Dengue disease surveillance: an updated systematic literature review

Objectives To review the evidence for the application of tools for dengue outbreak prediction/detection and trend monitoring in passive and active disease surveillance systems in order to develop recommendations for endemic countries and identify important research needs. Methods This systematic literature review followed the protocol of a review from 2008, extending the systematic search from January 2007 to February 2013 on PubMed, EMBASE, CDSR, WHOLIS and Lilacs. Data reporting followed the PRISMA statement. The eligibility criteria comprised (i) population at risk of dengue, (ii) dengue disease surveillance, (iii) outcome of surveillance described and (iv) empirical data evaluated. The analysis classified studies based on the purpose of the surveillance programme. The main limitation of the review was expected publication bias. Results A total of 1116 papers were identified of which 36 articles were included in the review. Four cohort-based prospective studies calculated expansion factors demonstrating remarkable levels of underreporting in the surveillance systems. Several studies demonstrated that enhancement methods such as laboratory support, sentinel-based reporting and staff motivation contributed to improvements in dengue reporting. Additional improvements for passive surveillance systems are possible by incorporating simple data forms/entry/electronic-based reporting; defining clear system objectives; performing data analysis at the lowest possible level (e.g. district); seeking regular data feedback. Six studies showed that serotype changes were positively correlated with the number of reported cases or with dengue incidence, with lag times of up to 6 months. Three studies found that data on internet searches and event-based surveillance correlated well with the epidemic curve derived from surveillance data. Conclusions Passive surveillance providing the baseline for outbreak alert should be strengthened and appropriate threshold levels for outbreak alerts investigated. Additional enhancement tools such as syndromic surveillance, laboratory support and motivation strategies can be added. Appropriate alert signals need to be identified and integrated into a risk assessment tool. Shifts in dengue serotypes/genotype or electronic event-based surveillance have also considerable potential as indicator in dengue surveillance. Further research on evidence-based response strategies and cost-effectiveness is needed

Challenges in dengue research: A computational perspective

This is the final version of the article. Available from Wiley via the DOI in this record.The dengue virus is now the most widespread arbovirus affecting human populations, causing significant economic and social impact in South America and South-East Asia. Increasing urbanization and globalization, coupled with insufficient resources for control, misguided policies or lack of political will, and expansion of its mosquito vectors are some of the reasons why interventions have so far failed to curb this major public health problem. Computational approaches have elucidated on dengue's population dynamics with the aim to provide not only a better understanding of the evolution and epidemiology of the virus but also robust intervention strategies. It is clear, however, that these have been insufficient to address key aspects of dengue's biology, many of which will play a crucial role for the success of future control programmes, including vaccination. Within a multiscale perspective on this biological system, with the aim of linking evolutionary, ecological and epidemiological thinking, as well as to expand on classic modelling assumptions, we here propose, discuss and exemplify a few major computational avenues—real-time computational analysis of genetic data, phylodynamic modelling frameworks, within-host model frameworks and GPU-accelerated computing. We argue that these emerging approaches should offer valuable research opportunities over the coming years, as previously applied and demonstrated in the context of other pathogens.JL, AW and SG received funding from the European Research Council under the European Union's Seventh Framework Programme (FP7/2007-2013) / ERC grant agreement no. 268904 - DIVERSITY. MR was supported by a Royal Society University Research Fellowship. NRF by a Sir Henry Dale Fellowship jointly funded by the Wellcome Trust and the Royal Society (grant number 204311/Z/16/Z). WT has received funding from a doctoral scholarship from the Engineering and Physical Sciences Research Council (EPSRC) Doctoral Training Partnership

Pregovori s Europskom unijom, tijek dubinske analize za poglavlje 28. - Zaštita zdravlja i potrošača, dio o zaštiti zdravlja (Negotiations with EU and Progress of In depth Analysis for Chapter 28: Consumer Protection and Health - The Health Care Part)

Područje zaštite zdravlja tradicionalno nije pokriveno aquis communitaire-om, nego je uređenje toga područja prepušteno zemljama članicama. članak 152 Amsterdanskog ugovora poziva zemlje članice na koordinaciju i konsolidirane akcije donošenja nacionalnih politika javnog zdravstva za borbu protiv prioritetnih bolesti i preventivne aktivnosti sprječavanja bolesti, očuvanja zdravlja i poboljšanja kvalitete života. Podrška koordiniranim aktivnostima osigurana je kroz Public Health Programme u kojem se godišnje osigurava preko 30 milijuna Eura za projekte u skladu s prioritetnim ciljevima na nivou Europe, a za koje se zemlje članice, samostalno ili udruženo natječu putem prijave projekata. Harmonizacija ovoga područja nije predviđena osim za specifične slučajeve kao što su krv i krvni derivati, tkiva i stanice, zarazne bolesti i duhan, pri kojima se standardi sigurnosti i kvalitete moraju uskladiti radi osiguravanja istovjetnog stupnja zaštite zdravlja stanovništva čitave ujedinjene Europe. Kao instrument koordinirane borbe protiv određenih masovnih ili važnih bolesti donose se rezolucije, preporuke, konvencije, i programi, koje zemlje članice nastoje slijediti sukladno vlastitom izboru prioriteta i mogućnostima djelovanja.S Hrvatske strane na pregovorima su sudjelovali stručnjaci Ministarstva zdravstva i socijalne skrbi, Hrvatskog zavoda za javno zdravstvo i Hrvatskog zavoda za transfuzijsku medicinu. Kroz prezentacije hrvatskih stručnjaka predstavnicima EK prikazana je duga i bogata tradicija preventivne medicine, još od statuta Dalmatinskih gradova srednjega vijeka i dubrovačke karantene do današnjih dana kada je   razvijen vlastiti organizacijski model strukture i funkcionalnosti javnoga zdravstva. Uz legislativno uređenje ovoga područja i usporedbu s europskim propisima prikazani su im i najnoviji statistički podaci i pokazatelji stanja na čemu su nam izrazili zahvalnost

Pregovori s Europskom unijom, tijek dubinske analize za poglavlje 28. - Zaštita zdravlja i potrošača, dio o zaštiti zdravlja (Negotiations with EU and Progress of In depth Analysis for Chapter 28: Consumer Protection and Health–The Health Care Part)

Područje zaštite zdravlja tradicionalno nije pokriveno aquis communitaire-om, nego je uređenje toga područja prepušteno zemljama članicama. članak 152 Amsterdanskog ugovora poziva zemlje članice na koordinaciju i konsolidirane akcije donošenja nacionalnih politika javnog zdravstva za borbu protiv prioritetnih bolesti i preventivne aktivnosti sprječavanja bolesti, očuvanja zdravlja i poboljšanja kvalitete života. Podrška koordiniranim aktivnostima osigurana je kroz Public Health Programme u kojem se godišnje osigurava preko 30 milijuna Eura za projekte u skladu s prioritetnim ciljevima na nivou Europe, a za koje se zemlje članice, samostalno ili udruženo natječu putem prijave projekata. Harmonizacija ovoga područja nije predviđena osim za specifične slučajeve kao što su krv i krvni derivati, tkiva i stanice, zarazne bolesti i duhan, pri kojima se standardi sigurnosti i kvalitete moraju uskladiti radi osiguravanja istovjetnog stupnja zaštite zdravlja stanovništva čitave ujedinjene Europe. Kao instrument koordinirane borbe protiv određenih masovnih ili važnih bolesti donose se rezolucije, preporuke, konvencije, i programi, koje zemlje članice nastoje slijediti sukladno vlastitom izboru prioriteta i mogućnostima djelovanja.S Hrvatske strane na pregovorima su sudjelovali stručnjaci Ministarstva zdravstva i socijalne skrbi, Hrvatskog zavoda za javno zdravstvo i Hrvatskog zavoda za transfuzijsku medicinu. Kroz prezentacije hrvatskih stručnjaka predstavnicima EK prikazana je duga i bogata tradicija preventivne medicine, još od statuta Dalmatinskih gradova srednjega vijeka i dubrovačke karantene do današnjih dana kada je   razvijen vlastiti organizacijski model strukture i funkcionalnosti javnoga zdravstva. Uz legislativno uređenje ovoga područja i usporedbu s europskim propisima prikazani su im i najnoviji statistički podaci i pokazatelji stanja na čemu su nam izrazili zahvalnost

Dengue in Madeira Island

This is a preprint of a paper whose final and definite form will be published in the volume Mathematics of Planet Earth that initiates the book series CIM Series in Mathematical Sciences (CIM-MS) published by Springer. Submitted Oct/2013; Revised 16/July/2014 and 20/Sept/2014; Accepted 28/Sept/2014.Dengue is a vector-borne disease and 40% of world population is at risk. Dengue transcends international borders and can be found in tropical and subtropical regions around the world, predominantly in urban and semi-urban areas. A model for dengue disease transmission, composed by mutually-exclusive compartments representing the human and vector dynamics, is presented in this study. The data is from Madeira, a Portuguese island, where an unprecedented outbreak was detected on October 2012. The aim of this work is to simulate the repercussions of the control measures in the fight of the disease

Syndromic approach to arboviral diagnostics for global travelers as a basis for infectious disease surveillance

Background Arboviruses have overlapping geographical distributions and can cause symptoms that coincide with more common infections. Therefore, arbovirus infections are often neglected by travel diagnostics. Here, we assessed the potential of syndrome-based approaches for diagnosis and surveillance of neglected arboviral diseases in returning travelers. Method To map the patients high at risk of missed clinical arboviral infections we compared the quantity of all arboviral diagnostic requests by physicians in the Netherlands, from 2009 through 2013, with a literature-based assessment of the travelers’ likely exposure to an arbovirus. Results 2153 patients, with travel and clinical history were evaluated. The diagnostic assay for dengue virus (DENV) was the most commonly requested (86%). Of travelers returning from Southeast Asia with symptoms compatible with chikungunya virus (CHIKV), only 55% were tested. For travelers in Europe, arbovirus diagnostics were rarely requested. Over all, diagnostics for most arboviruses were requested only on severe clinical presentation. Conclusion Travel destination and syndrome were used inconsistently for triage of diagnostics, likely resulting in vast under-diagnosis of arboviral infections of public health significance. This study shows the need for more awareness among physicians and standardization of syndromic diagnostic algorithm

Climate change and the emergence of vector-borne diseases in Europe: Case study of dengue fever

Background: Dengue fever is the most prevalent mosquito-borne viral disease worldwide. Dengue transmission is critically dependent on climatic factors and there is much concern as to whether climate change would spread the disease to areas currently unaffected. The occurrence of autochthonous infections in Croatia and France in 2010 has raised concerns about a potential re-emergence of dengue in Europe. The objective of this study is to estimate dengue risk in Europe under climate change scenarios. Methods. We used a Generalized Additive Model (GAM) to estimate dengue fever risk as a function of climatic variables (maximum temperature, minimum temperature, precipitation, humidity) and socioeconomic factors (population density, urbanisation, GDP per capita and population size), under contemporary conditions (1985-2007) in Mexico. We then used our model estimates to project dengue incidence under baseline conditions (1961-1990) and three climate change scenarios: short-term 2011-2040, medium-term 2041-2070 and long-term 2071-2100 across Europe. The model was used to calculate average number of yearly dengue cases at a spatial resolution of 10 × 10 km grid covering all land surface of the currently 27 EU member states. To our knowledge, this is the first attempt to model dengue fever risk in Europe in terms of disease occurrence rather than mosquito presence. Results: The results were presented using Geographical Information System (GIS) and allowed identification of areas at high risk. Dengue fever hot spots were clustered around the coastal areas of the Mediterranean and Adriatic seas and the Po Valley in northern Italy. Conclusions: This risk assessment study is likely to be a valuable tool assisting effective and targeted adaptation responses to reduce the likely increased burden of dengue fever in a warmer world