Abstract
Dengue viruses are major contributors to illness and death globally. Here we analyze the extrinsic and intrinsic incubation periods (EIP and IIP), in the mosquito and human, respectively. We identified 146 EIP observations from 8 studies and 204 IIP observations from 35 studies. These data were fitted with censored Bayesian time-to-event models. The best-fitting temperature-dependent EIP model estimated that 95% of EIPs are between 5 and 33 days at 25°C, and 2 and 15 days at 30°C, with means of 15 and 6.5 days, respectively. The mean IIP estimate was 5.9 days, with 95% expected between days 3 and 10. Differences between serotypes were not identified for either incubation period. These incubation period models should be useful in clinical diagnosis, outbreak investigation, prevention and control efforts, and mathematical modeling of dengue virus transmission.
Highlights
Dengue viruses (DENV) are a major cause of illness, hospitalization, and death throughout the tropical and subtropical regions of the world [1]
There are two periods of interest: the incubation period (IIP), which marks the onset of symptoms as described above; and the latent period, the period between infection and the onset of infectiousness. The latter is another important determinant of transmission dynamics, but data is extremely sparse, so here we focus on the IIP as it is an important determinant of the temporal dynamics of human disease and may be used in a differential diagnosis, for example, for a traveler returning from a DENV-endemic area [11]
We limited the data to experimental or accidental exposure involving humans, primates, and mosquitoes to better reflect the incubation periods resulting from natural transmission events, rather than highly manipulated experimental ones
Summary
Dengue viruses (DENV) are a major cause of illness, hospitalization, and death throughout the tropical and subtropical regions of the world [1]. We focus on the extrinsic and intrinsic incubation periods of DENV infections. The extrinsic incubation period (EIP) is the viral incubation period between the time when a mosquito takes a viremic bloodmeal and the time when that mosquito becomes infectious. The intrinsic incubation period (IIP) is the time between a human being infected and the onset of symptoms due to the infection. These periods are important determinants of the temporal dynamics of DENV transmission and are critical for clinical diagnosis, outbreak investigation, implementation of prevention and control programming, and mathematical modeling of DENV transmission
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