Abstract

BackgroundThere was a dengue epidemic in several regions of China in 2013. No study has explored the dynamics of dengue transmission between different geographical locations with dengue outbreaks in China. The purpose of the study is to analyze the epidemiological characteristics and to explore the dynamic transmission of dengue in China, 2013.Methodology and Principal FindingsRecords of dengue cases of 2013 were obtained from the China Notifiable Disease Surveillance System. Full E-gene sequences of dengue virus detected from the outbreak regions of China were download from GenBank. Geographical Information System and heatmaps were used to describe the epidemiological characteristics. Maximum Likelihood phylogenetic and Bayesian phylogeographic analyses were conducted to explore the dengue dynamic transmission. Yunnan Province and Guangdong Province had the highest imported cases in the 2013 epidemic. In the locations with local dengue transmission, most of imported cases occurred from June to November 2013 while local dengue cases developed from July to December, 2013. There were significant variations for the incidences of dengue, in terms of age distributions, among different geographic locations. However, gender differences were identified in Guangzhou, Foshan and Xishuangbanna. DENV 1–3 were detected in all locations with the disease outbreaks. Some genotypes were detected in more than one locations and more than one genotypes have been detected in several locations. The dengue viruses introduced to outbreak areas were predominantly from Southeast Asia. In Guangdong Province, the phylogeographical results indicated that dengue viruses of DENV 1 were transmitted to neighboring cities Foshan and Zhongshan from Guangzhou city, and then transmitted to Jiangmen city. The virus in DENV 3 was introduced to Guangzhou city, Guangdong Province from Xishuangbanna prefecture, Yunnan Province.ConclusionsRepeated dengue virus introductions from Southeast Asia and subsequent domestic dengue transmission within different regions may have contributed to the dengue epidemics in China, 2013.

Highlights

  • Dengue is a mosquito-borne viral infectious disease caused by the four antigently distinct serotypes (DENV 1–4), which are mainly transmitted by Aedes aegypti and Aedes albopicuts

  • Repeated dengue virus introductions from Southeast Asia and subsequent domestic dengue transmission within different regions may have contributed to the dengue epidemics in China, 2013

  • The study results indicated that repeated dengue virus introductions from Southeast Asia and subsequent domestic dengue transmission within different regions may have contributed to the dengue epidemics in China, 2013

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Summary

Introduction

Dengue is a mosquito-borne viral infectious disease caused by the four antigently distinct serotypes (DENV 1–4), which are mainly transmitted by Aedes aegypti and Aedes albopicuts. Travel acquired cases were repeatedly imported to Europe from Africa, Southeast Asia and the Americas [7,8,9]. Local dengue transmission has occurred in Europe for the first time in many decades, with indigenous cases reported in France and Croatia in 2010 [10, 11]. In addition to sporadic cases, dengue outbreak occurred in Europe. At finer spatial scales (regional, intra-urban, neighborhood), population movements associated with work and recreation are important for dengue transmission [6], and house-tohouse human movements may shape spatial patterns of dengue incidence, causing significant heterogeneity in dengue incidence [16]. No study has explored the dynamics of dengue transmission between different geographical locations with dengue outbreaks in China. The purpose of the study is to analyze the epidemiological characteristics and to explore the dynamic transmission of dengue in China, 2013

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