Abstract
Background: Guangdong is a hyper-epidemic area of dengue, with accumulated over 0.72 million cases within the last four decades, accounting for more than 90% of cases in China. Methods: The epidemiology, seroprevalence, molecular evolution of dengue virus and the development of policies and strategies on prevention and control of dengue were analyzed in Guangdong, China from 1978 to 2017. Findings: The seasonal endemic of dengue in Guangdong, China was mainly sustained from July to October of each year. Young and middle-aged people over 18 years old were the most affected populations. Serological test of healthy donors’ serum samples showed a positive rate of 5.77%. All serotypes of DENV (1-4) were detected in Guangdong. DENV1 was the dominant serotype of dengue outbreaks, while with an increasing tendency of DENV 2 since 2010. Local outbreaks of DENV 3 were rare. DENV 4 was only encountered in imported cases. The imported cases were the main source of outbreaks of DENV 1-2. Early detection, management of dengue cases and precise vector control were the key strategies for local dengue prevention and control in Guangdong, China. Interpretation: Localization of dengue is still not established in Guangdong. Early detection, case management and implement of precise control strategies are key findings for preventing local dengue transmission, which may serve for countries still struggling to combat imported dengue in west pacific areas. Funding Information: The National Key Research and Development Program of China (2020YFC1200104) and The Guangzhou Science and Technology Program (201904010012). Declaration of Interests: The authors declare no conflicts of interest. Ethics Approval Statement: The serum sampling protocol from dengue cases and healthy donors was approved by the Ethics Committee of the Guangdong CDC. All associated procedures were performed according to the humanization regulations. Patients' information was collected from local hospitals. All subjects provided written informed consent.
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