The global distribution and burden of dengue
Open accessAbstract
Dengue is a systemic viral infection transmitted between humans by Aedes mosquitoes. For some patients, dengue is a life-threatening illness. There are currently no licensed vaccines or specific therapeutics, and substantial vector control efforts have not stopped its rapid emergence and global spread. The contemporary worldwide distribution of the risk of dengue virus infection and its public health burden are poorly known. Here we undertake an exhaustive assembly of known records of dengue occurrence worldwide, and use a formal modelling framework to map the global distribution of dengue risk. We then pair the resulting risk map with detailed longitudinal information from dengue cohort studies and population surfaces to infer the public health burden of dengue in 2010. We predict dengue to be ubiquitous throughout the tropics, with local spatial variations in risk influenced strongly by rainfall, temperature and the degree of urbanization. Using cartographic approaches, we estimate there to be 390 million (95% credible interval 284-528) dengue infections per year, of which 96 million (67-136) manifest apparently (any level of disease severity). This infection total is more than three times the dengue burden estimate of the World Health Organization. Stratification of our estimates by country allows comparison with national dengue reporting, after taking into account the probability of an apparent infection being formally reported. The most notable differences are discussed. These new risk maps and infection estimates provide novel insights into the global, regional and national public health burden imposed by dengue. We anticipate that they will provide a starting point for a wider discussion about the global impact of this disease and will help to guide improvements in disease control strategies using vaccine, drug and vector control methods, and in their economic evaluation.
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An estimated 70% of dengue virus infections are thought to occur in Asia.
“An estimated 70% of dengue virus infections are thought to occur in Asia. (2)”
From Epidemiology of dengue reported in the World Health Organization Western Pacific Region, 2013–2019 (2023) · cites this paper as [2]
The paper states that Asia bore 70% of the estimated 96 million *apparent* dengue infections globally in 2010 (section labelled Abstract; page unavailable). The citing sentence omits both the apparent-infection qualifier and the year, so the passage does not establish that 70% of all dengue virus infections occur in Asia. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThere is likely to be underreporting and, thus, an underestimation of the true regional burden of dengue in terms of the number of cases, case-fatality ratios and incidence.
“As a result of differences in case definitions and other factors, there is likely to be underreporting and, thus, an underestimation of the true regional burden in terms of the number of cases, CFRs and incidence. (1, 2)”
From Epidemiology of dengue reported in the World Health Organization Western Pacific Region, 2013–2019 (2023) · cites this paper as [2]
The Abstract says traditional surveillance captures a narrower range of dengue infections and identifies care-seeking, misdiagnosis and reporting failures as sources of undercounting. The Methods section compares estimated incidence with cases reported to WHO. Neither passage establishes that underreporting leads to underestimated case-fatality ratios. (LLM, conf=0.86)
Experimental — accuracy not yet measuredSharing information and data about dengue helps countries and areas better understand transmission patterns and supports the implementation of dengue prevention and control measures.
“Sharing information and data about dengue helps countries and areas better understand transmission patterns and supports the implementation of dengue prevention and control measures. (2)”
From Epidemiology of dengue reported in the World Health Organization Western Pacific Region, 2013–2019 (2023) · cites this paper as [2]
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“Among these diseases transmitted by mosquitoes, malaria and dengue are the most important infectious diseases and around 390 million people are affected by dengue per year (Bhatt et al. 2013) while nearly 216 million people are affected annually due to malaria (WHO 2011).”
Applications of gold nanoparticles in virus detection
Draz, M. S., & Shafiee, H. (2018) · Theranostics · doi:10.7150/thno.23856 · Cited by 351 · see citing works
“Currently, there are no specific treatments or protective vaccines available against DENV, and as a result of its rapid expansion, accurate and sensitive diagnostic techniques have become crucial for effective control and treatment applications [134].”
Limited Dengue Virus Replication in Field-Collected Aedes aegypti Mosquitoes Infected with Wolbachia
Turell, M. J., Frentiu, F. D., Zakir, T., Walker, T., Popovici, J., Pyke, A. T., van den Hurk, A. F., McGraw, E. A., & O’Neill, S. L. (2014) · Figshare · doi:10.1371/journal.pntd.0002688 · Cited by 345 · see citing works
Biochemistry and Molecular Biology of Flaviviruses
Barrows, N. J., Campos, R. K., Liao, K., Prasanth, K. R., Soto-Acosta, R., Yeh, S.-C., Schott, G., Pompon, J., Sessions, O. M., Bradrick, S. S., et al. (2018) · Chemical Reviews · doi:10.1021/acs.chemrev.7b00719 · Cited by 339 · see citing works
A review of Dengvaxia®: development to deployment
Thomas, S. J., & Yoon, I. (2019) · Human Vaccines & Immunotherapeutics · doi:10.1080/21645515.2019.1658503 · Cited by 341 · see citing works
“It is estimated there are over 390 million infections globally each year of which more than 95 million are clinically apparent.(3) There is no specific anti-DENV therapeutic, but supportive care is very effective when delivered by experienced practitioners.”
- Authors
- Bhatt, S., Gething, P. W., Brady, O. J., Messina, J. P., Farlow, A. W., Moyes, C. L., Drake, J. M., Brownstein, J. S., Hoen, A. G., Sankoh, O., Myers, M. F., George, D. B., Jaenisch, T., Wint, G. R. W., Simmons, C. P., Scott, T. W., Farrar, J. J., & Hay, S. I.
- Affiliations
- University of Oxford (GB)
- University of Georgia (US)
- Boston Children's Hospital (US)
- Dartmouth College (US)
- University of the Witwatersrand (ZA)
- National Institutes of Health (US)
- University Hospital Heidelberg (DE)
- Churchill Hospital (GB)
- National University of Singapore (SG)
- Corresponding author
- Hay, Simon I.
- ORCID
- Venue
- Nature
- Published
- 2013-04
- Volume
- 496
- Issue
- 7446
- Pages
- 504-507
- ISSN
- 0028-0836 (ISSN-L)
- 1476-4687
- PMC
- PMC3651993
- OpenAlex
- W2131222241
- Cited by
- 10,037
- References
- 52
- Citations by year
- 2026: 615 · 2025: 704 · 2024: 830 · 2023: 846 · 2022: 816 · 2021: 943 · 2020: 946 · 2019: 922 · 2018: 777 · 2017: 724 · 2016: 744 · 2015: 551 · 2014: 467 · 2013: 141 · 2012: 3
- FWCI
- 650.37
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- Minerva Access (University of Melbourne) (submittedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Spiral (Imperial College London) (submittedVersion)
- Funders
- U.S. Department of Homeland Security
- Wellcome Trust (089276, 095066, 084368, 097318)
- European Commission (261504)
- National Institutes of Health (5r01ai069341-05)
- Biotechnology and Biological Sciences Research Council (1090403)
- National Institute of General Medical Sciences (R01GM083224)
- National Institute of Allergy and Infectious Diseases (R01-AI069341, R01AI091980)
- Fogarty International Center
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Mosquito-borne diseases and control
- Social Sciences › Sociology and Political Science › Dengue and Mosquito Control Research
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Climate Change and Health Impacts
- Keywords
- dengue, global burden of disease, dengue incidence, dengue risk mapping, Aedes, mosquito-borne viral disease, temperature and precipitation effects, urbanization, dengue prevention, dengue control, tropical and subtropical regions, dengue vaccine
- MeSH terms
- Dengue, Dengue Virus, Humans, Public Health, Quality Control, Rain, Risk Factors, Temperature, Tropical Climate, Urbanization, Global Health, World Health Organization, Cohort Studies, Incidence, Databases, Factual
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