Dengue Fever and Severe Dengue in Barbados, 2008-2016.

Kirk Osmond Douglas,Fatih Anfasa,Sudip Kumar Dutta,Marquita Gittens-St Hilaire,Byron Martina,Fatih Anfasa,T Alafia Samuels

doi:10.3390/tropicalmed5020068

Abstract

Analysis of the temporal, seasonal and demographic distribution of dengue virus (DENV) infections in Barbados was conducted using national surveillance data from a total of 3994 confirmed dengue cases. Diagnosis was confirmed either by DENV–specific real time reverse transcriptase polymerase chain reaction (rRT–PCR), or non–structural protein 1 (NS1) antigen or enzyme linked immunosorbent assay (ELISA) tests; a case fatality rate of 0.4% (10/3994) was observed. The dengue fever (DF) prevalence varied from 27.5 to 453.9 cases per 100,000 population among febrile patients who sought medical attention annually. DF cases occurred throughout the year with low level of transmission observed during the dry season (December to June), then increased transmission during rainy season (July to November) peaking in October. Three major dengue epidemics occurred in Barbados during 2010, 2013 and possibly 2016 with an emerging three–year interval. DF prevalence among febrile patients who sought medical attention overall was highest among the 10–19 years old age group. The highest DF hospitalisation prevalence was observed in 2013. Multiple serotypes circulated during the study period and Dengue virus serotype 2 (DENV–2) was the most prevalent serotype during 2010, whilst DENV–1 was the most prevalent serotype in 2013. Two DENV–1 strains from the 2013 DENV epidemic were genetically more closely related to South East Asian strains, than Caribbean or South American strains, and represent the first ever sequencing of DENV strains in Barbados. However, the small sample size (n = 2) limits any meaningful conclusions. DF prevalence was not significantly different between females and males. Public health planning should consider DENV inter–epidemic periodicity, the current COVID–19 pandemic and similar clinical symptomology between DF and COVID–19. The implementation of routine sequencing of DENV strains to obtain critical data can aid in battling DENV epidemics in Barbados.

Highlights

Dengue fever (DF) is the most prevalent human arboviral disease in tropical and subtropical regions worldwide
We present epidemiological data across Barbados from a centralised laboratory where all suspected and confirmed dengue cases in the island are tested
All suspected febrile patients who seek medical attention on the island are referred to the central public health laboratory based on the similarity of clinical symptoms of Dengue virus (DENV), chikungunya virus (CHIKV), Zika virus (ZIKV), Leptospira and hantavirus infections including fever, malaise, myalgia, arthralgia, rash, retro–orbital pain, abdominal pain, nausea and vomiting

Summary

Introduction

Dengue fever (DF) is the most prevalent human arboviral disease in tropical and subtropical regions worldwide. Current dengue epidemiology research aids in vaccine planning initiatives as it describes the transmission dynamics within a population and the possible risk factors for DENV infections. Barbados has two annual seasons namely a dry and wet season. The dry season occurs from December–May and the wet/rainy season from June to November. DENV infection is transmitted year–round in Barbados and dengue epidemics have occurred in 1995, 1997, 2001, and 2007 [6,7,9]. Current systematic population data on dengue epidemiology in Barbados within the last 10 years has been absent. A recent dengue epidemiology study involved children up to 16 years old (2000–2009) but lacked detailed data on the entire population [8]

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Conclusion