Dengue and Dengue Virus in Guangdong, China, 1978–2017: Epidemiology, Seroprevalence, Evolution, and Policies

Abstract

BackgroundGuangdong is a hyperepidemic area of dengue, which has over 0.72 million cumulative cases within the last four decades, accounting for more than 90% of cases in China. The local epidemic of dengue in Guangdong is suspected to be triggered by imported cases and results in consequent seasonal transmission. However, the comprehensive epidemiological characteristics of dengue in Guangdong are still unclear.MethodsThe epidemiology, seroprevalence, molecular evolution of dengue virus, and the development of policies and strategies on the prevention and control of dengue were analyzed in Guangdong, China from 1978 to 2017.FindingsSeasonal transmission of dengue virus in Guangdong, China was mainly sustained from July to October of each year. August to September was the highest risk period of local dengue outbreaks. Most of the dengue cases in Guangdong were young and middle-aged adults. Five hundred and three fatal cases were recorded, which declined within the last two decades (n = 10). The serological test of healthy donors' serum samples showed a positive rate of 5.77%. Dengue virus 1–4 (DENV 1–4) was detected in Guangdong from 1978 to 2017. DENV 1 was the dominant serotype of dengue outbreaks from 1978 to 2017, with an increasing tendency of DENV 2 since 2010. Local outbreaks of DENV 3 were rare. DENV 4 was only encountered in imported cases in Guangdong, China. The imported cases were the main source of outbreaks of DENV 1–2. Early detection, management of dengue cases, and precise vector control were the key strategies for local dengue prevention and control in Guangdong, China.InterpretationDengue has not become an endemic arboviral disease in Guangdong, China. Early detection, case management, and implementation of precise control strategies are key findings for preventing local dengue transmission, which may serve for countries still struggling to combat imported dengue in the west pacific areas.

Mosquito densovirus significantly reduces the vector susceptibility to dengue virus serotype 2 in Aedes albopictus mosquitoes (Diptera: Culicidae)

“…Guangdong Province, which is located in southeast China, is a hyperendemic region of dengue transmission. Since the first outbreak of dengue fever in 1978, over 0.72 million cumulative cases have been recorded within the last 40 years, accounting for approximately 90 percent of cases in China [ 17 ]. Since 2010, dengue virus serotype 1 (DENV-1) and dengue virus serotype 2 (DENV-2) have been the predominant serotypes in Guangdong.…”

“…Since 2010, dengue virus serotype 1 (DENV-1) and dengue virus serotype 2 (DENV-2) have been the predominant serotypes in Guangdong. However, current epidemiological analysis supports that dengue has not yet developed into an endemic arboviral disease in Guangdong, with local dengue outbreaks still being initiated by imported cases [ 17 , 18 ]. Ae.…”

“…Ae. albopictus is the only confirmed transmission vector responsible for these dengue epidemics in Guangdong [ 17 ].…”

Genomic epidemiology of dengue in Shantou, China, 2019

“…Although outbreaks of dengue are reported almost annually in Guangdong and neighboring Guangxi, Fujian, and Yunnan provinces, Guangdong still ranks at the top of most hyperepidemic dengue areas in China. More than 0.72 million dengue cases have been reported in this province, accounting for over 90% of the total archived dengue cases in China during the last four decades ( 15 – 17 ). However, dengue is an arbovirus triggered by imported cases each year.…”

“…However, dengue is an arbovirus triggered by imported cases each year. Sustained transmission of dengue to the next epidemic season is occasional and rare in Guangdong, China ( 15 , 18 , 19 ). Thus, early detection of imported cases and tracking dynamics of DENV is the key to containing the local transmission of dengue.…”