Forty Years of Dengue Surveillance at a Tertiary Pediatric Hospital in Bangkok, Thailand, 1973–2012

Ananda Nisalak Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland; Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand; Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts

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Hannah E. Clapham Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland; Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand; Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts

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Siripen Kalayanarooj Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland; Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand; Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts

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Chonticha Klungthong Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland; Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand; Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts

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Butsaya Thaisomboonsuk Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland; Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand; Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts

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Stefan Fernandez Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland; Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand; Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts

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Julia Reiser Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland; Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand; Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts

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Anon Srikiatkhachorn Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland; Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand; Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts

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Louis R. Macareo Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland; Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand; Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts

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Justin T. Lessler Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland; Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand; Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts

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Derek A. T. Cummings Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland; Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand; Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts

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In-Kyu Yoon Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland; Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand; Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts

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DOI:
https://doi.org/10.4269/ajtmh.15-0337
Volume/Issue:
Volume 94: Issue 6
Page(s):
1342–1347
Restricted access
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Long-term observational studies can provide valuable insights into overall dengue epidemiology. Here, we present analysis of dengue cases at a pediatric hospital in Bangkok, Thailand, during a 40-year period from 1973 to 2012. Data were analyzed from 25,715 hospitalized patients with laboratory-confirmed dengue virus (DENV) infection. Several long-term trends in dengue disease were identified including an increase in mean age of hospitalized cases from an average of 7–8 years, an increase after 1990 in the proportion of post-primary cases for DENV-1 and DENV-3, and a decrease in the proportion of dengue hemorrhagic fever and dengue shock syndrome cases in primary and post-primary cases over time. Exploratory mechanistic analysis of these observed trends considered changes in diagnostic methods, demography, force of infection, and Japanese encephalitis vaccination as possible explanations. Thailand is an important setting for studying DENV transmission as it has a “mature” dengue epidemiology with a strong surveillance system in place since the early 1970s. We characterized changes in dengue epidemiology over four decades, and possible impact of demographic and other changes in the human population. These results may inform other countries where similar changes in transmission and population demographics may now or may soon be occurring.

Author Notes

* Address correspondence to Hannah E. Clapham, Department of Epidemiology, Johns Hopkins School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205. E-mail: Hannah.e.clapham@gmail.com
† These authors contributed equally to this work.

Financial support: Derek A. T. Cummings received funding from the National Institute of General Medical Sciences of the National Institutes of Health under award no. U54 GM088491. Hannah E. Clapham, Justin T. Lessler, and Derek A. T. Cummings received funding from the National Institutes of Health under award no. 5R01AI102939-03. Anon Srikiatkhachorn received funding from the National Institute of Allergy and Infectious Diseases under award no. 5 P01 AI034533-22.

Authors' addresses: Ananda Nisalak, Chonticha Klungthong, Butsaya Thaisomboonsuk, Stefan Fernandez, Julia Reiser, Louis R. Macareo, and In-Kyu Yoon, Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand, E-mails: anandan@afrims.org, chontichak@afrims.org, butsayat.fsn@afrims.org, stefan.fernandez.mil@mail.mil, julia.a.reiser@gmail.com, louis.macareo.mil@afrims.org, and inkyu.yoon.mil@afrims.org. Hannah E. Clapham, Justin T. Lessler, and Derek A. T. Cummings, Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, E-mails: hannah.e.clapham@gmail.com, jlessler@jhsph.edu, and derek.cummings@jhu.edu. Siripen Kalayanarooj, Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand, E-mail: siripenk@gmail.com. Anon Srikiatkhachorn, UMASS, Center for Infectious Disease and Vaccine Research, Worcester, MA, E-mail: anon.srikiatkhachorn@umassmed.edu.

Copyright:
© The American Society of Tropical Medicine and Hygiene 2016
Received:
06 May 2015
|
Accepted:
09 Dec 2015
|
Published Online:
01 Jun 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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