Abstract
BackgroundThe early identification of dengue infection is essential for timely and effective quarantine and vector control measures for preventing outbreaks of the disease. Kaohsiung City is responsible for most of the dengue cases in Taiwan. Thus, this study aims to identify major factors involved in the prevalence of dengue fever by analyzing the epidemiological and clinical characteristics, and to establish associations between weather parameters and dengue occurrence in this City.MethodsA retrospective study was conducted with 3,322 confirmed dengue cases. Appropriate statistical methods were used to compare differences and correlations between dengue occurrence and demographic, clinical and weather parameters.ResultsThe outbreak of dengue fever was found to be initiated by imported cases of dengue viruses from other endemic countries. Most of the confirmed cases were not reported to the health authority during the first visit to a doctor, and it took a median of 5 days after the appearance of the first syndromes for medical personnel to report suspected dengue cases. Accordingly, Aedes mosquitoes would have enough time to be infected and transmit the dengue virus. The diagnosis and notification criteria should not only include common symptoms of fever, myalgia, headache, skin rash and arthralgia, but should also be adjusted to include the most frequent symptoms of loss of appetite and feeling thirsty to shorten the notification time. Significantly positive correlations were found between the number of confirmed cases and weather parameters (i.e., temperature, rainfall and relative humidity) at a time lag of 1 month and 2 months. The predictive models for dengue occurrence using these three parameters at a 2-month lag time were established.ConclusionsThe surveillance of imported cases, adjustment of notification criteria and application of climatic predictive models would be helpful in strengthening the dengue early warning surveillance system.
Highlights
The global distribution of dengue fever (DF) in tropical and subtropical regions has caused a serious public health problem
The outbreak of dengue fever was found to be initiated by imported cases of dengue viruses from other endemic countries
Most of the confirmed cases were not reported to the health authority during the first visit to a doctor, and it took a median of 5 days after the appearance of the first syndromes for medical personnel to report suspected dengue cases
Summary
The global distribution of dengue fever (DF) in tropical and subtropical regions has caused a serious public health problem. According to the World Health Organization (WHO), an estimated 50–100 million dengue infections occur each year, and close to 75% of the population exposed to DF are in the Asia-Pacific region [1]. The most severe outbreaks of DF in Taiwan occurred in 1915, 1931, 1942, 1988 and 2002. This disease became endemic, with yearly and frequent outbreaks thereafter. Most of the dengue cases occurred in southern Taiwan, in Kaohsiung [2]. The early identification of dengue infection is essential for timely and effective quarantine and vector control measures for preventing outbreaks of the disease. Kaohsiung City is responsible for most of the dengue cases in Taiwan. This study aims to identify major factors involved in the prevalence of dengue fever by analyzing the epidemiological and clinical characteristics, and to establish associations between weather parameters and dengue occurrence in this City
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