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The interplay of climate, intervention and imported cases as determinants of the 2014 dengue outbreak in Guangzhou.

Abstract Dengue is a fast spreading mosquito-borne disease that affects more than half of the population worldwide. An unprecedented outbreak happened in Guangzhou, China in 2014, which contributed 52 percent of all dengue cases that occurred in mainland China between 1990 and 2015. Our previous analysis, based on a deterministic model, concluded that the early timing of the first imported case that triggered local transmission and the excessive rainfall thereafter were the most important determinants of the large final epidemic size in 2014. However, the deterministic model did not allow us to explore the driving force of the early local transmission. Here, we expand the model to include stochastic elements and calculate the successful invasion rate of cases that entered Guangzhou at different times under different climate and intervention scenarios. The conclusion is that the higher number of imported cases in May and June was responsible for the early outbreak instead of climate. Although the excessive rainfall in 2014 did increase the success rate, this effect was offset by the low initial water level caused by interventions in late 2013. The success rate is strongly dependent on mosquito abundance during the recovery period of the imported case, since the first step of a successful invasion is infecting at least one local mosquito. The average final epidemic size of successful invasion decreases exponentially with introduction time, which means if an imported case in early summer initiates the infection process, the final number infected can be extremely large. Therefore, dengue outbreaks occurring in Thailand, Singapore, Malaysia and Vietnam in early summer merit greater attention, since the travel volumes between Guangzhou and these countries are large. As the climate changes, destroying mosquito breeding sites in Guangzhou can mitigate the detrimental effects of the probable increase in rainfall in spring and summer.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title plos neglected tropical diseases
Publication Year Start



 

PMID- 28640895
OWN - NLM
STAT- Publisher
DA  - 20170622
LR  - 20170622
IS  - 1935-2735 (Electronic)
IS  - 1935-2727 (Linking)
VI  - 11
IP  - 6
DP  - 2017 Jun 22
TI  - The interplay of climate, intervention and imported cases as determinants of the 
      2014 dengue outbreak in Guangzhou.
PG  - e0005701
LID - 10.1371/journal.pntd.0005701 [doi]
AB  - Dengue is a fast spreading mosquito-borne disease that affects more than half of 
      the population worldwide. An unprecedented outbreak happened in Guangzhou, China 
      in 2014, which contributed 52 percent of all dengue cases that occurred in
      mainland China between 1990 and 2015. Our previous analysis, based on a
      deterministic model, concluded that the early timing of the first imported case
      that triggered local transmission and the excessive rainfall thereafter were the 
      most important determinants of the large final epidemic size in 2014. However,
      the deterministic model did not allow us to explore the driving force of the
      early local transmission. Here, we expand the model to include stochastic
      elements and calculate the successful invasion rate of cases that entered
      Guangzhou at different times under different climate and intervention scenarios. 
      The conclusion is that the higher number of imported cases in May and June was
      responsible for the early outbreak instead of climate. Although the excessive
      rainfall in 2014 did increase the success rate, this effect was offset by the low
      initial water level caused by interventions in late 2013. The success rate is
      strongly dependent on mosquito abundance during the recovery period of the
      imported case, since the first step of a successful invasion is infecting at
      least one local mosquito. The average final epidemic size of successful invasion 
      decreases exponentially with introduction time, which means if an imported case
      in early summer initiates the infection process, the final number infected can be
      extremely large. Therefore, dengue outbreaks occurring in Thailand, Singapore,
      Malaysia and Vietnam in early summer merit greater attention, since the travel
      volumes between Guangzhou and these countries are large. As the climate changes, 
      destroying mosquito breeding sites in Guangzhou can mitigate the detrimental
      effects of the probable increase in rainfall in spring and summer.
FAU - Cheng, Qu
AU  - Cheng Q
AD  - Ministry of Education Key Laboratory for Earth System Modeling, Department of
      Earth System Science, Tsinghua University, Beijing, People's Republic of China.
FAU - Jing, Qinlong
AU  - Jing Q
AD  - Department of Medical Statistics and Epidemiology, School of Public Health, Sun
      Yat-Sen University, Guangzhou, Guangdong, People's Republic of China.
AD  - Department of Infectious Diseases, Guangzhou Center for Disease Control and
      Prevention, Guangzhou, Guangdong, People's Republic of China.
FAU - Spear, Robert C
AU  - Spear RC
AD  - Environmental Health Sciences, School of Public Health, University of California,
      Berkeley, California, United States of America.
FAU - Marshall, John M
AU  - Marshall JM
AD  - Division of Biostatistics and Epidemiology, School of Public Health, University
      of California, Berkeley, California, United States of America.
FAU - Yang, Zhicong
AU  - Yang Z
AD  - Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong,
      People's Republic of China.
AD  - Key Laboratory of Tropical Disease Control (Sun Yat-sen University), Ministry of 
      Education, Guangzhou, Guangdong, People's Republic of China.
FAU - Gong, Peng
AU  - Gong P
AUID- ORCID: http://orcid.org/0000-0003-1513-3765
AD  - Ministry of Education Key Laboratory for Earth System Modeling, Department of
      Earth System Science, Tsinghua University, Beijing, People's Republic of China.
AD  - Joint Center for Global Change Studies, Beijing, People's Republic of China.
LA  - eng
PT  - Journal Article
DEP - 20170622
PL  - United States
TA  - PLoS Negl Trop Dis
JT  - PLoS neglected tropical diseases
JID - 101291488
EDAT- 2017/06/24 06:00
MHDA- 2017/06/24 06:00
CRDT- 2017/06/23 06:00
PHST- 2016/12/14 [received]
PHST- 2017/06/10 [accepted]
AID - 10.1371/journal.pntd.0005701 [doi]
AID - PNTD-D-16-02198 [pii]
PST - aheadofprint
SO  - PLoS Negl Trop Dis. 2017 Jun 22;11(6):e0005701. doi:
      10.1371/journal.pntd.0005701.

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