Best Practices in Dengue Surveillance: A Report from the Asia-Pacific and Americas Dengue Prevention Boards

Abstract

BackgroundDengue fever is a virus infection that is spread by the Aedes aegypti mosquito and can cause severe disease especially in children. Dengue fever is a major problem in tropical and sub-tropical regions of the world.Methodology/Principal FindingsWe invited dengue experts from around the world to attend meetings to discuss dengue surveillance. We reviewed literature, heard detailed reports on surveillance programs, and shared expert opinions.ResultsPresentations by 22 countries were heard during the 2.5 day meetings. We describe the best methods of surveillance in general, the stakeholders in dengue surveillance, and the steps from mosquito bite to reporting of a dengue case to explore how best to carry out dengue surveillance. We also provide details and a comparison of the dengue surveillance programs by the presenting countries.Conclusions/SignificanceThe experts provided recommendations for achieving the best possible data from dengue surveillance accepting the realities of the real world (e.g., limited funding and staff). Their recommendations included: (1) Every dengue endemic country should make reporting of dengue cases to the government mandatory; (2) electronic reporting systems should be developed and used; (3) at minimum dengue surveillance data should include incidence, hospitalization rates, deaths by age group; (4) additional studies should be completed to check the sensitivity of the system; (5) laboratories should share expertise and data; (6) tests that identify dengue virus should be used in patients with fever for four days or less and antibody tests should be used after day 4 to diagnose dengue; and (7) early detection and prediction of dengue outbreaks should be goals for national surveillance systems.

Dengue seropositivity in a randomly selected sample from Yucatan analyzed in the context of dengue cases reported between 1996 and 2006

“…In Mexico, serosurveys are not included in the dengue epidemiologic surveillance system. [10,11] According to the World Health Organization, active surveillance can provide an accurate and pertinent warning for Dengue epidemics that can improve the preventive strategies, but it is important to use it effectively for planning an effective response, while passive surveillance systems alone are ineffective for detecting an epidemic much before peak transmission. If we put the data we analyzed in the present study as an antecedent of what happened in the years following the last serosurvey, we can imply that if serosurveys were developed periodically, and if they included serotype specific immunity analyses (PRNT) along with vector surveillance, the Mexican epidemiologic bureau could have been able to predict early the outbreaks and it could have been able to plan specific strategies to reduce the burden of dengue in the region.…”

Burden of Dengue Infection and Disease in a Pediatric Cohort in Urban Sri Lanka

“…[17][18][19][20][21] Most estimates of dengue incidence in the region are based on hospital-based studies and nationally reported cases, which grossly underestimate the true burden of disease and infection. 31 We followed a cohort of 799 children in Colombo, Sri Lanka, and estimated the incidence of infection and disease to be 8.39 and 3.38 cases/100 children, respectively. The ratio of clinically inapparent to apparent infections was 1.48, which indicated that for every apparent infection there were approximately 1.5 inapparent infections in children.…”

Differential expression of NADPH oxidase-2 (Nox-2) and nuclear factor-erythroid 2-related factor 2 (Nrf2) transcripts in peripheral blood mononuclear cells isolated from dengue patients

“…Around 3.6 billion people are living under the risk of dengue infection [1] (http://www.who.int/denguecontrol/9789241504034/ en/). Average annual incidence of 20,474 dengue cases has reported in India during the tenure of 2006-2012 [18].…”