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García-García D, Fernández-Martínez B, Bartumeus F, Gómez-Barroso D. Modeling the Regional Distribution of International Travelers in Spain to Estimate Imported Cases of Dengue and Malaria: Statistical Inference and Validation Study. JMIR Public Health Surveill 2024; 10:e51191. [PMID: 38801767 PMCID: PMC11165286 DOI: 10.2196/51191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/18/2023] [Accepted: 03/05/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Understanding the patterns of disease importation through international travel is paramount for effective public health interventions and global disease surveillance. While global airline network data have been used to assist in outbreak prevention and effective preparedness, accurately estimating how these imported cases disseminate locally in receiving countries remains a challenge. OBJECTIVE This study aimed to describe and understand the regional distribution of imported cases of dengue and malaria upon arrival in Spain via air travel. METHODS We have proposed a method to describe the regional distribution of imported cases of dengue and malaria based on the computation of the "travelers' index" from readily available socioeconomic data. We combined indicators representing the main drivers for international travel, including tourism, economy, and visits to friends and relatives, to measure the relative appeal of each region in the importing country for travelers. We validated the resulting estimates by comparing them with the reported cases of malaria and dengue in Spain from 2015 to 2019. We also assessed which motivation provided more accurate estimates for imported cases of both diseases. RESULTS The estimates provided by the best fitted model showed high correlation with notified cases of malaria (0.94) and dengue (0.87), with economic motivation being the most relevant for imported cases of malaria and visits to friends and relatives being the most relevant for imported cases of dengue. CONCLUSIONS Factual descriptions of the local movement of international travelers may substantially enhance the design of cost-effective prevention policies and control strategies, and essentially contribute to decision-support systems. Our approach contributes in this direction by providing a reliable estimate of the number of imported cases of nonendemic diseases, which could be generalized to other applications. Realistic risk assessments will be obtained by combining this regional predictor with the observed local distribution of vectors.
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Affiliation(s)
- David García-García
- Department of Communicable Diseases, National Centre of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
- Epidemiology and Public Health Biomedical Network Research Consortium (CIBERESP), Madrid, Spain
| | - Beatriz Fernández-Martínez
- Department of Communicable Diseases, National Centre of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
- Epidemiology and Public Health Biomedical Network Research Consortium (CIBERESP), Madrid, Spain
| | - Frederic Bartumeus
- Group of Theoretical and Computational Ecology, Centre for Advanced Studies of Blanes, Spanish Research Council, Blanes, Spain
- Ecological and Forestry Applications Research Centre, Barcelona, Spain
- Catalan Institution for Research and Advanced Studies, Barcelona, Spain
| | - Diana Gómez-Barroso
- Department of Communicable Diseases, National Centre of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
- Epidemiology and Public Health Biomedical Network Research Consortium (CIBERESP), Madrid, Spain
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Maillard O, Belot J, Adenis T, Rollot O, Adenis A, Guihard B, Gérardin P, Bertolotti A. Early diagnosis of dengue: Diagnostic utility of the SD BIOLINE Dengue Duo rapid test in Reunion Island. PLoS Negl Trop Dis 2023; 17:e0011253. [PMID: 36996260 PMCID: PMC10089357 DOI: 10.1371/journal.pntd.0011253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 04/11/2023] [Accepted: 03/20/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND In Reunion Island, dengue outbreaks have been occurring since 2018. The healthcare facilities are facing the problem of managing a massive influx of patients and a growing care burden. The aim of this study was to evaluate the performance of the SD Bioline Dengue Duo rapid diagnostic test in adults consulting at an emergency department during the 2019 epidemic. METHODOLOGY/PRINCIPAL FINDINGS This retrospective study of diagnostic accuracy included patients over 18 years old, suspected of dengue, who were admitted to emergency units of the University Hospital of Reunion between the 1st of January and 30th of June, 2019, and were tested for dengue fever with the SD Bioline Dengue Duo rapid diagnostic test and reverse transcriptase polymerase chain reaction. Over the study period, 2099 patients were screened retrospectively. Of them, 671 patients matched the inclusion criteria. The overall rapid diagnostic test performance was 42% for sensitivity and 15% for specificity. The non-structural 1 antigen component had a good specificity of 82% but a low sensitivity of 12%. The immunoglobulin M component had a sensitivity of 28% and a specificity of 33%. Sensitivities were slightly improved beyond the 5th day of illness compared to the early stage for all components, but only the non-structural 1 antigen component had a better specificity of 91%. Furthermore, predictive values were low and post-test probabilities never improved pre-test probabilities in our setting. CONCLUSIONS/SIGNIFICANCE These results suggest that the SD Bioline Dengue Duo RDT did not achieve sufficient performance levels to rule in, or discard, an early point of care dengue diagnosis in the emergency department during the 2019 epidemic in Reunion.
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Affiliation(s)
- Olivier Maillard
- Department of Public Health and Research, CHU Réunion, Saint-Pierre, Reunion, France
- Clinical Investigation Center, INSERM CIC1410, CHU Réunion, Saint Pierre, Reunion, France
| | - Jeanne Belot
- Department of Emergency Medicine, CHU Réunion, Saint-Pierre, Reunion, France
| | - Thibault Adenis
- Department of Emergency Medicine, CHU Réunion, Saint-Pierre, Reunion, France
| | - Olivier Rollot
- Department of Public Health and Research, CHU Réunion, Saint-Pierre, Reunion, France
- Clinical Investigation Center, INSERM CIC1410, CHU Réunion, Saint Pierre, Reunion, France
| | - Antoine Adenis
- Department of Public Health and Research, CH Andrée Rosemon, Cayenne, French Guiana, France
- Clinical Investigation Center, INSERM CIC1424, CH Andrée Rosemon, Cayenne, French Guiana, France
| | - Bertrand Guihard
- Department of Emergency Medicine, CHU Réunion, Saint Denis, Reunion, France
| | - Patrick Gérardin
- Department of Public Health and Research, CHU Réunion, Saint-Pierre, Reunion, France
- Clinical Investigation Center, INSERM CIC1410, CHU Réunion, Saint Pierre, Reunion, France
| | - Antoine Bertolotti
- Clinical Investigation Center, INSERM CIC1410, CHU Réunion, Saint Pierre, Reunion, France
- Department of Infectious Diseases and Dermatology, CHU Réunion, Saint-Pierre, Reunion, France
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Sakamoto K, Yamauchi T, Kokaze A. Mathematical model estimation of dengue fever transmission risk from Southeast and South Asia into Japan between 2016 and 2018. Environ Health Prev Med 2023; 28:50. [PMID: 37690835 PMCID: PMC10495242 DOI: 10.1265/ehpm.22-00267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 07/28/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND Dengue fever is a viral infection transmitted to humans through the bite of a mosquito infected with the dengue virus. Dengue is one of the most common infectious diseases in the world, and its incidence is rapidly increasing. We estimated the risk of dengue importation from endemic countries to Japan and the transmission risk within Japan using data collected between 2016 and 2018. METHODS We conducted simulations that included the number of reported dengue infections and travelers per month in ten countries in Southeast and South Asia. RESULTS The estimated importation risks for Japanese returnees and international travelers from each of the ten endemic countries was approximately 1.0 every month from 2016 to 2018. The autochthonous transmission risk in Japan from any target country was 1.0 from June to September yearly. The estimated number of Japanese dengue cases returning to Japan is approximately 25 times higher than that of imported cases reported in Japan. CONCLUSIONS The risk of dengue importation into Japan can be sufficiently high. Attention should be paid to autochthonous transmission spread between June and September when mosquitoes are active in Japan. Estimates of seasonal risk variation from each dengue virus-endemic country can be used to inform preventive and control measures for dengue in Japan.
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Affiliation(s)
- Ken Sakamoto
- Department of Hygiene, Public Health and Preventive Medicine, School of Medicine, Showa University, Tokyo, Japan
| | - Takenori Yamauchi
- Department of Hygiene, Public Health and Preventive Medicine, School of Medicine, Showa University, Tokyo, Japan
| | - Akatsuki Kokaze
- Department of Hygiene, Public Health and Preventive Medicine, School of Medicine, Showa University, Tokyo, Japan
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Sang S, Yue Y, Wang Y, Zhang X. The epidemiology and evolutionary dynamics of massive dengue outbreak in China, 2019. Front Microbiol 2023; 14:1156176. [PMID: 37138627 PMCID: PMC10149964 DOI: 10.3389/fmicb.2023.1156176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/29/2023] [Indexed: 05/05/2023] Open
Abstract
Introduction In 2019, China experienced massive dengue outbreaks with high incidence and expanded outbreak areas. The study aims to depict dengue's epidemiology and evolutionary dynamics in China and explore the possible origin of these outbreaks. Methods Records of confirmed dengue cases in 2019 were obtained from the China Notifiable Disease Surveillance System. The sequences of complete envelope gene detected from the outbreak provinces in China in 2019 were retrieved from GenBank. Maximum Likelihood trees were constructed to genotype the viruses. The median-joining network was used to visualize fine-scale genetic relationships. Four methods were used to estimate the selective pressure. Results A total of 22,688 dengue cases were reported, 71.4% of which were indigenous cases and 28.6% were imported cases (including from abroad and from other domestic provinces). The abroad cases were predominantly imported from Southeast Asia countries (94.6%), with Cambodia (3,234 cases, 58.9%), and Myanmar (1,097 cases, 20.0%) ranked as the top two. A total of 11 provinces with dengue outbreaks were identified in the central-south of China, of which Yunnan and Guangdong provinces had the highest number of imported and indigenous cases. The primary source of imported cases in Yunnan was from Myanmar, while in the other ten provinces, the majority of imported cases were from Cambodia. Guangdong, Yunnan and Guangxi provinces were China's primary sources of domestically imported cases. Phylogenetic analysis of the viruses in outbreak provinces revealed three genotypes: (I, IV, and V) in DENV 1, Cosmopolitan and Asian I genotypes in DENV 2, and two genotypes (I and III) in DENV 3. Some genotypes concurrently circulated in different outbreak provinces. Most of the viruses were clustered with those from Southeast Asia. Haplotype network analysis showed that Southeast Asia, possibly Cambodia and Thailand, was the respective origin of the viruses in clade 1 and 4 for DENV 1. Positive selection was detected at codon 386 in clade 1. Conclusion Dengue importation from abroad, especially from Southeast Asia, resulted in the dengue epidemic in China in 2019. Domestic transmission between provinces and positive selection on virus evolution may contribute to the massive dengue outbreaks.
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Affiliation(s)
- Shaowei Sang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, Shandong, China
- Clinical Research Center of Shandong University, Jinan, Shandong, China
- *Correspondence: Shaowei Sang,
| | - Yujuan Yue
- State Key Laboratory of Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention, National Institute for Communicable, Disease Control and Prevention, Beijing, China
| | - Yiguan Wang
- Institute of Ecology and Evolution, University of Edinburgh, Edinburgh, United Kingdom
| | - Xiangwei Zhang
- Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Xiangwei Zhang,
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Ren ZZ, Zheng Y, Sun T, Wang GY, Chen XM, Zhou YM. A survey of clinical and laboratory characteristics of the dengue fever epidemic from 2017 to 2019 in Zhejiang, China. Medicine (Baltimore) 2022; 101:e31143. [PMID: 36281095 PMCID: PMC9592481 DOI: 10.1097/md.0000000000031143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
To explore the epidemic, clinical, and laboratory characteristics of dengue patients in Zhejiang and the possible mechanism. Epidemic, clinical and laboratory data of 231 dengue patients admitted to the Second Affiliated Hospital of Zhejiang Traditional Chinese Medicine University between August 2017 and December 2019 were collected. GSE43777 dataset was downloaded from the Gene Expression Omnibus database and was used for the immune cell infiltration analysis, logistic regression analysis, and nomogram construction. Gene set enrichment analysis (GSEA) was performed to explore the possible regulatory pathways in dengue infection. Further, the receiver operating characteristic curve analysis and decision curve analysis were conducted to evaluate the value of related immune cells in predicting dengue severity. Among the 231 patients, the gender ratio was 1:1.1 (male/female). The patients in the <60 years age group, 60 to 80 years age group, and >80 years age group were 47.2%, 45.5%, and 7.3%, respectively. The major symptoms were fever (100%), weak (98.3%), anorexia (76.6%), muscle and joint pain (62.3%), and nausea (46.8%). In dengue patients, 98.7% of serum samples had decreased platelet levels, 96.5% of them had decreased white blood cell (WBC) levels, 97.8% had elevated aspartate aminotransferase levels, 82.3% had elevated lactate dehydrogenase levels, 49.4% had increased creatinine levels, and 35.5% had increased creatine kinase levels. Pneumonia, pleural effusion, and bilateral pleural reaction were observed in 16.5%, 8.2%, and 4.8%, respectively of dengue patients. Gallbladder wall roughness and splenomegaly accounted for 6.1% and 4.3% of all cases. Moreover, the levels of T cell, B cell, and dendritic cells were significantly higher in the convalescent group and they were involved in immune- and metabolism-related pathways. Of note, low levels of these 3 immune cells correlated with high dengue infection risk, while only dendritic cells exhibited satisfactory performance in predicting dengue severity. Dengue fever patients often onset with fever, accompanied by mild abnormalities of the blood system and other organ functions. Moreover, T cells, B cells, and dendritic cells might be involved in dengue infection and development.
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Affiliation(s)
- Ze-Ze Ren
- Department of Infectious Disease, The Second Affiliated Hospital of Zhejiang Chinese Medicine University, Hangzhou, Zhejiang, China
| | - Yi Zheng
- Department of Infectious Disease, The Second Affiliated Hospital of Zhejiang Chinese Medicine University, Hangzhou, Zhejiang, China
| | - Tao Sun
- Department of Infectious Disease, The Second Affiliated Hospital of Zhejiang Chinese Medicine University, Hangzhou, Zhejiang, China
| | - Gang-Yi Wang
- Department of Infectious Disease, The Second Affiliated Hospital of Zhejiang Chinese Medicine University, Hangzhou, Zhejiang, China
| | - Xiao-Mei Chen
- Department of Infectious Disease, The Second Affiliated Hospital of Zhejiang Chinese Medicine University, Hangzhou, Zhejiang, China
| | - Yu-Mei Zhou
- Department of Infectious Disease, The Second Affiliated Hospital of Zhejiang Chinese Medicine University, Hangzhou, Zhejiang, China
- *Correspondence: Yu-Mei Zhou, Department of Infectious Disease, The Second Affiliated Hospital of Zhejiang Chinese Medicine University, No.318 Chaowang Road, Hangzhou 310005, Zhejiang, China (e-mail: )
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Ammar SE, Mclntyre M, Baker MG, Hales S. New Zealand travellers to high-risk destinations for arbovirus infection make little effort to avoid mosquito bites. J R Soc N Z 2022. [DOI: 10.1080/03036758.2022.2071951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Sherif E. Ammar
- Department of Public Health, University of Otago, Wellington, New Zealand
- Institute of Environmental Science and Research (ESR), Wellington, New Zealand
| | - Mary Mclntyre
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Michael G. Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Simon Hales
- Department of Public Health, University of Otago, Wellington, New Zealand
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Dengue Fever in Italy: The "Eternal Return" of an Emerging Arboviral Disease. Trop Med Infect Dis 2022; 7:tropicalmed7010010. [PMID: 35051126 PMCID: PMC8782038 DOI: 10.3390/tropicalmed7010010] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/04/2022] [Accepted: 01/12/2022] [Indexed: 01/27/2023] Open
Abstract
Enhanced surveillance for dengue virus (DENV) infections in Italy has been implemented since 2012, with annual reports from the National Health Institute. In this study, we summarize available evidence on the epidemiology of officially notified DENV infections from 2010–2021. In total, 1043 DENV infection cases were diagnosed, and most of them occurred in travelers, with only 11 autochthonous cases. The annual incidence rates of DENV infections peaked during 2019 with 0.277 cases per 100,000 (95% confidence interval [95% CI] 0.187–0.267), (age-adjusted incidence rate: 0.328, 95% CI 0.314–0.314). Cases of DENV were clustered during the summer months of July (11.4%), August (19.3%), and September (12.7%). The areas characterized by higher notification rates were north-western (29.0%), and mostly north-eastern Italy (41.3%). The risk for DENV infection in travelers increased in the time period 2015–2019 (risk ratio [RR] 1.808, 95% CI 1.594–2.051) and even during 2020–2021 (RR 1.771, 95% CI 1.238–2.543). Higher risk for DENV was additionally reported in male subjects compared with females subjects, and aged 25 to 44 years, and in individuals from northern and central Italy compared to southern regions and islands. In a multivariable Poisson regression model, the increased number of travelers per 100 inhabitants (incidence rate ratio [IRR] 1.065, 95% CI 1.036–1.096), the incidence in other countries (IRR 1.323, 95% CI 1.165–1.481), the share of individuals aged 25 to 44 years (IRR 1.622, 95% CI 1.338–1.968), and foreign-born residents (IRR 2.717, 95% CI 1.555–3.881), were identified as effectors of annual incidence. In summary, although the circulation of DENV remains clustered among travelers, enhanced surveillance is vital for the early detection of human cases and the prompt implementation of response measures.
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Barzon L, Gobbi F, Capelli G, Montarsi F, Martini S, Riccetti S, Sinigaglia A, Pacenti M, Pavan G, Rassu M, Padovan MT, Manfrin V, Zanella F, Russo F, Foglia F, Lazzarini L. Autochthonous dengue outbreak in Italy 2020: clinical, virological and entomological findings. J Travel Med 2021; 28:6354471. [PMID: 34409443 PMCID: PMC8499737 DOI: 10.1093/jtm/taab130] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/08/2021] [Accepted: 08/09/2021] [Indexed: 12/02/2022]
Abstract
BACKGROUND In August 2020, in the context of COVID-19 pandemics, an autochthonous dengue outbreak was identified for the first time in Italy. METHODS Following the reporting of the index case of autochthonous dengue, epidemiological investigation, vector control and substances of human origin safety measures were immediately activated, according to the national arbovirus surveillance plan. Dengue cases were followed-up with weekly visits and laboratory tests until recovery and clearance of viral RNA from blood. RESULTS The primary dengue case was identified in a young woman, who developed fever after returning from Indonesia to northern Italy, on 27 July 2020. She spent the mandatory quarantine for COVID-19 at home with relatives, six of whom developed dengue within two weeks. Epidemiological investigation identified further five autochthonous dengue cases among people who lived or stayed near the residence of the primary case. The last case of the outbreak developed fever on 29 September 2020. Dengue cases had a mild febrile illness, except one with persistent asthenia and myalgia. DENV-1 RNA was detected in blood and/or urine in all autochthonous cases, up to 35 days after fever onset. All cases developed IgM and IgG antibodies which cross-reacted with West Nile virus (WNV) and other flaviviruses. Sequencing of the full viral genome from blood samples showed over 99% nucleotide identity with DENV-1 strains isolated in China in 2014-2015; phylogenetic analysis classified the virus within Genotype I. Entomological site inspection identified a high density of Aedes albopictus mosquitoes, which conceivably sustained local DENV-1 transmission. Aedes koreicus mosquitoes were also collected in the site. CONCLUSIONS Areas in Europe with high density of Aedes mosquitoes should be considered at risk for dengue transmission. The presence of endemic flaviviruses, such as WNV, might pose problems in the laboratory diagnosis.
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Affiliation(s)
- Luisa Barzon
- Veneto Region Arbovirosis Task Force, Dorsoduro, 3493 - Rio Nuovo - 30123 Venezia, Italy.,Department of Molecular Medicine, University of Padova, via A. Gabelli 63, 35121 Padova, Italy.,Microbiology and Virology Unit, Padova University Hospital, Via Giustiniani 2, 35128 Padova, Italy
| | - Federico Gobbi
- Veneto Region Arbovirosis Task Force, Dorsoduro, 3493 - Rio Nuovo - 30123 Venezia, Italy.,Department of Infectious/Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Via Luigi Rizzardi 4, 37024, Negrar di Valpolicella, Verona, Italy
| | - Gioia Capelli
- Veneto Region Arbovirosis Task Force, Dorsoduro, 3493 - Rio Nuovo - 30123 Venezia, Italy.,Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020 Legnaro, Padova, Italy
| | - Fabrizio Montarsi
- Veneto Region Arbovirosis Task Force, Dorsoduro, 3493 - Rio Nuovo - 30123 Venezia, Italy.,Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020 Legnaro, Padova, Italy
| | - Simone Martini
- Veneto Region Arbovirosis Task Force, Dorsoduro, 3493 - Rio Nuovo - 30123 Venezia, Italy.,Entostudio s.r.l., Viale del Lavoro, 66, 35020 Ponte San Nicolò, Padova, Italy
| | - Silvia Riccetti
- Department of Molecular Medicine, University of Padova, via A. Gabelli 63, 35121 Padova, Italy
| | - Alessandro Sinigaglia
- Department of Molecular Medicine, University of Padova, via A. Gabelli 63, 35121 Padova, Italy
| | - Monia Pacenti
- Microbiology and Virology Unit, Padova University Hospital, Via Giustiniani 2, 35128 Padova, Italy
| | - Giacomina Pavan
- Department of Microbiology, St. Bortolo Hospital, Viale Ferdinando Rodolfi 37, 36100 Vicenza, Italy
| | - Mario Rassu
- Department of Microbiology, St. Bortolo Hospital, Viale Ferdinando Rodolfi 37, 36100 Vicenza, Italy
| | - Maria Teresa Padovan
- Department of Public Health, Azienda AULSS8 Berica, Viale Ferdinando Rodolfi 37, 36100 Vicenza, Italy
| | - Vinicio Manfrin
- Department of Infectious Diseases, St. Bortolo Hospital, Viale Ferdinando Rodolfi 37, 36100 Vicenza, Italy
| | - Francesca Zanella
- Veneto Region Arbovirosis Task Force, Dorsoduro, 3493 - Rio Nuovo - 30123 Venezia, Italy.,Direzione Prevenzione, Sicurezza Alimentare Veterinaria, Dorsoduro, 3493 - Rio Nuovo - 30123 Venice, Italy
| | - Francesca Russo
- Veneto Region Arbovirosis Task Force, Dorsoduro, 3493 - Rio Nuovo - 30123 Venezia, Italy.,Direzione Prevenzione, Sicurezza Alimentare Veterinaria, Dorsoduro, 3493 - Rio Nuovo - 30123 Venice, Italy
| | - Felice Foglia
- Department of Public Health, Azienda AULSS8 Berica, Viale Ferdinando Rodolfi 37, 36100 Vicenza, Italy
| | - Luca Lazzarini
- Department of Infectious Diseases, St. Bortolo Hospital, Viale Ferdinando Rodolfi 37, 36100 Vicenza, Italy
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Yang X, Quam MBM, Zhang T, Sang S. Global burden for dengue and the evolving pattern in the past 30 years. J Travel Med 2021; 28:6368502. [PMID: 34510205 DOI: 10.1093/jtm/taab146] [Citation(s) in RCA: 87] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 09/05/2021] [Accepted: 09/07/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Dengue is the most prevalent and rapidly spreading mosquito-borne viral disease. We present the global, regional and national burden of dengue from 1990 to 2019 based on the findings from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019). METHODS Based upon GBD 2019 dengue data on age-standardized incidence rate (ASIR), age-standardized death rate (ASDR) and age-standardized disability-adjusted life years (DALYs) rate, this study estimates and presents annual percentage change (EAPC) to quantify trends over time to assess potential correlates of increased dengue activity, such as global travel and warming. RESULTS Globally from 1990 to 2019, dengue incident cases, deaths and DALYs gradually increased. Those under 5 years of age, once accounting for the largest portion of deaths and DALYs in 1990, were eclipsed by those who were 15-49 years old in 2019. Age standardized incidence [ASIR: EAPC: 3.16, 95% confidence interval (CI): 2.90-3.43], death (ASDR: EAPC: 5.42, 95% CI: 2.64-8.28) and DALY rates (EAPC: 2.31, 95% CI: 2.00-2.62) accelerated most among high-middle and high sociodemographic index (SDI) regions. South-East Asia and South Asia had most of the dengue incident cases, deaths and DALYs, but East Asia had the fastest rise in ASIR (EAPC: 4.57, 95% CI: 4.31, 4.82), while Tropical Latin America led in ASDR (EAPC: 11.32, 95% CI: 9.11, 13.58) and age-standardized DALYs rate (EAPC: 4.13, 95% CI: 2.98, 5.29). SDI showed consistent bell-shaped relationship with ASIR, ASDR and age-standardized DALYs rate. Global land-ocean temperature index and air passenger travel metrics were found to be remarkably positively correlated with dengue burden. CONCLUSIONS The burden of dengue has become heavier from 1990 to 2019, amidst the three decades of urbanization, warming climates and increased human mobility in much of the world. South-East Asia and South Asia remain as regions of concern, especially in conjunction with the Americas' swift rise in dengue burden.
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Affiliation(s)
- Xiaorong Yang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, Shandong 250012, People's Republic of China.,Clinical Research Center, Shandong University, Jinan, Shandong 250012, People's Republic of China
| | - Mikkel B M Quam
- Section on Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, 90187, Sweden.,Division of Epidemiology, College of Public Health, The Ohio State University, 43210, USA
| | - Tongchao Zhang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, Shandong 250012, People's Republic of China.,Clinical Research Center, Shandong University, Jinan, Shandong 250012, People's Republic of China
| | - Shaowei Sang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, Shandong 250012, People's Republic of China.,Clinical Research Center, Shandong University, Jinan, Shandong 250012, People's Republic of China.,Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, Shandong 250012, People's Republic of China
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10
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Semenza JC, Paz S. Climate change and infectious disease in Europe: Impact, projection and adaptation. THE LANCET REGIONAL HEALTH. EUROPE 2021; 9:100230. [PMID: 34664039 PMCID: PMC8513157 DOI: 10.1016/j.lanepe.2021.100230] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Europeans are not only exposed to direct effects from climate change, but also vulnerable to indirect effects from infectious disease, many of which are climate sensitive, which is of concern because of their epidemic potential. Climatic conditions have facilitated vector-borne disease outbreaks like chikungunya, dengue, and West Nile fever and have contributed to a geographic range expansion of tick vectors that transmit Lyme disease and tick-borne encephalitis. Extreme precipitation events have caused waterborne outbreaks and longer summer seasons have contributed to increases in foodborne diseases. Under the Green Deal, The European Union aims to support climate change health policy, in order to be better prepared for the next health security threat, particularly in the aftermath of the traumatic COVID-19 experience. To bolster this policy process we discuss climate change-related hazards, exposures and vulnerabilities to infectious disease and describe observed impacts, projected risks, with policy entry points for adaptation to reduce these risks or avoid them altogether.
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Affiliation(s)
- Jan C. Semenza
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Shlomit Paz
- Department of Geography and Environmental Studies, University of Haifa, Haifa, Israel
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Early warning systems (EWSs) for chikungunya, dengue, malaria, yellow fever, and Zika outbreaks: What is the evidence? A scoping review. PLoS Negl Trop Dis 2021; 15:e0009686. [PMID: 34529649 PMCID: PMC8445439 DOI: 10.1371/journal.pntd.0009686] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background Early warning systems (EWSs) are of increasing importance in the context of outbreak-prone diseases such as chikungunya, dengue, malaria, yellow fever, and Zika. A scoping review has been undertaken for all 5 diseases to summarize existing evidence of EWS tools in terms of their structural and statistical designs, feasibility of integration and implementation into national surveillance programs, and the users’ perspective of their applications. Methods Data were extracted from Cochrane Database of Systematic Reviews (CDSR), Google Scholar, Latin American and Caribbean Health Sciences Literature (LILACS), PubMed, Web of Science, and WHO Library Database (WHOLIS) databases until August 2019. Included were studies reporting on (a) experiences with existing EWS, including implemented tools; and (b) the development or implementation of EWS in a particular setting. No restrictions were applied regarding year of publication, language or geographical area. Findings Through the first screening, 11,710 documents for dengue, 2,757 for Zika, 2,706 for chikungunya, 24,611 for malaria, and 4,963 for yellow fever were identified. After applying the selection criteria, a total of 37 studies were included in this review. Key findings were the following: (1) a large number of studies showed the quality performance of their prediction models but except for dengue outbreaks, only few presented statistical prediction validity of EWS; (2) while entomological, epidemiological, and social media alarm indicators are potentially useful for outbreak warning, almost all studies focus primarily or exclusively on meteorological indicators, which tends to limit the prediction capacity; (3) no assessment of the integration of the EWS into a routine surveillance system could be found, and only few studies addressed the users’ perspective of the tool; (4) almost all EWS tools require highly skilled users with advanced statistics; and (5) spatial prediction remains a limitation with no tool currently able to map high transmission areas at small spatial level. Conclusions In view of the escalating infectious diseases as global threats, gaps and challenges are significantly present within the EWS applications. While some advanced EWS showed high prediction abilities, the scarcity of tool assessments in terms of integration into existing national surveillance systems as well as of the feasibility of transforming model outputs into local vector control or action plans tends to limit in most cases the support of countries in controlling disease outbreaks.
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Affiliation(s)
- Annelies Wilder-Smith
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
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Wilder-Smith A. COVID-19 in comparison with other emerging viral diseases: risk of geographic spread via travel. TROPICAL DISEASES TRAVEL MEDICINE AND VACCINES 2021; 7:3. [PMID: 33517914 PMCID: PMC7847598 DOI: 10.1186/s40794-020-00129-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 12/26/2020] [Indexed: 12/17/2022]
Abstract
Purpose of review The COVID-19 pandemic poses a major global health threat. The rapid spread was facilitated by air travel although rigorous travel bans and lockdowns were able to slow down the spread. How does COVID-19 compare with other emerging viral diseases of the past two decades? Recent findings Viral outbreaks differ in many ways, such as the individuals most at risk e.g. pregnant women for Zika and the elderly for COVID-19, their vectors of transmission, their fatality rate, and their transmissibility often measured as basic reproduction number. The risk of geographic spread via air travel differs significantly between emerging infectious diseases. Summary COVID-19 is not associated with the highest case fatality rate compared with other emerging viral diseases such as SARS and Ebola, but the combination of a high reproduction number, superspreading events and a globally immunologically naïve population has led to the highest global number of deaths in the past 20 decade compared to any other pandemic.
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Affiliation(s)
- A Wilder-Smith
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK. .,Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany.
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14
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Abstract
PURPOSE OF REVIEW Societal lockdowns in response to the COVID-19 pandemic have led to unprecedented disruption to daily life across the globe. A collateral effect of these lockdowns may be a change to transmission dynamics of a wide range of infectious diseases that are all highly dependent on rates of contact between humans. With timing, duration and intensity of lockdowns varying country-to-country, the wave of lockdowns in 2020 present a unique opportunity to observe how changes in human contact rates, disease control and surveillance affect dengue virus transmission in a global natural experiment. We explore the theoretical basis for the impact of lockdowns on dengue transmission and surveillance then summarise the current evidence base from country reports. RECENT FINDINGS We find considerable variation in the intensity of dengue epidemics reported so far in 2020 with some countries experiencing historic low levels of transmission while others are seeing record outbreaks. Despite many studies warning of the risks of lockdown for dengue transmission, few empirically quantify the impact and issues such as the specific timing of the lockdowns and multi-annual cycles of dengue are not accounted for. In the few studies where such issues have been accounted for, the impact of lockdowns on dengue appears to be limited. SUMMARY Studying the impact of lockdowns on dengue transmission is important both in how we deal with the immediate COVID-19 and dengue crisis, but also over the coming years in the post-pandemic recovery period. It is clear lockdowns have had very different impacts in different settings. Further analyses might ultimately allow this unique natural experiment to provide insights into how to better control dengue that will ultimately lead to better long-term control.
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Affiliation(s)
- Oliver Brady
- Department of Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | - Annelies Wilder-Smith
- Department of Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
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15
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Osman S, Preet R. Dengue, chikungunya and Zika in GeoSentinel surveillance of international travellers: a literature review from 1995 to 2020. J Travel Med 2020; 27:6007546. [PMID: 33258476 DOI: 10.1093/jtm/taaa222] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 11/18/2020] [Accepted: 11/19/2020] [Indexed: 12/19/2022]
Abstract
INTRODUCTION GeoSentinel is a global surveillance network of travel medicine providers seeing ill-returned travellers. Much of our knowledge on health problems and infectious encountered by international travellers has evolved as a result of GeoSentinel surveillance, providing geographic and temporal trends in morbidity among travellers while contributing to improved pre-travel advice. We set out to synthesize epidemiological information, clinical manifestations and time trends for dengue, chikungunya and Zika in travellers as captured by GeoSentinel. METHODS We conducted a systematic literature search in PubMed on international travellers who presented with dengue, chikungunya or Zika virus infections to GeoSentinel sites around the world from 1995 until 2020. RESULTS Of 107 GeoSentinel publications, 42 articles were related to dengue, chikungunya and/or Zika. The final analyses and synthesis of and results presented here are based on the findings from 27 original articles covering the three arboviral diseases. CONCLUSIONS Dengue is the most frequent arboviral disease encountered in travellers presenting to GeoSentinel sites, with increasing trends over the past two decades. In Southeast Asia, annual proportionate morbidity increased from 50 dengue cases per 1000 ill returned travellers in non-epidemic years to an average of 159 cases per 1000 travellers during epidemic years. The highest number of travellers with chikungunya virus infections was reported during the chikungunya outbreak in the Americas and the Caribbean in the years 2013-16. Zika was first reported by GeoSentinel already in 2012, but notifications peaked in the years 2016-17 reflecting the public health emergency in the Americas at the time.
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Affiliation(s)
- S Osman
- Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, Umeå, 90185, Sweden
| | - R Preet
- Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, Umeå, 90185, Sweden
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16
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Liebig J, de Hoog F, Paini D, Jurdak R. Forecasting the probability of local dengue outbreaks in Queensland, Australia. Epidemics 2020; 34:100422. [PMID: 33340847 DOI: 10.1016/j.epidem.2020.100422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 10/25/2020] [Accepted: 11/18/2020] [Indexed: 10/22/2022] Open
Abstract
The global incidence of dengue is increasing, and many previously unaffected areas have reported local cases of the vector-borne disease in recent years. For the effective containment of local outbreaks health authorities rely on the prompt notification of new cases. However, due to severe under-reporting and misdiagnosis, non-endemic countries face difficulties in containing local outbreaks, and the possibility of dengue becoming endemic. Outbreak control measures in non-endemic countries are largely reactive and health authorities would benefit from a universal early warning system that forecasts the probability of dengue outbreaks for given times and locations. We develop a model that establishes a link between pre- and post-border risk of dengue outbreaks. Specifically, we predict the probability of travellers importing dengue from other countries as well as the probability of those travellers causing local outbreaks. Our model can act as an early warning system, forecasting likely times and places of dengue outbreaks. We run our model for the Australian state of Queensland over a period of twelve years. Our results reveal the airports where dengue infected travellers are most likely to arrive and geographic locations associated with high outbreak probabilities. Our results can be used by health authorities to better utilise prevention and control resources and lead to the development of new prevention measures.
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Affiliation(s)
- Jessica Liebig
- Health & Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Brisbane, Queensland, Australia.
| | - Frank de Hoog
- Data61, Commonwealth Scientific and Industrial Research Organisation, Canberra, Australian Capital Territory, Australia
| | - Dean Paini
- Health & Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Canberra, Australian Capital Territory, Australia
| | - Raja Jurdak
- School of Computer Science, Queensland University of Technology, Brisbane, Queensland, Australia; Data61, Commonwealth Scientific and Industrial Research Organisation, Brisbane, Queensland, Australia
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17
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Zé-Zé L, Borges V, Osório HC, Machado J, Gomes JP, Alves MJ. Mitogenome diversity of Aedes (Stegomyia) albopictus: Detection of multiple introduction events in Portugal. PLoS Negl Trop Dis 2020; 14:e0008657. [PMID: 32997656 PMCID: PMC7549828 DOI: 10.1371/journal.pntd.0008657] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 10/12/2020] [Accepted: 07/28/2020] [Indexed: 12/29/2022] Open
Abstract
Aedes albopictus, along with Ae. aegypti, are key arbovirus vectors that have been expanding their geographic range over the last decades. In 2017, Ae. albopictus was detected for the first time at two distinct locations in Portugal. In order to understand how the Ae. albopictus populations recently introduced in Portugal are genetically related and which is their likely route of invasion, we performed an integrative cytochrome C oxidase I gene (COI)- and mitogenome-based phylogeographic analysis of mosquitoes samples collected in Portugal in 2017 and 2018 in the context of the global Ae. albopictus diversity. COI-based analysis (31 partial sequences obtained from 83 mosquitoes) revealed five haplotypes (1 to 5), with haplotype 1 (which is widely distributed in temperate areas worldwide) being detected in both locations. Haplotypes 2 and 3 were exclusively found in Southern region (Algarve), while haplotype 4 and 5 were only detected in the North of Portugal (Penafiel, Oporto region). Subsequent high discriminatory analyses based on Ae. albopictus mitogenome (17 novel sequences) not only confirmed a high degree of genetic variability within and between populations at both geographic locations (compatible with the Ae. albopictus mosquito populations circulating in Europe), but also revealed two mitogenome mutational signatures not previously reported at worldwide level. While our results generally sustain the occurrence of multiple introduction events, fine mitogenome sequence inspection further indicates a possible Ae. albopictus migration within the country, from the Northern introduction locality to the Southern region. In summary, the observed scenario of high Ae. albopictus genetic diversity in Portugal, together with the detection of mosquitoes in successive years since 2017 in Algarve and Penafiel, points that both Ae. albopictus populations seem to be already locally established, as its presence has been reported for three consecutive years, raising the public health awareness for future mosquito-borne diseases outbreaks. In 2017, Aedes albopictus was reported for the first time in Portugal at two distinct locations, in the premises of a tire company in Penafiel, in the North, and nearby a golf course in Algarve, a tourism destination in the southernmost country region. The geographical spread of this species is promoted by egg and larvae transport in aquatic trade goods, as tires and aquatic plants, and adult anthropophilic behavior that favors passive land transportation. In Portugal, especially in the Southern region, temperate climate conditions are adequate for adult mosquitoes to survive most of the year. In a way to understand the genetic variability of Ae. albopictus populations introduced in Portugal, we analyzed 31 cytochrome C oxidase I gene (COI) partial sequences and 17 mitogenome sequences, integrating them in the context of the global Ae. albopictus phylogeographic diversity (i.e., 183 COI and 26 mitogenome sequences previously reported at worldwide level). Although COI haplotype 1 predominated, four additional haplotypes (2 to 5) were detected in Portugal. Subsequent in-depth mitogenome analysis revealed considerable genetic diversity, including not only sequences relating to mitogenomes reported mainly from Italy, Japan and China, but also two novel mitogenome mutational signatures. Our study indicates that Ae. albopictus is locally established in Portugal and intra-country dispersal may have already happened, highlighting the challenges for vector surveillance and control programs aiming at restraining arbovirus disease burden in the future.
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Affiliation(s)
- Líbia Zé-Zé
- Centre for Vectors and Infectious Diseases Research, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge, Águas de Moura, Portugal
- BioISI—Biosystems & Integrative Sciences Institute, Faculty of Sciences, University of Lisbon, Lisbon, Portugal
- * E-mail:
| | - Vítor Borges
- Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - Hugo Costa Osório
- Centre for Vectors and Infectious Diseases Research, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge, Águas de Moura, Portugal
- Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - Jorge Machado
- Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - João Paulo Gomes
- Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - Maria João Alves
- Centre for Vectors and Infectious Diseases Research, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge, Águas de Moura, Portugal
- Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
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Constant A, McColl K, Raude J. The Ecology of Protective Behaviors: A Study in New Risk Areas for Mosquito-Borne Diseases. ECOHEALTH 2020; 17:315-325. [PMID: 33151432 DOI: 10.1007/s10393-020-01500-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 09/05/2020] [Accepted: 09/08/2020] [Indexed: 06/11/2023]
Abstract
During the last decade, tiger mosquitoes have rapidly colonized a large number of European countries, increasing the risk of infection with mosquito-borne diseases (MBDs), and constituting an emerging health threat in the region. The objectives of the present study were to prospectively investigate changes in Self-protective Behaviors, beliefs and attitudes regarding MBDs in Mediterranean France, and to assess the influence of social and cognitive time-varying covariates on behaviors. Data were collected using the same computer-assisted telephone survey in 2012, 2013 and 2014 among respondents residing in French Mediterranean regions. Weighted estimates in multivariate analysis were computed using the generalized estimating equation technique, with Self-protective Behaviors as a repeated outcome. Perceived exposure to tiger mosquitoes and knowledge about MBDs increased significantly between 2012 and 2014. Most respondents suffered from mosquito bites over the same period, but only 4 in 10 adopted Self-protective Behaviors. These behaviors were mostly related to the frequency of mosquito bites, perceived exposure to tiger mosquitoes, and to higher perceived vulnerability to MBDs. In conclusion, French Mediterranean residents are increasingly knowledgeable about MBDs and the proximity of tiger mosquitoes. However, self-protection was predominantly related to the frequency of mosquito bites and higher perceived vulnerability. These results suggest that Self-protective Behaviors are being shaped more in new risk areas by environmental cues to which people are exposed than by other common personal determinants of health behaviors.
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Affiliation(s)
- Aymery Constant
- Ecoles des Hautes Etudes en Santé Publique School of Public Health, Avenue du Prof. Leon Bernard, 35043, Rennes Cedex, France.
| | - Kathy McColl
- Ecoles des Hautes Etudes en Santé Publique School of Public Health, Avenue du Prof. Leon Bernard, 35043, Rennes Cedex, France
| | - Jocelyn Raude
- Ecoles des Hautes Etudes en Santé Publique School of Public Health, Avenue du Prof. Leon Bernard, 35043, Rennes Cedex, France
- Unité des Virus Émergents (UVE: Aix-Marseille Univ - IRD 190 - Inserm 1207 - IHU Méditerranée Infection), Marseille, France
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19
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Vincent M, Larrieu S, Vilain P, Etienne A, Solet JL, François C, Roquebert B, Jaffar Bandjee MC, Filleul L, Menudier L. From the threat to the large outbreak: dengue on Reunion Island, 2015 to 2018. ACTA ACUST UNITED AC 2020; 24. [PMID: 31771702 PMCID: PMC6885751 DOI: 10.2807/1560-7917.es.2019.24.47.1900346] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background With more than 300 million infections estimated annually worldwide, dengue is the most prevalent arboviral infection. On Reunion Island, after a large outbreak in 1977–78, only limited episodes of viral circulation or sporadic cases were reported till 2015. Aim Our objective was to document and report on the circulation of dengue virus after the occurrence of a small outbreak during austral summer 2015/16 and until the large outbreak of 2018. Methods Beside the mandatory notification of biologically confirmed dengue cases, additional systems of surveillance were set up: estimation of dengue-like syndrome in people seeking care by their family doctor, surveillance of emergency department visits related to dengue, surveillance of hospitalised dengue patients and deaths classifications. Results After a moderate outbreak during summer 2015/16 with 231 cases, 2017 was characterised by limited viral circulation (97 cases) which, however, persisted during the austral winter. By February 2018, the number of cases had increased and led to a peak at the beginning of May 2018. More than 6,000 cases were reported this year (dengue virus type 2 only). In addition, six deaths of dengue patients were notified. Conclusion In 2017, the persistence of transmission during winter created favourable conditions for the emergence of an epidemic during summer 2018. After this moderate epidemic wave, the viral circulation persisted during winter 2018 for the second year, opening the door for the second wave in 2019 and for potential endemisation of the disease on Reunion Island in the near future.
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20
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Two complementary model-based methods for calculating the risk of international spreading of a novel virus from the outbreak epicentre. The case of COVID-19. Epidemiol Infect 2020; 148:e109. [PMID: 32513345 PMCID: PMC7298081 DOI: 10.1017/s0950268820001223] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
We present two complementary model-based methods for calculating the risk of international spread of the novel coronavirus SARS-CoV-2 from the outbreak epicentre. One model aims to calculate the number of cases that would be exported from an endemic country to disease-free regions by travellers. The second model calculates the probability that an infected traveller will generate at least one secondary autochthonous case in the visited country. Although this paper focuses on the data from China, our methods can be adapted to calculate the risk of importation and subsequent outbreaks. We found an average R0 = 5.31 (ranging from 4.08 to 7.91) and a risk of spreading of 0.75 latent individuals per 1000 travellers. In addition, one infective traveller would be able to generate at least one secondary autochthonous case in the visited country with a probability of 23%.
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21
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Ravasi D, Parrondo Monton D, Guidi V, Flacio E. Evaluation of the public health risk for autochthonous transmission of mosquito-borne viruses in southern Switzerland. MEDICAL AND VETERINARY ENTOMOLOGY 2020; 34:244-250. [PMID: 31802522 DOI: 10.1111/mve.12421] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 09/23/2019] [Accepted: 11/15/2019] [Indexed: 06/10/2023]
Abstract
Epidemics of mosquito-borne diseases such as chikungunya and dengue fever are becoming more frequent around the world. In Switzerland, autochthonous cases have not been reported so far, although the presence of the vector Aedes albopictus in urban areas of southern Switzerland increases the risk of indigenous transmissions subsequent to imported cases. In 2018, the potential risk of an outbreak of arboviral diseases was assessed in five municipalities of southern Switzerland. The population abundance of Ae. albopictus was evaluated during the mosquito active season by the mean number of Ae. albopictus bites per day per person (estimated using the human landing collection method) and the risk of outbreak in the case of the introduction of chikungunya, dengue or Zika viruses was estimated. In the five localities investigated, no epidemic risk appeared to be present for any of the arboviruses taken into consideration in the initial months (i.e. mid-May to end of July) of Ae. albopictus activity. In the case of the introduction of chikungunya (mutated or not), dengue (serotype 1) or Zika (African lineage) viruses during mid-end August, an epidemic could have occurred in all the municipalities investigated. In mid-end September, the introduction of same arboviruses could have led to an epidemic in three of the five municipalities investigated.
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Affiliation(s)
- D Ravasi
- Laboratory of Applied Microbiology, Department of Environment, Construction and Design, University of Applied Sciences and Arts of Southern Switzerland, Bellinzona, Switzerland
| | - D Parrondo Monton
- Laboratory of Applied Microbiology, Department of Environment, Construction and Design, University of Applied Sciences and Arts of Southern Switzerland, Bellinzona, Switzerland
| | - V Guidi
- Laboratory of Applied Microbiology, Department of Environment, Construction and Design, University of Applied Sciences and Arts of Southern Switzerland, Bellinzona, Switzerland
| | - E Flacio
- Laboratory of Applied Microbiology, Department of Environment, Construction and Design, University of Applied Sciences and Arts of Southern Switzerland, Bellinzona, Switzerland
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22
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Caputo B, Manica M. Mosquito surveillance and disease outbreak risk models to inform mosquito-control operations in Europe. CURRENT OPINION IN INSECT SCIENCE 2020; 39:101-108. [PMID: 32403040 DOI: 10.1016/j.cois.2020.03.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/09/2020] [Accepted: 03/25/2020] [Indexed: 06/11/2023]
Abstract
Surveillance programs are needed to guide mosquito-control operations to reduce both nuisance and the spread of mosquito-borne diseases. Understanding the thresholds for action to reduce both nuisance and the risk of arbovirus transmission is becoming critical. To date, mosquito surveillance is mainly implemented to inform about pathogen transmission risks rather than to reduce mosquito nuisance even though lots of control efforts are aimed at the latter. Passive surveillance, such as digital monitoring (validated by entomological trapping), is a powerful tool to record biting rates in real time. High-quality data are essential to model the risk of arbovirus diseases. For invasive pathogens, efforts are needed to predict the arrival of infected hosts linked to the small-scale vector to host contact ratio, while for endemic pathogens efforts are needed to set up region-wide highly structured surveillance measures to understand seasonal re-activation and pathogen transmission in order to carry out effective control operations.
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Affiliation(s)
- Beniamino Caputo
- Department of Public Health and Infectious Diseases, University of Rome La Sapienza, Piazzale A. Moro 5, 38010, 00185 Rome, Italy.
| | - Mattia Manica
- Department of Biodiversity and Molecular Ecology, Research and Innovation Centre, Fondazione Edmund Mach, Via E. Mach 1, 38010 San Michele all' Adige, Italy
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23
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Pan CY, Liu WL, Su MP, Chang TP, Ho HP, Shu PY, Huang JJ, Lin LJ, Chen CH. Epidemiological analysis of the Kaohsiung city strategy for dengue fever quarantine and epidemic prevention. BMC Infect Dis 2020; 20:347. [PMID: 32414340 PMCID: PMC7226716 DOI: 10.1186/s12879-020-4942-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 03/02/2020] [Indexed: 01/20/2023] Open
Abstract
Background Dengue is endemic in over 100 countries and is an important public health problem worldwide. Dengue fever is not endemic in Taiwan; the importation of dengue viruses from neighboring countries via close commercial links and air travel is considered to be the cause of local outbreaks. Therefore, efforts toward disease control have focused on preventing the importation of dengue into Taiwan. In this study, we investigated the relationships between the numbers of imported and indigenous dengue cases to test the validity of this strategy. Methods Data on cases of dengue fever that occurred between 2013 and 2018 were obtained from the surveillance systems of the Taiwan Center for Disease Control and Kaohsiung City Health Department. Standard epidemiological data, including the monthly numbers of indigenous and imported cases of dengue, were calculated. Potential associations between the numbers of indigenous and imported cases were investigated using correlation analyses. Results We identified a possible relationship between the period of disease concealment and the number of imported dengue cases, which resulted in epidemics of indigenous dengue fever within local communities. Further analysis of confirmed cases during previous epidemics in Kaohsiung City found that the risk of indigenous dengue fever may be related to the likelihood that patients with imported dengue fever will stay within local communities. Conclusion Given the correlations found between imported and indigenous cases of dengue fever, as well as the relationship between the disease concealment period and the risk of indigenous dengue fever, prevention of disease importation and efficient identification of dengue cases within high-risk communities remain the major priorities for disease control.
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Affiliation(s)
- Chao-Ying Pan
- Department of Health, Kaohsiung City Government, Kaohsiung City, Taiwan
| | - Wei-Liang Liu
- National Mosquito-Borne Diseases Control Research Center, National Health Research Institutes, Zhunan, Taiwan
| | - Matthew-P Su
- Department of Biological Science, Nagoya University, Nagoya, 464-8602, Japan
| | - Te-Pin Chang
- National Mosquito-Borne Diseases Control Research Center, National Health Research Institutes, Zhunan, Taiwan
| | - Hui-Pin Ho
- Department of Health, Kaohsiung City Government, Kaohsiung City, Taiwan
| | - Pei-Yun Shu
- Center for Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan, Republic of China
| | - Joh-Jong Huang
- Bureau of Social Affairs, Tainan City Government, Tainan City, Taiwan
| | - Li-Jen Lin
- Department of Health, Kaohsiung City Government, Kaohsiung City, Taiwan.
| | - Chun-Hong Chen
- National Mosquito-Borne Diseases Control Research Center, National Health Research Institutes, Zhunan, Taiwan. .,National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan.
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24
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Tozan Y, Headley TY, Sewe MO, Schwartz E, Shemesh T, Cramer JP, Eberhardt KA, Ramharter M, Harrison N, Leder K, Angheben A, Hatz C, Neumayr A, Chen LH, De Pijper CA, Grobusch MP, Wilder-Smith A. A Prospective Study on the Impact and Out-of-Pocket Costs of Dengue Illness in International Travelers. Am J Trop Med Hyg 2020; 100:1525-1533. [PMID: 30994088 DOI: 10.4269/ajtmh.18-0780] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Although the costs of dengue illness to patients and households have been extensively studied in endemic populations, international travelers have not been the focus of costing studies. As globalization and human travel activities intensify, travelers are increasingly at risk for emerging and reemerging infectious diseases, such as dengue. This exploratory study aims to investigate the impact and out-of-pocket costs of dengue illness among travelers. We conducted a prospective study in adult travelers with laboratory-confirmed dengue and recruited patients at travel medicine clinics in eight different countries from December 2013 to December 2015. Using a structured questionnaire, we collected information on patients and their health-care utilization and out-of-pocket expenditures, as well as income and other financial losses they incurred because of dengue illness. A total of 90 patients participated in the study, most of whom traveled for tourism (74%) and visited countries in Asia (82%). Although 22% reported hospitalization and 32% receiving ambulatory care while traveling, these percentages were higher at 39% and 71%, respectively, after returning home. The out-of-pocket direct and indirect costs of dengue illness were US$421 (SD 744) and US$571 (SD 1,913) per episode, respectively, averaging to a total out-of-pocket cost of US$992 (SD 2,052) per episode. The study findings suggest that international travelers incur important direct and indirect costs because of dengue-related illness. This study is the first to date to investigate the impact and out-of-pocket costs of travel-related dengue illness from the patient's perspective and paves the way for future economic burden studies in this population.
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Affiliation(s)
- Yesim Tozan
- New York University College of Global Public Health, New York, New York.,New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Tyler Y Headley
- New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Maquines Odhiambo Sewe
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health Unit, Umeå University, Umeå, Sweden
| | - Eli Schwartz
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Tamar Shemesh
- Sheba Medical Center, Institute of Tropical and Travel Medicine, Ramat-Gan, Israel
| | - Jakob P Cramer
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine and I Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kirsten A Eberhardt
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine and I Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Ramharter
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine and I Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nicole Harrison
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Karin Leder
- School of Public Health and Preventive Medicine, Monash University and Victorian Infectious Disease Service, Royal Melbourne Hospital, Melbourne, Australia
| | - Andrea Angheben
- Centre for Tropical Diseases, IRCCS Hospital Sacro Cuore-Don Calabria, Verona, Italy
| | - Christoph Hatz
- University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Andreas Neumayr
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Lin Hwei Chen
- Mount Auburn Hospital, Cambridge, and Harvard Medical School, Boston, Massachusetts
| | - Cornelis A De Pijper
- Division of Internal Medicine, Department of Infectious Diseases, Center for Tropical Medicine and Travel Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Martin P Grobusch
- Division of Internal Medicine, Department of Infectious Diseases, Center for Tropical Medicine and Travel Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Annelies Wilder-Smith
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom.,Heidelberg Global Health Institute, University of Heidelberg, Heidelberg, Germany.,Department of Public Health and Clinical Medicine, Epidemiology and Global Health Unit, Umeå University, Umeå, Sweden
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Liebig J, Jansen C, Paini D, Gardner L, Jurdak R. A global model for predicting the arrival of imported dengue infections. PLoS One 2019; 14:e0225193. [PMID: 31800583 PMCID: PMC6892502 DOI: 10.1371/journal.pone.0225193] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 10/30/2019] [Indexed: 11/18/2022] Open
Abstract
With approximately half of the world's population at risk of contracting dengue, this mosquito-borne disease is of global concern. International travellers significantly contribute to dengue's rapid and large-scale spread by importing the disease from endemic into non-endemic countries. To prevent future outbreaks and dengue from establishing in non-endemic countries, knowledge about the arrival time and location of infected travellers is crucial. We propose a network model that predicts the monthly number of dengue-infected air passengers arriving at any given airport. We consider international air travel volumes to construct weighted networks, representing passenger flows between airports. We further calculate the probability of passengers, who travel through the international air transport network, being infected with dengue. The probability of being infected depends on the destination, duration and timing of travel. Our findings shed light onto dengue importation routes and reveal country-specific reporting rates that have been until now largely unknown. This paper provides important new knowledge about the spreading dynamics of dengue that is highly beneficial for public health authorities to strategically allocate the often limited resources to more efficiently prevent the spread of dengue.
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Affiliation(s)
- Jessica Liebig
- Data61, Commonwealth Scientific and Industrial Research Organisation, Brisbane, Queensland, Australia
- * E-mail:
| | - Cassie Jansen
- Communicable Diseases Branch, Department of Health, Brisbane, Queensland, Australia
| | - Dean Paini
- Health & Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Canberra, Australian Capital Territory, Australia
| | - Lauren Gardner
- Data61, Commonwealth Scientific and Industrial Research Organisation, Brisbane, Queensland, Australia
- Department of Civil Engineering, Johns Hopkins University, Baltimore, Maryland, United States of America
- School of Civil and Environmental Engineering, University of New South Wales, Sydney, New South Wales, Australia
| | - Raja Jurdak
- Data61, Commonwealth Scientific and Industrial Research Organisation, Brisbane, Queensland, Australia
- School of Electrical Engineering and Computer Science, Queensland University of Technology, Brisbane, Queensland, Australia
- School of Computer Science and Engineering, University of New South Wales, Sydney, New South Wales, Australia
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Halstead S, Wilder-Smith A. Severe dengue in travellers: pathogenesis, risk and clinical management. J Travel Med 2019; 26:5551100. [PMID: 31423536 DOI: 10.1093/jtm/taz062] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 08/13/2019] [Accepted: 08/14/2019] [Indexed: 12/14/2022]
Abstract
RATIONALE FOR REVIEW Dengue is a frequent cause of febrile illness among travellers and has overtaken malaria as the leading cause of febrile illness for those traveling to Southeast Asia. The purpose is to review the risk of dengue and severe dengue in travellers with a particular focus on the pathogenesis and clinical management of severe dengue. RISK, PATHOGENESIS AND CLINICAL MANAGEMENT The risk of travel-acquired dengue depends on destination, season and duration of travel and activities during travel. Seroconversion rates reported in travellers, therefore, vary between <1% and >20%. The most common life-threatening clinical response to dengue infection is the dengue vascular permeability syndrome, epidemiologically linked to secondary infection, but can also occur in primary infection. Tertiary and quaternary infections are usually associated with mild or no disease. Antibody-dependent enhancement, viral factors, age, host factors and clinical experience of the managing physician modulate the risk of progressing to severe dengue. The relative risk of severe dengue in secondary versus primary infection ranges from 2 to 7. The absolute risk of severe dengue in children in highly endemic areas is ~0.1% per year for primary infections and 0.4% for secondary infections. About 2-4% of secondary infections lead to severe dengue. Severe dengue and death are both relatively rare in general travellers but more frequently in those visiting friends and relatives. Clinical management of severe dengue depends on judicious use of fluid rehydration. CONCLUSIONS Although dengue is a frequent cause of travel illness, severe dengue and deaths are rare. Nevertheless, dengue infections can interrupt travel and lead to evacuation and major out-of-pocket costs. Dengue is more frequent than many other travel-related vaccine preventable diseases, such as hepatitis A, hepatitis B, rabies, Japanese encephalitis and yellow fever, indicating a need for a dengue vaccine for travellers.
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Affiliation(s)
- Scott Halstead
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Annelies Wilder-Smith
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK.,Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
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27
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Le Tyrant M, Bley D, Leport C, Alfandari S, Guégan JF. Low to medium-low risk perception for dengue, chikungunya and Zika outbreaks by infectious diseases physicians in France, Western Europe. BMC Public Health 2019; 19:1014. [PMID: 31366341 PMCID: PMC6889449 DOI: 10.1186/s12889-019-7317-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 07/15/2019] [Indexed: 11/17/2022] Open
Abstract
Background Many tropical countries are currently experiencing dengue (DEN), chikungunya (CHIK) and also more recently Zika (ZIKA) epidemics (particularly in Latin America). Although the risk of transmission and spread of these infections in temperate regions remains a controversial issue, vector-borne diseases have been widely reported in the media and have been the focus of preventive strategies by national and international policy-makers and public health authorities. In this context, we wanted to determine the extent of risk perception in infectious diseases (ID) physicians of the current and future risk of arboviral disease introduction, autochthonous case development and epidemic scenarios in France, Western Europe. Methods To this aim, we developed an original standardized questionnaire survey which was disseminated by the French Infectious Diseases Society to ID physician members. Results We found that ID physicians perceived the risk of introduction and outbreak development of DEN, CHIK and ZIKA in France to be low to medium-low. Generalized Linear Model(s) identified medical school training, the extent of professional experience, and awareness of the French national plan regarding arboviral infections as significant predictors for lower risk perception among respondents. Conclusion Despite the fact that arboviral diseases are increasingly being imported into France, sometimes resulting in sporadic autochtonous transmission, French ID physicians do not perceive the risk as high. Better communication and education targeting health professionals and citizens will be needed to enhance the effectiveness of the French national plan to prepare against arboviral diseases. Electronic supplementary material The online version of this article (10.1186/s12889-019-7317-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marion Le Tyrant
- UMR ESPACE 7300, CNRS, Aix Marseille University, Avignon Université, Université Nice Sophia-Antipolis, F-13545, Aix-en-Provence, France.,UMR MIVEGEC, IRD, CNRS, University of Montpellier, Centre IRD de Montpellier, F-34394, Montpellier, Cedex 5, France
| | - Daniel Bley
- UMR ESPACE 7300, CNRS, Aix Marseille University, Avignon Université, Université Nice Sophia-Antipolis, F-13545, Aix-en-Provence, France
| | - Catherine Leport
- Université Paris-Diderot, Inserm 1137, UMR 1137, 16, rue Henri-Huchard, 75870, Paris, Cedex 18, France.,Mission COREB Nationale, Assistance publique - Hôpitaux de Paris, 75004, Paris, France
| | - Serge Alfandari
- Service de réanimation et maladies infectieuses, Centre hospitalier de Tourcoing, Tourcoing, France
| | - Jean-François Guégan
- UMR MIVEGEC, IRD, CNRS, University of Montpellier, Centre IRD de Montpellier, F-34394, Montpellier, Cedex 5, France. .,UMR ASTRE, INRA, Cirad, University of Montpellier, Campus international de Baillarguet, Montferrier-sur-Lez, F-34980, Montpellier, France. .,International U.N. programme FutureEarth, OneHealth global research programme, Montréal, Canada.
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28
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Lillepold K, Rocklöv J, Liu-Helmersson J, Sewe M, Semenza JC. More arboviral disease outbreaks in continental Europe due to the warming climate? J Travel Med 2019; 26:5372542. [PMID: 30850834 DOI: 10.1093/jtm/taz017] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 03/07/2019] [Indexed: 11/13/2022]
Affiliation(s)
- Kate Lillepold
- European Centre for Disease Prevention and Control, Stockholm Sweden
| | - Joacim Rocklöv
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Jing Liu-Helmersson
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.,Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Maquins Sewe
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Jan C Semenza
- European Centre for Disease Prevention and Control, Stockholm Sweden
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29
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Nasserie T, Brent SE, Tuite AR, Moineddin R, Yong JHE, Miniota J, Bogoch II, Watts AG, Khan K. Association between air travel and importation of chikungunya into the USA. J Travel Med 2019; 26:5476406. [PMID: 31011752 DOI: 10.1093/jtm/taz028] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 04/12/2019] [Accepted: 04/12/2019] [Indexed: 11/13/2022]
Abstract
Background: During infectious disease outbreaks with pandemic potential, the number of air passengers travelling from the outbreak source to international destinations has been used as a proxy for disease importation risk to new locations. However, evaluations of the validity of this approach are limited. We sought to quantify the association between international air travel and disease importation using the 2014-2016 chikungunya outbreak in the Americas as a case study. Methods: We used country-level chikungunya case data to define a time period of epidemic activity for each of the 45 countries and territories in the Americas reporting outbreaks between 2014 and 2016. For each country, we identified airports within or proximate to areas considered suitable for chikungunya transmission and summed the number of commercial air passengers departing from these airports during the epidemic period to each US state. We used negative binomial models to quantify the association between the number of incoming air passengers from countries experiencing chikungunya epidemics and the annual rate of chikungunya importation into the USA at the state level. Results: We found a statistically significant positive association between passenger flows via airline travel from countries experiencing chikungunya epidemics and the number of imported cases in the USA at the state level (P < 0.0001). Additionally, we found that as the number of arriving airline passengers increased by 10%, the estimated number of imported cases increased by 5.2% (95% CI: 3.0-7.6). Conclusion: This validation study demonstrated that air travel was strongly associated with observed importation of chikungunya cases in the USA and can be a useful proxy for identifying areas at increased risk for disease importation. This approach may be useful for understanding exportation risk of other arboviruses.
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Affiliation(s)
- Tahmina Nasserie
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,BlueDot, Toronto, Canada.,Department of Health Research & Policy, Stanford University School of Medicine, Stanford, California USA
| | - Shannon E Brent
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,BlueDot, Toronto, Canada.,Michael G DeGroote School of Medicine, McMaster University, Hamilton, Canada
| | - Ashleigh R Tuite
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,BlueDot, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Rahim Moineddin
- BlueDot, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Department of Family & Community Medicine, University of Toronto, Toronto, Canada
| | - Jean H E Yong
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,BlueDot, Toronto, Canada
| | - Jennifer Miniota
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,BlueDot, Toronto, Canada
| | - Isaac I Bogoch
- Department of Medicine, Division of Infectious Diseases, University of Toronto, Toronto, Canada
| | - Alexander G Watts
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,BlueDot, Toronto, Canada
| | - Kamran Khan
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,BlueDot, Toronto, Canada.,Department of Medicine, Division of Infectious Diseases, University of Toronto, Toronto, Canada
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Abstract
We present a model to optimise a vaccination campaign aiming to prevent or to curb a Zika virus outbreak. We show that the optimum vaccination strategy to reduce the number of cases by a mass vaccination campaign should start when the Aedes mosquitoes' density reaches the threshold of 1.5 mosquitoes per humans, the moment the reproduction number crosses one. The maximum time it is advisable to wait for the introduction of a vaccination campaign is when the first ZIKV case is identified, although this would not be as effective to minimise the number of infections as when the mosquitoes' density crosses the critical threshold. This suboptimum strategy, however, would still curb the outbreak. In both cases, the catch up strategy should aim to vaccinate at least 25% of the target population during a concentrated effort of 1 month immediately after identifying the threshold. This is the time taken to accumulate the herd immunity threshold of 56.5%. These calculations were done based on theoretical assumptions that vaccine implementation would be feasible within a very short time frame.
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Abstract
Mortality from severe dengue is low, but the economic and resource burden on health services remains substantial in endemic settings. Unfortunately, progress towards development of effective therapeutics has been slow, despite notable advances in the understanding of disease pathogenesis and considerable investment in antiviral drug discovery. For decades antibody-dependent enhancement has been the prevalent model to explain dengue pathogenesis, but it was only recently demonstrated in vivo and in clinical studies. At present, the current mainstay of management for most symptomatic dengue patients remains careful observation and prompt but judicious use of intravenous hydration therapy for those with substantial vascular leakage. Various new promising technologies for diagnosis of dengue are currently in the pipeline. New sample-in, answer-out nucleic acid amplification technologies for point-of-care use are being developed to improve performance over current technologies, with the potential to test for multiple pathogens using a single specimen. The search for biomarkers that reliably predict development of severe dengue among symptomatic individuals is also a major focus of current research efforts. The first dengue vaccine was licensed in 2015 but its performance depends on serostatus. There is an urgent need to identify correlates of both vaccine protection and disease enhancement. A crucial assessment of vector control tools should guide a research agenda for determining the most effective interventions, and how to best combine state-of-the-art vector control with vaccination.
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Affiliation(s)
- Annelies Wilder-Smith
- London School of Hygiene & Tropical Medicine, London, UK; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany.
| | - Eng-Eong Ooi
- Duke-National University of Singapore Medical School, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Olaf Horstick
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Bridget Wills
- Oxford University Clinical Research Unit, Wellcome Trust Asia Programme, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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Expected Changes of Montenegrin Climate, Impact on the Establishment and Spread of the Asian Tiger Mosquito (Aedes albopictus), and Validation of the Model and Model-Based Field Sampling. ATMOSPHERE 2018. [DOI: 10.3390/atmos9110453] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Aedes albopictus has become established in many parts of Europe since its introduction at the end of the 20th century. It can vector a range of arboviruses, of which Chikungunya and Dengue are most significant for Europe. An analysis of the expected climate change and the related shift in Köppen zones for Montenegro and impact on the establishment of Ae. albopictus was conducted. Outputs of a mechanistic Aedes albopictus model were validated by 2245 presence/absence records collected from 237 different sites between 2001 and 2014. Finally, model-based sampling was designed and performed at 48 sites in 2015, in a previously unexplored northern part of Montenegro, and results were validated. The Eta Belgrade University (EBU)-Princeton Ocean Model (POM) regional climate model was used with the A2 emissions scenario for the 2001–2030 and 2071–2100 integration periods. The results point to a significant increase in suitability for the mosquito and a vertical shift to higher altitudes by the end of the century. The model showed excellent results with the area under the receiver operating characteristic curve (AUC) of 0.94. This study provides a tool for prioritizing surveillance efforts (model-based surveillance), especially when resources are limited. This is the first published analysis of Climate Change that incorporates observations from the national synoptic grid and the subsequent impact on Ae. albopictus in Montenegro.
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Lai S, Johansson MA, Yin W, Wardrop NA, van Panhuis WG, Wesolowski A, Kraemer MUG, Bogoch II, Kain D, Findlater A, Choisy M, Huang Z, Mu D, Li Y, He Y, Chen Q, Yang J, Khan K, Tatem AJ, Yu H. Seasonal and interannual risks of dengue introduction from South-East Asia into China, 2005-2015. PLoS Negl Trop Dis 2018; 12:e0006743. [PMID: 30412575 PMCID: PMC6248995 DOI: 10.1371/journal.pntd.0006743] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 11/21/2018] [Accepted: 10/21/2018] [Indexed: 12/19/2022] Open
Abstract
Due to worldwide increased human mobility, air-transportation data and mathematical models have been widely used to measure risks of global dispersal of pathogens. However, the seasonal and interannual risks of pathogens importation and onward transmission from endemic countries have rarely been quantified and validated. We constructed a modelling framework, integrating air travel, epidemiological, demographical, entomological and meteorological data, to measure the seasonal probability of dengue introduction from endemic countries. This framework has been applied retrospectively to elucidate spatiotemporal patterns and increasing seasonal risk of dengue importation from South-East Asia into China via air travel in multiple populations, Chinese travelers and local residents, over a decade of 2005-15. We found that the volume of airline travelers from South-East Asia into China has quadrupled from 2005 to 2015 with Chinese travelers increased rapidly. Following the growth of air traffic, the probability of dengue importation from South-East Asia into China has increased dramatically from 2005 to 2015. This study also revealed seasonal asymmetries of transmission routes: Sri Lanka and Maldives have emerged as origins; neglected cities at central and coastal China have been increasingly vulnerable to dengue importation and onward transmission. Compared to the monthly occurrence of dengue reported in China, our model performed robustly for importation and onward transmission risk estimates. The approach and evidence could facilitate to understand and mitigate the changing seasonal threat of arbovirus from endemic regions.
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Affiliation(s)
- Shengjie Lai
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
- WorldPop, Department of Geography and Environment, University of Southampton, Southampton, United Kingdom
- Division of Infectious Disease, Key Laboratory of Surveillance and Early–warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Changping District, Beijing, China
- Flowminder Foundation, Stockholm, Sweden
| | - Michael A. Johansson
- Dengue Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
- Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Wenwu Yin
- Division of Infectious Disease, Key Laboratory of Surveillance and Early–warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Changping District, Beijing, China
| | - Nicola A. Wardrop
- WorldPop, Department of Geography and Environment, University of Southampton, Southampton, United Kingdom
- Department for International Development, London, United Kingdom
| | - Willem G. van Panhuis
- Epidemiology and Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Amy Wesolowski
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Moritz U. G. Kraemer
- Harvard Medical School, Harvard University, Boston, MA, United States of America
- Computational Epidemiology Lab, Boston Children’s Hospital, Boston, MA, United States of America
- Department of Zoology, University of Oxford, New Radcliffe House, Radcliffe Observatory Quarter, Oxford, United Kingdom
| | - Isaac I. Bogoch
- Department of Medicine, Division of Infectious Diseases, University of Toronto, Toronto, ON, Canada
- Divisions of General Internal Medicine and Infectious Diseases, University Health Network, Toronto, ON, Canada
| | - Dylain Kain
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Aidan Findlater
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Marc Choisy
- MIVEGEC, IRD, CNRS, University of Montpellier, Montpellier, France
- Oxford University Clinical Research Unit, National Hospital for Tropical Diseases, Hanoi, Vietnam
| | - Zhuojie Huang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Di Mu
- Division of Infectious Disease, Key Laboratory of Surveillance and Early–warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Changping District, Beijing, China
| | - Yu Li
- Division of Infectious Disease, Key Laboratory of Surveillance and Early–warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Changping District, Beijing, China
| | - Yangni He
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Qiulan Chen
- Division of Infectious Disease, Key Laboratory of Surveillance and Early–warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Changping District, Beijing, China
| | - Juan Yang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Kamran Khan
- Department of Medicine, Division of Infectious Diseases, University of Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, Ontario, Canada
| | - Andrew J. Tatem
- WorldPop, Department of Geography and Environment, University of Southampton, Southampton, United Kingdom
- Flowminder Foundation, Stockholm, Sweden
| | - Hongjie Yu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
- Division of Infectious Disease, Key Laboratory of Surveillance and Early–warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Changping District, Beijing, China
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Wilder-Smith A. Risk of Dengue in Travelers: Implications for Dengue Vaccination. Curr Infect Dis Rep 2018; 20:50. [DOI: 10.1007/s11908-018-0656-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Tuite AR, Thomas-Bachli A, Acosta H, Bhatia D, Huber C, Petrasek K, Watts A, Yong JHE, Bogoch II, Khan K. Infectious disease implications of large-scale migration of Venezuelan nationals. J Travel Med 2018; 25:5091517. [PMID: 30192972 PMCID: PMC6142906 DOI: 10.1093/jtm/tay077] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 08/21/2018] [Accepted: 09/04/2018] [Indexed: 01/20/2023]
Abstract
Background The ongoing economic and political crisis in Venezuela has resulted in a collapse of the healthcare system and the re-emergence of previously controlled or eliminated infectious diseases. There has also been an exodus of Venezuelan international migrants in response to the crisis. We sought to describe the infectious disease risks faced by Venezuelan nationals and assess the international mobility patterns of the migrant population. Methods We synthesized data on recent infectious disease events in Venezuela and among international migrants from Venezuela, as well as on current country of residence among the migrant population. We used passenger-level itinerary data from the International Air Transport Association to evaluate trends in outbound air travel from Venezuela over time. We used two parameter-free mobility models, the radiation and impedance models, to estimate the expected population flows from Venezuelan cities to other major Latin American and Caribbean cities. Results Outbreaks of measles, diphtheria and malaria have been reported across Venezuela and other diseases, such as HIV and tuberculosis, are resurgent. Changes in migration in response to the crisis are apparent, with an increase in Venezuelan nationals living abroad, despite an overall decline in the number of outbound air passengers. The two models predicted different mobility patterns, but both highlighted the importance of Colombian cities as destinations for migrants and also showed that some migrants are expected to travel large distances. Despite the large distances that migrants may travel internationally, outbreaks associated with Venezuelan migrants have occurred primarily in countries proximate to Venezuela. Conclusions Understanding where international migrants are relocating is critical, given the association between human mobility and the spread of infectious diseases. In data-limited situations, simple models can be useful for providing insights into population mobility and may help identify areas likely to receive a large number of migrants.
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Affiliation(s)
- Ashleigh R Tuite
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
- BlueDot, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Andrea Thomas-Bachli
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
- BlueDot, Toronto, Canada
| | - Hernan Acosta
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
- BlueDot, Toronto, Canada
| | - Deepit Bhatia
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
- BlueDot, Toronto, Canada
| | - Carmen Huber
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
- BlueDot, Toronto, Canada
| | - Kieran Petrasek
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
- BlueDot, Toronto, Canada
| | - Alexander Watts
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
- BlueDot, Toronto, Canada
| | - Jean H E Yong
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
- BlueDot, Toronto, Canada
| | - Isaac I Bogoch
- Department of Medicine, Division of Infectious Diseases, University of Toronto, Toronto, Canada
- Divisions of General Internal Medicine and Infectious Diseases, University Health Network, Toronto, Canada
| | - Kamran Khan
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
- BlueDot, Toronto, Canada
- Department of Medicine, Division of Infectious Diseases, University of Toronto, Toronto, Canada
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Wilder-Smith A, Tissera H, AbuBakar S, Kittayapong P, Logan J, Neumayr A, Rocklöv J, Byass P, Louis VR, Tozan Y, Massad E, Preet R. Novel tools for the surveillance and control of dengue: findings by the DengueTools research consortium. Glob Health Action 2018; 11:1549930. [PMID: 30560735 PMCID: PMC6282436 DOI: 10.1080/16549716.2018.1549930] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 11/10/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Dengue fever persists as a major global disease burden, and may increase as a consequence of climate change. Along with other measures, research actions to improve diagnosis, surveillance, prevention, and predictive models are highly relevant. The European Commission funded the DengueTools consortium to lead a major initiative in these areas, and this review synthesises the outputs and findings of this work conducted from 2011 to 2016. Research areas: DengueTools organised its work into three research areas, namely [1] Early warning and surveillance systems; [2] Strategies to prevent dengue in children; and [3] Predictive models for the global spread of dengue. Research area 1 focused on case-studies undertaken in Sri Lanka, including developing laboratory-based sentinel surveillance, evaluating economic impact, identifying drivers of transmission intensity, evaluating outbreak prediction capacity and developing diagnostic capacity. Research area 2 addressed preventing dengue transmission in school children, with case-studies undertaken in Thailand. Insecticide-treated school uniforms represented an intriguing potential approach, with some encouraging results, but which were overshadowed by a lack of persistence of insecticide on the uniforms with repeated washing. Research area 3 evaluated potential global spread of dengue, particularly into dengue-naïve areas such as Europe. The role of international travel, changing boundaries of vectors, developing models of vectorial capacity under different climate change scenarios and strategies for vector control in outbreaks was all evaluated. CONCLUDING REMARKS DengueTools was able to make significant advances in methods for understanding and controlling dengue transmission in a range of settings. These will have implications for public health agendas to counteract dengue, including vaccination programmes. OUTLOOK Towards the end of the DengueTools project, Zika virus emerged as an unexpected epidemic in the central and southern America. Given the similarities between the dengue and Zika viruses, with vectors in common, some of the DengueTools thinking translated readily into the Zika situation.
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Affiliation(s)
- Annelies Wilder-Smith
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Hasitha Tissera
- Epidemiological Unit, Ministry of Health, Colombo, Sri Lanka
| | - Sazaly AbuBakar
- WHO Collaborating Centre for Arbovirus Reference and Research (Dengue/Severe Dengue), Tropical Infectious Diseases Research and Education Centre (TIDREC) University of Malaya, Kuala Lumpur, Malaysia
| | - Pattamaporn Kittayapong
- Center of Excellence for Vectors and Vector-Borne Diseases, Department of Biology, Faculty of Science, Mahidol University, Salaya, Nakhon Pathom, Bangkok, Thailand
| | - James Logan
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - Andreas Neumayr
- Department of Medical Services, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Joacim Rocklöv
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Peter Byass
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Valérie R. Louis
- Heidelberg Institute of Global Health, Heidelberg University Medical School, Heidelberg, Germany
| | - Yesim Tozan
- Heidelberg Institute of Global Health, Heidelberg University Medical School, Heidelberg, Germany
- NYU College of Global Public Health, New York, NY, USA
| | - Eduardo Massad
- School of Applied Mathematics, Fundacao Getulio Vargas, Rio de Janeiro, Brazil
| | - Raman Preet
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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