title: Epidemiology of dengue virus in Iquitos, Peru 1999 to 2005: interepidemic and epidemic patterns of transmission.
abstract: BACKGROUND
  Comprehensive, longitudinal field studies that monitor both disease and vector populations for dengue viruses are urgently needed as a pre-requisite for developing locally adaptable prevention programs or to appropriately test and license new vaccines.
  
  
  RESULTS
  We report the results from such a study spanning 5 years in the Amazonian city of Iquitos, Peru where DENV infection was monitored serologically among approximately 2,400 members of a neighborhood-based cohort and through school-based absenteeism surveillance for active febrile illness among a subset of this cohort. At baseline, 80% of the study population had DENV antibodies, seroprevalence increased with age, and significant geographic variation was observed, with neighborhood-specific age-adjusted rates ranging from 67.1 to 89.9%. During the first 15 months, when DENV-1 and DENV-2 were co-circulating, population-based incidence rates ranged from 2-3 infections/100 person-years (p-years). The introduction of DENV-3 during the last half of 2001 was characterized by 3 distinct periods: amplification over at least 5-6 months, replacement of previously circulating serotypes, and epidemic transmission when incidence peaked at 89 infections/100 p-years.
  
  
  CONCLUSIONS
  Neighborhood-specific baseline seroprevalence rates were not predictive of geographic incidence patterns prior to the DENV-3 introduction, but were closely mirrored during the invasion of this serotype. Transmission varied geographically, with peak incidence occurring at different times among the 8 geographic zones in approximately 16 km(2) of the city. The lag from novel serotype introduction to epidemic transmission and knowledge of spatially explicit areas of elevated risk should be considered for more effective application of limited resources for dengue prevention.
authors.affiliation: Department of Entomology, University of California Davis, Davis, California, USA.
authors.forename: Amy C
authors.initials: AC
authors.lastname: Morrison
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Minnick
authors.forename: Claudio
authors.initials: C
authors.lastname: Rocha
authors.forename: Brett M
authors.initials: BM
authors.lastname: Forshey
authors.forename: Steven T
authors.initials: ST
authors.lastname: Stoddard
authors.forename: Arthur
authors.initials: A
authors.lastname: Getis
authors.forename: Dana A
authors.initials: DA
authors.lastname: Focks
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Russell
authors.forename: James G
authors.initials: JG
authors.lastname: Olson
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Blair
authors.forename: Douglas M
authors.initials: DM
authors.lastname: Watts
authors.forename: Moises
authors.initials: M
authors.lastname: Sihuincha
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Scott
authors.forename: Tadeusz J
authors.initials: TJ
authors.lastname: Kochel
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003715:Dengue / Q000453:epidemiology* / Q000635:transmission*; D003716:Dengue Virus / Q000276:immunology*; D005260:Female; D005335:Fever of Unknown Origin / Q000453:epidemiology; D005843:Geography; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010568:Peru / Q000453:epidemiology; D016036:Seroepidemiologic Studies; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral
references.citation: Am J Epidemiol. 2002 Jul 1;156(1):52-9
references.pmid: 12076888
references.citation: Curr Top Microbiol Immunol. 2010;338:115-28
references.pmid: 19802582
references.citation: Bull Pan Am Health Organ. 1992;26(3):201-7
references.pmid: 1393192
references.citation: Am J Trop Med Hyg. 1988 Jan;38(1):172-80
references.pmid: 3341519
references.citation: Am J Trop Med Hyg. 1989 Apr;40(4):418-27
references.pmid: 2540664
references.citation: Virology. 1999 Apr 25;257(1):1-6
references.pmid: 10208914
references.citation: Infect Genet Evol. 2008 Sep;8(5):682-8
references.pmid: 18674640
references.citation: Trends Microbiol. 2002 Feb;10(2):100-3
references.pmid: 11827812
references.citation: J Med Entomol. 2004 Nov;41(6):1123-42
references.pmid: 15605653
references.citation: Am J Trop Med Hyg. 2009 Nov;81(5):825-33
references.pmid: 19861618
references.citation: Am J Trop Med Hyg. 1996 Oct;55(4):459-63
references.pmid: 8916809
references.citation: Trop Med Int Health. 2002 Sep;7(9):757-62
references.pmid: 12225506
references.citation: Epidemiol Rev. 1995;17(2):321-35
references.pmid: 8654514
references.citation: J Med Entomol. 2004 May;41(3):502-10
references.pmid: 15185957
references.citation: Lancet. 2002 Jul 27;360(9329):310-2
references.pmid: 12147378
references.citation: J Clin Microbiol. 1992 Mar;30(3):545-51
references.pmid: 1372617
references.citation: Lancet. 1999 Oct 23;354(9188):1431-4
references.pmid: 10543670
references.citation: Vector Borne Zoonotic Dis. 2009 Feb;9(1):87-92
references.pmid: 18788903
references.citation: Am J Epidemiol. 2002 Jul 1;156(1):40-51
references.pmid: 12076887
references.citation: Am J Trop Med Hyg. 1997 May;56(5):566-72
references.pmid: 9180609
references.citation: Am J Trop Med Hyg. 2009 Apr;80(4):656-60
references.pmid: 19346395
references.citation: Am J Trop Med Hyg. 2003 Dec;69(6 Suppl):5-11
references.pmid: 14740949
references.citation: J Clin Lab Anal. 1993;7(4):230-7
references.pmid: 8395596
references.citation: J Clin Microbiol. 1985 Aug;22(2):250-4
references.pmid: 4031038
references.citation: PLoS Med. 2008 Mar 18;5(3):e68
references.pmid: 18351798
references.citation: Adv Virus Res. 2003;61:3-65
references.pmid: 14714429
references.citation: Am J Trop Med Hyg. 1999 Sep;61(3):412-9
references.pmid: 10497982
references.citation: J Med Entomol. 2004 Jul;41(4):634-42
references.pmid: 15311454
references.citation: Trop Med Int Health. 2006 Jun;11(6):935-42
references.pmid: 16772016
references.citation: Proc Natl Acad Sci U S A. 1994 Mar 29;91(7):2395-400
references.pmid: 8146129
references.citation: Am J Epidemiol. 1984 Nov;120(5):653-69
references.pmid: 6496446
references.citation: Comp Immunol Microbiol Infect Dis. 2004 Sep;27(5):319-30
references.pmid: 15225982
references.citation: Am J Trop Med Hyg. 2003 Nov;69(5):494-505
references.pmid: 14695086
references.citation: Am J Trop Med Hyg. 2005 Feb;72(2):209-20
references.pmid: 15741559
references.citation: Emerg Infect Dis. 2009 Nov;15(11):1815-8
references.pmid: 19891873