title: Dengue Contingency Planning: From Research to Policy and Practice.
abstract: BACKGROUND
  Dengue is an increasingly incident disease across many parts of the world. In response, an evidence-based handbook to translate research into policy and practice was developed. This handbook facilitates contingency planning as well as the development and use of early warning and response systems for dengue fever epidemics, by identifying decision-making processes that contribute to the success or failure of dengue surveillance, as well as triggers that initiate effective responses to incipient outbreaks.
  
  
  RESULTS
  Available evidence was evaluated using a step-wise process that included systematic literature reviews, policymaker and stakeholder interviews, a study to assess dengue contingency planning and outbreak management in 10 countries, and a retrospective logistic regression analysis to identify alarm signals for an outbreak warning system using datasets from five dengue endemic countries. Best practices for managing a dengue outbreak are provided for key elements of a dengue contingency plan including timely contingency planning, the importance of a detailed, context-specific dengue contingency plan that clearly distinguishes between routine and outbreak interventions, surveillance systems for outbreak preparedness, outbreak definitions, alert algorithms, managerial capacity, vector control capacity, and clinical management of large caseloads. Additionally, a computer-assisted early warning system, which enables countries to identify and respond to context-specific variables that predict forthcoming dengue outbreaks, has been developed.
  
  
  CONCLUSIONS
  Most countries do not have comprehensive, detailed contingency plans for dengue outbreaks. Countries tend to rely on intensified vector control as their outbreak response, with minimal focus on integrated management of clinical care, epidemiological, laboratory and vector surveillance, and risk communication. The Technical Handbook for Surveillance, Dengue Outbreak Prediction/ Detection and Outbreak Response seeks to provide countries with evidence-based best practices to justify the declaration of an outbreak and the mobilization of the resources required to implement an effective dengue contingency plan.
authors.affiliation: Institute of Public Health, University of Heidelberg, Heidelberg, Germany.|Special Programme for Research and Training WHO-TDR, Geneva, Switzerland.
authors.forename: Silvia
authors.initials: S
authors.lastname: Runge-Ranzinger
authors.affiliation: Special Programme for Research and Training WHO-TDR, Geneva, Switzerland.|Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
authors.forename: Axel
authors.initials: A
authors.lastname: Kroeger
authors.affiliation: Special Programme for Research and Training WHO-TDR, Geneva, Switzerland.
authors.forename: Piero
authors.initials: P
authors.lastname: Olliaro
authors.affiliation: Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: McCall
authors.affiliation: Ministry of Health, Mexico City, Mexico.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Sánchez Tejeda
authors.affiliation: Public Health Consultant, San Diego, California, United States of America.
authors.forename: Linda S
authors.initials: LS
authors.lastname: Lloyd
authors.affiliation: Ministry of Health, Kuala Lumpur, Malaysia.
authors.forename: Lokman
authors.initials: L
authors.lastname: Hakim
authors.affiliation: Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
authors.forename: Leigh R
authors.initials: LR
authors.lastname: Bowman
authors.affiliation: Institute of Public Health, University of Heidelberg, Heidelberg, Germany.
authors.forename: Olaf
authors.initials: O
authors.lastname: Horstick
authors.affiliation: Ministry of Health, Brasilia, Brazil.
authors.forename: Giovanini
authors.initials: G
authors.lastname: Coelho