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dc.contributor.authorRajarethinam, Jayanthien
dc.contributor.authorAng, Li-Weien
dc.contributor.authorOng, Janeten
dc.contributor.authorYcasas, Joyceen
dc.contributor.authorHapuarachchi, Hapuarachchige Chandithaen
dc.contributor.authorYap, Graceen
dc.contributor.authorChong, Chee-Sengen
dc.contributor.authorLai, Yee-Lingen
dc.contributor.authorCutter, Jefferyen
dc.contributor.authorHo, Dereken
dc.contributor.authorLee, Vernonen
dc.contributor.authorNg, Lee-Chingen
dc.identifier.citationRajarethinam, J., Ang, L.-W., Ong, J., Ycasas, J., Hapuarachchi, H. P., Yap, G., et al. (2018). Dengue in Singapore from 2004 to 2016 : cyclical epidemic patterns dominated by serotypes 1 and 2. The American Journal of Tropical Medicine and Hygiene, 99(1), 204-210.en
dc.description.abstractSingapore has experienced periodic dengue epidemics despite maintaining a low Aedes house index. Each epidemic was associated with a switch in the predominant serotype. We investigated the temporal dynamics of dengue fever and dengue virus (DENV) and analyzed the epidemiological and entomological patterns of dengue in Singapore from 2004 to 2016. The case surveillance is based on a mandatory notification system that requires all medical practitioners to report clinically suspected and laboratory-confirmed cases. Circulating (DENV) serotypes are monitored through a virus surveillance program. Entomological surveillance involves inspections for larval breeding and monitoring of adults using gravitraps. Singapore experienced a similar epidemic pattern during 2004–2007 and 2013–2016. The pattern involved a 2-year DENV-1 epidemic occurring after a switch in the predominant serotype from DENV-2 to DENV-1, followed by a “lull” year. Thereafter, the predominant serotype switched back to DENV-2, tailed by a small-scale epidemic. Across the years, the highest incidence group was in the 25–44 years age group. The incidence rate of those aged ≥ 55 years was about half of that of the 15–24 years age group during DENV-1 predominant years. However, it was almost equal to the younger age group in DENV-2 predominant years. Types of Aedes aegypti breeding habitats remained similar. Dengue incidence was significantly higher in areas with high breeding percentage (BP) than areas with low BP (P < 0.05). In conclusion, the oscillation of DENV-1 and DENV-2, throughout the 13-year period, led to a cyclical epidemic pattern and older adults were more affected by DENV-2 than DENV-1.en
dc.format.extent7 p.en
dc.relation.ispartofseriesThe American Journal of Tropical Medicine and Hygieneen
dc.rights© 2018 The American Society of Tropical Medicine and Hygiene. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en
dc.subjectDengue Epidemicen
dc.titleDengue in Singapore from 2004 to 2016 : cyclical epidemic patterns dominated by serotypes 1 and 2en
dc.typeJournal Articleen
dc.contributor.schoolSchool of Biological Sciencesen
dc.description.versionPublished versionen
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