title: Controlling dengue with vaccines in Thailand.
abstract: BACKGROUND
  Dengue is a mosquito-borne infectious disease that constitutes a growing global threat with the habitat expansion of its vectors Aedes aegyti and A. albopictus and increasing urbanization. With no effective treatment and limited success of vector control, dengue vaccines constitute the best control measure for the foreseeable future. With four interacting dengue serotypes, the development of an effective vaccine has been a challenge. Several dengue vaccine candidates are currently being tested in clinical trials. Before the widespread introduction of a new dengue vaccine, one needs to consider how best to use limited supplies of vaccine given the complex dengue transmission dynamics and the immunological interaction among the four dengue serotypes.
  
  
  RESULTS
  We developed an individual-level (including both humans and mosquitoes), stochastic simulation model for dengue transmission and control in a semi-rural area in Thailand. We calibrated the model to dengue serotype-specific infection, illness and hospitalization data from Thailand. Our simulations show that a realistic roll-out plan, starting with young children then covering progressively older individuals in following seasons, could reduce local transmission of dengue to low levels. Simulations indicate that this strategy could avert about 7,700 uncomplicated dengue fever cases and 220 dengue hospitalizations per 100,000 people at risk over a ten-year period.
  
  
  CONCLUSIONS
  Vaccination will have an important role in controlling dengue. According to our modeling results, children should be prioritized to receive vaccine, but adults will also need to be vaccinated if one wants to reduce community-wide dengue transmission to low levels.
authors.affiliation: Center for Statistics and Quantitative Infectious Diseases, Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America.
authors.forename: Dennis L
authors.initials: DL
authors.lastname: Chao
authors.forename: Scott B
authors.initials: SB
authors.lastname: Halstead
authors.forename: M Elizabeth
authors.initials: ME
authors.lastname: Halloran
authors.forename: Ira M
authors.initials: IM
authors.lastname: Longini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003715:Dengue / Q000453:epidemiology* / Q000517:prevention & control* / Q000635:transmission; D053059:Dengue Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D003716:Dengue Virus / Q000145:classification; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D017589:Immunization Programs; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D012703:Serotyping; D013785:Thailand / Q000453:epidemiology; D055815:Young Adult
chemical_list: D053059:Dengue Vaccines