Journal Article

House-to-house human movement drives dengue virus transmission

Reiner, Robert C., Vazquez-Prokopec, Gonzalo M., Vilcarromero, Stalin, Kochel, Tadeusz J., Morrison, Amy C., Astete, Helvio, Halsey, Eric S., Forshey, Brett M., Kitron, Uriel, Stoddard, Steven T., Elder, John P., Scott, Thomas W., Paz-Soldan, Valerie A.

2013

Overview

Dengue is a mosquito-borne disease of growing global health importance. Prevention efforts focus on mosquito control, with limited success. New insights into the spatiotemporal drivers of dengue dynamics are needed to design improved disease-prevention strategies. Given the restricted range of movement of the primary mosquito vector, Aedes aegypti , local human movements may be an important driver of dengue virus (DENV) amplification and spread. Using contact-site cluster investigations in a case-control design, we demonstrate that, at an individual level, risk for human infection is defined by visits to places where contact with infected mosquitoes is likely, independent of distance from the home. Our data indicate that house-to-house human movements underlie spatial patterns of DENV incidence, causing marked heterogeneity in transmission rates. At a collective level, transmission appears to be shaped by social connections because routine movements among the same places, such as the homes of family and friends, are often similar for the infected individual and their contacts. Thus, routine, house-to-house human movements do play a key role in spread of this vector-borne pathogen at fine spatial scales. This finding has important implications for dengue prevention, challenging the appropriateness of current approaches to vector control. We argue that reexamination of existing paradigms regarding the spatiotemporal dynamics of DENV and other vector-borne pathogens, especially the importance of human movement, will lead to improvements in disease prevention.

• Publisher: National Academy of Sciences,National Acad Sciences
• Subject: Adolescent / Adult / Aedes - virology / Aedes aegypti / Animals / Aquatic insects / Arboviroses / Biological and medical sciences / Biological Sciences / Child / Child, Preschool / Cluster Analysis / cluster investigation / Cohort Studies / Contact Tracing / Data transmission / Dengue / Dengue - epidemiology / Dengue - transmission / Dengue - virology / Dengue fever / Dengue fevers / Dengue virus / Disease control / Disease prevention / Disease transmission / Epidemiology / Female / Fundamental and applied biological sciences. Psychology / Global health / Heterogeneity / Homes / Houses / Housing / human diseases / Human movement / Human viral diseases / Humans / Incidence / Infant / Infant, Newborn / Infections / Infectious diseases / insect vectors / Insect Vectors - virology / Locomotion / Longitudinal Studies / Male / Medical sciences / Medically important nuisances and vectors, pests of stored products and materials: population survey and control / Middle Aged / Models, Biological / mosquito control / Mosquitoes / Pathogens / Peru - epidemiology / Prevention / risk / Risk assessment / Tropical viral diseases / vector control / Vector-borne diseases / Vectors. Intermediate hosts / Viral diseases / virus transmission / Viruses / Young Adult