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Am. J. Trop. Med. Hyg., 81(2), 2009, pp. 280-286
Copyright © 2009 by The American Society of Tropical Medicine and Hygiene

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Dengue Transmission in the Small-Island Setting: Investigations from the Caribbean Island of Grenada

Karin L. Schiøler* AND Calum N. Macpherson
Department of International Health, Immunology, and Microbiology, University of Copenhagen, Denmark; Windward Islands Research and Education Foundation, St. George’s University, Grenada

The Caribbean region has experienced a major surge in dengue activity in recent decades. Yet, for many, and especially the smaller islands, the true extent and general epidemiology of dengue transmission remains unclear because of inadequate systems of surveillance and reporting. We established an active surveillance system supported by laboratory-based diagnosis on the small island of Grenada, from January 2001 through June 2002. The surveillance data provided evidence of three distinct modes of disease dynamics in the form of low endemic, pre-epidemic, and overt epidemic transmission of mostly benign dengue fever. A shift in serotype activity and modal age was evident during the noted transition, with the more densely populated south end of the island presenting the focus of transmission.

Received July 7, 2008. Accepted for publication April 20, 2009.

Acknowledgments: We acknowledge the support of the Grenada Ministry of Health and the Environment and in particular Agnes Banfield, Public Health and Surveillance Nurse at the Division of Epidemiology without whom this project would not have succeeded. We are also grateful for the technical support, viral specimen, and laboratory reagents provided by Vance Vorndam, former Director of the Dengue Laboratory, CDC Dengue Branch in Puerto Rico. Finally, we thank Flemming Konradsen and Michael Alifrangis from the Department of International Health, Immunology, and Microbiology, University of Copenhagen for their comments and advice in preparation of this manuscript.

Financial Support: Financial support was provided by the Danish Research Academy and the Windward Islands Research and Education Foundation. The American Society of Tropical Medicine and Hygiene (ASTMH) assisted with publication expenses.

* Address correspondence to Karin L. Schiøler, Department of International Health, Immunology and Microbiology, University of Copenhagen, CSS, Øster Farimagsgade 5, DK-1014 Copenhagen K, Denmark. E-mail: ksch{at}sund.ku.dk

Authors’ addresses: Karin L. Schiøler, Department of International Health, Immunology and Microbiology, University of Copenhagen, CSS, Øster Farimagsgade 5, DK-1014 Copenhagen K, Denmark, Tel: (+45)35327181, Fax: (+45)35327736, E-mail: ksch{at}sund.ku.dk. Calum N. Macpherson, Windward Islands Research and Education Foundation, True Blue Campus, St. George’s University, St. George’s, Grenada, Tel: (+473)4443997, Fax: (+473)4443041, E-mail: cmacpherson{at}sgu.edu.

Reprint requests: Karin L. Schiøler, Department of International Health, Immunology and Microbiology, University of Copenhagen, CSS, Øster Farimagsgade 5, DK-1014 Copenhagen K, Denmark, E-mail: ksch{at}sund.ku.dk.






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Copyright © 2009 by the American Society of Tropical Medicine and Hygiene.