title: Characterizing a large outbreak of dengue fever in Guangdong Province, China.
abstract: BACKGROUND
  Dengue cases have been reported each year for the past 25 years in Guangdong Province, China with a recorded historical peak in 2014. This study aims to describe the epidemiological characteristics of this large outbreak in order to better understand its epidemic factors and to inform control strategies.
  
  
  METHODS
  Data for clinically diagnosed and laboratory-confirmed dengue fever cases in 2014 were extracted from the China Notifiable Infectious Disease Reporting System. We analyzed the incidence and characteristics of imported and indigenous cases in terms of population, temporal and spatial distributions.
  
  
  RESULTS
  A total of 45 224 dengue fever cases and 6 deaths were notified in Guangdong Province in 2014, with an incidence of 47.3 per 100 000 people. The elderly (65+ years) represented 11.7 % of total indigenous cases with the highest incidence (72.3 per 100 000). Household workers and the unemployed accounted for 23.1 % of indigenous cases. The majority of indigenous cases occurred in the 37(th) to 44(th) week of 2014 (September and October) and almost all (20 of 21) prefecture-level cities in Guangdong were affected. Compared to the non-Pearl River Delta Region, the Pearl River Delta Region accounted for the majority of dengue cases and reported cases earlier in 2014. Dengue virus serotypes 1 (DENV-1), 2 (DENV-2) and 3 (DENV-3) were detected and DENV-1 was predominant (88.4 %).
  
  
  CONCLUSIONS
  Dengue fever is a serious public health problem and is emerging as a continuous threat in Guangdong Province. There is an urgent need to enhance dengue surveillance and control, especially for the high-risk populations in high-risk areas.
authors.affiliation: Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.
authors.forename: Jian-Peng
authors.initials: JP
authors.lastname: Xiao
authors.affiliation: Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.
authors.forename: Jian-Feng
authors.initials: JF
authors.lastname: He
authors.affiliation: Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.
authors.forename: Ai-Ping
authors.initials: AP
authors.lastname: Deng
authors.affiliation: Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.
authors.forename: Hua-Liang
authors.initials: HL
authors.lastname: Lin
authors.affiliation: Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.
authors.forename: Tie
authors.initials: T
authors.lastname: Song
authors.affiliation: Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.
authors.forename: Zhi-Qiang
authors.initials: ZQ
authors.lastname: Peng
authors.affiliation: Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.|School of Public Health, Sun Yat-sen University, Guangzhou, China.
authors.forename: Xiao-Cheng
authors.initials: XC
authors.lastname: Wu
authors.affiliation: Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Liu
authors.affiliation: Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.
authors.forename: Zhi-Hao
authors.initials: ZH
authors.lastname: Li
authors.affiliation: Center for Environment and Population Health, Griffith University, Brisbane, Australia.
authors.forename: Shannon
authors.initials: S
authors.lastname: Rutherford
authors.affiliation: Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.
authors.forename: Wei-Lin
authors.initials: WL
authors.lastname: Zeng
authors.affiliation: Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.
authors.forename: Xing
authors.initials: X
authors.lastname: Li
authors.affiliation: Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China. mawj@gdiph.org.cn.
authors.forename: Wen-Jun
authors.initials: WJ
authors.lastname: Ma
authors.affiliation: Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China. zyh@cdcp.org.cn.
authors.forename: Yong-Hui
authors.initials: YH
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D003715:Dengue / Q000453:epidemiology* / Q000821:virology; D003716:Dengue Virus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification* / Q000502:physiology; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult
keywords: China; Dengue fever; Epidemiology; Outbreak