Dengue Fever and Severe Dengue in Barbados, 2008–2016

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Abstract

Analysis of the temporal, seasonal and demographic distribution of dengue virus (DENV) infections in Barbados was conducted using national surveillance data from a total of 3994 confirmed dengue cases. Diagnosis was confirmed either by DENV–specific real time reverse transcriptase polymerase chain reaction (rRT–PCR), or non–structural protein 1 (NS1) antigen or enzyme linked immunosorbent assay (ELISA) tests; a case fatality rate of 0.4% (10/3994) was observed. The dengue fever (DF) prevalence varied from 27.5 to 453.9 cases per 100,000 population among febrile patients who sought medical attention annually. DF cases occurred throughout the year with low level of transmission observed during the dry season (December to June), then increased transmission during rainy season (July to November) peaking in October. Three major dengue epidemics occurred in Barbados during 2010, 2013 and possibly 2016 with an emerging three–year interval. DF prevalence among febrile patients who sought medical attention overall was highest among the 10–19 years old age group. The highest DF hospitalisation prevalence was observed in 2013. Multiple serotypes circulated during the study period and Dengue virus serotype 2 (DENV–2) was the most prevalent serotype during 2010, whilst DENV–1 was the most prevalent serotype in 2013. Two DENV–1 strains from the 2013 DENV epidemic were genetically more closely related to South East Asian strains, than Caribbean or South American strains, and represent the first ever sequencing of DENV strains in Barbados. However, the small sample size ( n = 2) limits any meaningful conclusions. DF prevalence was not significantly different between females and males. Public health planning should consider DENV inter–epidemic periodicity, the current COVID–19 pandemic and similar clinical symptomology between DF and COVID–19. The implementation of routine sequencing of DENV strains to obtain critical data can aid in battling DENV epidemics in Barbados.

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Dengue, Urbanization and Globalization: The Unholy Trinity of the 21st Century

Duane J. Gubler (2011)

Dengue is the most important arboviral disease of humans with over half of the world’s population living in areas of risk. The frequency and magnitude of epidemic dengue have increased dramatically in the past 40 years as the viruses and the mosquito vectors have both expanded geographically in the tropical regions of the world. There are many factors that have contributed to this emergence of epidemic dengue, but only three have been the principal drivers: 1) urbanization, 2) globalization and 3) lack of effective mosquito control. The dengue viruses have fully adapted to a human-Aedes aegypti-human transmission cycle, in the large urban centers of the tropics, where crowded human populations live in intimate association with equally large mosquito populations. This setting provides the ideal home for maintenance of the viruses and the periodic generation of epidemic strains. These cities all have modern airports through which 10s of millions of passengers pass each year, providing the ideal mechanism for transportation of viruses to new cities, regions and continents where there is little or no effective mosquito control. The result is epidemic dengue. This paper discusses this unholy trinity of drivers, along with disease burden, prevention and control and prospects for the future.

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Epidemiology of dengue: past, present and future prospects

Natasha Evelyn Anne Murray, Mikkel Quam, Annelies Wilder-Smith (2013)

Dengue is currently regarded globally as the most important mosquito-borne viral disease. A history of symptoms compatible with dengue can be traced back to the Chin Dynasty of 265–420 AD. The virus and its vectors have now become widely distributed throughout tropical and subtropical regions of the world, particularly over the last half-century. Significant geographic expansion has been coupled with rapid increases in incident cases, epidemics, and hyperendemicity, leading to the more severe forms of dengue. Transmission of dengue is now present in every World Health Organization (WHO) region of the world and more than 125 countries are known to be dengue endemic. The true impact of dengue globally is difficult to ascertain due to factors such as inadequate disease surveillance, misdiagnosis, and low levels of reporting. Currently available data likely grossly underestimates the social, economic, and disease burden. Estimates of the global incidence of dengue infections per year have ranged between 50 million and 200 million; however, recent estimates using cartographic approaches suggest this number is closer to almost 400 million. The expansion of dengue is expected to increase due to factors such as the modern dynamics of climate change, globalization, travel, trade, socioeconomics, settlement and also viral evolution. No vaccine or specific antiviral therapy currently exists to address the growing threat of dengue. Prompt case detection and appropriate clinical management can reduce the mortality from severe dengue. Effective vector control is the mainstay of dengue prevention and control. Surveillance and improved reporting of dengue cases is also essential to gauge the true global situation as indicated in the objectives of the WHO Global Strategy for Dengue Prevention and Control, 2012–2020. More accurate data will inform the prioritization of research, health policy, and financial resources toward reducing this poorly controlled disease. The objective of this paper is to review historical and current epidemiology of dengue worldwide and, additionally, reflect on some potential reasons for expansion of dengue into the future.

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The history of dengue outbreaks in the Americas.

Olivia Brathwaite Dick, José San Martín, Romeo Montoya … (2012)

Dengue is a viral disease usually transmitted by Aedes aegypti mosquitoes. Dengue outbreaks in the Americas reported in medical literature and to the Pan American Health Organization are described. The outbreak history from 1600 to 2010 was categorized into four phases: Introduction of dengue in the Americas (1600-1946); Continental plan for the eradication of the Ae. aegypti (1947-1970) marked by a successful eradication of the mosquito in 18 continental countries by 1962; Ae. aegypti reinfestation (1971-1999) caused by the failure of the mosquito eradication program; Increased dispersion of Ae. aegypti and dengue virus circulation (2000-2010) characterized by a marked increase in the number of outbreaks. During 2010 > 1.7 million dengue cases were reported, with 50,235 severe cases and 1,185 deaths. A dramatic increase in the number of outbreaks has been reported in recent years. Urgent global action is needed to avoid further disease spread.

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Journal

Journal ID (nlm-ta): Trop Med Infect Dis

Journal ID (iso-abbrev): Trop Med Infect Dis

Journal ID (publisher-id): tropicalmed

Title: Tropical Medicine and Infectious Disease

Publisher: MDPI

ISSN (Electronic): 2414-6366

Publication date (Electronic): 02 May 2020

Publication date Collection: June 2020

Volume: 5

Issue: 2

Electronic Location Identifier: 68

Affiliations

[1 ]Faculty of Medical Sciences, University of the West Indies, Cave Hill, St. Michael BB11000, Barbados; marquita.gittens@ 123456cavehill.uwi.edu

[2 ]Artemis One Health Research Foundation, Molengraaffsingel 10, 2629 JD Delft, The Netherlands; s.dutta@ 123456artemisonehealth.com (S.K.D.); b.martina@ 123456artemisonehealth.com (B.M.)

[3 ]Department of Viroscience, Postgraduate School Molecular Medicine, Erasmus University Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands; fatih.anfasa@ 123456gmail.com

[4 ]Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Diponegoro 71, Central Jakarta 10430, Indonesia

[5 ]Epidemiology Research Unit, Caribbean Institute for Health Research (CAIHR), University of the West Indies, Mona, Kingston 7, Jamaica; alafia.samuels@ 123456cavehill.uwi.edu

[6 ]Best–dos Santos Public Health Laboratory, Enmore Complex, Martindales Road, St. Michael BB11155, Barbados

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[* ]Correspondence: kirk.douglas.7911@ 123456gmail.com ; Tel.: +246-834-3963

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Kirk Osmond Douglas https://orcid.org/0000-0002-3409-870X

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Publisher ID: tropicalmed-05-00068

DOI: 10.3390/tropicalmed5020068

PMC ID: 7345827

PubMed ID: 32370128

SO-VID: 4410fded-6084-44b3-8eac-b73ecf441036

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Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

Dengue Fever and Severe Dengue in Barbados, 2008–2016

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MDPI: Coronavirus

Most cited references 80

Dengue, Urbanization and Globalization: The Unholy Trinity of the 21st Century

Epidemiology of dengue: past, present and future prospects

The history of dengue outbreaks in the Americas.

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