Abstract
Dengue is a major health burden, but it can be challenging to examine transmission and evaluate control measures because outbreaks depend on multiple factors, including human population structure, prior immunity and climate. We combined population-representative paired sera collected before and after the 2013/14 dengue-3 outbreak in Fiji with surveillance data to determine how such factors influence transmission and control in island settings. Our results suggested the 10-19 year-old age group had the highest risk of infection, but we did not find strong evidence that other demographic or environmental risk factors were linked to seroconversion. A mathematical model jointly fitted to surveillance and serological data suggested that herd immunity and seasonally varying transmission could not explain observed dynamics. However, the model showed evidence of an additional reduction in transmission coinciding with a vector clean-up campaign, which may have contributed to the decline in cases in the later stages of the outbreak.
Highlights
IntroductionThe reported incidence of dengue has risen rapidly
In recent years, the reported incidence of dengue has risen rapidly
We found that 58.6% of participants (154/263) were ELISA seropositive to at least one dengue viruses (DENV) serotype in late 2013
Summary
The reported incidence of dengue has risen rapidly. In the Asia-Pacific region, which bears 75% of the global dengue disease burden, there are more than 1.8 billion people at risk of infection with dengue viruses (DENV) (World Health Organization, 2009). Increased air travel and urbanisation could have contributed to the geographic spread of infection (Gubler, 1998; Simmons et al, 2012), with transmission by mosquitoes of the Aedes genus, including Aedes aegypti and Aedes albopictus (Halstead, 2007).
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