title: Multiple Sources of Infection and Potential Endemic Characteristics of the Large Outbreak of Dengue in Guangdong in 2014.
abstract: A large outbreak of dengue, with the most documented cases, occurred in Guangdong China in 2014. Epidemiological studies and phylogenetic analysis of the isolated dengue virus (DENV) showed this outbreak was attributed to multiple sources and caused by at least two genotypes of DENV-1 (Genotypes I and III) and two genotypes of DENV-2 (Cosmopolitan and Asian I Genotypes). A retrospective review and phylogenetic analysis of DENV isolated in Guangdong showed that DENV-1 Genotype I strains were reported continuously during 2004-2014, Genotype III strains were reported during 2009-2014 ; DENV-2 Cosmopolitan and Asian I Genotype strains were reported continuously during 2012-2014. At least 45,171 cases were reported in this outbreak, with 65.9% of the patients in the 21-55-year-old group. A trend toward a decrease in the daily newly emerged cases lagged by approximately 20 days compared with the mosquito density curve. Several epidemiological characteristics of this outbreak and the stably sustained serotypes and genotypes of DENV isolated in Guangdong suggest that Guangdong has been facing a threat of transforming from a dengue epidemic area to an endemic area. The high temperature, drenching rain, rapid urbanization, and pandemic of dengue in Southeast Asia may have contributed to this large outbreak of dengue.
authors.affiliation: Guangdong Provincial Key Laboratory of Tropical Disease Research, and Key Laboratory of Prevention and Control for Emerging Infectious Diseases of Guangdong Higher Institutes, School of Public Health and Tropical Medicine, Southern Medical University, #1023 South Shatai Road, Guangzhou, Guangdong Province, 510515, China.
authors.forename: Shu-Qun
authors.initials: SQ
authors.lastname: Shen
authors.affiliation: Guangdong Provincial Key Laboratory of Tropical Disease Research, and Key Laboratory of Prevention and Control for Emerging Infectious Diseases of Guangdong Higher Institutes, School of Public Health and Tropical Medicine, Southern Medical University, #1023 South Shatai Road, Guangzhou, Guangdong Province, 510515, China.
authors.forename: Hai-Xia
authors.initials: HX
authors.lastname: Wei
authors.affiliation: Department of Clinical Laboratory, the 458th Hospital of PLA, #801 Dongfeng Dong Road, Guangzhou, Guangdong Province, 510602, China.
authors.forename: Yong-Hang
authors.initials: YH
authors.lastname: Fu
authors.affiliation: Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University.
authors.forename: Hao
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of pediatrics, Zhongshan Boai Hospital Affiliated to Southern Medical University, Zhongshan, Guangdong Province, 528403, China.
authors.forename: Qing-Yi
authors.initials: QY
authors.lastname: Mo
authors.affiliation: Guangdong Provincial Key Laboratory of Tropical Disease Research, and Key Laboratory of Prevention and Control for Emerging Infectious Diseases of Guangdong Higher Institutes, School of Public Health and Tropical Medicine, Southern Medical University, #1023 South Shatai Road, Guangzhou, Guangdong Province, 510515, China.
authors.forename: Xiao-Jun
authors.initials: XJ
authors.lastname: Wang
authors.affiliation: Guangdong Provincial Key Laboratory of Tropical Disease Research, and Key Laboratory of Prevention and Control for Emerging Infectious Diseases of Guangdong Higher Institutes, School of Public Health and Tropical Medicine, Southern Medical University, #1023 South Shatai Road, Guangzhou, Guangdong Province, 510515, China.
authors.forename: Sheng-Qun
authors.initials: SQ
authors.lastname: Deng
authors.affiliation: Guangdong Provincial Key Laboratory of Tropical Disease Research, and Key Laboratory of Prevention and Control for Emerging Infectious Diseases of Guangdong Higher Institutes, School of Public Health and Tropical Medicine, Southern Medical University, #1023 South Shatai Road, Guangzhou, Guangdong Province, 510515, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhao
authors.affiliation: Guangdong Provincial Key Laboratory of Tropical Disease Research, and Key Laboratory of Prevention and Control for Emerging Infectious Diseases of Guangdong Higher Institutes, School of Public Health and Tropical Medicine, Southern Medical University, #1023 South Shatai Road, Guangzhou, Guangdong Province, 510515, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Guangdong Provincial Key Laboratory of Tropical Disease Research, and Key Laboratory of Prevention and Control for Emerging Infectious Diseases of Guangdong Higher Institutes, School of Public Health and Tropical Medicine, Southern Medical University, #1023 South Shatai Road, Guangzhou, Guangdong Province, 510515, China.
authors.forename: Xiao-Shuang
authors.initials: XS
authors.lastname: Feng
authors.affiliation: Max-Delbrueck-Center for Molecular Medicine. Robert-Roessle-str. 10, Berlin, 13125, Germany.
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.affiliation: Guangdong Provincial Key Laboratory of Tropical Disease Research, and Key Laboratory of Prevention and Control for Emerging Infectious Diseases of Guangdong Higher Institutes, School of Public Health and Tropical Medicine, Southern Medical University, #1023 South Shatai Road, Guangzhou, Guangdong Province, 510515, China.
authors.forename: Hong-Juan
authors.initials: HJ
authors.lastname: Peng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D009033:Culicidae / Q000821:virology*; D003715:Dengue / Q000453:epidemiology* / Q000503:physiopathology / Q000821:virology; D003716:Dengue Virus / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification / Q000472:pathogenicity; D004196:Disease Outbreaks; D005838:Genotype; D006358:Hot Temperature; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007303:Insect Vectors / Q000821:virology*; D008875:Middle Aged; D010802:Phylogeny; D012367:RNA, Viral / Q000235:genetics; D011891:Rain; D017422:Sequence Analysis, DNA; D065288:Serogroup; D014507:Urbanization
chemical_list: D012367:RNA, Viral