title: Dynamics of dengue virus circulation: a silent epidemic in a complex urban area.
abstract: Serotypes of dengue DEN-1 and DEN-2 have been reported in much of Brazil over the last 15 years, and DEN-3 serotype was only recently detected. This prospective study was conducted in Salvador, a large city in north-east Brazil, where two epidemics were previously recorded (DEN-1 and DEN-2). We obtained the seroprevalence and 1-year incidence of dengue infections in the population of 30 sampling areas of Salvador and analysed the relationship between intensity of viral circulation, standard of living and vector density. High seroprevalence (68.7%) and annual incidence (70.6%) of infection for one or both circulating serotypes (DEN-1 and DEN-2) were found. High rates of transmission were observed in all studied areas, from the highest to the lowest socio-economic status. The mean PI (Premise Index) for Aedes aegypti was 7.4% (range 0.27-25.6%). Even in the areas with the lowest PI (</=3%) the observed seroincidence was 54.6%. These findings highlighted the existence of a silent epidemic during a period perceived by the Health Services as of low endemicity, indicating the strength and speed of dengue transmission in the city of Salvador.
authors.affiliation: Instituto de Saúde Coletiva, Universidade Federal da Bahia, Rua Padre Feijó, 29 Canela, 40.110-170 Salvador-Bahia, Brazil. magloria@ufba.br
authors.forename: Maria da Glória
authors.initials: Mda G
authors.lastname: Teixeira
authors.forename: Maurício L
authors.initials: ML
authors.lastname: Barreto
authors.forename: Maria da Conceição N
authors.initials: Mda C
authors.lastname: Costa
authors.forename: Leila Denize A
authors.initials: LD
authors.lastname: Ferreira
authors.forename: Pedro F C
authors.initials: PF
authors.lastname: Vasconcelos
authors.forename: Sandy
authors.initials: S
authors.lastname: Cairncross
mesh_terms: D000293:Adolescent; D000328:Adult; D000330:Aedes; D000367:Age Factors; D000368:Aged; D000818:Animals; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003715:Dengue / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control* / Q000821:virology; D003716:Dengue Virus / Q000145:classification; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007303:Insect Vectors; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014504:Urban Health