The metropolitan region of Tainan City in southern Taiwan experienced a dengue outbreak in 2015. This manuscript describes basic epidemiological features of this outbreak and uses spatial and temporal analysis tools to understand the spread of dengue during the outbreak. The analysis found that, independently of gender, dengue incidence rate increased with age, and proportionally affected more males below the age of 40 years but females above the age of 40 years. A spatial scan statistic was applied to detect clusters of disease transmission. The scan statistic found that dengue spread in a north-south diffusion direction, which is across the North, West-Central and South districts of Tainan City. Spatial regression models were used to quantify factors associated with transmission. This analysis indicated that neighborhoods with high proportions of residential area (or low wetland cover) were associated with dengue transmission. However, these association patterns were non-linear. The findings presented here can help Taiwanese public health agencies to understand the fundamental epidemiological characteristics and diffusion patterns of the 2015 dengue outbreak in Tainan City. This type of information is fundamental for policy making to prevent future uncontrolled dengue outbreaks, given that results from this study suggest that control interventions should be emphasized in the North and West-Central districts of Tainan city, in areas with a moderate percentage of residential land cover.
The assumption that vector abundance differences might drive spatial and temporal heterogeneities in vector-borne disease transmission is common, though data supporting it is scarce. Here, we present data from two common mosquito species Aedes aegypti (Linnaeus) and Culex quinquefasciatus Say, biweekly sampled as adults, from March 2016 through December 2017, with BG-sentinel traps in two neighboring districts of Kaohsiung City (KC), Taiwan. One district has historically been a dengue transmission hotspot (Sanmin), and the other a coldspot (Nanzih). We collected a total 41,027 mosquitoes, and we found that average mosquito abundance (mean ± S.D.) was higher in Sanmin (Ae. aegypti: 9.03 ± 1.46; Cx. quinquefasciatus: 142.57 ± 14.38) than Nanzih (Ae. aegypti: 6.21 ± 0.47; Cx. quinquefasciatus: 63.37 ± 8.71) during the study period. In both districts, Ae. aegypti and Cx. quinquefasciatus population dynamics were sensitive to changes in temperature, the most platykurtic environmental variable at KC during the study period, a pattern predicted by Schmalhausen’s law, which states that organisms are more sensitive to small changes in environmental variables whose average value is more uncertain than its extremes. Our results also suggest that differences in Ae. aegypti abundance might be responsible for spatial differences in dengue transmission at KC. Our comparative approach, where we also observed a significant increment in the abundance of Cx. quinquefasciatus in the dengue transmission hotspot, suggests this area might be more likely to experience outbreaks of other vector borne diseases and should become a primary focus for vector surveillance and control.
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