Journal
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA
Volume 112, Issue 42, Pages 13069-13074Publisher
NATL ACAD SCIENCES
DOI: 10.1073/pnas.1501375112
Keywords
dengue; epidemiology; surveillance data; Southeast Asia; dynamics
Categories
Funding
- Bill and Melinda Gates Foundation [49276]
- US National Institute of General Medical Sciences [5U54GM088491]
- University of Malaya [UM.C/HIR/MOHE/CHAN/15]
- Career Award at the Scientific Interface from the Burroughs Wellcome Fund
- US NIH [R01AI102939, R01AI114703]
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Dengue is a mosquito-transmitted virus infection that causes epidemics of febrile illness and hemorrhagic fever across the tropics and subtropics worldwide. Annual epidemics are commonly observed, but there is substantial spatiotemporal heterogeneity in intensity. A better understanding of this heterogeneity in dengue transmission could lead to improved epidemic prediction and disease control. Time series decomposition methods enable the isolation and study of temporal epidemic dynamics with a specific periodicity (e.g., annual cycles related to climatic drivers and multiannual cycles caused by dynamics in population immunity). We collected and analyzed up to 18 y of monthly dengue surveillance reports on a total of 3.5 million reported dengue cases from 273 provinces in eight countries in Southeast Asia, covering similar to 10(7) km(2). We detected strong patterns of synchronous dengue transmission across the entire region, most markedly during a period of high incidence in 1997-1998, which was followed by a period of extremely low incidence in 2001-2002. This synchrony in dengue incidence coincided with elevated temperatures throughout the region in 1997-1998 and the strongest El NiNo episode of the century. Multiannual dengue cycles (2-5 y) were highly coherent with the Oceanic NiNo Index, and synchrony of these cycles increased with temperature. We also detected localized traveling waves of multiannual dengue epidemic cycles in Thailand, Laos, and the Philippines that were dependent on temperature. This study reveals forcing mechanisms that drive synchronization of dengue epidemics on a continental scale across Southeast Asia.
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