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Urban Growth in Asian Cities. Spread of dengue hemorrhagic fever in Asia. 1950-1969. 1970-1979. 1980-2011. The spread of dengue h emorrhagic fever in the Americas . Prior to 1981. 1981-2011. Adapted from Gubler, 1998. The changing e pidemiology of dengue.
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Spread of dengue hemorrhagic fever in Asia 1950-1969 1970-1979 1980-2011
The spread of dengue hemorrhagic fever in the Americas Prior to 1981 1981-2011 Adapted from Gubler, 1998
The changing epidemiology of dengue • Expanding geographic distribution • Hyperendemicity • Increased epidemic activity • Emergence of severe disease No of Cases Source: DengueNet
New dengue Disease Burden estimates Deaths 21,000 DSS 2 million DHF 34 million? Dengue Fever 230 million Infections At-Risk Population 3.6 billion Beatty ME, Letson GW, Margolis HS., Phuket, Thailand October 17-19, 2008.
Why have we seen such a dramatic increase in epidemic Dengue Hemorrhagic Fever? Major Drivers • Demographic Changes (Pop Growth) • Environmental Change - Urbanization - Changing lifestyles • Modern Transportation (Globalization) • Increased Movement of People, Animals, Commodities and pathogens • Lack of Effective Mosquito Control
Urban growth in Asian and American Cities, 1950-2010 Population (Millions) Mean population of Dhaka, Bangkok, Jakarta, Manila and Saigon. Mean population of Rio de Janeiro, Sao Paulo, San Juan, Caracas and Guayaquil.
Average annual number of global airline passengers by decade, 1950-2010 Million of Passenger (Mil) Period IATA 2010
Global distribution of dengue virus serotypes, 1970-2000 1981 1977 1981 1979 1994 1980 1982 1975 1985 1971 DENV – 1; DENV – 2; DENV – 3; DENV – 4