Epidemic Patterns of Dengue From 1980-2007

Chelsea Adair
Professor Neff
BIOL 1615-032
April 8, 2015
Epidemic Patterns of Dengue from 1980-2007
Introduction:
Dengue is a disease spread by mosquitoes and caused by viruses grouped within four serotypes.
Found worldwide in over 100 countries and increasing in incidence, the disease varies from
asymptomatic, to mild (referred to with the acronym DF for dengue fever), and to severe and often fatal
(referred to as DHF for dengue hemorrhagic fever). Despite its wide range and prevalence, there is no
specific treatment for the disease, and mosquito control is the sole strategy used for prevention. Within
the last decade of when the study was published, the Americas in particular had seen a notable increase in
cases. In response, this study set out to collect and analyze available information on dengues epidemic
patterns in the Americas from the time period of 1980 to 2007. The study did not have a hypothesis but
rather a goal of collecting information and understanding the diseases patterns.
Materials and Methods
In order to examine the patterns of the disease, dengue infection records were gathered from
several sources, with the two major sources being the records of the World Health Organization (WHO)
and the Pan American Health Organization (PAHO). Other records used included online sources such as
Brazils Ministry of Health and the Honduran Direccion General de Vigilancia en Salud websites. These
records were used to examine patterns such as age and gender distribution, differences in the diseases
behavior between individual countries, the diseases seasonality, fatalities, and the prevalence and spread
of the different serotypes of viruses between countries.
Results
Many patterns of dengue were observed as a result of this study. For example, the total reported
occurrences of dengue in the region studied increased greatly over the twenty-seven year period (from
about one million cases in the 80s to almost 4,800,000 from 2000-2007). The number of DHF cases as
well as its percentage of total dengue cases also increased from 1980s-2007 (from 1.3% to 2.4%).
Epidemic cycles were seen to be every three to five years.
The study also took a look at what regions had the highest proportion of cases in their population
during different time periods. The Hispanic Caribbean and Central America/Mexico had the highest
proportions in the 80s, the Southern Cone and Andean subregions had the highest in the 90s, and
proportions stayed the same from 2000-2007, although total cases reported increased. Overall, Brazil was
the country reporting the highest percentage of cases (54.5%) over the course of the studys entire
observed time period.
Other patterns uncovered in the study included the observation that age group most affected varied
with location (Most of Brazils cases occurred in the first half of the year, whereas in Honduras and
Mexico cases were more prevalent in the second half of the year), as well as the pattern of women tending
to get infected with the disease more often than men.
Discussion
The data collected in the study suggested that the incidence of dengue has and will continue to
rise, and this poses a significant concern to the public health of the Americas. Over the time period
studied, dengues distribution expanded throughout the Americas, with Brazil in particular experiencing a
high percentage of the total cases (63%). Though patterns can be recognized in dengue, the diseases
patterns vary somewhat by location. For example, though young children are the most infected age group
in Asian countries, it is older age groups that are most commonly infected in the Americas.
Researchers speculate that factors involved the Americas increase in dengue could be related to
the lessened implementation of PAHOs Aedes aegypti (the primary species of mosquito spreading the
disease) eradication program, as well as growing population, poor sanitary conditions in urban areas, poor
public health infrastructure, and lessened access to health care. Other factors such as increased
international travel and changing climate may play into the diseases worldwide expansion.
The researchers admit the study has its limitations, including that dengue cases may be
underreported and countries can vary in their reporting of those cases over different time periods. Most of
the cases reported were also not confirmed by laboratory testing.
In conclusion, dengues prevalence and thus seriousness as a public health threat were seen to
increase over the 27 years studied and can be expected to continue increasing. The researchers
suggestions for combatting the disease more effectively includes the development of vaccines for each
virus serotype along with implementing a PAHO initiative and the Integrated Management Strategy for
Dengue Prevention.
Bibliography
San Martn, Jos Luis et al. The Epidemiology of Dengue in the Americas Over the Last Three Decades:
A Worrisome Reality. The American Journal of Tropical Medicine and Hygiene 82.1 (2010): 128
135. PMC. Web. 9 Apr. 2015.

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Chelsea Adair

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