Skip to main content
×
×
Home

Dengue hospitalisations in Brazil: annual wave from West to East and recent increase among children

  • J. WUNDERLICH (a1), R. ACUÑA-SOTO (a2) and W. J. ALONSO (a3)
Summary

The number of dengue epidemics in Brazil has increased dramatically in the last 15 years. In this study, we analysed the seasonal patterns in the incidence of hospitalisations due to dengue across the different states of Brazil and compared these with the corresponding climatic patterns. We discovered that the seasonality of dengue hospitalisations in Brazil has a clear zonal gradient, characterised by the progression of primary peaks from West to East during the first half of the year, which may be associated with the increased vapour pressure and rainfall during this period, leading to increased mosquito abundance and activity. We also found that the proportion of children among hospitalised individuals was especially high during the peak outbreaks in 2007/2008 and 2010. This may be due to the emergence and spread of the new DENV-2 Southeast Asian genotype lineage II from 2007, which has probably arrived from the Caribbean and may have caused an increase in incidence and severity of the disease, particularly among children. Our findings may allow health systems to improve control interventions and contribute to reducing dengue morbidity and mortality by using integrated vector control in conjunction with early diagnosis and prompt supportive care.

Copyright
Corresponding author
*Author for correspondence: W. J. Alonso, MSc, PhD, Laboratory for Human Evolutionary and Ecological Studies, Department of Genetics and Evolutionary Biology, University of São Paulo, São Paulo 05508-090, Brazil. (Email: Wladimir.j.alonso@wolfson.oxon.org)
References
Hide All
1. World Health Organization. Fact sheet: Dengue and severe dengue, 2017 (http://www.who.int/mediacentre/factsheets/fs117/en/). Accessed 18 April 2017.
2. Bhatt, S, et al. The global distribution and burden of dengue. Nature 2013; 496: 504507.
3. GBD 2015 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the global burden of disease study 2015. The Lancet 2016; 388: 15451602. doi: 10.1016/S0140-6736(16)31678-6.
4. GBD 2015 Mortality and Causes of Death Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the global burden of disease study 2015. The Lancet 2016; 388: 14591544. doi: 10.1016/S0140-6736(16)31012-1.
5. Pan American Health Organization. Dengue: PAHO/WHO data, maps and statistics, 2017 (http://www.paho.org/hq/index.php?option=com_topics&view=rdmore&cid=6290&Itemid=40734&lang=en). Accessed 10 January 2017.
6. Ikejezie, J, et al. Zika virus transmission – region of the Americas, May 15, 2015-December 15, 2016. Morbidity and Mortality Weekly Report 2017; 66: 329334.
7. GBD 2015 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015: a systematic analysis for the global burden of disease study 2015. The Lancet 2016; 388: 16031658.
8. Martelli, CMT, et al. Economic impact of dengue: multicenter study across four Brazilian regions. PLoS Neglected Tropical Diseases 2015; 9: e0004042.
9. San Martín, JL, 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 2010; 82: 128135.
10. Halstead, SB. Dengue in the Americas and Southeast Asia: do they differ? La Revista Panamericana de Salud Pública 2006; 20: 407415.
11. Teixeira, MG, et al. Epidemiological trends of dengue disease in Brazil (2000–2010): a systematic literature search and analysis. PLoS Neglected Tropical Diseases 2013; 7: e2520.
12. Burattini, MN, et al. Age and regional differences in clinical presentation and risk of hospitalization for dengue in Brazil, 2000–2014. Clinics (São Paulo) 2016; 71: 455463. doi: 10.6061/clinics/2016(08)08.
13. Guzmán, MG, et al. Dengue: a continuing global threat. Nature Reviews Microbiology 2010; 8: S716.
14. Alvarez, M, et al. Dengue hemorrhagic fever caused by sequential dengue 1–3 virus infections over a long time interval: Havana epidemic, 2001–2002. The American Journal of Tropical Medicine and Hygiene 2006; 75: 11131117.
15. Díaz-Quijano, FA, Waldman, EA. Factors associated with dengue mortality in Latin America and the Caribbean, 1995–2009: an ecological study. The American Journal of Tropical Medicine and Hygiene 2012; 86: 328334.
16. Sanofi Pasteur. First dengue vaccine approved in more than 10 countries, 2017 (http://www.sanofipasteur.com/en/articles/first_dengue_vaccine_approved_in_more_than_10_countries.aspx). Accessed 21 March 2017.
17. World Health Organization. Meeting of the strategic advisory group of experts on immunization, April 2016: conclusions and recommendations. The Weekly Epidemiological Record 2016; 91: 266284.
18. Vannice, KS, Durbin, A, Hombach, J. Status of vaccine research and development of vaccines for dengue. Vaccine 2016; 34: 29342938.
19. Paixão, ES, et al. Trends and factors associated with dengue mortality and fatality in Brazil. Revista da Sociedade Brasileira de Medicina Tropical 2015; 48: 399405.
20. Sarti, E, et al. A comparative study on active and passive epidemiological surveillance for dengue in five countries of Latin America. International Journal of Infectious Diseases 2016; 44: 4449.
21. Naish, S, et al. Climate change and dengue: a critical and systematic review of quantitative modelling approaches. BMC Infectious Diseases 2014; 14: 167.
22. Chang, AY, et al. Social justice, climate change, and dengue. Health and Human Rights Journal 2014; 16: 93104.
23. Ministry of Health of Brazil. DATASUS, 2016 (http://www.datasus.gov.br). Accessed 20 August 2016.
24. Coelho, GE, et al. Sensitivity of the dengue surveillance system in Brazil for detecting hospitalized cases. PLoS Neglected Tropical Diseases 2016; 10: e0004705.
25. Brazilian Institute of Geography and Statistics. IBGE, 2014 (http://www.ibge.gov.br/home/). Accessed 29 July 2014.
26. Harris, I, et al. Updated high-resolution grids of monthly climatic observations – the CRU TS3·10 dataset. International Journal of Climatology 2014; 34: 623642.
27. Rogers, DJ, Hay, SI, Packer, MJ. Predicting the distribution of tsetse flies in West Africa using temporal Fourier processed meteorological satellite data. Annals of Tropical Medicine and Parasitology 1996; 90: 225241.
28. Alonso, WJ, McCormick, BJ. EPIPOI: a user-friendly analytical tool for the extraction and visualization of temporal parameters from epidemiological time series. BMC Public Health 2012; 12: 982.
29. Alonso, WJ, McCormick, BJ, Schuck-Paim, C. Influenza and specific humidity in French Guiana: when analytical simplicity is golden. The Journal of Infection 2014; 68: 604605. doi: 10.1016/j.jinf.2014.02.002.
30. Alonso, WJ, López, D, Schuck-Paim, C. Popweaver: a program for interpolation and visualization of census and other sparsely collected data. Journal of Population Research 2017;34: 303311.
31. Estallo, EL, et al. Weather variability associated with Aedes (Stegomyia) aegypti (dengue vector) oviposition dynamics in northwestern Argentina. PLoS ONE 2015; 10: e0127820.
32. Schatzmayr, H, Nogueira, RMR. An outbreak of dengue virus at Rio de Janeiro – 1986. Memórias do Instituto Oswaldo Cruz 1986; 81: 245246.
33. Barreto, ML, Teixeira, MG. Dengue no Brasil: situação epidemiológica e contribuições para uma agenda de pesquisa. Estudos Avançados 2008; 22: 5372.
34. Nogueira, RMR, et al. Isolation of dengue virus type 2 in Rio de Janeiro. Memórias do Instituto Oswaldo Cruz 1990; 85: 253.
35. Faria, NR, et al. Twenty years of DENV-2 activity in Brazil: molecular characterization and phylogeny of strains isolated from 1990 to 2010. PLoS Neglected Tropical Diseases 2013; 7: e2095.
36. Nunes, MR, et al. Phylogeography of dengue virus serotype 4, Brazil, 2010–2011. Emerging Infectious Diseases 2012; 18: 18581864.
37. Rodríguez-Barraquer, I, et al. From re-emergence to hyperendemicity: the natural history of the dengue epidemic in Brazil. PLoS Neglected Tropical Diseases 2011; 5: e935.
38. Bardina, SV, et al. Enhancement of Zika virus pathogenesis by preexisting antiflavivirus immunity. Science 2017; 356: 175180.
39. Gamble, J, et al. Age-related changes in microvascular permeability: a significant factor in the susceptibility of children to shock? Clinical Science 2000; 98: 211216.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Type Description Title
WORD
Supplementary materials

Wunderlich et al supplementary material
Figures S1-S5

 Word (1.2 MB)
1.2 MB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 13
Total number of PDF views: 93 *
Loading metrics...

Abstract views

Total abstract views: 410 *
Loading metrics...

* Views captured on Cambridge Core between 13th December 2017 - 12th June 2018. This data will be updated every 24 hours.