Volume 94, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



We present the results of a laboratory-based surveillance of dengue in Taiwan in 2014. A total of 240 imported dengue cases were identified. The patients had arrived from 16 countries, and Malaysia, Indonesia, the Philippines, and China were the most frequent importing countries. Phylogenetic analyses showed that genotype I of dengue virus type 1 (DENV-1) and the cosmopolitan genotype of DENV-2 were the predominant DENV strains circulating in southeast Asia. The 2014 dengue epidemic was the largest ever to occur in Taiwan since World War II, and there were 15,492 laboratory-confirmed indigenous dengue cases. Phylogenetic analysis showed that the explosive dengue epidemic in southern Taiwan was caused by a DENV-1 strain of genotype I imported from Indonesia. There were several possible causes of this outbreak, including delayed notification of the outbreak, limited staff and resources for control measures, abnormal weather conditions, and a serious gas pipeline explosion in the dengue hot spot areas in Kaohsiung City. However, the results of this surveillance indicated that both active and passive surveillance systems should be strengthened so appropriate public health measures can be taken promptly to prevent large-scale dengue outbreaks.


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  1. WHO, 2012. Global Strategy for Dengue Prevention and Control, 2012–2020. Geneva, Switzerland: World Health Organization. [Google Scholar]
  2. Calisher CH, Karabatsos N, Dalrymple JM, Shope RE, Porterfield JS, Westaway EG, Brandt WE, , 1989. Antigenic relationships between flaviviruses as determined by cross-neutralization tests with polyclonal antisera. J Gen Virol 70: 3743.[Crossref] [Google Scholar]
  3. Lindenbach BD, Rice CM, , 2003. Molecular biology of flaviviruses. Adv Virus Res 59: 2361.[Crossref] [Google Scholar]
  4. Burke DS, Nisalak A, Johnson DE, Scott RM, , 1988. A prospective study of dengue infections in Bangkok. Am J Trop Med Hyg 38: 172180. [Google Scholar]
  5. Nimmannitya S, , 1987. Clinical spectrum and management of dengue haemorrhagic fever. Southeast Asian J Trop Med Public Health 18: 392397. [Google Scholar]
  6. WHO, 2009. Dengue Guideline for Diagnosis, Treatment, Prevention and Control. Geneva, Switzerland: World Health Organization. [Google Scholar]
  7. Gubler DJ, , 1998. Dengue and dengue hemorrhagic fever. Clin Microbiol Rev 11: 480496. [Google Scholar]
  8. Gibbons RV, Vaughn DW, , 2002. Dengue: an escalating problem. BMJ 324: 15631566.[Crossref] [Google Scholar]
  9. Brady OJ, Gething PW, Bhatt S, Messina JP, Brownstein JS, Hoen AG, Moyes CL, Farlow AW, Scott TW, Hay SI, , 2012. Refining the global spatial limits of dengue virus transmission by evidence-based consensus. PLoS Negl Trop Dis 6: e1760.[Crossref] [Google Scholar]
  10. Bhatt S, Gething PW, Brady OJ, Messina JP, Farlow AW, Moyes CL, Drake JM, Brownstein JS, Hoen AG, Sankoh O, Myers MF, George DB, Jaenisch T, Wint GR, Simmons CP, Scott TW, Farrar JJ, Hay SI, , 2013. The global distribution and burden of dengue. Nature 496: 504507.[Crossref] [Google Scholar]
  11. Murray NE, Quam MB, Wilder-Smith A, , 2013. Epidemiology of dengue: past, present and future prospects. Clin Epidemiol 5: 299309. [Google Scholar]
  12. Chang LH, Hsu EL, Teng HJ, Ho CM, , 2007. Differential survival of Aedes aegypti and Aedes albopictus (Diptera: Culicidae) larvae exposed to low temperatures in Taiwan. J Med Entomol 44: 205210.[Crossref] [Google Scholar]
  13. Huang JH, Liao TL, Chang SF, Su CL, Chien LJ, Kuo YC, Yang CF, Lin CC, Shu PY, , 2007. Laboratory-based dengue surveillance in Taiwan, 2005: a molecular epidemiologic study. Am J Trop Med Hyg 77: 903909. [Google Scholar]
  14. Shu PY, Su CL, Liao TL, Yang CF, Chang SF, Lin CC, Chang MC, Hu HC, Huang JH, , 2009. Molecular characterization of dengue viruses imported into Taiwan during 2003–2007: geographic distribution and genotype shift. Am J Trop Med Hyg 80: 10391046. [Google Scholar]
  15. Huang JH, Su CL, Yang CF, Liao TL, Hsu TC, Chang SF, Lin CC, Shu PY, , 2012. Molecular characterization and phylogenetic analysis of dengue viruses imported into Taiwan during 2008–2010. Am J Trop Med Hyg 87: 349358.[Crossref] [Google Scholar]
  16. Chang SF, Huang JH, Shu PY, , 2012. Characteristics of dengue epidemics in Taiwan. J Formos Med Assoc 111: 297299.[Crossref] [Google Scholar]
  17. Shu PY, Chien LJ, Chang SF, Su CL, Kuo YC, Liao TL, Ho MS, Lin TH, Huang JH, , 2005. Fever screening at airports and imported dengue. Emerg Infect Dis 11: 460462.[Crossref] [Google Scholar]
  18. Shu PY, Chang SF, Kuo YC, Yueh YY, Chien LJ, Sue CL, Lin TH, Huang JH, , 2003. Development of group- and serotype-specific one-step SYBR green I-based real-time reverse transcription-PCR assay for dengue virus. J Clin Microbiol 41: 24082416.[Crossref] [Google Scholar]
  19. Shu PY, Chen LK, Chang SF, Yueh YY, Chow L, Chien LJ, Chin C, Lin TH, Huang JH, , 2003. Comparison of capture immunoglobulin M (IgM) and IgG enzyme-linked immunosorbent assay (ELISA) and nonstructural protein NS1 serotype-specific IgG ELISA for differentiation of primary and secondary dengue virus infections. Clin Diagn Lab Immunol 10: 622630. [Google Scholar]
  20. Shu PY, Huang JH, , 2004. Current advances in dengue diagnosis. Clin Diagn Lab Immunol 11: 642650. [Google Scholar]
  21. Shu PY, Yang CF, Kao JF, Su CL, Chang SF, Lin CC, Yang WC, Shih H, Yang SY, Wu PF, Wu HS, Huang JH, , 2009. Application of the dengue virus NS1 antigen rapid test for on-site detection of imported dengue cases at airports. Clin Vaccine Immunol 16: 589591.[Crossref] [Google Scholar]
  22. Thompson JD, Higgins DG, Gibson TJ, , 1994. CLUSTAL W: improving the sensitivity of progressive multiple sequence alignment through sequence weighting, position-specific gap penalties and weight matrix choice. Nucleic Acids Res 22: 46734680.[Crossref] [Google Scholar]
  23. Tamura K, Stecher G, Peterson D, Filipski A, Kumar S, , 2013. MEGA6: Molecular Evolutionary Genetics Analysis version 6.0. Mol Biol Evol 30: 27252729.[Crossref] [Google Scholar]
  24. A-Nuegoonpipat A, Berlioz-Arthaud A, Chow V, Endy T, Lowry K, Mai le Q, Ninh TU, Pyke A, Reid M, Reynes JM, Su Yun ST, Thu HM, Wong SS, Holmes EC, Aaskov J, , 2004. Sustained transmission of dengue virus type 1 in the Pacific due to repeated introductions of different Asian strains. Virology 329: 505512.[Crossref] [Google Scholar]
  25. Twiddy SS, Farrar JJ, Vinh Chau N, Wills B, Gould EA, Gritsun T, Lloyd G, Holmes EC, , 2002. Phylogenetic relationships and differential selection pressures among genotypes of dengue-2 virus. Virology 298: 6372.[Crossref] [Google Scholar]
  26. Nayak V, Dessau M, Kucera K, Anthony K, Ledizet M, Modis Y, , 2009. Crystal structure of dengue virus type 1 envelope protein in the postfusion conformation and its implications for membrane fusion. J Virol 83: 43384344.[Crossref] [Google Scholar]
  27. WHO, 2015. Update on the Dengue Situation in the Western Pacific Region. Northern Hemisphere. Available at: http://www.wpro.who.int/emerging_diseases/dengue_biweekly_20150519.pdf. Accessed June 1, 2015. [Google Scholar]
  28. Tan HF, Yeh CY, Chang HW, Chang CK, Tseng HF, , 2009. Private doctors' practices, knowledge, and attitude to reporting of communicable diseases: a national survey in Taiwan. MBC Infect Dis 9: e11. [Google Scholar]
  29. Chen CM, Kou HW, Liu DP, , 2014. Impact assessment of petrochemical gas explosions on dengue fever epidemic in Kaohsiung City [in Chinese]. Taiwan Public Health Assoc 33: 563567. [Google Scholar]
  30. Weaver SC, Barrett AD, , 2004. Transmission cycles, host range, evolution and emergence of arboviral disease. Nat Rev Microbiol 2: 789801.[Crossref] [Google Scholar]
  31. Naish S, Dale P, Mackenzie JS, McBride J, Mengersen K, Tong S, , 2014. Climate change and dengue: a critical and systematic review of quantitative modelling approaches. BMC Infect Dis 14: e167.[Crossref] [Google Scholar]

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  • Received : 15 Nov 2015
  • Accepted : 04 Jan 2016
  • Published online : 06 Apr 2016

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