Epidemic resurgence of dengue fever in Singapore in 2013-2014: A virological and entomological perspective

Dengue resurged in Singapore during 2013-14, causing an outbreak with unprecedented number of cases in the country. In the present study, we summarise the epidemiological, virological and entomological findings gathered through the dengue surveillance programme and highlight the drivers of the epide...

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Bibliographic Details
Published in:BMC infectious diseases 2016-06, Vol.16 (1), p.300-300, Article 300
Main Authors: Hapuarachchi, Hapuarachchige Chanditha, Koo, Carmen, Rajarethinam, Jayanthi, Chong, Chee-Seng, Lin, Cui, Yap, Grace, Liu, Lilac, Lai, Yee-Ling, Ooi, Peng Lim, Cutter, Jeffery, Ng, Lee-Ching
Format: Article
Language:English
Subjects:
Adult
Aedes
Animals
Care and treatment
Dengue
Dengue - epidemiology
Dengue - virology
Dengue Virus - genetics
Dengue Virus - isolation & purification
Diagnosis
Disease Outbreaks
Epidemiology
Genotype
Humans
Incidence
Infectious diseases
Insect Vectors
Larva
Serogroup
Singapore - epidemiology
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Summary:Dengue resurged in Singapore during 2013-14, causing an outbreak with unprecedented number of cases in the country. In the present study, we summarise the epidemiological, virological and entomological findings gathered through the dengue surveillance programme and highlight the drivers of the epidemic. We also describe how the surveillance system facilitated the preparedness to moderate epidemic transmission of dengue in the country. The case surveillance was based on a mandatory notification system that requires all medical practitioners to report clinically-suspected and laboratory-confirmed cases within 24 hours. The circulating Dengue virus (DENV) populations were monitored through an island wide virus surveillance programme aimed at determining the serotypes and genotypes of circulating virus strains. Entomological surveillance included adult Aedes surveillance as well as premise checks for larval breeding. A switch in the dominant serotype from DENV-2 to DENV-1 in March 2013 signalled a potential spike in cases, and the alert was corroborated by an increase in average Aedes house index. The alert triggered preparedness and early response to moderate the impending outbreak. The two-year outbreak led to 22,170 cases in 2013 and 18,338 in 2014, corresponding to an incidence rate of 410.6 and 335.0 per 100,000 population, respectively. DENV-1 was the dominant serotype in 2013 (61.7 %, n = 5,071) and 2014 (79.2 %, n = 5,226), contributed largely by a newly-introduced DENV-1 genotype III strain. The percentage of houses with Ae. aegypti breeding increased significantly (p 
ISSN:1471-2334
1471-2334
DOI:10.1186/s12879-016-1606-z