Background Spatial and temporal changes in the dengue incidence are associated with multiple factors, such as climate, immunity among a population against dengue viruses (DENV), circulating DENV serotypes and vertical transmission (VT) of DENV in an area at a given time. The level of VT in a specific location has epidemiological implications in terms of viral maintenance in vectors. Identification of the circulating DENV serotypes in both patients and Aedes mosquito larvae in an area may be useful for the early detection of outbreaks. We report here the results of a prospective descriptive study that was conducted to detect the levels of VT in Aedes mosquito larvae and circulating DENV serotypes in patients and Aedes mosquito larvae from December 2015 to March 2017 in an area of Sri Lanka at high risk for dengue. Methods A total of 200 patients with clinically suspected dengue who had been admitted to a tertiary care hospital during a dengue outbreak (3 study periods: December 2015–January 2016, June–August 2016, December 2016–January 2017) and in the inter-outbreak periods (February–May 2016 and September–November 2016) were investigated. Blood samples were drawn from the study participants to test for DENV. The houses of the study participants were visited within 7 days of admission to the hospital, and Aedes larvae were also collected within a radius of 400 m from the houses. The larvae were separately identified to species and then pooled according to each patient’s identification number. Patients’ sera and the Aedes larvae were tested to identify the infecting DENV serotypes using a reverse transcription PCR (RT-PCR) method. Levels of VT in Aedes mosquito larvae were also identified. Results All four DENV serotypes (DENV-1 to -4) were identified in the study area. In the early part of the study (December 2015–February 2016), DENV-3 was predominant and from April 2016 to March 2017, DENV-2 became the most predominant type. Four cases of DENV co-infections were noted during the study period in patients. Interestingly, all four DENV serotypes were detected in Aedes albopictus larvae, which was the prominent immature vectorial form identified throughout the study period in the area, showing 9.8% VT of DENV. With the exception of DENV-4, the other three DENV serotypes were identified in Aedes aegypti larvae with a VT of 8.1%. Conclusion Comparatively high rates of VT of DENV was detected in Ae. albopictus and Ae. aegypti larvae. A shift in the predominant DENV serotype with simultaneous circulation of all four DENV serotypes was identified in the study area from December 2015 to March 2017. Graphical Abstract
PurposeThis paper examines how the properties and patterns of a collaborative “networked hierarchy” incident command system (ICS) archetype can provide incident command centres with extra capabilities to manage public service delivery during COVID-19.Design/methodology/approachThe paper illustrates the case of Sri Lanka's COVID-19 administration during its “first wave” (from 15 February to 1 September 2020). Primary data were collected through in-depth interviews with government officials who were directly involved in the administration of the COVID-19 outbreak. Secondary data sources were government publications and web sources. The data were analysed and interpreted by using narrative analysis and archetype theory respectively.FindingsThe findings highlight how Sri Lanka's public sector responses to COVID-19 have followed a collaborative “networked hierarchy” ICS archetype. More specifically, the government changed its normative ICS “properties” by incorporating a diverse group of intergovernmental agencies such as the police, the military, the health service and administrative services by articulating new patterns of collaborative working, namely, organisational values, beliefs and ideas that fit with the Sri Lankan public service context.Originality/valueIn responding to high magnitude healthcare emergencies, the flexibility of a collaborative networked ICS hierarchy enables different balances of organisational properties to be incorporated, such as hierarchy and horizontal networking and “patterns” in public service provision.
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