Risk estimates of dengue in travelers to dengue endemic areas using mathematical models.
BACKGROUND
Dengue has emerged as a frequent problem in international travelers. The risk depends on destination, duration, and season of travel. However, data to quantify the true risk for travelers to acquire dengue are lacking.


METHODS
We used mathematical models to estimate the risk of nonimmune persons to acquire dengue when traveling to Singapore. From the force of infection, we calculated the risk of dengue dependent on duration of stay and season of arrival.


RESULTS
Our data highlight that the risk for nonimmune travelers to acquire dengue in Singapore is substantial but varies greatly with seasons and epidemic cycles. For instance, for a traveler who stays in Singapore for 1 week during the high dengue season in 2005, the risk of acquiring dengue was 0.17%, but it was only 0.00423% during the low season in a nonepidemic year such as 2002.


CONCLUSIONS
Risk estimates based on mathematical modeling will help the travel medicine provider give better evidence-based advice for travelers to dengue endemic countries.
Massad
Eduardo
E
Medical Informatics, The University of Sāo Paulo, São Paulo, Brazil.
Wilder-Smith
Annelies
A
D000818:Animals; D009033:Culicidae / Q000821:virology; D003715:Dengue / Q000453:epidemiology* / Q000635:transmission; D019353:Endemic Diseases; D006801:Humans; D007303:Insect Vectors; D008433:Mathematics; D015233:Models, Statistical; D018570:Risk Assessment / Q000379:methods*; D012846:Singapore / Q000453:epidemiology; D014195:Travel