Abstract
Mosquito-borne viruses threaten the Caribbean due to the region’s tropical climate and seasonal reception of international tourists. Outbreaks of chikungunya and Zika have demonstrated the rapidity with which these viruses can spread. Concurrently, dengue fever cases have climbed over the past decade. Sustainable disease control measures are urgently needed to quell virus transmission and prevent future outbreaks. Here, to improve upon current control methods, we analyze temporal and spatial patterns of chikungunya, Zika, and dengue outbreaks reported in the Dominican Republic between 2012 and 2018. The viruses that cause these outbreaks are transmitted by Aedes mosquitoes, which are sensitive to seasonal climatological variability. We evaluate whether climate and the spatio-temporal dynamics of dengue outbreaks could explain patterns of emerging disease outbreaks. We find that emerging disease outbreaks were robust to the climatological and spatio-temporal constraints defining seasonal dengue outbreak dynamics, indicating that constant surveillance is required to prevent future health crises.
Highlights
Mosquito-borne viruses threaten the Caribbean due to the region’s tropical climate and seasonal reception of international tourists
Between 2012 and 2018, the Dominican Republic, a country that shares the Caribbean island La Hispaniola with Haiti (Fig. 1a), experienced five disease outbreaks caused by mosquito-borne viruses (Fig. 1b, c)
When we compared the temporal dynamics of transmission potential to reported disease incidence by visual inspection, we found that the number of emerging disease cases reported weekly peaked before transmission potential had reached a seasonal maximum for both outbreaks, whereas the number of dengue cases reported weekly peaked after this point for two of the three dengue outbreaks (Fig. 2a)
Summary
Mosquito-borne viruses threaten the Caribbean due to the region’s tropical climate and seasonal reception of international tourists. New approaches centered around sustainable, long-term surveillance are needed to curtail the potential for future public health crises in the Caribbean One such approach is the use of climate data to evaluate the risk of viral spread. We considered whether, whereas climate may be a useful indicator for future endemic virus outbreaks, other factors including population size, demographics, and the timing of introduction should be considered when developing strategies to prevent future emerging disease outbreaks To answer these questions in the context of the Caribbean, we analyzed dengue, chikungunya, and Zika cases reported daily in the Dominican Republic between 2012 and 2018. We propose the use of two indicators, the incidence of febrile illness cases and dengue case fatality rates (CFRs), to monitor surveillance performance and identify potential emerging threats
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