%0 Journal Article
%T Detecting and Responding to a Dengue Outbreak: Evaluation of Existing Strategies in Country Outbreak Response Planning
%A Julia Harrington
%A Axel Kroeger
%A Silvia Runge-Ranzinger
%A Tim O'Dempsey
%J Journal of Tropical Medicine
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/756832
%X Background. Dengue outbreaks are occurring with increasing frequency and intensity. Evidence-based epidemic preparedness and effective response are now a matter of urgency. Therefore, we have analysed national and municipal dengue outbreak response plans. Methods. Thirteen country plans from Asia, Latin America and Australia, and one international plan were obtained from the World Health Organization. The information was transferred to a data analysis matrix where information was extracted according to predefined and emerging themes and analysed for scope, inconsistencies, omissions, and usefulness. Findings. Outbreak response planning currently has a considerable number of flaws. Outbreak governance was weak with a lack of clarity of stakeholder roles. Late timing of responses due to poor surveillance, a lack of combining routine data with additional alerts, and lack of triggers for initiating the response weakened the functionality of plans. Frequently an outbreak was not defined, and early response mechanisms based on alert signals were neglected. There was a distinct lack of consideration of contextual influences which can affect how an outbreak detection and response is managed. Conclusion. A model contingency plan for dengue outbreak prediction, detection, and response may help national disease control authorities to develop their own more detailed and functional context specific plans. 1. Introduction Dengue, a mosquito-borne viral disease, is emerging as one of the worldĄŻs most rapidly spreading and important infectious diseases of the twenty first century [1] A somewhat different disease scenario exists today, with all four viral serotypes circulating in Asia, Africa, and the Americas, an estimated 3.6 billion people living in dengue endemic countries, and over 50 million dengue infections occurring annually [2]. The increasing global threat of dengue outbreaks in both endemic and nonendemic regions has led to a focus on establishing an effective outbreak response. A dengue outbreak response has been defined as the sum of measures specifically addressing a dengue outbreak, with the aim of reducing case fatality rates, case number, and entomological parameters [3]. In addition to this, in order to detect the outbreak, systematic surveillance needs to be in place. Emergency preparedness and anticipated response planning are an integral part of dengue control, yet this is often neglected in dengue endemic countries [1]. Different measures need to be implemented depending on the context of dengue in the area. Thus, in endemic areas, the ability to
%U http://www.hindawi.com/journals/jtm/2013/756832/