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International dispersal of dengue through air travel: importation risk for Europe.

Semenza JC, Sudre B, Miniota J, Rossi M, Hu W, Kossowsky D, Suk JE, Van Bortel W, Khan K - PLoS Negl Trop Dis (2014)

Bottom Line: In fact, 38% more travellers arrived in 2013 into those parts of Europe where Ae. albopictus has recently been introduced, compared to 2010.The presence of the vector is a necessary, but not sufficient, prerequisite for DENV onward transmission, which depends on a number of additional factors.However, our empirical model can provide spatio-temporal elements to public health interventions.

View Article: PubMed Central - PubMed

Affiliation: European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.

ABSTRACT

Background: The worldwide distribution of dengue is expanding, in part due to globalized traffic and trade. Aedes albopictus is a competent vector for dengue viruses (DENV) and is now established in numerous regions of Europe. Viremic travellers arriving in Europe from dengue-affected areas of the world can become catalysts of local outbreaks in Europe. Local dengue transmission in Europe is extremely rare, and the last outbreak occurred in 1927-28 in Greece. However, autochthonous transmission was reported from France in September 2010, and from Croatia between August and October 2010.

Methodology: We compiled data on areas affected by dengue in 2010 from web resources and surveillance reports, and collected national dengue importation data. We developed a hierarchical regression model to quantify the relationship between the number of reported dengue cases imported into Europe and the volume of airline travellers arriving from dengue-affected areas internationally.

Principal findings: In 2010, over 5.8 million airline travellers entered Europe from dengue-affected areas worldwide, of which 703,396 arrived at 36 airports situated in areas where Ae. albopictus has been recorded. The adjusted incidence rate ratio for imported dengue into European countries was 1.09 (95% CI: 1.01-1.17) for every increase of 10,000 travellers; in August, September, and October the rate ratios were 1.70 (95%CI: 1.23-2.35), 1.46 (95%CI: 1.02-2.10), and 1.35 (95%CI: 1.01-1.81), respectively. Two Italian cities where the vector is present received over 50% of all travellers from dengue-affected areas, yet with the continuing vector expansion more cities will be implicated in the future. In fact, 38% more travellers arrived in 2013 into those parts of Europe where Ae. albopictus has recently been introduced, compared to 2010.

Conclusions: The highest risk of dengue importation in 2010 was restricted to three months and can be ranked according to arriving traveller volume from dengue-affected areas into cities where the vector is present. The presence of the vector is a necessary, but not sufficient, prerequisite for DENV onward transmission, which depends on a number of additional factors. However, our empirical model can provide spatio-temporal elements to public health interventions.

No MeSH data available.


Related in: MedlinePlus

Number of international air travellers arriving in the EU, by country and month, 2010.
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pntd-0003278-g001: Number of international air travellers arriving in the EU, by country and month, 2010.

Mentions: Over 103 million travellers entered Europe on commercial flights in 2010; the distribution by destination country and month is shown in figure 1. Of the total number of travellers, 26.6% originated from North Africa and West Asia, 25.0% from North America, 13.5% from East Asia, 4.9% from South Asia, 7.4% from Eastern Europe and Central Asia, 6.9% from Sub-Saharan Africa, 4.9% from South America, 4.5% from Mexico, Central America and the Caribbean, 4.1% from West, North and South Europe and around 2% from Australia, New Zealand and the Pacific Islands. The monthly average number of international travellers for the peak travel season (third quarter: July, August and September 2010) for selected high traffic countries was approximately 2.2 million for the United Kingdom (UK); 1.7 million for France; 1.7 million for Germany; 1 million for Italy; 669,000 for Spain; 484,000 for the Netherlands; and 183,000 for Sweden.


International dispersal of dengue through air travel: importation risk for Europe.

Semenza JC, Sudre B, Miniota J, Rossi M, Hu W, Kossowsky D, Suk JE, Van Bortel W, Khan K - PLoS Negl Trop Dis (2014)

Number of international air travellers arriving in the EU, by country and month, 2010.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4256202&req=5

pntd-0003278-g001: Number of international air travellers arriving in the EU, by country and month, 2010.
Mentions: Over 103 million travellers entered Europe on commercial flights in 2010; the distribution by destination country and month is shown in figure 1. Of the total number of travellers, 26.6% originated from North Africa and West Asia, 25.0% from North America, 13.5% from East Asia, 4.9% from South Asia, 7.4% from Eastern Europe and Central Asia, 6.9% from Sub-Saharan Africa, 4.9% from South America, 4.5% from Mexico, Central America and the Caribbean, 4.1% from West, North and South Europe and around 2% from Australia, New Zealand and the Pacific Islands. The monthly average number of international travellers for the peak travel season (third quarter: July, August and September 2010) for selected high traffic countries was approximately 2.2 million for the United Kingdom (UK); 1.7 million for France; 1.7 million for Germany; 1 million for Italy; 669,000 for Spain; 484,000 for the Netherlands; and 183,000 for Sweden.

Bottom Line: In fact, 38% more travellers arrived in 2013 into those parts of Europe where Ae. albopictus has recently been introduced, compared to 2010.The presence of the vector is a necessary, but not sufficient, prerequisite for DENV onward transmission, which depends on a number of additional factors.However, our empirical model can provide spatio-temporal elements to public health interventions.

View Article: PubMed Central - PubMed

Affiliation: European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.

ABSTRACT

Background: The worldwide distribution of dengue is expanding, in part due to globalized traffic and trade. Aedes albopictus is a competent vector for dengue viruses (DENV) and is now established in numerous regions of Europe. Viremic travellers arriving in Europe from dengue-affected areas of the world can become catalysts of local outbreaks in Europe. Local dengue transmission in Europe is extremely rare, and the last outbreak occurred in 1927-28 in Greece. However, autochthonous transmission was reported from France in September 2010, and from Croatia between August and October 2010.

Methodology: We compiled data on areas affected by dengue in 2010 from web resources and surveillance reports, and collected national dengue importation data. We developed a hierarchical regression model to quantify the relationship between the number of reported dengue cases imported into Europe and the volume of airline travellers arriving from dengue-affected areas internationally.

Principal findings: In 2010, over 5.8 million airline travellers entered Europe from dengue-affected areas worldwide, of which 703,396 arrived at 36 airports situated in areas where Ae. albopictus has been recorded. The adjusted incidence rate ratio for imported dengue into European countries was 1.09 (95% CI: 1.01-1.17) for every increase of 10,000 travellers; in August, September, and October the rate ratios were 1.70 (95%CI: 1.23-2.35), 1.46 (95%CI: 1.02-2.10), and 1.35 (95%CI: 1.01-1.81), respectively. Two Italian cities where the vector is present received over 50% of all travellers from dengue-affected areas, yet with the continuing vector expansion more cities will be implicated in the future. In fact, 38% more travellers arrived in 2013 into those parts of Europe where Ae. albopictus has recently been introduced, compared to 2010.

Conclusions: The highest risk of dengue importation in 2010 was restricted to three months and can be ranked according to arriving traveller volume from dengue-affected areas into cities where the vector is present. The presence of the vector is a necessary, but not sufficient, prerequisite for DENV onward transmission, which depends on a number of additional factors. However, our empirical model can provide spatio-temporal elements to public health interventions.

No MeSH data available.


Related in: MedlinePlus