Severe Dengue Fever Outbreak in Taiwan

Sheng-Fan Wang Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung, Taiwan; Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Infection Disease, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Natural Products, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Gastroenterology, Department of Internal Medicine Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan; Department of Microbiology and Immunology, College of Medicine, Kaohsiung Medical, University, Kaohsiung, Taiwan; Center for Dengue Fever Control and Research, Kaohsiung Medical University, Kaohsiung, Taiwan

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Wen-Hung Wang Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung, Taiwan; Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Infection Disease, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Natural Products, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Gastroenterology, Department of Internal Medicine Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan; Department of Microbiology and Immunology, College of Medicine, Kaohsiung Medical, University, Kaohsiung, Taiwan; Center for Dengue Fever Control and Research, Kaohsiung Medical University, Kaohsiung, Taiwan

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Ko Chang Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung, Taiwan; Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Infection Disease, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Natural Products, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Gastroenterology, Department of Internal Medicine Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan; Department of Microbiology and Immunology, College of Medicine, Kaohsiung Medical, University, Kaohsiung, Taiwan; Center for Dengue Fever Control and Research, Kaohsiung Medical University, Kaohsiung, Taiwan

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Yen-Hsu Chen Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung, Taiwan; Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Infection Disease, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Natural Products, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Gastroenterology, Department of Internal Medicine Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan; Department of Microbiology and Immunology, College of Medicine, Kaohsiung Medical, University, Kaohsiung, Taiwan; Center for Dengue Fever Control and Research, Kaohsiung Medical University, Kaohsiung, Taiwan

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Sung-Pin Tseng Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung, Taiwan; Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Infection Disease, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Natural Products, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Gastroenterology, Department of Internal Medicine Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan; Department of Microbiology and Immunology, College of Medicine, Kaohsiung Medical, University, Kaohsiung, Taiwan; Center for Dengue Fever Control and Research, Kaohsiung Medical University, Kaohsiung, Taiwan

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Chia-Hung Yen Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung, Taiwan; Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Infection Disease, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Natural Products, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Gastroenterology, Department of Internal Medicine Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan; Department of Microbiology and Immunology, College of Medicine, Kaohsiung Medical, University, Kaohsiung, Taiwan; Center for Dengue Fever Control and Research, Kaohsiung Medical University, Kaohsiung, Taiwan

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Deng-Chyang Wu Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung, Taiwan; Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Infection Disease, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Natural Products, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Gastroenterology, Department of Internal Medicine Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan; Department of Microbiology and Immunology, College of Medicine, Kaohsiung Medical, University, Kaohsiung, Taiwan; Center for Dengue Fever Control and Research, Kaohsiung Medical University, Kaohsiung, Taiwan

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Yi-Ming Arthur Chen Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung, Taiwan; Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Infection Disease, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Natural Products, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Gastroenterology, Department of Internal Medicine Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan; Department of Microbiology and Immunology, College of Medicine, Kaohsiung Medical, University, Kaohsiung, Taiwan; Center for Dengue Fever Control and Research, Kaohsiung Medical University, Kaohsiung, Taiwan

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DOI:
https://doi.org/10.4269/ajtmh.15-0422
Volume/Issue:
Volume 94: Issue 1
Page(s):
193–197
Restricted access
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Dengue fever (DF) is a vector-borne disease caused by dengue viruses (DENVs). Epidemic dengue occurs intermittently in Taiwan. In 2014, Taiwan experienced its largest DF outbreak. There were 15,732 DF cases reported. There were a total of 136 dengue hemorrhagic fever (DHF) cases, of which 20 resulted in death. Most DF cases were reported in southern Taiwan. A total of 15,043 (96%) cases were from Kaohsiung, a modern city in southern Taiwan. This report reviews DF epidemics in Taiwan during 2005–2014. The correlation between DF and DHF along with temperature and precipitation were conjointly examined. We conclude that most dengue epidemics in Taiwan resulted from imported DF cases. Results indicate three main factors that may have been associated with this DF outbreak in Kaohsiung: an underground pipeline explosion combined with subsequent rainfall and higher temperature. These factors may have enhanced mosquito breeding activity, facilitating DENV transmission.

Author Notes

* Address correspondence to Sheng-Fan Wang, Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, 100, Shih-Chuang 1st Road, Kaohsiung 80708, Taiwan, E-mail: wasf1234@kmu.edu.tw or Yi-Ming Arthur Chen, Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung 80708, Taiwan, E-mail: arthur@kmu.edu.tw

Financial support: This work was supported by grants from Center for Infectious Disease and Cancer Research, Kaohsiung Medical University (KMUTP104E04 and KMUTP104E00) and Center for Disease Control, Taiwan (grant MOHW104-CDC-C-114-114901). It was also partially supported by grants from the Kaohsiung Medical University Research Foundation (KMU-Q104001) and the Ministry of Science and Technology, Republic of China (MOST 104-2321-B-037-002).

Authors' addresses: Sheng-Fan Wang and Sung-Pin Tseng, Department of Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung, Taiwan, E-mails: wasf1234@kmu.edu.tw and tsengsp@kmu.edu.tw. Wen-Hung Wang and Yi-Ming Arthur Chen, Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan, E-mails: bole0918@gmail.com and arthur@kmu.edu.tw. Ko Chang and Deng-Chyang Wu, Division of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, E-mails: johnsonckk@yahoo.com.tw and dechwu@yahoo.com. Yen-Hsu Chen, Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, E-mail: d810070@kmu.edu.tw. Chia-Hung Yen, Graduate Institute of Natural Products, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan, E-mail: chyen@kmu.edu.tw.

Copyright:
© The American Society of Tropical Medicine and Hygiene 2016
Received:
08 Jun 2015
|
Accepted:
07 Oct 2015
|
Published Online:
06 Jan 2016
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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