close to the Jamaïcan topotype known to be particularly virulent. Since the beginning of 1993 and actually, dengue is still circulating in French Guiana, but at low level and dengue-1 and dengue-4 strains are occasionally isolated.

  2. 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.

  3. [Dengue epidemic in Ribeirão Preto, SP, Brazil: a preliminary note].

    PubMed

    Pontes, R J; Dal Fabbro, A L; Rocha, G de M; Santiago, R C; Figueiredo, L T; Castro e Silva, A A; Garotti, V D; Pintyá, J M

    1991-08-01

    A preliminary note on an outbreak of dengue which occurred in the city of Ribeirão Preto, State of S. Paulo, Brazil, from November 1990 to March 1991, is given. One case of Level II Dengue Hemorrhagic Fever/Dengue Shock Syndrome (DHF/DSS) and two deaths associated with dengue related shock are described. Clinicians and epidemiologists are alerted to the possibility of sporadic DHF/DSS cases during outbreaks of classical dengue in formerly free areas.

  4. 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

  5. A portable approach for the surveillance of dengue virus-infected mosquitoes.

    PubMed

    Muller, David A; Frentiu, Francesca D; Rojas, Alejandra; Moreira, Luciano A; O'Neill, Scott L; Young, Paul R

    2012-07-01

    Dengue virus is the most significant human viral pathogen spread by the bite of an infected mosquito. With no vaccine or antiviral therapy currently available, disease prevention relies largely on surveillance and mosquito control. Preventing the onset of dengue outbreaks and effective vector management would be considerably enhanced through surveillance of dengue virus prevalence in natural mosquito populations. However, current approaches to the identification of virus in field-caught mosquitoes require relatively slow and labor intensive techniques such as virus isolation or RT-PCR involving specialized facilities and personnel. A rapid and portable method for detecting dengue virus-infected mosquitoes is described. Using a hand held battery operated homogenizer and a dengue diagnostic rapid strip the viral protein NS1 was detected as a marker of dengue virus infection. This method could be performed in less than 30 min in the field, requiring no downstream processing, and is able to detect a single infected mosquito in a pool of at least 50 uninfected mosquitoes. The method described in this study allows rapid, real-time monitoring of dengue virus presence in mosquito populations and could be a useful addition to effective monitoring and vector control responses. PMID:22575689

  6. 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.

  7. 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.

  8. DENGUE: GLOBAL THREAT.

    PubMed

    Thisyakorn, Usa; Thisyakorn, Chule

    2015-01-01

    Dengue is a mosquito-borne viral disease, which is currently an expanding global problem. Four closely related dengue serotypes cause the disease, which ranges from asymptomatic infection to undifferentiated fever, dengue fever (DF), and dengue hemorrhagic fever (DHF). DHF is characterized by fever, bleeding diathesis, and a tendency to develop a potentially fatal shock syndrome. Dengue infection with organ impairment mainly involves the central nervous system and the liver. Consistent hematological findings include vasculopathy, coagulopathy, and thrombocytopenia. Laboratory diagnosis includes virus isolation, serology, and detection of dengue ribonucleic acid. Successful treatment, which is mainly supportive, depends on early recognition of the disease and careful monitoring for shock. A severity-based revised dengue classification for medical interventions has been developed and validated in many countries. There is no specific dengue treatment, and prevention is currently limited to vector control measures. The world's first, large-scale dengue vaccine efficacy study demonstrated its efficacy and a reduction of dengue disease severity with a good safety profile in a study of more than 30,000 volunteers from Asia and Latin America.

  9. Surveillance for dengue and dengue hemorrhagic fever.

    PubMed

    Gubler, D J

    1989-01-01

    Dengue and dengue hemorrhagic fever are emerging as major public health problems in most tropical countries. Effective prevention and control programs will depend on improved surveillance designed to provide early warning of dengue epidemics. This article outlines a reasonable approach to dengue surveillance of this kind. Virologic surveillance should be considered the most important element in any such early warning system. Dengue virus transmission should be monitored to determine which serotypes are present, their distribution, and the type of illnesses associated with each. Other key components of an active surveillance system should include monitoring of fever activity and clinical surveillance for cases of severe and fatal disease associated with viral syndromes. Collectively, these three surveillance components can provide an early warning capability permitting emergency mosquito control measures to be implemented and major epidemics to be averted.

  10. 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

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

    PubMed

    Jeon, Min Huok; Kim, Tae Hyong

    2016-06-01

    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

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

    PubMed

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

    2003-02-01

    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.

  13. 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.

  14. 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.

  15. 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.

  16. [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.

  17. 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.

  18. 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.

  19. Clinical spectrum of dengue fever in a tertiary care centre with particular reference to atypical presentation in the 2012 outbreak in Kolkata.

    PubMed

    Majumdar, Ritwika; Jana, Chanchal Kumar; Ghosh, Sandip; Biswas, Uttam

    2012-12-01

    During the summer of 2012, dengue fever epidemic has emerged in Kolkata and spread throughout West Bengal. During the epidemic period, wide spectrum of atypical presentations of dengue fever has been observed. Here, in this study, the spectrum of dengue fever was analysed in 300 patients who were found to have dengue serology positive (NS1, IgM, IgG). The study was done in the department of medicine, RG Kar Medical College, Kolkata. The patients were classified according to age, gender, duration of symptoms on admission, associated comorbidities and coinfections, complications that developed after admission, the final outcome and duration till death after symptoms developed. The dengue fever cases started to appear from April but it attained its peak during August-September this year. All ages were affected but the brunt was borne maximally by those between 15 and 40 years. Females were more affected than males. It may be concluded from the study that 30% had no complications while 70% cases developed complications, 4% cases had underlying comorbidities and coinfections, 68% developed thrombocytopenia and other haemorrhagic features, 55% serositis, 25% acalculous cholecystitis, 20% myocarditis, 15% pancreatitis, 5% had central nervous system involvement, 0.66% rhabdomyolysis and myositis, 0.33% secondary vasculitis and death occurred in 3% cases. More number of patients were having multiple and atypical complications requiring hospitalisation. Mortality was more common in patients with associated comorbidities and coinfection. Awareness, early treatment with aggressive fluid replacement therapy with close monitoring, supportive management andpatient education showed promising results.

  20. 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. PMID:23886895

  1. Anthracene-based inhibitors of dengue virus NS2B-NS3 protease.

    PubMed

    Tomlinson, Suzanne M; Watowich, Stanley J

    2011-02-01

    Dengue virus (DENV) is a mosquito-borne flavivirus that has strained global healthcare systems throughout tropical and subtropical regions of the world. In addition to plaguing developing nations, it has re-emerged in several developed countries with recent outbreaks in the USA (CDC, 2010), Australia (Hanna et al., 2009), Taiwan (Kuan et al., 2010) and France (La Ruche et al., 2010). DENV infection can cause significant disease, including dengue fever, dengue hemorrhagic fever, dengue shock syndrome, and death. There are no approved vaccines or antiviral therapies to prevent or treat dengue-related illnesses. However, the viral NS2B-NS3 protease complex provides a strategic target for antiviral drug development since NS3 protease activity is required for virus replication. Recently, we reported two compounds with inhibitory activity against the DENV protease in vitro and antiviral activity against dengue 2 (DEN2V) in cell culture (Tomlinson et al., 2009a). Analogs of one of the lead compounds were purchased, tested in protease inhibition assays, and the data evaluated with detailed kinetic analyses. A structure activity relationship (SAR) identified key atomic determinants (i.e. functional groups) important for inhibitory activity. Four "second series" analogs were selected and tested to validate our SAR and structural models. Here, we report improvements to inhibitory activity ranging between ∼2- and 60-fold, resulting in selective low micromolar dengue protease inhibitors.

  2. Screening Analogs of β-OG Pocket Binder as Fusion Inhibitor of Dengue Virus 2

    PubMed Central

    Tambunan, Usman SF; Zahroh, Hilyatuz; Parikesit, Arli A; Idrus, Syarifuddin; Kerami, Djati

    2015-01-01

    Dengue is an infectious disease caused by dengue virus (DENV) and transmitted between human hosts by mosquitoes. Recently, Indonesia was listed as a country with the highest cases of dengue by the Association of Southeast Asian Nations. The current treatment for dengue disease is supportive therapy; there is no antiviral drug available in the market against dengue. Therefore, a research on antiviral drug against dengue is very important, especially to prevent outbreak explosion. In this research, the development of dengue antiviral is performed through the inhibition of n-octyl-β-D-glucoside (β-OG) binding pocket on envelope protein of DENV by using analogs of β-OG pocket binder. There are 828 compounds used in this study, and all of them were screened based on the analysis of molecular docking, pharmacological character prediction of the compounds, and molecular dynamics simulation. The result of these analyses revealed that the compound that can be used as an antiviral candidate against DENV is 5-(3,4-dichlorophenyl)-N-[2-(p-tolyl) benzotriazol-5-yl]furan-2-carboxamide. PMID:26617459

  3. 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

  4. Prospects for dengue vaccines for travelers.

    PubMed

    Lim, Sl-Ki; Lee, Yong Seok; Namkung, Suk; Lim, Jacqueline K; Yoon, In-Kyu

    2016-07-01

    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

  5. 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

  6. Dengue: a global threat.

    PubMed

    Thisyakorn, Usa; Thisyakorn, Chule

    2015-01-01

    Dengue, a mosquito-borne viral disease, is currently an expanding global problem. The disease is caused by four closely related dengue serotypes; it ranges from asymptomatic infection to undifferentiated fever, dengue fever (DF) and dengue hemorrhagic fever (DHF). DHF is characterized by fever, bleeding diathesis and a tendency to develop apotentially fatal shock syndrome. Dengue infection with organ impairment mainly involves the central nervous system and liver. Consistent hematological findings include vasculopathy, coagulopathy and thrombocytopenia. Laboratory diagnoses include virus isolation, serology, and detection ofdengue ribonucleic acid. Successful treatment, which is mainly supportive, depends on early recognition of the disease and careful monitoring for shock. A severity-based revised dengue classification for medical interventions has been developed and validated in many countries. So far however, there has not been any specific dengue treatment; prevention is currently limited to vector control measures. The world's first, large-scale dengue vaccine, efficacy study demonstrated its efficacy and a reduction of dengue's severity in a study of more than 10,000 volunteers in Asia. Initial safety data are consistent with a good safety profile.

  7. A survey of knowledge, attitude and practice of the prevention of dengue hemorrhagic fever in an urban community of Thailand.

    PubMed

    Swaddiwudhipong, W; Lerdlukanavonge, P; Khumklam, P; Koonchote, S; Nguntra, P; Chaovakiratipong, C

    1992-06-01

    To evaluate the effect of a health education program on the prevention and control of dengue hemorrhagic fever (DHF) in the municipality of Mae Sot, Tak Province, a survey of adult residents, mainly housewives, was conducted in late April 1990 to assess their knowledge of DHF and practice of preventive methods. A total of 417 respondents from 417 households selected by a systematic-cluster sampling method were interviewed. More than 90% of them knew that the disease is transmitted by Aedes mosquitos and indicated water jars and water retention in the houses as the common breeding places. However, the other two common breeding places, ant-traps and cement baths, were less frequently mentioned. This finding was consistent with the greater proportion of respondents who reported no larval control methods for these two kinds of containers than for the others. Covering water containers was the most common practice to prevent mosquito breeding in drinking-water containers whereas addition of abate (temephos sand granules) or changing stored water frequently was commonly used for non-drinking water storage. Larval control for ant-traps was mainly accomplished by the addition of chemicals, including abate, salt, oil or detergent. Health education efforts in this area could induce the majority of respondents to accept themselves as responsible for the Aedes control program. Health education by health personnel played an important role in disseminating DHF information and prevention methods. Radio and television were the main effective mass media for public health education on DHF in this area.

  8. 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…

  9. 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.

  10. 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.

  11. Prevention

    MedlinePlus

    ... Prevention Treatment 2003 U.S. Outbreak African Rodent Importation Ban For Clinicians Clinical Recognition Specimen Collection Treatment Smallpox ... Examining Animals with Suspected Monkeypox African Rodent Importation Ban Resources Related Links Poxvirus Molluscum Contagiosum Orf Virus ( ...

  12. [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.

  13. Characteristic of dengue disease in Taiwan: 2002-2007.

    PubMed

    Lin, Chien-Chou; Huang, Yh-Hsiung; Shu, Pei-Yun; Wu, Ho-Sheng; Lin, Yee-Shin; Yeh, Trai-Ming; Liu, Hsiao-Sheng; Liu, Ching-Chuan; Lei, Huan-Yao

    2010-04-01

    Taiwan's dengue outbreaks have a unique type of transmission: starting by import from abroad in early summer, spreading out locally, and ending in the winter. This pattern repeats every year. Most of the dengue patients are adults, with dengue fever peaking in the 50-54 year age range, and dengue hemorrhagic fever in the 60-64 year age range. Two patterns of dengue infection were found: DENV-2 in 2002 with 74% of secondary infection in contrast to non-DENV-2 (DENV-1 or DENV-3) in 2004-2007 with approximately 70% of primary infection. Secondary dengue virus infection increases disease morbidity, but not mortality in adults. The active serological surveillance shows two-thirds of the dengue-infected adults are symptomatic post infection. The Taiwanese experience of adult dengue should be valuable for countries or areas where, although dengue is not endemic, the Aedes aegypti vector exists and dengue virus can be introduced by travelers.

  14. Mumps outbreaks in four universities in the North West of England: prevention, detection and response.

    PubMed

    Kay, D; Roche, M; Atkinson, J; Lamden, K; Vivancos, R

    2011-05-17

    Evidence suggests that primary and secondary vaccine failure have contributed to recent university-based mumps outbreaks. We describe the epidemiology and public health management of two such outbreaks that occurred simultaneously in two areas of the North West of England, affecting four universities, using data from routine surveillance, serology testing, and telephone interviews and electronic questionnaires. Vaccination status was obtained from GP records. Cases were predominantly first year students living in university halls of residence. Public health response involved active surveillance, isolation advice and targeted vaccination clinics. Many students lack natural immunity and mumps vaccination. Factors hindering the public health response include delayed notifications, inability to readily define the 'at risk' population, low vaccine uptake, and lack of an evidence-based, cost effective strategy.

  15. 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

  16. A persistent outbreak of measles despite appropriate prevention and control measures.

    PubMed

    Davis, R M; Whitman, E D; Orenstein, W A; Preblud, S R; Markowitz, L E; Hinman, A R

    1987-09-01

    From January 4 to May 13, 1985, an outbreak of 137 cases of measles occurred in Montana and persisted for 12 generations of spread. A total of 114 cases occurred on the Blackfeet Indian reservation in northwest Montana. Of the 137 cases, 82 (59.9%) were in school-aged children (aged 5-19 years). Of the 114 cases on the reservation, 108 (94.7%) were classified as programmatically nonpreventable. A total of 64 (82.1%) of the 78 patients on the reservation who were born after 1956 and were above the recommended age at vaccination had a history of adequate measles vaccination. Additionally, an audit of immunization records at the schools in Browning, Montana, where most of the cases occurred, showed that 98.7% of students were appropriately vaccinated. A retrospective cohort study in the Browning schools failed to identify age at vaccination or time since vaccination as significant risk factors for vaccine failure. Overall vaccine efficacy was 96.9% (95% confidence interval = 89.5-98.2%). None of 80 Browning students who were vaccinated at less than 12 months of age and revaccinated at 15 months of age or older became infected. A case-control study showed a significant association between attendance at Browning basketball games and infection early in the outbreak. This outbreak suggests that measles transmission may persist in some settings despite appropriate implementation of the current measles elimination strategy.

  17. DENGUE VIRAL INFECTIONS

    PubMed Central

    Gurugama, Padmalal; Garg, Pankaj; Perera, Jennifer; Wijewickrama, Ananda; Seneviratne, Suranjith L

    2010-01-01

    Dengue viral infections are one of the most important mosquito-borne diseases in the world. Presently dengue is endemic in 112 countries in the world. It has been estimated that almost 100 million cases of dengue fever and half a million cases of dengue hemorrhagic fever (DHF) occur worldwide. An increasing proportion of DHF is in children less than 15 years of age, especially in South East and South Asia. The unique structure of the dengue virus and the pathophysiologic responses of the host, different serotypes, and favorable conditions for vector breeding have led to the virulence and spread of the infections. The manifestations of dengue infections are protean from being asymptomatic to undifferentiated fever, severe dengue infections, and unusual complications. Early recognition and prompt initiation of appropriate supportive treatment are often delayed resulting in unnecessarily high morbidity and mortality. Attempts are underway for the development of a vaccine for preventing the burden of this neglected disease. This review outlines the epidemiology, clinical features, pathophysiologic mechanisms, management, and control of dengue infections. PMID:20418983

  18. Dengue viral infections.

    PubMed

    Gurugama, Padmalal; Garg, Pankaj; Perera, Jennifer; Wijewickrama, Ananda; Seneviratne, Suranjith L

    2010-01-01

    Dengue viral infections are one of the most important mosquito-borne diseases in the world. Presently dengue is endemic in 112 countries in the world. It has been estimated that almost 100 million cases of dengue fever and half a million cases of dengue hemorrhagic fever (DHF) occur worldwide. An increasing proportion of DHF is in children less than 15 years of age, especially in South East and South Asia. The unique structure of the dengue virus and the pathophysiologic responses of the host, different serotypes, and favorable conditions for vector breeding have led to the virulence and spread of the infections. The manifestations of dengue infections are protean from being asymptomatic to undifferentiated fever, severe dengue infections, and unusual complications. Early recognition and prompt initiation of appropriate supportive treatment are often delayed resulting in unnecessarily high morbidity and mortality. Attempts are underway for the development of a vaccine for preventing the burden of this neglected disease. This review outlines the epidemiology, clinical features, pathophysiologic mechanisms, management, and control of dengue infections.

  19. Dengue infection: a global concern.

    PubMed

    Pancharoen, Chitsanu; Kulwichit, Wanla; Tantawichien, Terapong; Thisyakorn, Usa; Thisyakorn, Chule

    2002-06-01

    Dengue infection, one of the most important mosquito-borne viral diseases of humans, is now a significant problem in several tropical countries. The disease, caused by the four dengue virus serotypes, ranges from asymptomatic infection, undifferentiated fever, dengue fever (DF) to severe dengue hemorrhagic fever (DHF) with or without shock. DHF is characterized by fever, bleeding diathesis and a tendency to develop a potentially fatal shock syndrome. Hematological findings include vasculopathy, coagulopathy and thrombocytopenia as the most constant findings. During the last twenty-five years, there have been increasing reports of dengue infection with unusual manifestations, mainly with cerebral and hepatic symptoms. Laboratory diagnosis includes virus isolation, serology and detection of dengue ribonucleic acid. Successful treatment, which is mainly supportive, depends on early recognition of the disease and careful monitoring for shock. Prevention depends on control of the mosquito vector. More efforts must be made to understand the pathogenesis of DHF in order to develop a safe and effective dengue vaccine.

  20. 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.

  1. Dengue fever in the Western Hemisphere.

    PubMed

    Castleberry, Jason S; Mahon, Connie R

    2003-01-01

    Dengue virus, an arthropod-borne viral agent, causes two distinct diseases: classic dengue fever (DF) and dengue hemorrhagic fever (DHF). There are four dengue virus serotypes: DEN-1, DEN-2, DEN-3, and DEN-4. Although infection with dengue stimulates immunologic response to a serotype, there is no cross-immunity conferred. Hence, a person can potentially be infected with each serotype during his or her lifetime. An infected female Aedes mosquito transmits the virus from person to person while feeding. The disease, now endemic in more than 100 countries in Africa, the Americas, the Eastern Mediterranean, Southeast Asia, and Western Pacific, is spreading to new areas and causing explosive outbreaks. Because of the major impact on lives and local economies epidemics produce, rapid detection of dengue infection has become an important public health research issue. Recently developed serological procedures to detect dengue infections have shown great potential for field use.

  2. Dengue--a re-emerging infectious disease in Singapore.

    PubMed

    Goh, K T

    1997-09-01

    Despite its well-established integrated nationwide Aedes mosquito control programme which incorporates source reduction, public health education and law enforcement, Singapore has not been spared from the regional resurgence of dengue. The disease incidence has been increasing from 9.3 per 100,000 in 1988 to 102.7 per 100,000 in 1996 at the time when the Aedes house index (HI) has dropped to around 1% from > 25% in the 1960s. Majority of the cases reported from 1990 to 1996 were dengue fever (DF); dengue haemorrhagic fever (DHF) constituted only 6.7%. The case-fatality rate was 0.1% with 13 (81.3%) of 16 serologically confirmed deaths above 19 years of age. The median age has shifted from 14 years in 1973 to 27 years in 1996. The proportion of primary infections also increased from about one-third in 1990 to nearly half in 1996. All four dengue serotypes have been detected from infected persons with dengue 2 predominating in 1990, 1991 and 1993, dengue 3 in 1992 and 1994 and dengue 1 in 1995 and 1996. The disease incidence was significantly correlated with Aedes aegypti HI and residents of compound houses had a significantly higher rate of infection as well as a higher morbidity rate compared with dwellers of high-rise public housing estates. Seroprevalence surveys confirmed the low level of dengue transmission. The immunity level of the general population has been declining with only 6.4% of children and young adults below 25 years of age possessing haemagglutination-inhibition antibody to dengue 2. It would appear that the successful vector control programme over the last two decades has brought about a paradoxical situation in that outbreaks tend to occur more frequently and with even greater intensity because of the low herd immunity of the population. Until the dengue vaccine is commercially available for mass immunisation of the population, community-based integrated control of Aedes aegypti remains the key to the prevention and control of DF/DHF.

  3. [Dengue in Panama, 1993].

    PubMed

    Quiroz, E; Ortega, M; Guzmán, M G; Vázquez, S; Pelegrino, J L; Campos, C; Bayard, V; Vázquez, M; Kourí, G

    1997-01-01

    Up to 1993, Panama was the only country in Central America where the autochthonous transmission of dengue virus had been detected without experimenting an explosive epidemic despite being reinfected with the Aedes aegypti mosquito since 1985. The characteristics of this first outbreak reported on November 19, 1993, are described in this paper. It is shown that even when there is a Program for the Surveillance and Control of Dengue, which considers low levels of Aedes aegypti infection and a system for the early detection of the virus, the epidemics appear if the community does not take an active part as it happened in 1994, 1995, and 1996. The 14 cases reported were located in an area under the responsibility of the Health Center in San Isidro, Belisario Porras, Special District of San Miguelito, in Panama City (13 cases in 4 blocks of the sector of Santa Librada and 1 case in San Isidro Valley). 3 patients were under 15 and 8 over 36, the other 3 were between 15 and 24.9 were females. The dengue type 2 virus was isolated in 3 patients. The presence of IgM and IgG antibodies to dengue was demonstrated in 11 patients, whereas in 8 over 20 it was observed a secondary type answer. According to the clinical picture, the epidemic was classified as dengue fever. The seroepidemiological survey carried out in the sector of Santa Librada and its surroundings 5 months after the appearance of the symptoms in the first case showed a prevalence of antibodies to dengue of 5.7% (46/802), mainly among individuals over 44. These results confirmed that the outbreak was geographically limited.

  4. [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.

  5. [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. PMID:15030659

  6. 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.

  7. 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. PMID:25872683

  8. 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

  9. Studies on dengue and dengue haemorrhagic fever (DHF) in West Bengal State, India.

    PubMed

    Hati, A K

    2006-03-01

    A large outbreak of dengue and dengue haemorrhagic fever (DHF) occurred from August to November 2005 involving all districts of West Bengal. Altogether 6293 persons were serologically diagnosed to be suffering from dengue through detection of IgM antibodies, with 27 (0.42%) seropositive deaths. In Kolkata alone 3967 persons were affected with 14 deaths. A total of 874 sera samples from febrile patients were quantitatively analysed for IgG and IgM antibodies using the IVD microwell ELISA dengue fever test kit. In 21.6%, no antibody was detected and 52.6% had only IgG antibodies. In 8.9% only IgM antibodies and in 16.8% both IgG, IgM antibodies were present, suggesting primary and secondary dengue respectively. About 10% of secondary dengue would develop DHF. As in this outbreak secondary dengue was 65.3% of total dengue cases, so of the 6293 dengue victims presumably, 3998 had secondary dengue, thus having risk of DHF in about 400 persons. Case fatality rate amongst DHF patients was 8.5%. This study also indicated that DHF would be a nagging problem in coming days. Age-group analysis of primary and secondary dengue cases revealed that although secondary cases occurred in all ages, more of primary cases belonged to younger ages (1-10) years and more of secondary cases in middle to older ages. Prevailing type during this outbreak was DEN3. This epidemiological study of an outbreak categorized prevalence of primary and secondary dengue, calculated risk factors for precipitation of DHF, model of which could be utilized to compare and evaluate future epidemiological pattern, where-ever and whenever applicable.

  10. The risk of yellow fever in a dengue-infested area.

    PubMed

    Massad, E; Coutinho, F A; Burattini, M N; Lopez, L F

    2001-01-01

    Yellow fever and dengue are viral infections that in urban centres are transmitted by the same arthropod vector, a mosquito of the genus Aedes. In order to estimate the risk of an epidemic of urban yellow fever in a dengue-infested area we calculated the threshold in the basic reproduction number, R0, of dengue, above which any single sylvatic yellow fever-infected individual will trigger an urban yellow fever epidemic. Specifically, we analysed the relationship between the extrinsic incubation period and the duration of viraemia, from which it is possible to define the R0 for dengue that would also suggest an outbreak potential for yellow fever. We also calculated the critical proportion of people to vaccinate against yellow fever in order to prevent an epidemic in a dengue-endemic area. The theory proposed is illustrated by the case of São Paulo State in southern Brazil, where dengue is endemic and the risk of urban yellow fever is already imminent.

  11. 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

  12. Lessons raised by the major 2010 dengue epidemics in the French West Indies.

    PubMed

    Larrieu, S; Cassadou, S; Rosine, J; Chappert, J L; Blateau, A; Ledrans, M; Quénel, P

    2014-03-01

    Dengue fever has been endemo-epidemic in the whole Region of America. In 2010, Guadeloupe and Martinique experienced historical epidemics, with an estimated attack rate of 10% in two islands. When considering the temporal evolution of epidemiological indicators, an unusual increase in the number of dengue cases could be detected very early. Two main factors might have facilitated the settlement of a viral transmission despite the dry season: a low immunity of the population against the circulating serotype and particular climatic conditions, notably very high temperatures which could have improved both virus and vector efficiency. This unusual situation was considered as a warning sign, and indeed led to major outbreaks in both islands a few weeks later. This event underlines that follow-up of epidemiological indicators is necessary to detect the unusual situations as soon as possible. Furthermore, development of biological and modelling tools should be promoted, as well as integrated management strategies for dengue prevention and control. PMID:24315801

  13. Lessons raised by the major 2010 dengue epidemics in the French West Indies.

    PubMed

    Larrieu, S; Cassadou, S; Rosine, J; Chappert, J L; Blateau, A; Ledrans, M; Quénel, P

    2014-03-01

    Dengue fever has been endemo-epidemic in the whole Region of America. In 2010, Guadeloupe and Martinique experienced historical epidemics, with an estimated attack rate of 10% in two islands. When considering the temporal evolution of epidemiological indicators, an unusual increase in the number of dengue cases could be detected very early. Two main factors might have facilitated the settlement of a viral transmission despite the dry season: a low immunity of the population against the circulating serotype and particular climatic conditions, notably very high temperatures which could have improved both virus and vector efficiency. This unusual situation was considered as a warning sign, and indeed led to major outbreaks in both islands a few weeks later. This event underlines that follow-up of epidemiological indicators is necessary to detect the unusual situations as soon as possible. Furthermore, development of biological and modelling tools should be promoted, as well as integrated management strategies for dengue prevention and control.

  14. 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.

  15. The epidemiologic surveillance of dengue-fever in French Guiana: when achievements trigger higher goals.

    PubMed

    Flamand, Claude; Quenel, Philippe; Ardillon, Vanessa; Carvalho, Luisiane; Bringay, Sandra; Teisseire, Maguelonne

    2011-01-01

    The epidemiology of dengue fever in French Guiana is marked by a combination of permanent transmission of the virus in the whole country and the occurrence of regular epidemics. Since 2006, a multi data source surveillance system was implemented to monitor dengue fever patterns, to improve early detection of outbreaks and to allow a better provision of information to health authorities, in order to guide and evaluate prevention activities and control measures. This report illustrates the validity and the performances of the system. We describe the experience gained by such a surveillance system and outline remaining challenges. Future works will consist in the use of other data sources such as environmental factors in order to improve knowledge on virus transmission mechanisms and determine how to use them for outbreaks prediction.

  16. Chikungunya outbreak in Guangdong Province, China, 2010.

    PubMed

    Wu, De; Wu, Jie; Zhang, Qiaoli; Zhong, Haojie; Ke, Changwen; Deng, Xiaoling; Guan, Dawei; Li, Hui; Zhang, Yonghui; Zhou, Huiqiong; He, Jianfeng; Li, Linghui; Yang, Xingfen

    2012-03-01

    A disease outbreak with dengue-like symptoms was reported in Guangdong Province, China, in October 2010. Testing results confirmed that the pathogen causing the outbreak was chikungunya virus. Phylogenic analysis indicated that this virus was a member of the Indian Ocean clade of the East/Center/South African subgroup of chikungunya virus.

  17. 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

    ... ] providers, and persons responsible for developing, implementing, and evaluating infection prevention and control programs for healthcare settings across the continuum of care. This guideline provides...

  18. Epidemic dengue transmission in southern Sumatra, Indonesia.

    PubMed

    Corwin, A L; Larasati, R P; Bangs, M J; Wuryadi, S; Arjoso, S; Sukri, N; Listyaningsih, E; Hartati, S; Namursa, R; Anwar, Z; Chandra, S; Loho, B; Ahmad, H; Campbell, J R; Porter, K R

    2001-01-01

    An outbreak of dengue fever (DF), dengue haemorrhagic fever (DHF), and dengue shock syndrome (DSS) in the city of Palembang, south Sumatra, Indonesia was investigated to (i) validate epidemic occurrence, (ii) confirm dengue virus aetiology and associated serotype(s), (iii) provide a demonstrable measure of community impact, and (iv) identify causative relationship (if any) with climatic El Niño Southern Oscillation (ENSO) influences. Trend analysis based on a 6-year retrospective review of hospital records demonstrates a 3-fold increase in clinical cases for the outbreak period (January-April 1998), relative to historical records. In the 2 hospitals surveyed, the monthly mean number of outbreak-related dengue cases over 4 months was 833 (range 650-995 cases/month); the mean monthly value for the previous 72 months was 107 (range 14-779 cases/month). An apparent trend in epidemic transmission was observed, evolving from a 5-year cyclic phenomenon to an annual occurrence, often indistinguishable from one year to the next. The proportional distribution of clinical outbreak cases into DF, DHF and DSS diagnostic categories was 24%, 66%, and 10%, respectively. The population aged 10-19 years accounted for the largest (35%) proportion of hospitalized DHF cases, followed by children aged 5-9 years (25%) and children aged 4 years (16%). Serum samples obtained during acute illness from 221 hospitalized patients were examined using serology, RT-PCR, and virus isolation in cell culture: 59% of samples had laboratory evidence of a dengue infection. All 4 dengue virus serotypes (DEN 1-4) were identified in epidemic circulation, with DEN 3 predominating (43%). DEN 1 was the principal serotype associated with less severe dengue illness, suggesting that virulence may be, in part, a function of infecting serotype. The climatic influence of ENSO on rainfall and temperature in the months leading up to and during the outbreak was dramatic, and is likely to contribute to favourable

  19. Current perspectives on the spread of dengue in India.

    PubMed

    Gupta, Ekta; Ballani, Neha

    2014-01-01

    Dengue fever (DF) and dengue hemorrhagic fever (DHF) are important arthropod-borne viral diseases. Each year, there are ~50 million dengue infections and ~500,000 individuals are hospitalized with DHF, mainly in Southeast Asia. Dengue in India has dramatically expanded over the last few decades, with rapidly changing epidemiology. The first major DHF outbreak in the entire nation occurred in 1996 by dengue virus serotype 2, and after a gap of almost a decade, the country faced yet another DF outbreak in the year 2003 by dengue virus serotype 3. A dramatic increase in the number and frequency of outbreaks followed, and, at present, in most of the states of India, dengue is almost endemic. At present, all the four serotypes are seen in circulation, but the predominant serotype keeps changing. Despite this trend, surveillance, reporting, and diagnosis of dengue remain largely passive in India. More active community-based epidemiological studies with intensive vector control and initiatives for dengue vaccine development should be geared up to control the spread of dengue in India. We review here the factors that may have contributed to the changing epidemiology of dengue in India.

  20. Modelling the control strategies against dengue in Singapore.

    PubMed

    Burattini, M N; Chen, M; Chow, A; Coutinho, F A B; Goh, K T; Lopez, L F; Ma, S; Massad, E

    2008-03-01

    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.

  1. 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

  2. The 1986 dengue and dengue hemorrhagic fever epidemic in Puerto Rico: epidemiologic and clinical observations.

    PubMed

    Dietz, V; Gubler, D J; Ortiz, S; Kuno, G; Casta-Vélez, A; Sather, G E; Gómez, I; Vergne, E

    1996-09-01

    In 1986 Puerto Rico experienced its eleventh dengue outbreak of this century, but the first with simultaneous transmission of three dengue virus serotypes, and the first with significant numbers of severe and fatal hemorrhagic disease. Overall, 10,659 cases were reported; 1,257 cases were laboratory confirmed as having current or recent dengue infection. Dengue 4 (DEN-4) was the predominant serotype (160/363 isolates, 44%) followed by dengue 1 (DEN-1) with 134 isolates (37%) and dengue 2 (DEN-2), 69 isolates (19%). Transmission peaked during September, but large numbers of cases occurred through November. Seventy-one (91%) of Puerto Rico's 78 municipalities had laboratory-confirmed cases. Fifty-one percent of all confirmed cases occurred in metropolitan San Juan. Most cases presented clinically as classical dengue fever, but 37% of all confirmed cases were reported to have developed some type of hemorrhagic manifestation, and 6% reported hematemesis. In addition, 29 laboratory confirmed cases met the WHO case definition for dengue hemorrhagic fever, 3 of which were fatal. Among the 29 laboratory-confirmed cases of dengue hemorrhagic fever/ dengue shook syndrome, virus was isolated from 12; one DEN-1, three DEN-2, and eight DEN-4. Among laboratory confirmed cases, infants less than one year of age were at greater risk of developing dengue hemorrhagic fever/ dengue shook syndrome, hematemesis and any reported hemorrhage than were the other age groups evaluated.

  3. 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

  4. Mosquitoes, models, and dengue.

    PubMed

    Lifson, A R

    1996-05-01

    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

  5. 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. PMID:27368091

  6. 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 Pearl Ben-Joseph, ... Nile Virus First Aid: Vomiting Are Insect Repellents With DEET ...

  7. An elaboration of theory about preventing outbreaks in homogeneous populations to include heterogeneity or preferential mixing.

    PubMed

    Feng, Zhilan; Hill, Andrew N; Smith, Philip J; Glasser, John W

    2015-12-01

    The goal of many vaccination programs is to attain the population immunity above which pathogens introduced by infectious people (e.g., travelers from endemic areas) will not cause outbreaks. Using a simple meta-population model, we demonstrate that, if sub-populations either differ in characteristics affecting their basic reproduction numbers or if their members mix preferentially, weighted average sub-population immunities cannot be compared with the proportionally-mixing homogeneous population-immunity threshold, as public health practitioners are wont to do. Then we review the effect of heterogeneity in average per capita contact rates on the basic meta-population reproduction number. To the extent that population density affects contacts, for example, rates might differ in urban and rural sub-populations. Other differences among sub-populations in characteristics affecting their basic reproduction numbers would contribute similarly. In agreement with more recent results, we show that heterogeneous preferential mixing among sub-populations increases the basic meta-population reproduction number more than homogeneous preferential mixing does. Next we refine earlier results on the effects of heterogeneity in sub-population immunities and preferential mixing on the effective meta-population reproduction number. Finally, we propose the vector of partial derivatives of this reproduction number with respect to the sub-population immunities as a fundamentally new tool for targeting vaccination efforts.

  8. Importance of controlling pH-depended dissolved inorganic carbon to prevent algal bloom outbreaks.

    PubMed

    Liu, Na; Yang, Yixuan; Li, Feng; Ge, Fei; Kuang, Yangduo

    2016-11-01

    This study investigated effects of pH-depended inorganic carbon (IC) species and pH on algal growth in the sewage simulation system, and fruitfully discussed the relationships among IC, pH and algal growth by the Monod kinetics. Results showed HCO3(-) significantly increased algal growth by 3.17-6.52 times than that of CO3(2-) and/or glucose when the value of pH was in the range of 8.0-9.5, and also the preferentially utilized indicated by the affinity coefficient (Kp) of HCO3(-), CO3(2-) and glucose (0.17, 15.14 and 31.22, respectively). Meanwhile, the same pH range facilitated HCO3(-) to become a dominated species (e.g., 48.80-93.19% of total IC). More importantly, good linear correlations pairwise existed among pH, IC species and algae growth. These results suggested pH plays a critical role in regulation of IC species and algae growth, which would be an efficient method to control the IC discharge from sewage effluents and weaken bloom outbreak. PMID:27584901

  9. Importance of controlling pH-depended dissolved inorganic carbon to prevent algal bloom outbreaks.

    PubMed

    Liu, Na; Yang, Yixuan; Li, Feng; Ge, Fei; Kuang, Yangduo

    2016-11-01

    This study investigated effects of pH-depended inorganic carbon (IC) species and pH on algal growth in the sewage simulation system, and fruitfully discussed the relationships among IC, pH and algal growth by the Monod kinetics. Results showed HCO3(-) significantly increased algal growth by 3.17-6.52 times than that of CO3(2-) and/or glucose when the value of pH was in the range of 8.0-9.5, and also the preferentially utilized indicated by the affinity coefficient (Kp) of HCO3(-), CO3(2-) and glucose (0.17, 15.14 and 31.22, respectively). Meanwhile, the same pH range facilitated HCO3(-) to become a dominated species (e.g., 48.80-93.19% of total IC). More importantly, good linear correlations pairwise existed among pH, IC species and algae growth. These results suggested pH plays a critical role in regulation of IC species and algae growth, which would be an efficient method to control the IC discharge from sewage effluents and weaken bloom outbreak.

  10. A travel medicine view of dengue and dengue hemorrhagic fever.

    PubMed

    Meltzer, Eyal; Schwartz, Eli

    2009-09-01

    Dengue fever is the most prevalent arboviral infection worldwide, with up to 40% of the world population living in endemic regions. Among travelers to tropical countries, dengue infection is increasingly reported, and it is now a leading cause of post-travel fever. Outbreaks of dengue-like illness were already described since the 18th century, but it is only in the last half century that a severe form of the disease - dengue hemorrhagic fever (DHF) has been described. Although the cause of DHF is not established, the prevailing theory attributes the disease to antibody-dependent enhancement of viral replication, in the presence of a secondary dengue infection. Comparative studies of primary vs. secondary infection are difficult to perform in endemic countries because of the rarity of primary infection except during early infancy. Travelers on the other hand are usually diagnosed with primary infection and are therefore a better study population. Data on dengue and DHF among travelers appears to suggest that severe dengue and DHF occur in similar rates among cases with primary and with secondary infections. Epidemiological and physiological data from travelers suggest that the prevailing theory on the causes of DHF needs to be reconsidered.

  11. Geographical information system (GIS) in investigation of an outbreak.

    PubMed

    Nisha, V; Gad, Santosh S; Selvapandian, David; Suganya, V; Rajagopal, V; Suganti, Pearlin; Balraj, V; Devasundaram, Jayanth

    2005-03-01

    An outbreak of fever in a village in southern India was reported on 1st September, 2001. The first reported case presented with epistaxis and a platelet count of 27000h(1)/mm3. Clinical, laboratory and entomological evidence supported a diagnosis of dengue fever. One third of the village was affected and 3.7 % of the population presented with haemorrhagic symptoms; none were fatal. Five acute cases tested for dengue specific IgM showed that two were positive. The larvae of Aedes aegypti were discovered from domestic water collections in the village. Spatial analysis done with the help of Geographical Information Systems software (GIS) demonstrated a centrifugal spread of cases from the most affected street until it involved the entire village. Spatial analysis revealed that cases occurred in clusters and that these could not have occurred by chance. This was our first experience in producing a geo-referenced map of a village area and in spatial analysis. GIS is a novel and simple tool for outbreak investigations and the spatial analyst adds additional information to the data collected. Control of adult mosquitoes and larvae prevented the outbreak from spreading to an adjacent village.

  12. Complete genome sequencing and comparative analysis of three dengue virus type 2 Pakistani isolates.

    PubMed

    Akram, Madiha; Idrees, Muhammad

    2016-03-01

    Dengue is currently one of the most important arthropod borne human viral diseases caused by a flavivirus named as dengue virus. It is now endemic in Pakistan since many dengue fever outbreaks have been observed in Pakistan during the last three decades. Major serotype of dengue virus circulating in Pakistan is serotype 2. Complete genome sequences of three Pakistani dengue virus serotype 2 isolates were generated. Analysis of complete genome sequences showed that Pakistani isolates of dengue virus serotype 2 belonged to cosmopolitan genotype. This study identifies a number of amino acid substitutions that were introduced in local dengue virus serotype 2 isolate over the years. The study provides a significant insight into the evolution of serotype 2 of dengue virus in Pakistan. This is the first report of complete genome sequence information of dengue virus from the most recent outbreak (2013) in Punjab, Pakistan.

  13. 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

    2003-12-01

    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.

  14. Recent Advances in Dengue: Relevance to Puerto Rico

    PubMed Central

    Noyd, David H.; Sharp, Tyler M.

    2015-01-01

    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. PMID:26061055

  15. 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. PMID:26061055

  16. 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.

  17. 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.

  18. 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

  19. 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. PMID:27643596

  20. Typing of dengue viruses in clinical specimens and mosquitoes by single-tube multiplex reverse transcriptase PCR.

    PubMed

    Harris, E; Roberts, T G; Smith, L; Selle, J; Kramer, L D; Valle, S; Sandoval, E; Balmaseda, A

    1998-09-01

    In recent years, dengue viruses (serotypes 1 to 4) have spread throughout tropical regions worldwide. In many places, multiple dengue virus serotypes are circulating concurrently, which may increase the risk for the more severe form of the disease, dengue hemorrhagic fever. For the control and prevention of dengue fever, it is important to rapidly detect and type the virus in clinical samples and mosquitoes. Assays based on reverse transcriptase (RT) PCR (RT-PCR) amplification of dengue viral RNA can offer a rapid, sensitive, and specific approach to the typing of dengue viruses. We have reduced a two-step nested RT-PCR protocol to a single-tube reaction with sensitivity equivalent to that of the two-step protocol (1 to 50 PFU) in order to maximize simplicity and minimize the risk of sample cross-contamination. This assay was also optimized for use with a thermostable RT-polymerase. We designed a plasmid-based internal control that produces a uniquely sized product and can be used to control for both reverse transcription or amplification steps without the risk of generating false-positive results. This single-tube RT-PCR procedure was used to type dengue viruses during the 1995 and 1997-1998 outbreaks in Nicaragua. In addition, an extraction procedure that permits the sensitive detection of viral RNA in pools of up to 50 mosquitoes without PCR inhibition or RNA degradation was developed. This assay should serve as a practical tool for use in countries where dengue fever is endemic, in conjunction with classical methods for surveillance and epidemiology of dengue viruses.

  1. Dengue haemorrhagic fever/dengue shock syndrome: lessons from the Cuban epidemic, 1981.

    PubMed Central

    Kouri, G. P.; Guzmán, M. G.; Bravo, J. R.; Triana, C.

    1989-01-01

    Dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS) is one of the principal causes of hospitalization and death among children in several south-east Asian countries. Also, in the Region of the Americas, there has been an increase in the frequency of dengue fever epidemics and in the number of cases of DHF/DSS. In 1981 an epidemic of dengue haemorrhagic fever occurred in Cuba and this suggests that there is a high risk that such epidemics could recur in the region. The article summarizes the main clinical, virological, and epidemiological data obtained during the outbreak, some of which are reported for the first time. PMID:2805215

  2. Dengue haemorrhagic fever/dengue shock syndrome: lessons from the Cuban epidemic, 1981.

    PubMed

    Kouri, G P; Guzmán, M G; Bravo, J R; Triana, C

    1989-01-01

    Dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS) is one of the principal causes of hospitalization and death among children in several south-east Asian countries. Also, in the Region of the Americas, there has been an increase in the frequency of dengue fever epidemics and in the number of cases of DHF/DSS. In 1981 an epidemic of dengue haemorrhagic fever occurred in Cuba and this suggests that there is a high risk that such epidemics could recur in the region. The article summarizes the main clinical, virological, and epidemiological data obtained during the outbreak, some of which are reported for the first time.

  3. 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

  4. 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.

  5. DGV: Dengue Genographic Viewer.

    PubMed

    Yamashita, Akifumi; Sakamoto, Tetsuya; Sekizuka, Tsuyoshi; Kato, Kengo; Takasaki, Tomohiko; Kuroda, Makoto

    2016-01-01

    Dengue viruses (DENVs) and their vectors are widely distributed throughout the tropical and subtropical regions of the world. An autochthonous case of DENV was reported in Tokyo, Japan, in 2014, for the first time in 70 years. A comprehensive database of DENV sequences containing both serotype and genotype data and epidemiological data is crucial to trace DENV outbreak isolates and promptly respond to outbreaks. We constructed a DENV database containing the serotype, genotype, year and country/region of collection by collecting all publically available DENV sequence information from the National Center for Biotechnology Information (NCBI) and assigning genotype information. We also implemented the web service Dengue Genographic Viewer (DGV), which shows the geographical distribution of each DENV genotype in a user-specified time span. DGV also assigns the serotype and genotype to a user-specified sequence by performing a homology search against the curated DENV database, and shows its homologous sequences with the geographical position and year of collection. DGV also shows the distribution of DENV-infected entrants to Japan by plotting epidemiological data from the Infectious Agents Surveillance Report (IASR), Japan. This overview of the DENV genotype distribution may aid in planning for the control of DENV infections. DGV is freely available online at: (https://gph.niid.go.jp/geograph/dengue/content/genomemap). PMID:27375595

  6. DGV: Dengue Genographic Viewer

    PubMed Central

    Yamashita, Akifumi; Sakamoto, Tetsuya; Sekizuka, Tsuyoshi; Kato, Kengo; Takasaki, Tomohiko; Kuroda, Makoto

    2016-01-01

    Dengue viruses (DENVs) and their vectors are widely distributed throughout the tropical and subtropical regions of the world. An autochthonous case of DENV was reported in Tokyo, Japan, in 2014, for the first time in 70 years. A comprehensive database of DENV sequences containing both serotype and genotype data and epidemiological data is crucial to trace DENV outbreak isolates and promptly respond to outbreaks. We constructed a DENV database containing the serotype, genotype, year and country/region of collection by collecting all publically available DENV sequence information from the National Center for Biotechnology Information (NCBI) and assigning genotype information. We also implemented the web service Dengue Genographic Viewer (DGV), which shows the geographical distribution of each DENV genotype in a user-specified time span. DGV also assigns the serotype and genotype to a user-specified sequence by performing a homology search against the curated DENV database, and shows its homologous sequences with the geographical position and year of collection. DGV also shows the distribution of DENV-infected entrants to Japan by plotting epidemiological data from the Infectious Agents Surveillance Report (IASR), Japan. This overview of the DENV genotype distribution may aid in planning for the control of DENV infections. DGV is freely available online at: (https://gph.niid.go.jp/geograph/dengue/content/genomemap). PMID:27375595

  7. Dengue virus NS1 triggers endothelial permeability and vascular leak that is prevented by NS1 vaccination.

    PubMed

    Beatty, P Robert; Puerta-Guardo, Henry; Killingbeck, Sarah S; Glasner, Dustin R; Hopkins, Kaycie; Harris, Eva

    2015-09-01

    The four dengue virus serotypes (DENV1 to DENV4) are mosquito-borne flaviviruses that cause up to ~100 million cases of dengue annually worldwide. Severe disease is thought to result from immunopathogenic processes involving serotype cross-reactive antibodies and T cells that together induce vasoactive cytokines, causing vascular leakage that leads to shock. However, no viral proteins have been directly implicated in triggering endothelial permeability, which results in vascular leakage. DENV nonstructural protein 1 (NS1) is secreted and circulates in patients' blood during acute infection; high levels of NS1 are associated with severe disease. We show that inoculation of mice with DENV NS1 alone induces both vascular leakage and production of key inflammatory cytokines. Furthermore, simultaneous administration of NS1 with a sublethal dose of DENV2 results in a lethal vascular leak syndrome. We also demonstrate that NS1 from DENV1, DENV2, DENV3, and DENV4 triggers endothelial barrier dysfunction, causing increased permeability of human endothelial cell monolayers in vitro. These pathogenic effects of physiologically relevant amounts of NS1 in vivo and in vitro were blocked by NS1-immune polyclonal mouse serum or monoclonal antibodies to NS1, and immunization of mice with NS1 from DENV1 to DENV4 protected against lethal DENV2 challenge. These findings add an important and previously overlooked component to the causes of dengue vascular leak, identify a new potential target for dengue therapeutics, and support inclusion of NS1 in dengue vaccines. PMID:26355030

  8. Dengue in Greece in 1927 and 1928 and the pathogenesis of dengue hemorrhagic fever: new data and a different conclusion.

    PubMed

    Rosen, L

    1986-05-01

    A massive outbreak of dengue, with a high incidence of hemorrhagic manifestations and a high death rate, occurred in Athens and neighboring areas of Greece in 1927 and 1928. For many years it was believed that the episode had been caused by dengue type 1 virus. Recently, it was claimed that dengue type 2 virus also was present in Athens in 1928, and this report is cited in support of the hypotheses that dengue hemorrhagic fever is almost always the result of sequential infection with different dengue serotypes and that infection with dengue type 2 following dengue type 1 is particularly pathogenic. In the present study of 258 Greek residents born from 1914 to 1938, it was also found that dengue type 2 had occurred in Greece--but after 1928. No evidence was found that that virus had occurred in the country during, or within 13 years before, the 1927-1928 epidemic.

  9. 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. PMID:24605464

  10. 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.

  11. 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.

  12. Serological evaluation of suspected West Nile virus human cases following its introduction during a dengue outbreak in Puerto Rico in 2007.

    PubMed

    Hunsperger, Elizabeth; Beltran, Manuela; Acosta, Luz Nereida; Jordan-Munoz, Jorge; Torres, Jomil; Luce, Richard; Tomashek, Kay M

    2011-06-01

    A laboratory testing algorithm was evaluated to confirm West Nile virus (WNV) infection in human serum following the introduction of the virus in Puerto Rico in 2007. This testing algorithm used two standard diagnostic assays, the IgM antibody capture enzyme-linked immunosorbent assay (MAC ELISA) and real-time reverse transcriptase PCR (RT-PCR), along with two nonconventional assays, the nonstructural protein 1 (NS1) ELISA and a 90%-plaque-reduction neutralization test (PRNT(90)) with IgG depletion for dengue virus (DENV) and WNV. A total of 2,321 serum samples from suspected WNV human cases were submitted for testing. Approximately one-third (867, 37%) were cross-reactive for DENV and WNV by MAC ELISA and had negative RT-PCR results for both viruses. Of a subset of 43 samples tested, 31 (72%) of these cases were identified as positive for DENV in the PRNT(90) with IgG depletion and 8 (19%) were positive in the DENV NS1 antigen ELISA. These two assays combined differentiated 36 (84%) of the samples that could not be diagnosed using the standard diagnostic testing methods.

  13. [The 1991 dengue epidemic in Kaohsiung City].

    PubMed

    Harn, M R; Chiang, Y L; Tian, M J; Chang, Y H; Ko, Y C

    1993-03-01

    In Kaohsiung City, dengue fever subsided for two years after the 1987-1988 epidemic. The main reason that it recurred was due to late diagnoses of the dengue fever in patients because of mild or atypical clinical presentations. The first patient contracted dengue fever from Thailand in mid-May, 1991. The disease then spread among his co-workers. Dengue fever was not suspected until the 9th patient contracted it in early July 1991. Through chain transmission, the epidemic spread in the community and even to other parts of Taiwan. There were 113 confirmed dengue cases in Kaohsiung City, and a total of 175 cases on the whole island during the 1991 epidemic. The clinical manifestations were mainly fever, body pain, dizziness, general weakness, and a skin rash. No instances of severe bleeding, shock or dengue hemorrhagic fever were found. Seven dengue 1 and three dengue 3 viruses were isolated from the sera of patients. We found that the clinical severity of the 1991 dengue epidemic was milder, and the viral isolation rate was lower, compared with the 1987-1988 epidemic, although these two outbreaks of dengue fever were both mostly due to dengue type 1. Genetic variation in the dengue virus may be the explanation. Clinically, about 35% of the patients were missed or not reported, although they were finally demonstrated to be dengue fever patients during a patient survey in the epidemic area. For early detection, viral surveys should be performed in new epidemic regions in addition to fixed-spot surveillance.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. Fractional Derivatives in Dengue Epidemics

    NASA Astrophysics Data System (ADS)

    Pooseh, Shakoor; Rodrigues, Helena Sofia; Torres, Delfim F. M.

    2011-09-01

    We introduce the use of fractional calculus, i.e., the use of integrals and derivatives of non-integer (arbitrary) order, in epidemiology. The proposed approach is illustrated with an outbreak of dengue disease, which is motivated by the first dengue epidemic ever recorded in the Cape Verde islands off the coast of west Africa, in 2009. Numerical simulations show that in some cases the fractional models fit better the reality when compared with the standard differential models. The classical results are obtained as particular cases by considering the order of the derivatives to take an integer value.

  15. Imported dengue virus serotype 1 from Madeira to Finland 2012.

    PubMed

    Huhtamo, E; Korhonen, Em; Vapalahti, O

    2013-01-01

    Imported dengue cases originating from the Madeiran outbreak are increasingly reported. In 2012 five Finnish travellers returning from Madeira were diagnosed with dengue fever. Viral sequence data was obtained from two patients. The partial C-preM sequences (399 and 396 bp respectively) were found similar to that of an autochthonous case from Madeira. The partial E-gene sequence (933 bp) which was identical among the two patients grouped phylogenetically with South American strains of dengue virus serotype 1.

  16. [Active surveillance for dengue and dengue hemorrhagic fever].

    PubMed

    Gubler, D J

    1989-07-01

    Dengue and dengue hemorrhagic fever are emerging as major public health problems in most tropical countries. Effective prevention and control programs will depend on improved surveillance. A new approach to active surveillance is outlined with emphasis on the interepidemic period. The objective is to develop an early warning surveillance system than can predict epidemic dengue. Virologic surveillance is the most important in an early warning system. Dengue virus transmission should be monitored to provide information on which serotypes are present, their distribution, and the type of illness associated with each serotype. Other components of the active surveillance system include fever alert and clinical surveillance for severe and fatal disease associated with viral syndrome. Individually, each component is not very sensitive, but collectively, they provide an early warning capability that allows detection of newly introduced dengue virus serotypes well in advance of epidemic transmission. With such information, emergency mosquito control can be implemented and major epidemics averted.

  17. Intervention measures, turning point, and reproduction number for dengue, Singapore, 2005.

    PubMed

    Hsieh, Ying-Hen; Ma, Stefan

    2009-01-01

    The 2005 dengue outbreak in Singapore cumulated in > 14,000 cases and 27 reported dengue deaths. We fit the single-phase Richards model to weekly dengue notification numbers to detect the turning point for the outbreak, which enables us to study the impact of intervention measures relating to the turning point. The results indicate that turning point had most likely occurred in late August or early September, before large-scale intervention measures were implemented. The "initial" reproduction number for the outbreak is estimated to be ~1.89-2.23 (95% confidence interval: 1.15-3.00). One of the lessons learned from the 2003 severe acute respiratory syndrome (SARS) outbreak is that multiple phases of outbreak were observed in some affected countries when efforts to intensify intervention or to sustain vigilance were compromised. Intensive and continuing efforts in the implementation of control measures are essential in reducing further dengue occurrences during any resurgence of dengue.

  18. Dengue virus.

    PubMed

    Ross, Ted M

    2010-03-01

    Dengue is the most prevalent arthropod-borne virus affecting humans today. The virus group consists of 4 serotypes that manifest with similar symptoms. Dengue causes a spectrum of disease, ranging from a mild febrile illness to a life-threatening dengue hemorrhagic fever. Breeding sites for the mosquitoes that transmit dengue virus have proliferated, partly because of population growth and uncontrolled urbanization in tropical and subtropical countries. Successful vector control programs have also been eliminated, often because of lack of governmental funding. Dengue viruses have evolved rapidly as they have spread worldwide, and genotypes associated with increased virulence have spread across Asia and the Americas. This article describes the virology, epidemiology, clinical manifestations and outcomes, and treatments/vaccines associated with dengue infection.

  19. Dengue Fever in mainland China.

    PubMed

    Wu, Jin-Ya; Lun, Zhao-Rong; James, Anthony A; Chen, Xiao-Guang

    2010-09-01

    Dengue is an acute emerging infectious disease transmitted by Aedes mosquitoes and has become a serious global public health problem. In mainland China, a number of large dengue outbreaks with serious consequences have been reported as early as 1978. In the three decades from 1978 to 2008, a total of 655,324 cases were reported, resulting in 610 deaths. Since the 1990s, dengue epidemics have spread gradually from Guangdong, Hainan, and Guangxi provinces in the southern coastal regions to the relatively northern and western regions including Fujian, Zhejiang, and Yunnan provinces. As the major transmission vectors of dengue viruses, the biological behavior and vectorial capacity of Aedes mosquitoes have undergone significant changes in the last two decades in mainland China, most likely the result of urbanization and global climate changes. In this review, we summarize the geographic and temporal distributions, the serotype and genotype distributions of dengue viruses in mainland China, and analyze the current status of surveillance and control of vectors for dengue transmission.

  20. Mumps Cases and Outbreaks

    MedlinePlus

    ... or cigarettes, might increase spread of the virus. MMR vaccine prevents most, but not all, cases of mumps ... is 78% (range: 49% to 92%) effective. The MMR vaccine protects against currently circulating mumps strains. Outbreaks can ...

  1. 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

    2016-01-01

    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. PMID:26829532

  2. 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.

  3. 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

  4. An Epidemic of Dengue-1 in a Remote Village in Rural Laos

    PubMed Central

    Dubot-Pérès, Audrey; Vongphrachanh, Phengta; Denny, Justin; Phetsouvanh, Rattanaphone; Linthavong, Singharath; Sengkeopraseuth, Bounthanom; Khasing, Amphai; Xaythideth, Vimattha; Moore, Catrin E.; Vongsouvath, Manivanh; Castonguay-Vanier, Josée; Sibounheuang, Bountoy; Chanthongthip, Anisone; de Lamballerie, Xavier; Newton, Paul N.

    2013-01-01

    In the Lao PDR (Laos), urban dengue is an increasingly recognised public health problem. We describe a dengue-1 virus outbreak in a rural northwestern Lao forest village during the cool season of 2008. The isolated strain was genotypically “endemic” and not “sylvatic,” belonging to the genotype 1, Asia 3 clade. Phylogenetic analyses of 37 other dengue-1 sequences from diverse areas of Laos between 2007 and 2010 showed that the geographic distribution of some strains remained focal overtime while others were dispersed throughout the country. Evidence that dengue viruses have broad circulation in the region, crossing country borders, was also obtained. Whether the outbreak arose from dengue importation from an urban centre into a dengue-naïve community or crossed into the village from a forest cycle is unknown. More epidemiological and entomological investigations are required to understand dengue epidemiology and the importance of rural and forest dengue dynamics in Laos. PMID:23951379

  5. 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.

  6. Dengue fever, Hawaii, 2001-2002.

    PubMed

    Effler, Paul V; Pang, Lorrin; Kitsutani, Paul; Vorndam, Vance; Nakata, Michele; Ayers, Tracy; Elm, Joe; Tom, Tammy; Reiter, Paul; Rigau-Perez, José G; Hayes, John M; Mills, Kristin; Napier, Mike; Clark, Gary G; Gubler, Duane J

    2005-05-01

    Autochthonous dengue infections were last reported in Hawaii in 1944. In September 2001, the Hawaii Department of Health was notified of an unusual febrile illness in a resident with no travel history; dengue fever was confirmed. During the investigation, 1,644 persons with locally acquired denguelike illness were evaluated, and 122 (7%) laboratory-positive dengue infections were identified; dengue virus serotype 1 was isolated from 15 patients. No cases of dengue hemorrhagic fever or shock syndrome were reported. In 3 instances autochthonous infections were linked to a person who reported denguelike illness after travel to French Polynesia. Phylogenetic analyses showed the Hawaiian isolates were closely associated with contemporaneous isolates from Tahiti. Aedes albopictus was present in all communities surveyed on Oahu, Maui, Molokai, and Kauai; no Ae. aegypti were found. This outbreak underscores the importance of maintaining surveillance and control of potential disease vectors even in the absence of an imminent disease threat.

  7. Dengue infection: a growing global health threat.

    PubMed

    Hemungkorn, Marisa; Thisyakorn, Usa; Thisyakorn, Chule

    2007-10-01

    Dengue infection, one of the most devastating mosquito-borne viral diseases in humans, is now a significant problem in several tropical countries. The disease, caused by the four dengue virus serotypes, ranges from asymptomatic infection to undifferentiated fever, dengue fever (DF), and severe dengue hemorrhagic fever (DHF) with or without shock. DHF is characterized by fever, bleeding diathesis and a tendency to develop a potentially fatal shock syndrome. Consistent hematological findings include vasculopathy, coagulopathy, and thrombocytopenia. There are increasing reports of dengue infection with unusual manifestations that mainly involve cerebral and hepatic symptoms. Laboratory diagnosis includes virus isolation, serology, and detection of dengue ribonucleic acid. Successful treatment, which is mainly supportive, depends on early recognition of the disease and careful monitoring for shock. Prevention depends primarily on control of the mosquito vector. Further study of the pathogenesis of DHF is required for the development of a safe and effective dengue vaccine.

  8. Imported Dengue Fever: an important reemerging disease.

    PubMed

    Courtney, Malachi; Shetty, Avinash K

    2009-11-01

    Fever in a returned traveler from the tropics often poses a diagnostic challenge to the emergency department physician because of the potential for serious morbidity and mortality associated with certain infections such as falciparum malaria and dengue. We report a case of imported dengue fever in a 15-year-old adolescent boy acquired during a recent travel to Guatemala. Dengue fever is a mosquito-transmitted viral infection of global importance. The majority of US residents with dengue become infected during travel to tropical areas. In recent years, dengue has remerged in US tropical and subtropical areas. The disease is underreported in the United States along the Mexican border. The epidemiology, clinical manifestations, diagnosis, control, and prevention of this important global reemerging infectious disease are reviewed. Clinicians should include dengue in the differential diagnosis of febrile illness in children who have recently returned from dengue endemic areas.

  9. [Dengue in Mexico: an analysis of two decades].

    PubMed

    Torres-Galicia, Ivonne; Cortés-Poza, David; Becker, Ingeborg

    2014-01-01

    Dengue is one of the main vector-borne diseases and has become a severe Public Health problem during the last decade, both in Mexico and worldwide. This report analyses two decades (1990-2011) of dengue in Mexico, based on reports published by the Ministry of Health. The data show that although the incidence rate of dengue in Mexico has remained constant throughout the last two decades, the incidence rate for dengue hemorrhagic fever has increased importantly since 2002 (20% of cases). Additionally, during the last decade, the increase in the incidence rate of dengue and dengue hemorrhagic fever has shifted towards a younger population and the disease outbreaks showed a longer duration throughout the year. We conclude that dengue is showing a changing pattern and the factors involved remain to be analyzed.

  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. PMID:22973027

  11. 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.

  12. Importance of Internet Surveillance in Public Health Emergency Control and Prevention: Evidence From a Digital Epidemiologic Study During Avian Influenza A H7N9 Outbreaks

    PubMed Central

    Zhu, Honghong; Jiang, Tao; Wang, Xinyi; Chen, Lei; Jiang, Zhenggang; Zheng, Dawei

    2014-01-01

    Background Outbreaks of human infection with a new avian influenza A H7N9 virus occurred in China in the spring of 2013. Control and prevention of a new human infectious disease outbreak can be strongly affected by public reaction and social impact through the Internet and social media. Objective This study aimed to investigate the potential roles of Internet surveillance in control and prevention of the human H7N9 outbreaks. Methods Official data for the human H7N9 outbreaks were collected via the China National Health and Family Planning Committee website from March 31 to April 24, 2013. We obtained daily posted and forwarded number of blogs for the keyword “H7N9” from Sina microblog website and a daily Baidu Attention Index (BAI) from Baidu website, which reflected public attention to the outbreak. Rumors identified and confirmed by the authorities were collected from Baidu search engine. Results Both daily posted and forwarded number and BAI for keyword H7N9 increased quickly during the first 3 days of the outbreaks and remained at a high level for 5 days. The total daily posted and forwarded number for H7N9 on Sina microblog peaked at 850,000 on April 3, from zero blogs before March 31, increasing to 97,726 on April 1 and to 370,607 on April 2, and remaining above 500,000 from April 5-8 before declining to 208,524 on April 12. The total daily BAI showed a similar pattern of change to the total daily posted and forwarded number over time from March 31 to April 12. When the outbreak locations spread, especially into other areas of the same province/city and the capital, Beijing, daily posted and forwarded number and BAI increased again to a peak at 368,500 and 116,911, respectively. The median daily BAI during the studied 25 days was significantly higher among the 7 provinces/cities with reported human H7N9 cases than the 2 provinces without any cases (P<.001). So were the median daily posted and forwarded number and daily BAI in each province/city except

  13. Dengue conundrums.

    PubMed

    Gibbons, Robert V

    2010-11-01

    Dengue virus is the most common arboviral infection of humans in the tropical and subtropical regions of the world. This review briefly describes some of the challenges it presents. Dengue is an emerging disease; it is increasing in geographical distribution and severity, despite being significantly underreported. The World Health Organization case definition for the generally more severe manifestation of infection, dengue haemorrhagic fever (DHF), is controversial. The name DHF is something of a misnomer as the disease infrequently results in frank haemorrhage; the hallmark of DHF is actually plasma leakage. The existence of four closely related dengue virus serotypes contributes to difficulties in diagnosis and to original antigenic sin in the serological response to infection. The existence of multiple serotypes can result in more severe disease upon a second infection and complicates vaccine development. Nevertheless, a safe and effective vaccine is the greatest prospect for stemming the tide of dengue.

  14. 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

  15. 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.

  16. Chikungunya and dengue autochthonous cases in Europe, 2007-2012.

    PubMed

    Tomasello, Danilo; Schlagenhauf, Patricia

    2013-01-01

    A large number of autochthonous cases of dengue fever (2237) and chikungunya fever (231) occurred in Europe (Italy, France, Croatia, Madeira) during the period covered by our analysis (2007-2012). In all dengue outbreaks, the circulating strain, identified by means of molecular analysis, was the DENV-1 strain. Dengue and chikungunya are infectious diseases that often result in hospitalizations and are associated with high public health costs. The dengue epidemic on the island of Madeira resulted in 122 hospitalizations. Only one death (from chikungunya) occurred but long-term sequelae were described after the chikungunya outbreak in Emilia-Romagna, Italy. Vector control is key to reducing the impact of these diseases. During the chikungunya outbreak in Italy and the dengue outbreak in Madeira, appropriate measures for the control of mosquitoes (Aedes aegypti and Aedes albopictus) were effectively implemented. The effectiveness of these measures (reducing the number of breeding sites, application of pesticides and insecticides, public health education) was shown in the context of these real-life outbreaks. All the pre-requisites for autochthonous transmission of both dengue virus and chikungunya virus (vectors, viremic returned travellers, climatic conditions) are present in Europe. Constant surveillance is imperative.

  17. 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.

  18. [Epidemiology of dengue fever in China since 1978].

    PubMed

    Xiong, Yiquan; Chen, Qing

    2014-12-01

    Since 1978, dengue fever occurred endemically and epidemically every 4 to 7 years in China, affecting commonly people aged between 20 and 60 years with similar incidences in males and females. Four serotypes of dengue virus have been identified in China, with DENV-1 as the predominant serotype. The incidence of dengue fever became gradually decreased after 1997 but increased significantly in the recent two years, especially in 2014, where, up to November, a total of 44894 cases had been reported in Guangdong Province. In this review, the authors summarize the epidemiology, geographical and population distribution of dengue fever in China since 1978 and analyze the factors contributing to the outbreak in 2014.

  19. Serotype-specific dengue virus circulation and dengue disease in Bangkok, Thailand from 1973 to 1999.

    PubMed

    Nisalak, Ananda; Endy, Timothy P; Nimmannitya, Suchitra; Kalayanarooj, Siripen; Thisayakorn, Usa; Scott, Robert M; Burke, Donald S; Hoke, Charles H; Innis, Bruce L; Vaughn, David W

    2003-02-01

    Dengue virus circulation and association with epidemics and severe dengue disease were studied in hospitalized children with suspected dengue at the Queen Sirikit National Institute of Child Health in Bangkok, Thailand, from 1973 to 1999. Dengue serology was performed on all patients and viral isolation attempted on laboratory-confirmed patients. Acute dengue was diagnosed in 15,569 children and virus isolated from 4,846. DEN-3 was the most frequent serotype in primary dengue (49% of all isolates), DEN-2 in secondary and in dengue hemorrhagic fever (37% and 35%, respectively). The predominant dengue serotype varied by year: DEN-1 from 1990-92, DEN-2 from 1973-86 and 1988-89; DEN-3 in 1987 and 1995-99; and DEN-4 from 1993-94. Only DEN-3 was associated with severe outbreak years. Our findings illustrate the uniqueness of each serotype in producing epidemics and severe disease and underscore the importance of long-term surveillance of dengue serotypes in understanding the epidemiology of these viruses.

  20. [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.

  1. Incidence of dengue in a tertiary care centre--Kasturba Hospital, Manipal.

    PubMed

    Baruah, J; Ananda, Shiv; Arun Kumar, G

    2006-07-01

    Dengue is the most important Arbovirus in the world in terms of occurrence and impact. It has been responsible for some devastating outbreaks and accounts for nearly 50-100 million cases of dengue fever and 2-5 lac cases of the dengue hemorrhagic fever worldwide. Dengue is caused by an arbovirus, which belongs to the Flaviviridae and is maintained in nature principally through biological transmission between susceptible vertebrate hosts by hematophagous arthropods. The incidence and global distribution of dengue has greatly increased in recent years and affects almost every country between the topics of Capricorn and Cancer. Although outbreaks of dengue fever has been occurring with regularity all over the country, and there have been 2 reported outbreaks in the neighboring district Mangalore in 1993 and 1996, there has been no reported outbreak in Manipal, which is what is responsible for the present study. In the study, out of the 100 clinically suspected cases of dengue, 44% tested positive for dengue IgM antibody, thus proving current dengue infection. Twenty six cases were from Shimoga district, which indicates increased dengue virus activity in this area and the possible endemicity in the region.

  2. [Dengue vaccines].

    PubMed

    Morita, Kouichi

    2008-10-01

    Dengue is the most important mosquito borne virus infection in the tropics. Based on the effects of global warming, it is expected that dengue epidemic areas will further expand in the next decades unless effective and affordable vaccines are made available soon. At the moment, several vaccine developers have utilized live-attenuated live tetravalent vaccines and two of them have already completed phase two trials. However, the risk of antibody-dependent enhancement infection is not well elucidated and thus further and careful evaluation of the safety on proposed candidate vaccines are essential. At the moment, Bill and Melinda Gates Foundation strongly support the vaccine development through the Pediatric Dengue Vaccine Initiative.

  3. 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

  4. Dengue specific immunoglobulins M, A, and E in primary and secondary dengue 4 infected Salvadorian children.

    PubMed

    Vazquez, Susana; Lozano, Celina; Perez, Ana Beatriz; Castellanos, Yinet; Ruiz, Didye; Calzada, Naifi; Guzmán, Maria Guadalupe

    2014-09-01

    El Salvador is a Central American country that has been affected by several dengue outbreaks. This study investigated the levels of IgM, IgA, and IgE anti-dengue antibodies in serum samples from children in El Salvador, with a clinical and serological diagnosis of dengue infection during the dengue 4 outbreak in 2002-2003. Seventy one serum samples were tested by ELISA and cases were classified in three groups: 13 primary dengue fever (PDF), 21 secondary dengue fever (SDF), and 37 secondary dengue hemorrhagic fever (SDHF). Also, the specificity of anti-dengue IgM for the different serotypes was tested. No significant differences in the IgM response were found between PDF and SDF, but these were detected between PDF and SDHF (P = 0.0053) and between SDF and SDHF (P = 0.0003). The IgA and IgE values showed a statistically significant difference between primary and secondary groups. The highest positivity percentage of IgA was between 95% (SDF) and 100% (SDHF) towards day 7 of onset of fever. All secondary cases were positive for IgE antibodies. The specificity of IgM was determined for DENV-4 virus in primary and secondary DF groups. This is the first study on dengue cases in Salvadorian children related to the immune response of different immunoglobulins to the type of infection and the clinical picture. Further prospective studies are needed to define if the pattern of immunoglobulins can determine early dengue infection and/or severity.

  5. The first epidemic of dengue hemorrhagic fever in French Guiana.

    PubMed

    Reynes, J M; Laurent, A; Deubel, V; Telliam, E; Moreau, J P

    1994-11-01

    From July 1991 to October 1992, an outbreak of dengue spread into the main urban areas of French Guiana, where 90% of the country's 114,808 inhabitants live. In mid-July 1991 dengue-2 virus was identified as being responsible for most cases, while dengue-1 virus was rarely isolated and circulated at a low level. The number of dengue cases during this period was unknown because there was no clinically based dengue surveillance system. The only available data were for the number of suspected cases as indicated by the number of patients for whom blood samples were submitted to a laboratory for dengue diagnosis. Eight hundred forty-seven of the 2,948 suspected cases were diagnosed in the laboratory as dengue cases. Six fatal cases were reported. This outbreak was marked by the appearance of the first clinical cases of dengue hemorrhagic fever (DHF) in French Guiana. Forty cases met the World Health Organization definition of clinical DHF: 32 were grade II, seven were grade III, and one was grade IV and fatal. Eighteen cases were confirmed in the laboratory and 12 were probable; there was no proof of the dengue etiology for the remaining patients.

  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. A review of the vector management methods to prevent and control outbreaks of West Nile virus infection and the challenge for Europe.

    PubMed

    Bellini, Romeo; Zeller, Herve; Van Bortel, Wim

    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

  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. Dengue fever.

    PubMed

    Payling, K J

    1997-04-01

    Dengue fever, and its more serious haemorrhagic form, is increasingly being found among UK travellers to tropical and sub-tropical countries. This Update examines transmission, the main symptoms and nursing care of affected people.

  10. Dengue fever

    MedlinePlus

    ... 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 ...

  11. 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...

  12. Role of healthcare workers in early epidemic spread of Ebola: policy implications of prophylactic compared to reactive vaccination policy in outbreak prevention and control.

    PubMed

    Coltart, Cordelia E M; Johnson, Anne M; Whitty, Christopher J M

    2015-01-01

    Ebola causes severe illness in humans and has epidemic potential. How to deploy vaccines most effectively is a central policy question since different strategies have implications for ideal vaccine profile. More than one vaccine may be needed. A vaccine optimised for prophylactic vaccination in high-risk areas but when the virus is not actively circulating should be safe, well tolerated, and provide long-lasting protection; a two- or three-dose strategy would be realistic. Conversely, a reactive vaccine deployed in an outbreak context for ring-vaccination strategies should have rapid onset of protection with one dose, but longevity of protection is less important. In initial cases, before an outbreak is recognised, healthcare workers (HCWs) are at particular risk of acquiring and transmitting infection, thus potentially augmenting early epidemics. We hypothesise that many early outbreak cases could be averted, or epidemics aborted, by prophylactic vaccination of HCWs. This paper explores the potential impact of prophylactic versus reactive vaccination strategies of HCWs in preventing early epidemic transmissions. To do this, we use the limited data available from Ebola epidemics (current and historic) to reconstruct transmission trees and illustrate the theoretical impact of these vaccination strategies. Our data suggest a substantial potential benefit of prophylactic versus reactive vaccination of HCWs in preventing early transmissions. We estimate that prophylactic vaccination with a coverage >99% and theoretical 100% efficacy could avert nearly two-thirds of cases studied; 75% coverage would still confer clear benefit (40% cases averted), but reactive vaccination would be of less value in the early epidemic. A prophylactic vaccination campaign for front-line HCWs is not a trivial undertaking; whether to prioritise long-lasting vaccines and provide prophylaxis to HCWs is a live policy question. Prophylactic vaccination is likely to have a greater impact on the

  13. Role of healthcare workers in early epidemic spread of Ebola: policy implications of prophylactic compared to reactive vaccination policy in outbreak prevention and control.

    PubMed

    Coltart, Cordelia E M; Johnson, Anne M; Whitty, Christopher J M

    2015-01-01

    Ebola causes severe illness in humans and has epidemic potential. How to deploy vaccines most effectively is a central policy question since different strategies have implications for ideal vaccine profile. More than one vaccine may be needed. A vaccine optimised for prophylactic vaccination in high-risk areas but when the virus is not actively circulating should be safe, well tolerated, and provide long-lasting protection; a two- or three-dose strategy would be realistic. Conversely, a reactive vaccine deployed in an outbreak context for ring-vaccination strategies should have rapid onset of protection with one dose, but longevity of protection is less important. In initial cases, before an outbreak is recognised, healthcare workers (HCWs) are at particular risk of acquiring and transmitting infection, thus potentially augmenting early epidemics. We hypothesise that many early outbreak cases could be averted, or epidemics aborted, by prophylactic vaccination of HCWs. This paper explores the potential impact of prophylactic versus reactive vaccination strategies of HCWs in preventing early epidemic transmissions. To do this, we use the limited data available from Ebola epidemics (current and historic) to reconstruct transmission trees and illustrate the theoretical impact of these vaccination strategies. Our data suggest a substantial potential benefit of prophylactic versus reactive vaccination of HCWs in preventing early transmissions. We estimate that prophylactic vaccination with a coverage >99% and theoretical 100% efficacy could avert nearly two-thirds of cases studied; 75% coverage would still confer clear benefit (40% cases averted), but reactive vaccination would be of less value in the early epidemic. A prophylactic vaccination campaign for front-line HCWs is not a trivial undertaking; whether to prioritise long-lasting vaccines and provide prophylaxis to HCWs is a live policy question. Prophylactic vaccination is likely to have a greater impact on the

  14. [Unexpected Diseases in Two Patients with False-Positive Dengue Immunoglobulin M Antibody Test Results].

    PubMed

    Matono, Takashi; Kutsuna, Satoshi; Kato, Yasuyuki; Takeshita, Nozomi; Hayakawa, Kayoko; Kanagawa, Shuzo; Ohmagari, Norio

    2016-03-01

    In 2014, an outbreak of 162 domestic dengue fever infections occurred in Tokyo, Japan; the first outbreak of its kind in 70 years. Nineteen of these cases were confirmed in our center. Advancements in diagnostic methods have enabled an earlier diagnosis of dengue fever; however, unfamiliarity with the clinical course and characteristics of diagnostic tests for dengue fever can lead to misdiagnosis. We herein describe 2 cases of Japanese patients with false-positive dengue immunoglobulin M antibody test results, who were finally diagnosed as having dermatomyositis and acute hepatitis A infection, respectively. PMID:27197439

  15. [Dengue fever].

    PubMed

    Pick, N; Potasman, I

    1995-07-01

    Dengue fever is a viral disease, transmitted to man via mosquito bites. It is endemic in tropical regions (10 million infected annually) and is characterized by high fever, headache, myalgia, lethargy, vomiting, rash and neutropenia. The upward trend in the number of young Israelis visiting tropical countries increases the number of those potentially exposed to this disease. We present 4 Israelis who returned with dengue fever from Thailand.

  16. 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

  17. Recent progress in dengue vaccine development.

    PubMed

    Wei, Jianchun; Chen, Hui; An, Jing

    2014-12-01

    Dengue virus (DENV) has four distinct serotypes. DENV infection can result in classic dengue fever and life-threatening dengue hemorrhagic fever/dengue shock syndrome. In recent decades, DENV infection has become an important public health concern in epidemic-prone areas. Vaccination is the most effective measure to prevent and control viral infections. However, several challenges impede the development of effective DENV vaccines, such as the lack of suitable animal models and the antibody-dependent enhancement phenomenon. Although no licensed DENV vaccine is available, significant progress has been made. This review summarizes candidate DENV vaccines from recent investigations. PMID:25547681

  18. An epidemic of dengue fever in Wewak.

    PubMed

    Farrell, K T

    1978-06-01

    143 clinical cases of dengue fever were reported in Wewak between April and August 1976. 15 patients demonstrated a diagnostic rise in antibody titre for Group B arbovirus. Tests for complement-fixing antibody to dengue viruses did not indicate what type of dengue virus was responsible for the epidemic. Vector species Aedes aegypti and Aedes scutellaris were found before control measures were adopted but were not found four months later. The epidemiology of dengue fever is discussed and measures for prevention and control of epidemics are recommended.

  19. Dengue infection.

    PubMed

    Guzman, Maria G; Gubler, Duane J; Izquierdo, Alienys; Martinez, Eric; Halstead, Scott B

    2016-01-01

    Dengue is widespread throughout the tropics and local spatial variation in dengue virus transmission is strongly influenced by rainfall, temperature, urbanization and distribution of the principal mosquito vector Aedes aegypti. Currently, endemic dengue virus transmission is reported in the Eastern Mediterranean, American, South-East Asian, Western Pacific and African regions, whereas sporadic local transmission has been reported in Europe and the United States as the result of virus introduction to areas where Ae. aegypti and Aedes albopictus, a secondary vector, occur. The global burden of the disease is not well known, but its epidemiological patterns are alarming for both human health and the global economy. Dengue has been identified as a disease of the future owing to trends toward increased urbanization, scarce water supplies and, possibly, environmental change. According to the WHO, dengue control is technically feasible with coordinated international technical and financial support for national programmes. This Primer provides a general overview on dengue, covering epidemiology, control, disease mechanisms, diagnosis, treatment and research priorities. PMID:27534439

  20. 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

  1. 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

  2. Dengue in Florida (USA).

    PubMed

    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

  3. Dengue and dengue haemorrhagic fever.

    PubMed

    Rigau-Pérez, J G; Clark, G G; Gubler, D J; Reiter, P; Sanders, E J; Vorndam, A V

    1998-09-19

    The incidence and geographical distribution of dengue have greatly increased in recent years. Dengue is an acute mosquito-transmitted viral disease characterised by fever, headache, muscle and joint pains, rash, nausea, and vomiting. Some infections result in dengue haemorrhagic fever (DHF), a syndrome that in its most severe form can threaten the patient's life, primarily through increased vascular permeability and shock. The case fatality rate in patients with dengue shock syndrome can be as high as 44%. For decades, two distinct hypotheses to explain the mechanism of DHF have been debated-secondary infection or viral virulence. However, a combination of both now seems to be the plausible explanation. The geographical expansion of DHF presents the need for well-documented clinical, epidemiological, and virological descriptions of the syndrome in the Americas. Biological and social research are essential to develop effective mosquito control, medications to reduce capillary leakage, and a safe tetravalent vaccine.

  4. 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.

  5. 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.

  6. 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. PMID:25844431

  7. 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.

  8. Dengue and dengue hemorrhagic fever.

    PubMed

    Hayes, E B; Gubler, D J

    1992-04-01

    Hundreds of thousands of dengue cases are reported worldwide each year. Given the difficulty in obtaining full reporting, the actual number of human infections is probably much higher than the number reported. Dengue is usually a nonspecific febrile illness that resolves with supportive therapy but the clinical spectrum ranges from asymptomatic infection through severe hemorrhage and sudden fatal shock. The pathophysiology of the severe forms of dengue may be related to sequential infection with different serotypes, variations in virus virulence, interaction of the virus with environmental and host factors or a combination of these factors. Control of dengue at the present time is dependent on control of the principal vector mosquito, A. aegypti. Efforts to achieve such control are now focusing on community education and action towards eliminating this mosquito's breeding sites near human dwellings. Vaccine development continues, but at present the only way to avoid dengue in an area where it is endemic or epidemic is to use repellents and mosquito barriers. The movement of people to and from tropical areas makes dengue an important differential diagnosis in any patient with an acute illness and history of recent travel to tropical areas. Because of continued infestation of the southeastern United States with A. aegypti, indigenous transmission in the continental United States remains a public health concern.

  9. Influence of the dengue serotype, previous dengue infection, and plasma viral load on clinical presentation and outcome during a dengue-2 and dengue-4 co-epidemic.

    PubMed

    Thomas, Laurent; Verlaeten, Olivier; Cabié, André; Kaidomar, Stéphane; Moravie, Victor; Martial, Jenny; Najioullah, Fatiha; Plumelle, Yves; Fonteau, Christiane; Dussart, Philippe; Césaire, Raymond

    2008-06-01

    Martinique experienced a dengue outbreak with co-circulation of DENV-2 and DENV-4. In an emergency department-based study, we analyzed whether the clinical presentation and outcome of adult patients were related to serotype, immune status, or plasma viral load. Of the 146 adult patients who had confirmed dengue infection, 91 (62.3%) were classified as having classic dengue fever, 11 (7.5%) fulfilled World Health Organization criteria for dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS), 21 other patients (14.4%) presented with at least one typical feature of DHF/DSS [i.e., internal hemorrhage, plasma leakage, marked thrombocytopenia (platelet count < or = 50,000 platelets/mm(3)) and/or shock], and 23 further patients (15.8%) had unusual manifestations. Four patients died. Severe illness was more frequent in patients with secondary dengue infection (odds ratio, 7.18; 95% confidence interval, 3.1-16.7; P < 0.001). Multivariate regression analysis showed that gastrointestinal symptoms and other unusual manifestations were independently associated with DENV-2 infection, whereas cough and DHF/DSS features were independently associated with secondary immune response. A high plasma viral load was associated with DENV-2 infection, increased serum liver enzymes, and with DHF/DSS features in patients presenting after the third day of illness. The most severe cases of dengue resulted from the combined effects of DENV-2 and secondary infection.

  10. 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.

  11. 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.

  12. 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.

  13. 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. PMID:26855170

  14. 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

  15. The 1982 dengue epidemic in Malaysia: epidemiological, serological and virological aspects.

    PubMed

    Fang, R; Lo, E; Lim, T W

    1984-03-01

    In 1982, Malaysia experienced the worst dengue/dengue haemorrhagic fever outbreak in its history. All states in Peninsular and East Malaysia were similarly affected. There was a total of 3,005 cases with 35 deaths, with the majority of cases occurring between the months of July to October. There was a total of 1,001 laboratory confirmed cases. Most of the cases were in patients over the age of 15 years. The Chinese population was mainly affected, although a much higher proportion of Malays was noted in comparison to previous years. The main serotypes involved were dengue-1 and dengue-3. No dengue-4 serotype were isolated.

  16. 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. PMID:27130747

  17. Incidence of dengue fever in relation to climatic factors in Ludhiana, Punjab.

    PubMed

    Ram, S; Khurana, S; Kaushal, V; Gupta, R; Khurana, S B

    1998-10-01

    An outbreak of dengue fever occurred in Ludhiana in 1996 and 1997. A total of 505 patients who attended the hospital attached to Dayanand Medical College, Ludhiana were clinically diagnosed to have dengue fever. Of these, 460 cases were noticed between October and December 1996 while during 1997 only 45 dengue fever cases were observed. Serological examination using dengue IgG and IgM blot was performed with single serum samples of 189 patients. Of these, 129 serum samples were detected positive for anti dengue antibodies. Twenty eight patients died in the dengue epidemic, 12 of whom suffered from dengue haemorrhagic fever (DHF) and six with dengue shock syndrome (DSS). Male patients outnumbered the female patients. Seasonal and cyclic pattern of the disease incidence was observed.

  18. 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.

  19. Re-Emergence of Dengue Virus Type 3 in Canton, China, 2009–2010, Associated with Multiple Introductions through Different Geographical Routes

    PubMed Central

    Di, Biao; Bai, Zhijun; He, Peng; Jing, Qinlong; Zheng, Xueli

    2013-01-01

    Background Endemic dengue virus type 3 (DENV-3) infections have not been reported in Canton, China, since 1980. In March 2009, DENV-3 was isolated for the second time, occurring about 30 years after the previous circulation. In August, 3 other cases emerged. One much larger outbreak occurred again in 2010. To address the origin and particularly to determine whether the outbreaks were caused by the same viral genotype, we investigated the epidemiological