title: Vector densities that potentiate dengue outbreaks in a Brazilian city.
abstract: To identify the critical vector density that potentiates dengue outbreaks in an endemic site and to identify obstacles to anti-dengue activities, we correlated a series of dengue outbreaks in a Brazilian city with the intensity of its anti-vector source-reduction activities. The proportion of houses infested by vector mosquitoes correlated inversely with intensity of anti-mosquito interventions, and the vector population developed independently of rainfall. Local periods of drought promoted vector abundance in two ways: residents stored water in which vector mosquitoes could breed, and cholera outbreaks due to contaminated water diverted local health workers from routine anti-vector activities. One dengue outbreak became apparent to authorities more than two months after it commenced but would have been identified almost immediately had dengue-like disease in indicator hospitals been monitored. Active surveillance, therefore, offers a window of opportunity for promptly executed anti-dengue interventions. Source-reduction measures that suppress vector infestations to less than 1% of houses effectively avert outbreaks of dengue.
authors.affiliation: Departamento de Saude Comunitaria, Universidade Federal do Ceará/Brazil, Fortaleza-Ceará.
authors.forename: R J
authors.initials: RJ
authors.lastname: Pontes
authors.forename: J
authors.initials: J
authors.lastname: Freeman
authors.forename: J W
authors.initials: JW
authors.lastname: Oliveira-Lima
authors.forename: J C
authors.initials: JC
authors.lastname: Hodgson
authors.forename: A
authors.initials: A
authors.lastname: Spielman
mesh_terms: D000818:Animals; D001938:Brazil / Q000453:epidemiology; D002771:Cholera / Q000453:epidemiology; D009033:Culicidae; D003715:Dengue / Q000453:epidemiology*; D004196:Disease Outbreaks; D006801:Humans; D007303:Insect Vectors; D011156:Population Density; D011891:Rain; D019595:Severe Dengue / Q000453:epidemiology