原著和名: ヒモヅル科名: ヒカゲノカズラ科 = Lycopodiaceae採集地: 鹿児島県 屋久島 屋久町 安房林道 (大隅 屋久島 屋久町 安房林道)採集日: 1989/10/12採集者: 萩庭丈壽整理番号: JH016078国立科学博物館整理番号: TNS-VS-96607

Chaur-Dong Chen (795636)

Chi-Kung Ho (65131)

Chia-Chi Ku (2922099)

Chien-Chou Lin (2922087)

Chwan-Chuen King (39461)

Fuh-Yuan Shih (2922081)

Hau-Yuan Cheng (2922090)

Jien-Wei Liu (181764)

Jui-Hung Kao (422159)

Pei-Yun Shu (638471)

Ta-Chien Chan (185120)

Tsung-Hwa Tung (2922084)

Wu-Hsiung Tsai (2922093)

Yin-Hsia Chu (2922096)

Zheng-Rong Tiger Li (185136)

PLoS ONE

PubMed

<div>The increasing dengue burden and epidemic severity worldwide have highlighted the need to improve surveillance. In non-endemic areas such as Taiwan, where outbreaks start mostly with imported cases from Southeast Asia, a closer examination of surveillance dynamics to detect cases early is necessary. To evaluate problems with dengue surveillance and investigate the involvement of different factors at various epidemic stages, we investigated 632 laboratory-confirmed indigenous dengue cases in Kaohsiung City, Taiwan during 2009–2010. The estimated sensitivity of clinical surveillance was 82.4% (521/632). Initially, the modified serological surveillance (targeting only the contacts of laboratory-confirmed dengue cases) identified clinically unrecognized afebrile cases in younger patients who visited private clinics and accounted for 30.4% (35/115) of the early-stage cases. Multivariate regression indicated that hospital/medical center visits [Adjusted Odds Ratio (aOR): 11.6, 95% confidence interval (CI): 6.3–21.4], middle epidemic stage [aOR: 2.4 (1.2–4.7)], fever [aOR: 2.3 (2.3–12.9)], and musculo-articular pain [aOR: 1.9 (1.05–3.3)] were significantly associated with clinical reporting. However, cases with pruritus/rash [aOR: 0.47 (0.26–0.83)] and diarrhea [aOR: 0.47 (0.26–0.85)] were underreported. In conclusion, multiple factors contributed to dengue surveillance problems. To prevent a large-scale epidemic and minimize severe dengue cases, there is a need for integrated surveillance incorporating entomological, clinical, serological, and virological surveillance systems to detect early cases, followed by immediate prevention and control measures and continuous evaluation to ensure effectiveness. This effort will be particularly important for an arbovirus, such as Zika virus, with a high asymptomatic infection ratio. For dengue- non-endemic countries, we recommend serological surveillance be implemented in areas with high Aedes mosquito indices or many breeding sites. Syndromic surveillance, spatial analysis and monitoring changes in epidemiological characteristics using a geographical information system, as well as epidemic prediction models involving epidemiological, meteorological and environmental variables will be helpful for early risk communication to increase awareness.</div

FigShare

The Critical Role of Early Dengue Surveillance and Limitations of Clinical Reporting – Implications for Non-Endemic Countries

The increasing dengue burden and epidemic severity worldwide have highlighted the need to improve surveillance. In non-endemic areas such as Taiwan, where outbreaks start mostly with imported cases from Southeast Asia, a closer examination of surveillance dynamics to detect cases early is necessary. To evaluate problems with dengue surveillance and investigate the involvement of different factors at various epidemic stages, we investigated 632 laboratory-confirmed indigenous dengue cases in Kaohsiung City, Taiwan during 2009-2010. The estimated sensitivity of clinical surveillance was 82.4% (521/632). Initially, the modified serological surveillance (targeting only the contacts of laboratory-confirmed dengue cases) identified clinically unrecognized afebrile cases in younger patients who visited private clinics and accounted for 30.4% (35/115) of the early-stage cases. Multivariate regression indicated that hospital/medical center visits [Adjusted Odds Ratio (aOR): 11.6, 95% confidence interval (CI): 6.3-21.4], middle epidemic stage [aOR: 2.4 (1.2-4.7)], fever [aOR: 2.3 (2.3-12.9)], and musculo-articular pain [aOR: 1.9 (1.05-3.3)] were significantly associated with clinical reporting. However, cases with pruritus/rash [aOR: 0.47 (0.26-0.83)] and diarrhea [aOR: 0.47 (0.26-0.85)] were underreported. In conclusion, multiple factors contributed to dengue surveillance problems. To prevent a large-scale epidemic and minimize severe dengue cases, there is a need for integrated surveillance incorporating entomological, clinical, serological, and virological surveillance systems to detect early cases, followed by immediate prevention and control measures and continuous evaluation to ensure effectiveness. This effort will be particularly important for an arbovirus, such as Zika virus, with a high asymptomatic infection ratio. For dengue- non-endemic countries, we recommend serological surveillance be implemented in areas with high Aedes mosquito indices or many breeding sites. Syndromic surveillance, spatial analysis and monitoring changes in epidemiological characteristics using a geographical information system, as well as epidemic prediction models involving epidemiological, meteorological and environmental variables will be helpful for early risk communication to increase awareness

Jui-Hung Kao

Chaur-Dong Chen

Zheng-Rong Tiger Li

Ta-Chien Chan

Tsung-Hwa Tung

Ying-Hsia Chu

Hau-Yuan Cheng

Jien-Wei Liu

Fuh-Yuan Shih

Pei-Yun Shu

Chien-Chou Lin

Wu-Hsiung Tsai

Chia-Chi Ku

Chi-Kung Ho

Chwan-Chuen King

Directory of Open Access Journals

The Critical Role of Early Dengue Surveillance and Limitations of Clinical Reporting - Implications for Non-Endemic Countries.

(A) Weekly numbers of confirmed indigenous dengue cases: Dengue cases (dengue fever and dengue hemorrhagic fever cases) were identified through both clinical and serological surveillance systems in Kaohsiung City (from 28th week, 2009 to 7th week, 2010). Epidemic curve shows case numbers over time for dengue fever and dengue hemorrhagic fever cases detected by clinical and serological surveillance systems. (B) The weekly numbers of medical visits before notification to Kaohsiung DOH. Darker blue represents dengue patients in this epidemic seeking more medical visits (i.e. hospital shopping). (C) Weekly “Detection-delay Days” through the two surveillance systems. Darker blue color indicates longer detection-delay through clinical and serological surveillance systems. The means and medians of “detection delay days” around five days at the three epidemic stages showing differences in distributions but without statistical differences [means: early = 5.3±3.4, middle = 5.0±3.9, late = 5.1±3.3, p = 0.71; media: 5, 4, 5, p = 0.48; ranges: 0–27, 0–47, and 0–24]. In (B) and (C): Those weeks with low numbers were summarized to better understand the trends.</p

The Critical Role of Early Dengue Surveillance and Limitations of Clinical Reporting – Implications for Non-Endemic Countries - Fig 2

https://figshare.com/articles/The_Critical_Role_of_Early_Dengue_Surveillance_and_Limitations_of_Clinical_Reporting_Implications_for_Non-Endemic_Countries_-_Fig_2/3549189