title: Two clustering diffusion patterns identified from the 2001-2003 dengue epidemic, Kaohsiung, Taiwan.
abstract: This study analyzed the spatio-temporal patterns of 4,587 (94% of the total) confirmed dengue cases in Kaohsiung and Fengshan Cities (a two-city area) that occurred in Taiwan from 2001 to 2003. The epidemic had two simultaneous distinct diffusion patterns. One was a contiguous pattern, mostly limited to 1 km from an initial cluster, reflecting that there was a rapid dispersal of infected Aedes aegypti and viremic persons. The second followed a relocation pattern, involving clusters of cases that diffused over 10 weeks starting from the southern and moving to the northern parts of the two-city area. The virus from one clustering site jumped to several distant areas where it rapidly dispersed through a series of human-mosquito transmission cycles to several localities. In both patterns, transmission of disease quickly enlarged the epidemic areas. Future dengue control efforts would benefit from a timely syndromic surveillance system plus extensive public education on how to avoid further transmission.
authors.affiliation: Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China.
authors.forename: Chih-Chun
authors.initials: CC
authors.lastname: Kan
authors.forename: Pei-Fen
authors.initials: PF
authors.lastname: Lee
authors.forename: Tzai-Hung
authors.initials: TH
authors.lastname: Wen
authors.forename: Day-Yu
authors.initials: DY
authors.lastname: Chao
authors.forename: Min-Huei
authors.initials: MH
authors.lastname: Wu
authors.forename: Neal H
authors.initials: NH
authors.lastname: Lin
authors.forename: Scott Yan-Jang
authors.initials: SY
authors.lastname: Huang
authors.forename: Chuin-Shee
authors.initials: CS
authors.lastname: Shang
authors.forename: I-Chun
authors.initials: IC
authors.lastname: Fan
authors.forename: Pei-Yun
authors.initials: PY
authors.lastname: Shu
authors.forename: Jyh-Hsiung
authors.initials: JH
authors.lastname: Huang
authors.forename: Chwan-Chuen
authors.initials: CC
authors.lastname: King
authors.forename: Lu
authors.initials: L
authors.lastname: Pai
mesh_terms: D000293:Adolescent; D000328:Adult; D000330:Aedes / Q000821:virology; D017677:Age Distribution; D000818:Animals; D016000:Cluster Analysis; D003715:Dengue / Q000453:epidemiology*; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007303:Insect Vectors / Q000821:virology; D008297:Male; D008875:Middle Aged; D017678:Sex Distribution; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors