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. 2018 Mar 15;8(1):4629.
doi: 10.1038/s41598-018-22590-5.

Estimating the probability of dengue virus introduction and secondary autochthonous cases in Europe

Eduardo Massad  1   2   3   4 , Marcos Amaku  5 , Francisco Antonio Bezerra Coutinho  5 , Claudio José Struchiner  6 , Marcelo Nascimento Burattini  5   7 , Kamran Khan  8 , Jing Liu-Helmersson  9 , Joacim Rocklöv  9 , Moritz U G Kraemer  10 , Annelies Wilder-Smith  9   11   12
Affiliations

Estimating the probability of dengue virus introduction and secondary autochthonous cases in Europe

Eduardo Massad et al. Sci Rep. .

Abstract

Given the speed of air travel, diseases even with a short viremia such as dengue can be easily exported to dengue naïve areas within 24 hours. We set out to estimate the risk of dengue virus introductions via travelers into Europe and number of secondary autochthonous cases as a result of the introduction. We applied mathematical modeling to estimate the number of dengue-viremic air passengers from 16 dengue-endemic countries to 27 European countries, taking into account the incidence of dengue in the exporting countries, travel volume and the probability of being viremic at the time of travel. Our models estimate a range from zero to 167 air passengers who are dengue-viremic at the time of travel from dengue endemic countries to each of the 27 receiving countries in one year. Germany receives the highest number of imported dengue-viremic air passengers followed by France and the United Kingdom. Our findings estimate 10 autochthonous secondary asymptomatic and symptomatic dengue infections, caused by the expected 124 infected travelers who arrived in Italy in 2012. The risk of onward transmission in Europe is reassuringly low, except where Aedes aegypti is present.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
European countries in which Aedes albopictus was present in 2012 (From Environmental Risk Mapping: Aedes albopictusin Europe. European Centre for Disease Prevention and Control (ECDC Technical Report), Environmental risk mapping: Aedes albopictus in Europe, Stockholm: ECDC; 2013, available at: https://www.google.com.br/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&ved=0ahUKEwjVuMCy1v7UAhVJIJAKHQIxB_kQFggpMAE&url=http%3A%2F%2Fecdc.europa.eu%2Fen%2Fpublications%2FPublications%2Fclimate-change-environmental-risk-mapping-aedes.pdf&usg=AFQjCNEKPAVsU4vqMfGXjL4pHcqy9EXz-A&cad=rja.
Figure 2
Figure 2
Selected countries with the highest reported number of dengue cases in 2012 (The values are normalized per 1 million passengers. Brazil has the highest absolute numbers but not per million).
Figure 3
Figure 3
Expected number of dengue infections in air passengers arriving in European countries from the 16 selected countries in 2012.
Figure 4
Figure 4
Expected Number of Passengers Arriving Infected With Dengue in Europe in 2012.
See this image and copyright information in PMC

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