Consecutive large dengue outbreaks in Taiwan in 2014–2015

Wang, Sheng-Fan; Chang, Ko; Loh, El Wui; Wang, Wen Hung; Tseng, Sung-Pin; Lu, Po Liang; Chen, Yen Hsu; Chen, Yi Ming Arthur

doi:10.1038/emi.2016.124

Cited by 55 publications

(71 citation statements)

References 14 publications

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“…The secondary and tertiary prevention measures are to enhance disease surveillance and to control the mortality rate by improving health care quality. Under these prevention measures, the annual DF incidence in Taiwan was controlled to less than 10 cases per 100,000 individuals for two decades, except for a recent outbreak in 2014 and 2015, with a total of 15,492 indigenous cases (61.3 cases per 100,000 individuals) in 2014 and 43,419 cases (168.6 cases per 100,000 individuals) in 2015 reported by the Taiwan CDC [8]. The DF outbreaks in 2014 and 2015 prompted the use of novel vector control methods to complement flaws in the current strategies.…”

Section: Introductionmentioning

confidence: 99%

“…In this study, laboratory test and field trial were conducted in Kaohsiung city, where 59% (34,722/58,911) of the DF cases were distributed during the outbreak from 2014 to 2015 [8]. A new form of dissemination sites using PPF residual spray on the resting surfaces favored by Aedes mosquitoes was evaluated to determine the efficiency of emergence inhibition at cryptic sources in the field trial.…”

Section: Introductionmentioning

confidence: 99%

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Using UPLC–MS/MS to Evaluate the Dissemination of Pyriproxyfen by Aedes Mosquitoes to Combat Cryptic Larval Habitats after Source Reduction in Kaohsiung in Southern Taiwan

Chen

Lai

et al. 2020

Insects

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The policy regarding mosquito control strategies in Taiwan is based on integrated vector management (IVM). The major approach is source reduction via collaboration by both residents and governments. However, small and cryptic habitats of dengue vectors are hard to find and eliminate in urban communities. Therefore, this study evaluated a complementary approach that targeted cryptic habitats by utilizing mosquitoes themselves as vehicles to transfer an insect growth regulator, pyriproxyfen (PPF), to their breeding sites; the amount of PPF in breeding water was determined with ultra-performance liquid chromatography coupled with tandem mass spectrometry (UPLC-MS/MS). A bioassay conducted by introducing ten late-instar larvae into PPF solution was performed to assess emergence inhibition (EI). PPF was found at 0.56 ± 0.04 ng in 25 mL of water by dissemination via ten Aedes aegypti mosquitoes exposed to 0.01% PPF, leading to 100% EI. After the community-level source reduction, a field trial in Kaohsiung in Southern Taiwan showed that 30.8-31.5% of cryptic ovitraps reached EI ≥ 50% one month after spraying 0.01% PPF in microhabitats favored by mosquitoes. IVM in parallel with residual spraying of PPF on resting surfaces of mosquitoes could serve as a simple and complementary approach to reduce cryptic larval sources in urban communities in Southern Taiwan.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Using UPLC–MS/MS to Evaluate the Dissemination of Pyriproxyfen by Aedes Mosquitoes to Combat Cryptic Larval Habitats after Source Reduction in Kaohsiung in Southern Taiwan

Chen

Lai

et al. 2020

Insects

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“…Over the last decade, Taiwan has experienced two of the largest dengue outbreaks, the first in 2014 (Sheng-Fan Wang, 2015;Wang et al, 2016b) and the second even larger outbreak in 2015 (Wang et al, 2016a). The severity and relevant risks correlated with the 2015 outbreak are still not fully understood.…”

Section: Introductionmentioning

confidence: 99%

A clinical and epidemiological survey of the largest dengue outbreak in Southern Taiwan in 2015

Wang

Lin

Chang

et al. 2019

International Journal of Infectious Diseases

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This study examined the epidemiological, clinical, and immunological characteristics of the 2015 dengue outbreak in Taiwan. Methods: Clinical data were collected from dengue fever (DF) and dengue hemorrhagic fever (DHF) patients. A phylogenetic tree was used to analyze the source of the outbreak strain. Paired plasma samples from DF/DHF patients were used for antibody-dependent enhancement (ADE) assay and cytokine multiplex biometric immunoassay to validate the immunological mechanism. Results: This outbreak mainly occurred in two of the southern cities of Taiwan: Tainan (n = 22 777; 52%) and Kaohsiung (n = 19 784; 45%). A high DHF death rate was noted (34.6%). The case (DHF) and control (DF) study indicated that older age (>60 years), type II diabetes, and hypertension were risk factors correlated with the development of DHF (p < 0.0001). The phylogenetic tree results suggested that the outbreak-associated strain was dengue virus serotype 2 and cosmopolitan genotype, forming a stable cluster with the isolates from Thailand and Indonesia (bootstrap value of 99%). Cytokine analyses demonstrated that levels of interleukin (IL)-6, IL-4, IL-13, IL-1β, interferon gamma (IFN-g), and granulocyte-macrophage colony-stimulating factor (GM-CSF) were significantly higher in DHF patients compared to DF patients (p < 0.001). The ADE assay showed that diluted plasma containing preexisting dengue antibodies from DHF patients significantly enhanced dengue infection (p < 0.05). Conclusion: The results suggest that older age, type II diabetes, hypertension, immunological cytokine dysregulation, and preexisting dengue antibodies inducing ADE infection are correlated with dengue severity. This study also indicates that the largest dengue outbreak in Taiwan might have been a result of imported DF from dengue epidemic regions.

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“…The highest prevalence rate is among people in their sixties [6]. During 2015, a large-scale dengue outbreak, which was caused by the dengue virus serotype 2, occurred in Tainan City [7] and a total of 22,777 dengue cases were confirmed [8]. Among these, 2%-3% had severe diseases or complications that required intensive care [9, 10].…”

Section: Introductionmentioning

confidence: 99%

Causes of death among hospitalized adults with dengue fever in Tainan, 2015: emphasis on cardiac events and bacterial infections

Lee

Cia

Lee

et al. 2018

Preprint

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PLC) 2 26 27 Keyword: dengue fever, fatality, mortality, bacterial infection, bacteremia, cardiac 28 arrest, Taiwan 3 29 Abstract 30 Introduction. The 2015 dengue outbreak in southern Taiwan caused substantial 31 mortality rates in the elderly. We analyzed here the causes of death among adults with 32 dengue. 33 Methods. The retrospective study was conducted at a medical center in Tainan from 34 the 1 st of August to 31th of December in the year 2015. The detection of the dengue 35 NS1 antigen IgM or viral RNA in patients' blood were used to diagnose dengue.36 Clinical courses and causes of death were retrieved from chart reviews by two 37 intensivists.38 Results. There were 4,488 cases of dengue diagnosed in the study hospital, and these 39 cases had an in-hospital case fatality rate of 1.34% (60 cases). Of these, the mean age 40 was 73 years and gender did not predict outcome. Twenty-eight (46.7%) cases died of 41 severe dengue, and 29 (48.3%) deaths were possibly caused by dengue-related 42 complications, which were mostly secondary infections (24 cases). Most of the 43 families of fatal case (70%) signed do-not-resuscitate (DNR) orders prior to the 44 patients' death. When the dengue epidemic peaked, 13 cardiac arrest events, including 45 out-of-hospital (5 events) and in-hospital (8) cardiac arrests at the emergency 46 department, occurred within four weeks of the dengue epidemic. Notably, in half (7) 47 of these cases, the patients did not search for medical aid prior to experiencing cardiac 48 arrest. Of the 40 cases that had early death (occurring within one week after 49 hospitalization), 60% died of severe dengue. In contrast, 50% of the 20 deaths that 50 occurred later than one week after hospitalization were related to hospital-acquired 51 infections, mainly pneumonia.52 Conclusion. The elderly that experience dengue fever may die of severe dengue early 4 53 or die of secondary infections later. Cardiac arrests can also occur unpredictably at the 54 first aids, which highlight the need of professional and patient education regarding the 55 danger signs that are related to severe dengue in an epidemic setting. 5 56 Author summary 57 The 2015 dengue outbreak in Tainan City caused substantial deaths among the 58 elderly. The main causes of death were severe dengue and its complications. We here 59 highlight the deaths caused by heart complications of dengue that the elderly has 60 underlying cardiovascular comorbidities is more prone to be involved. The 61 presentations of heart complications vary, ranging from arrythmia to myocarditis and 62 to unexpected cardiac arrest. Clinicians should carefully evaluate and monitor the 63 heart function of patients with severe dengue and provide timing intervention. 64 Secondary infections or healthcare-associated infections may occur throughout the 65 whole hospitalized course. They were also the leading causes of death during the late 66 or recovery phase of dengue in the study. Judicious application of antimicrobial 67 agents and early elimination of infection ...

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Consecutive large dengue outbreaks in Taiwan in 2014–2015

Cited by 55 publications

References 14 publications

Using UPLC–MS/MS to Evaluate the Dissemination of Pyriproxyfen by Aedes Mosquitoes to Combat Cryptic Larval Habitats after Source Reduction in Kaohsiung in Southern Taiwan

Using UPLC–MS/MS to Evaluate the Dissemination of Pyriproxyfen by Aedes Mosquitoes to Combat Cryptic Larval Habitats after Source Reduction in Kaohsiung in Southern Taiwan

A clinical and epidemiological survey of the largest dengue outbreak in Southern Taiwan in 2015

Causes of death among hospitalized adults with dengue fever in Tainan, 2015: emphasis on cardiac events and bacterial infections

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