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Risk of dengue for tourists and teams during the World Cup 2014 in Brazil.

van Panhuis WG, Hyun S, Blaney K, Marques ET, Coelho GE, Siqueira JB, Tibshirani R, da Silva JB, Rosenfeld R - PLoS Negl Trop Dis (2014)

Bottom Line: Expected IR's during the games were generally low (<10/100,000) but predictions varied across locations and between models.Sensitivity analysis for both models indicated that the expected number of cases could be as low as 4 or 5 with 100,000 visitors and as high as 38 or 70 with 800,000 visitors (PR and EB, respectively).Quantitative risk estimates by different groups and methodologies should be made routinely for mass gathering events.

View Article: PubMed Central - PubMed

Affiliation: University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, United States of America.

ABSTRACT

Background: This year, Brazil will host about 600,000 foreign visitors during the 2014 FIFA World Cup. The concern of possible dengue transmission during this event has been raised given the high transmission rates reported in the past by this country.

Methodology/principal findings: We used dengue incidence rates reported by each host city during previous years (2001-2013) to estimate the risk of dengue during the World Cup for tourists and teams. Two statistical models were used: a percentile rank (PR) and an Empirical Bayes (EB) model. Expected IR's during the games were generally low (<10/100,000) but predictions varied across locations and between models. Based on current ticket allocations, the mean number of expected symptomatic dengue cases ranged from 26 (PR, 10th-100th percentile: 5-334 cases) to 59 (EB, 95% credible interval: 30-77 cases) among foreign tourists but none are expected among teams. These numbers will highly depend on actual travel schedules and dengue immunity among visitors. Sensitivity analysis for both models indicated that the expected number of cases could be as low as 4 or 5 with 100,000 visitors and as high as 38 or 70 with 800,000 visitors (PR and EB, respectively).

Conclusion/significance: The risk of dengue among tourists during the World Cup is expected to be small due to immunity among the Brazil host population provided by last year's epidemic with the same DENV serotypes. Quantitative risk estimates by different groups and methodologies should be made routinely for mass gathering events.

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Related in: MedlinePlus

Probability of weekly incidence rates based on the 2001–2013distribution for each city.Probabilities are shown for (A) round one for tourists,(B) round one for teams, and (C) round twoof the World Cup. The 10th percentile (P10), maximum (P100)and 2014 percentile (P2014) of the 2001–2013 distribution areindicated for each city in the lower panels.
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pntd-0003063-g002: Probability of weekly incidence rates based on the 2001–2013distribution for each city.Probabilities are shown for (A) round one for tourists,(B) round one for teams, and (C) round twoof the World Cup. The 10th percentile (P10), maximum (P100)and 2014 percentile (P2014) of the 2001–2013 distribution areindicated for each city in the lower panels.

Mentions: We used two methods to forecast expected IR's during 2014: percentile rank (PR)and Empirical Bayes (EB). The percentile of weeks 1–19 in 2014 on thedistribution of corresponding weeks in 2001–2013 (P2014) was highest forSão Paulo at 96%, indicating that the current 2014 epidemic hasbeen one of the worst in it's history (FigureS1). For most other cities, the P2014 ranged from20% to 65%. For each city, the probability distributions of theaverage weekly IR's during World Cup weeks in previous years were estimatedseparately (Figures2A-Cand S2). The cities of Fortaleza and Natal had consistentlyhigher past and expected IR's compared to all other cities with anIRP2014 in round one of 5.6 cases/100,000 (P10-Max:1.8–35.3) and 8.9 cases/100,000 (P10-Max: 2.6–82.9) respectively.For round two, their IRP2014 was 6.4 cases/100,000 (P10-Max:1.4–37.2) and 10.8 cases/100,000 (P10-Max: 3.8–72.4) respectively(Table1). For all cities, the maximum IR's reported in previous yearswere substantially higher compared to the IRP2014 due to some largeepidemics that occurred in the past. For example the maximum IR for the basecampcity of Santos (116.5/100,000) was 25 times as high as the IRP2014for this city (4.6/100,000). These maximum IR's represent the worst casescenario based on previous epidemics.


Risk of dengue for tourists and teams during the World Cup 2014 in Brazil.

van Panhuis WG, Hyun S, Blaney K, Marques ET, Coelho GE, Siqueira JB, Tibshirani R, da Silva JB, Rosenfeld R - PLoS Negl Trop Dis (2014)

Probability of weekly incidence rates based on the 2001–2013distribution for each city.Probabilities are shown for (A) round one for tourists,(B) round one for teams, and (C) round twoof the World Cup. The 10th percentile (P10), maximum (P100)and 2014 percentile (P2014) of the 2001–2013 distribution areindicated for each city in the lower panels.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4120682&req=5

pntd-0003063-g002: Probability of weekly incidence rates based on the 2001–2013distribution for each city.Probabilities are shown for (A) round one for tourists,(B) round one for teams, and (C) round twoof the World Cup. The 10th percentile (P10), maximum (P100)and 2014 percentile (P2014) of the 2001–2013 distribution areindicated for each city in the lower panels.
Mentions: We used two methods to forecast expected IR's during 2014: percentile rank (PR)and Empirical Bayes (EB). The percentile of weeks 1–19 in 2014 on thedistribution of corresponding weeks in 2001–2013 (P2014) was highest forSão Paulo at 96%, indicating that the current 2014 epidemic hasbeen one of the worst in it's history (FigureS1). For most other cities, the P2014 ranged from20% to 65%. For each city, the probability distributions of theaverage weekly IR's during World Cup weeks in previous years were estimatedseparately (Figures2A-Cand S2). The cities of Fortaleza and Natal had consistentlyhigher past and expected IR's compared to all other cities with anIRP2014 in round one of 5.6 cases/100,000 (P10-Max:1.8–35.3) and 8.9 cases/100,000 (P10-Max: 2.6–82.9) respectively.For round two, their IRP2014 was 6.4 cases/100,000 (P10-Max:1.4–37.2) and 10.8 cases/100,000 (P10-Max: 3.8–72.4) respectively(Table1). For all cities, the maximum IR's reported in previous yearswere substantially higher compared to the IRP2014 due to some largeepidemics that occurred in the past. For example the maximum IR for the basecampcity of Santos (116.5/100,000) was 25 times as high as the IRP2014for this city (4.6/100,000). These maximum IR's represent the worst casescenario based on previous epidemics.

Bottom Line: Expected IR's during the games were generally low (<10/100,000) but predictions varied across locations and between models.Sensitivity analysis for both models indicated that the expected number of cases could be as low as 4 or 5 with 100,000 visitors and as high as 38 or 70 with 800,000 visitors (PR and EB, respectively).Quantitative risk estimates by different groups and methodologies should be made routinely for mass gathering events.

View Article: PubMed Central - PubMed

Affiliation: University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, United States of America.

ABSTRACT

Background: This year, Brazil will host about 600,000 foreign visitors during the 2014 FIFA World Cup. The concern of possible dengue transmission during this event has been raised given the high transmission rates reported in the past by this country.

Methodology/principal findings: We used dengue incidence rates reported by each host city during previous years (2001-2013) to estimate the risk of dengue during the World Cup for tourists and teams. Two statistical models were used: a percentile rank (PR) and an Empirical Bayes (EB) model. Expected IR's during the games were generally low (<10/100,000) but predictions varied across locations and between models. Based on current ticket allocations, the mean number of expected symptomatic dengue cases ranged from 26 (PR, 10th-100th percentile: 5-334 cases) to 59 (EB, 95% credible interval: 30-77 cases) among foreign tourists but none are expected among teams. These numbers will highly depend on actual travel schedules and dengue immunity among visitors. Sensitivity analysis for both models indicated that the expected number of cases could be as low as 4 or 5 with 100,000 visitors and as high as 38 or 70 with 800,000 visitors (PR and EB, respectively).

Conclusion/significance: The risk of dengue among tourists during the World Cup is expected to be small due to immunity among the Brazil host population provided by last year's epidemic with the same DENV serotypes. Quantitative risk estimates by different groups and methodologies should be made routinely for mass gathering events.

Show MeSH
Related in: MedlinePlus