Dengue, Urbanization and Globalization: The Unholy Trinity of the 21st Century
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Dengue is the most important arboviral disease of humans with over half of the world's population living in areas of risk. The frequency and magnitude of epidemic dengue have increased dramatically in the past 40 years as the viruses and the mosquito vectors have both expanded geographically in the tropical regions of the world. There are many factors that have contributed to this emergence of epidemic dengue, but only three have been the principal drivers: 1) urbanization, 2) globalization and 3) lack of effective mosquito control. The dengue viruses have fully adapted to a human-Aedes aegypti-human transmission cycle, in the large urban centers of the tropics, where crowded human populations live in intimate association with equally large mosquito populations. This setting provides the ideal home for maintenance of the viruses and the periodic generation of epidemic strains. These cities all have modern airports through which 10s of millions of passengers pass each year, providing the ideal mechanism for transportation of viruses to new cities, regions and continents where there is little or no effective mosquito control. The result is epidemic dengue. This paper discusses this unholy trinity of drivers, along with disease burden, prevention and control and prospects for the future.
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Increased international travel and trade have led to the importation of dengue cases with different serotypes and the introduction of mosquito eggs through the importation of goods to areas where the population is susceptible and competent mosquitos exist.
“Second, increased international travel and trade have led to the importation of cases with different serotypes and the introduction of mosquito eggs through the importation of goods to areas where the population is susceptible and competent mosquitos exist. (49, 50)”
From Epidemiology of dengue reported in the World Health Organization Western Pacific Region, 2013–2019 (2023) · cites this paper as [49]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredThe risk of dengue transmission increases with rapid, unplanned, and unregulated urban development, poor water storage practices, and unsatisfactory sanitary conditions.
“The risk of dengue transmission increases with rapid, unplanned, and unregulated urban development, poor water storage practices, and unsatisfactory sanitary conditions [1].”
From A cross-sectional survey of Aedes aegypti immature abundance in urban and rural household containers in central Colombia (2017) · cites this paper as [1]
Aedes aegypti preferentially breeds in man-made water containers in close proximity to human habitations.
“This species preferentially breeds in man-made water containers in close proximity to human habitations [1].”
From A cross-sectional survey of Aedes aegypti immature abundance in urban and rural household containers in central Colombia (2017) · cites this paper as [1]
A true increase in dengue incidence may have occurred due to expanding urbanization and increasing population size and density, particularly in settings with increased exposure to competent dengue vectors and mosquito breeding grounds.
“First, a true increase in dengue incidence may have occurred due to expanding urbanization and increasing population size and density, particularly in settings with increased exposure to competent dengue vectors and mosquito breeding grounds. (49)”
From Epidemiology of dengue reported in the World Health Organization Western Pacific Region, 2013–2019 (2023) · cites this paper as [49]
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- Authors
- Gubler, D. J.
- Affiliations
- National University of Singapore (SG)
- Corresponding author
- Gubler, Duane J.
- Venue
- Tropical Medicine and Health
- Published
- 2011
- Volume
- 39
- Issue
- 4SUPPLEMENT
- Pages
- S3-S11
- ISSN
- 1348-8945 (ISSN-L)
- 1349-4147
- PMC
- PMC3317603
- OpenAlex
- W2058647993
- Cited by
- 1,098
- References
- 57
- Citations by year
- 2026: 75 · 2025: 91 · 2024: 83 · 2023: 107 · 2022: 75 · 2021: 111 · 2020: 108 · 2019: 74 · 2018: 83 · 2017: 70 · 2016: 67 · 2015: 56 · 2014: 59 · 2013: 31 · 2012: 5
- FWCI
- 30.51
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Tropical Medicine and Health (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- National University of Singapore (submittedVersion)
- 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
- Social Sciences › Arts and Humanities › History › History of Medicine and Tropical Health
- Keywords
- dengue, urbanization, globalization, Aedes aegypti, mosquito control, arbovirus infection, disease emergence, disease burden, dengue control
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