Epidemiology of dengue in a high-income country: a case study in Queensland, Australia

Viennet, Elvina, Ritchie, Scott A., Faddy, Helen M., Williams, Craig R. and Harley, David (2014) Epidemiology of dengue in a high-income country: a case study in Queensland, Australia. Parasites and Vectors, 7 . doi:10.1186/1756-3305-7-379


Author Viennet, Elvina
Ritchie, Scott A.
Faddy, Helen M.
Williams, Craig R.
Harley, David
Title Epidemiology of dengue in a high-income country: a case study in Queensland, Australia
Journal name Parasites and Vectors   Check publisher's open access policy
ISSN 1756-3305
Publication date 2014-08-19
Year available 2014
Sub-type Article (original research)
DOI 10.1186/1756-3305-7-379
Open Access Status DOI
Volume 7
Total pages 16
Place of publication London, United Kingdom
Publisher BioMed Central
Language eng
Abstract Background: Australia is one of the few high-income countries where dengue transmission regularly occurs. Dengue is a major health threat in North Queensland (NQ), where the vector Aedes aegypti is present. Whether NQ should be considered as a dengue endemic or epidemic region is an ongoing debate. To help address this issue, we analysed the characteristics of locally-acquired (LA) and imported dengue cases in NQ through time and space. We describe the epidemiology of dengue in NQ from 1995 to 2011, to identify areas to target interventions. We also investigated the timeliness of notification and identified high-risk areas.
Formatted abstract
Background: Australia is one of the few high-income countries where dengue transmission regularly occurs. Dengue is a major health threat in North Queensland (NQ), where the vector Aedes aegypti is present. Whether NQ should be considered as a dengue endemic or epidemic region is an ongoing debate. To help address this issue, we analysed the characteristics of locally-acquired (LA) and imported dengue cases in NQ through time and space. We describe the epidemiology of dengue in NQ from 1995 to 2011, to identify areas to target interventions. We also investigated the timeliness of notification and identified high-risk areas.

Methods: Data sets of notified cases and viraemic arrivals from overseas were analysed. We developed a time series based on the LA cases and performed an analysis to capture the relationship between incidence rate and demographic factors. Spatial analysis was used to visualise incidence rates through space and time.

Results: Between 1995 and 2011, 93.9% of reported dengue cases were LA, mainly in the 'Cairns and Hinterland' district; 49.7% were males, and the mean age was 38.0 years old. The sources of imported cases (6.1%) were Indonesia (24.6%), Papua New Guinea (23.2%), Thailand (13.4%), East Timor (8.9%) and the Philippines (6.7%), consistent with national data. Travellers importing dengue were predominantly in the age groups 30-34 and 45-49 years old, whereas the age range of patients who acquired dengue locally was larger. The number of LA cases correlated with the number of viraemic importations. Duration of viraemia of public health importance was positively correlated with the delay in notification. Dengue incidence varied over the year and was typically highest in summer and autumn. However, dengue activity has been reported in winter, and a number of outbreaks resulted in transmission year-round.

Conclusions: This study emphasizes the importance of delay in notification and consequent duration of viraemia of public health importance for dengue outbreak duration. It also highlights the need for targeted vector control programmes and surveillance of travellers at airports as well as regularly affected local areas. Given the likely increase in dengue transmission with climate change, endemicity in NQ may become a very real possibility.
Keyword Australia
Delay in notification
Dengue
Endemic
Epidemiology
Imported cases
Locally-acquired
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID APP1003371
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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