Epidemiology of dengue virus in Iquitos, Peru 1999 to 2005: interepidemic and epidemic patterns of transmission.
Epidemiology of dengue virus in Iquitos, Peru 1999 to 2005: interepidemic and epidemic patterns of transmission.
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DOI：
10.1371/journal.pntd.0000670
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发表时间：
2010-05-04
影响因子：
3.8
通讯作者：
Kochel TJ
中科院分区：
文献类型：
--
作者：
Morrison AC;Minnick SL;Rocha C;Forshey BM;Stoddard ST;Getis A;Focks DA;Russell KL;Olson JG;Blair PJ;Watts DM;Sihuincha M;Scott TW;Kochel TJ
迫切需要进行全面的、纵向的实地研究，监测登革热病毒的疾病和病媒群体，作为制定适应当地情况的预防方案或适当测试和许可新疫苗的先决条件。我们报告了在秘鲁的亚马逊伊基托斯市进行的为期5年的研究结果，在该研究中，对社区队列的12400名成员进行了DENV感染的血清学监测，并通过对该队列的一个子集进行了活动性发热疾病的学校缺勤监测。在基线时，80%的研究人群具有DENV抗体，血清阳性率随年龄增加而增加，并且观察到显著的地理差异，特定于社区的年龄调整率范围为67.1%至89.9%。在前15个月，当DENV-1和DENV-2共循环时，基于人群的发病率范围为2-3例感染/100人-年（p-年）。在2001年下半年期间DENV-3的引入的特征在于3个不同的时期：至少5-6个月的扩增、先前循环的血清型的替换和当发病率达到89感染/100 p-年的峰值时的流行病传播。在DENV-3引入之前，社区特异性基线血清阳性率不能预测地理发病模式，但在该血清型入侵期间密切反映。传播因地理位置而异，在该市1016平方公里的8个地理区域中，发病高峰出现在不同时间。从新血清型引入到流行病传播的滞后性以及对空间明确的高风险区域的了解，应被考虑用于更有效地应用有限的登革热预防资源。登革热是热带地区一种重要的蚊媒疾病，为了制定登革热的预防（包括疫苗）和控制计划，迫切需要进行全面、长期的现场流行病学研究。我们报告的结果，从1999年到2005年，在亚马逊河流域的伊基托斯市，秘鲁，监测12400名学童和一些成年家庭成员的登革热感染，每隔6个月。入组时，约80%的参与者既往感染过DENV血清型1和2或两者。在前15个月，在研究参与者中观察到每100名参与者中约有3名新感染。2001年，DENV-3，一种以前在该地区未观察到的血清型，以3个不同时期为特征的过程入侵伊基托斯：至少5-6个月的扩增，以前流行的血清型的替换，以及发病率达到峰值时的流行病传播。新发感染的发病模式在地理上与DENV-3到来之前的基线流行率不同，但在入侵期间密切反映了它们。登革病毒的传播在地理上与蚊子密度的增加相对应。一种新血清型的入侵通常在传统监测程序检测到病毒之前有5-6个月的沉默传播。这篇文章为随后的登革热流行病学出版物奠定了基础。
Comprehensive, longitudinal field studies that monitor both disease and vector populations for dengue viruses are urgently needed as a pre-requisite for developing locally adaptable prevention programs or to appropriately test and license new vaccines. We report the results from such a study spanning 5 years in the Amazonian city of Iquitos, Peru where DENV infection was monitored serologically among ∼2,400 members of a neighborhood-based cohort and through school-based absenteeism surveillance for active febrile illness among a subset of this cohort. At baseline, 80% of the study population had DENV antibodies, seroprevalence increased with age, and significant geographic variation was observed, with neighborhood-specific age-adjusted rates ranging from 67.1 to 89.9%. During the first 15 months, when DENV-1 and DENV-2 were co-circulating, population-based incidence rates ranged from 2–3 infections/100 person-years (p-years). The introduction of DENV-3 during the last half of 2001 was characterized by 3 distinct periods: amplification over at least 5–6 months, replacement of previously circulating serotypes, and epidemic transmission when incidence peaked at 89 infections/100 p-years. Neighborhood-specific baseline seroprevalence rates were not predictive of geographic incidence patterns prior to the DENV-3 introduction, but were closely mirrored during the invasion of this serotype. Transmission varied geographically, with peak incidence occurring at different times among the 8 geographic zones in ∼16 km2 of the city. The lag from novel serotype introduction to epidemic transmission and knowledge of spatially explicit areas of elevated risk should be considered for more effective application of limited resources for dengue prevention. To develop prevention (including vaccines) and control programs for dengue fever, a significant mosquito-borne disease in the tropics, there is an urgent need for comprehensive long term field epidemiological studies. We report results from a study that monitored ∼2,400 school children and some adult family members for dengue infection at 6 month intervals from 1999 to 2005, in the Amazonian city of Iquitos, Peru. At enrollment, ∼80% of the participants had a previous infection with DENV serotypes 1 and 2 or both. During the first 15 months, about 3 new infections for every 100 participants were observed among the study participants. In 2001, DENV-3, a serotype not previously observed in the region, invaded Iquitos in a process characterized by 3 distinct periods: amplification over at least a 5–6 month period, replacement of previously circulating serotypes, and epidemic transmission when incidence peaked. Incidence patterns of new infections were geographically distinct from baseline prevalence rates prior to arrival of DENV-3, but closely mirrored them during the invasion. DENV transmission varied geographically corresponding to elevated mosquito densities. The invasion of a novel serotype is often characterized by 5–6 months of silent transmission before traditional surveillance programs detect the virus. This article sets the stage for subsequent publications on dengue epidemiology.
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影响因子：
11.8
作者：
Forshey, Brett M.;Morrison, Amy C.;Kochel, Tadeusz J.
通讯作者：
Kochel, Tadeusz J.
影响因子：
5
作者：
Endy, TP;Chunsuttiwat, S;Ennis, FA
通讯作者：
Ennis, FA
DOI：
10.4269/ajtmh.1988.38.172
发表时间：
1988-01-01
影响因子：
3.3
作者：
BURKE, DS;NISALAK, A;SCOTT, RM
通讯作者：
SCOTT, RM
影响因子：
168.9
作者：
Kochel, TJ;Watts, DM;Russe, KL
通讯作者：
Russe, KL
DOI：
10.1016/j.cimid.2004.03.013
发表时间：
2004-09-01
影响因子：
2
作者：
Gubler, DJ
通讯作者：
Gubler, DJ