Characterizing a large outbreak of dengue fever in Guangdong Province, China

BackgroundDengue cases have been reported each year for the past 25 years in Guangdong Province, China with a recorded historical peak in 2014. This study aims to describe the epidemiological characteristics of this large outbreak in order to better understand its epidemic factors and to inform control strategies.MethodsData for clinically diagnosed and laboratory-confirmed dengue fever cases in 2014 were extracted from the China Notifiable Infectious Disease Reporting System. We analyzed the incidence and characteristics of imported and indigenous cases in terms of population, temporal and spatial distributions.ResultsA total of 45 224 dengue fever cases and 6 deaths were notified in Guangdong Province in 2014, with an incidence of 47.3 per 100 000 people. The elderly (65+ years) represented 11.7 % of total indigenous cases with the highest incidence (72.3 per 100 000). Household workers and the unemployed accounted for 23.1 % of indigenous cases. The majority of indigenous cases occurred in the 37th to 44th week of 2014 (September and October) and almost all (20 of 21) prefecture-level cities in Guangdong were affected. Compared to the non-Pearl River Delta Region, the Pearl River Delta Region accounted for the majority of dengue cases and reported cases earlier in 2014. Dengue virus serotypes 1 (DENV-1), 2 (DENV-2) and 3 (DENV-3) were detected and DENV-1 was predominant (88.4 %).ConclusionsDengue fever is a serious public health problem and is emerging as a continuous threat in Guangdong Province. There is an urgent need to enhance dengue surveillance and control, especially for the high-risk populations in high-risk areas.

[1]  L. Ng,et al.  Dengue Seroprevalence of Healthy Adults in Singapore: Serosurvey among Blood Donors, 2009 , 2015, The American journal of tropical medicine and hygiene.

[2]  S. Kienberger,et al.  Assessing socioeconomic vulnerability to dengue fever in Cali, Colombia: statistical vs expert-based modeling , 2013, International Journal of Health Geographics.

[3]  Gail M. Williams,et al.  Spatiotemporal analysis of indigenous and imported dengue fever cases in Guangdong province, China , 2012, BMC Infectious Diseases.

[4]  Andrew J Tatem,et al.  The changing epidemiology of dengue in China, 1990-2014: a descriptive analysis of 25 years of nationwide surveillance data , 2015, BMC Medicine.

[5]  U. Haque,et al.  Population Density, Water Supply, and the Risk of Dengue Fever in Vietnam: Cohort Study and Spatial Analysis , 2011, PLoS medicine.

[6]  Yi-quan Xiong,et al.  [Epidemiology of dengue fever in China since 1978]. , 2014, Nan fang yi ke da xue xue bao = Journal of Southern Medical University.

[7]  Hualiang Lin,et al.  Spatial Analysis of Dengue Fever in Guangdong Province, China, 2001-2006 , 2014, Asia-Pacific journal of public health.

[8]  Weizhong Yang,et al.  Time series analysis of dengue fever and weather in Guangzhou, China , 2009, BMC public health.

[9]  A. D. de Silva,et al.  The Human Antibody Response to Dengue Virus Infection , 2011, Viruses.

[10]  G. Comach,et al.  Dengue seroprevalence and risk factors for past and recent viral transmission in Venezuela: a comprehensive community-based study. , 2014, The American journal of tropical medicine and hygiene.

[11]  E. Ooi The re-emergence of dengue in China , 2015, BMC Medicine.

[12]  A. Wilder-Smith,et al.  Epidemiology of dengue: past, present and future prospects , 2013, Clinical epidemiology.

[13]  Bernard Cazelles,et al.  Dengue Dynamics in Binh Thuan Province, Southern Vietnam: Periodicity, Synchronicity and Climate Variability , 2010, PLoS neglected tropical diseases.

[14]  Jianfeng He,et al.  The Prevalence and Endemic Nature of Dengue Infections in Guangdong, South China: An Epidemiological, Serological, and Etiological Study from 2005–2011 , 2014, PloS one.

[15]  Rosanna W. Peeling,et al.  Dengue: a continuing global threat , 2010, Nature Reviews Microbiology.

[16]  A. Fauci,et al.  Dengue and hemorrhagic fever: a potential threat to public health in the United States. , 2008, JAMA.

[17]  Bill Bynum,et al.  Lancet , 2015, The Lancet.

[18]  Zhifeng Liu,et al.  Urban expansion dynamics and natural habitat loss in China: a multiscale landscape perspective , 2014, Global change biology.

[19]  Wuchun Cao,et al.  Isolation and characterization of dengue virus serotype 2 from the large dengue outbreak in Guangdong, China in 2014 , 2014, Science China Life Sciences.

[20]  L. Ng,et al.  2013 Dengue Outbreaks in Singapore and Malaysia Caused by Different Viral Strains , 2015, The American journal of tropical medicine and hygiene.

[21]  Y. Halasa,et al.  Economic and Disease Burden of Dengue Illness in India , 2014, The American journal of tropical medicine and hygiene.

[22]  Caio A. S. Coelho,et al.  Dengue outlook for the World Cup in Brazil: an early warning model framework driven by real-time seasonal climate forecasts. , 2014, The Lancet. Infectious diseases.

[23]  L. Luo,et al.  The Impacts of Mosquito Density and Meteorological Factors on Dengue Fever Epidemics in Guangzhou, China, 2006-2014: a Time-series Analysis. , 2015, Biomedical and environmental sciences : BES.

[24]  Yu Wang,et al.  Emergence and control of infectious diseases in China , 2008, The Lancet.

[25]  L. Luo,et al.  Molecular epidemiological and virological study of dengue virus infections in Guangzhou, China, during 2001–2010 , 2013, Virology Journal.

[26]  Xianwen Wang,et al.  Tracing The Largest Seasonal Migration on Earth , 2014 .

[27]  Tao Liu,et al.  Associations between risk perception, spontaneous adaptation behavior to heat waves and heatstroke in Guangdong province, China , 2013, BMC Public Health.

[28]  Raphaël Duboz,et al.  Can Human Movements Explain Heterogeneous Propagation of Dengue Fever in Cambodia? , 2012, PLoS neglected tropical diseases.

[29]  Lalit Kumar,et al.  Modeling dengue fever risk based on socioeconomic parameters, nationality and age groups: GIS and remote sensing based case study. , 2011, The Science of the total environment.

[30]  Jun Yang,et al.  Predicting Unprecedented Dengue Outbreak Using Imported Cases and Climatic Factors in Guangzhou, 2014 , 2015, PLoS neglected tropical diseases.

[31]  Guofa Zhou,et al.  Urbanization Increases Aedes albopictus Larval Habitats and Accelerates Mosquito Development and Survivorship , 2014, PLoS neglected tropical diseases.

[32]  R. Irizarry,et al.  Travelling waves in the occurrence of dengue haemorrhagic fever in Thailand , 2004, Nature.

[33]  Qiyong Liu,et al.  Dengue fever in China , 2015, The Lancet.

[34]  F. Konradsen,et al.  Dengue Outbreaks in High-Income Area, Kaohsiung City, Taiwan, 2003–2009 , 2012, Emerging infectious diseases.