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Dissecting Japan's Dengue Outbreak in 2014
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.ORCID iD: 0000-0003-4060-0449
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2016 (English)In: American Journal of Tropical Medicine and Hygiene, ISSN 0002-9637, E-ISSN 1476-1645, Vol. 94, no 2, 409-412 p.Article in journal (Refereed) Published
Abstract [en]

Despite Japan's temperate climate, a dengue outbreak occurred in Tokyo for the first time in over 70 years in 2014. We dissected this dengue outbreak based on phylogenetic analysis, travel interconnectivity, and environmental drivers for dengue epidemics. Comparing the available dengue virus 1 (DENV1) E gene sequence from this outbreak with 3,282 unique DENV1 sequences in National Center for Biotechnology Information suggested that the DENV might have been imported from China, Indonesia, Singapore, or Vietnam. With travelers arriving into Japan, Guangzhou (China) may have been the source of DENV introduction, given that Guangzhou also reported a large-scale dengue outbreak in 2014. Coinciding with the 2014 outbreak, Tokyo's climate conditions permitted the amplification of Aedes vectors and the annual peak of vectorial capacity. Given suitable vectors and climate conditions in addition to increasing interconnectivity with endemic areas of Asia, Tokyo's 2014 outbreak did not come as a surprise and may foretell more to come.

Place, publisher, year, edition, pages
2016. Vol. 94, no 2, 409-412 p.
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-115790DOI: 10.4269/ajtmh.15-0468ISI: 000369465500028PubMedID: 26711518OAI: oai:DiVA.org:umu-115790DiVA: diva2:900520
Funder
EU, FP7, Seventh Framework Programme, 282589
Available from: 2016-02-04 Created: 2016-02-04 Last updated: 2017-11-30Bibliographically approved
In thesis
1. Imported infections’ importance: global change driving Dengue dynamics
Open this publication in new window or tab >>Imported infections’ importance: global change driving Dengue dynamics
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Vikten av importerade infektioner : kan globala förändringar förklara Dengue utbrott?
Abstract [en]

Background Dengue is a significant problem of international health concern. According to the World Health Organization in 2012, globally, dengue is “the most important mosquito borne viral disease” with incidence 30 higher than it had been 50 years ago. While most of the burden of disease associated with dengue is located in areas with a tropical and sub-tropical climate, increasing evidence suggests temperate areas are also at risk. Considering the recent introduction of relevant mosquito vectors into Southern Europe, and increasing numbers of imported dengue via travelers, Europe and other temperate areas may be increasingly at risk for dengue emergence, establishment and local transmission in the foreseeable future.

Methods Recent dengue emergence in Madeira and reemergence in Tokyo underline the hypothesis that passenger air-travel can be an important conduit for the importation of vector-borne disease leading to emergence in naïve areas climatically suitable for dengue transmission, including parts of Europe. Combining information on travel with virus genetic similarity was useful in discerning likely pathways of for the importation of infections. Generalizing information learned from outbreaks in Tokyo and Madeira with global epidemic intelligence, global travel networks, and climate change projections, leads to more refined understanding of the magnitude of dengue infectious imported into temperate areas and these virus introduction events’ potential implications for seeding epidemics in the 21st century.

Results While compared to total travel, imported dengue events and epidemics of dengue outside the tropics are rare, our combined evidence and modeled estimations suggest strongly that epidemic dengue emergence in temperate areas is possible and will continue to increase. We found that global change dynamics including warming temperatures in the much of the northern hemisphere and increasing passenger interconnectivity between areas endemic for dengue and dengue free areas are key mechanisms partly explaining these unprecedented epidemiological transitions.

Conclusion While we calibrated our models on information known about dengue, many elements of the methods and conclusions may increase understanding of the potentially global implications for imported infections of other climate-sensitive infectious diseases’ that may have similar parameters. During 2016 and the years to come, techniques developed in this doctoral research will contribute to models used in risk analysis for vector-borne diseases of interest, including the increasing important potential for imported Chikungunya and Zika viruses into a variety of unexposed areas. 

Place, publisher, year, edition, pages
Umeå: Umeå University, 2016. 99 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1793
Keyword
Dengue, Zika, Vector-borne Disease, Aedes, Global Change, Climate Change, Viral Evolution, Phylogenetics, Travel, Interconnectivity, Disease Modeling, Madeira, Italy, Japan, Europe
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-118645 (URN)978-91-7601-443-1 (ISBN)
Public defence
2016-04-22, Room 135, Building 9A, Northlands University Hospital (sal 135, byggnad 9A, Norrlands Universitetssjukhus), Umeå, Sweden, 13:00 (English)
Opponent
Supervisors
Funder
EU, FP7, Seventh Framework Programme, 282589
Available from: 2016-03-31 Created: 2016-03-28 Last updated: 2016-04-20Bibliographically approved

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