Decreased dengue cases attributable to the effect of COVID-19 in Guangzhou in 2020 |
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| Authors: | Liyun Jiang Yuan Liu Wenzhe Su Wenhui Liu Zhicong Yang |
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| Affiliation: | 1. Virology Department, Guangzhou Centre for Disease Control and Prevention, Baiyunqu Qidelu 1, Guangdong, China;2. Pesticide and Disinfection Department, Guangzhou Centre for Disease Control and Prevention, Baiyunqu Qidelu 1, Guangdong, China;3. Epidemiology Department, Guangzhou Centre for Disease Control and Prevention, Baiyunqu Qidelu 1, Guangdong, China;University of Hong Kong, HONG KONG |
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| Abstract: | ![]()
The dengue fever epidemic in Guangzhou may have been affected by the Coronavirus Disease 2019 (COVID-19) pandemic. The number of dengue cases dropped drastically in 2020, and there have been only 2 local cases, suggesting that dengue has not become endemic in Guangzhou.Guangzhou is located on the southeast coast of China and is the country’s third largest city. Since 1978, outbreaks of dengue fever have occurred intermittently in this city. In the past decade, the number of reported dengue cases reached more than 1,000 in 2013, 2014, 2018, and 2019, with 37,385 cases reported in 2014 alone. Therefore, dengue fever is a major public health concern in Guangzhou, and there is a continuing argument that it is endemic in Guangzhou [1–3].The numbers of dengue cases from 2017 to 2020 are shown in | Open in a separate windowIn 2020, the 14-day quarantine in a designated hotel for international travelers to curb the spread of Coronavirus Disease 2019 (COVID-19) was an important public health intervention. People had to remain indoors except for medical care needs. All imported dengue cases were identified during their quarantine periods. No secondary case related to the imported cases was reported. This may be because Aedes albopictus, which is the major vector of dengue in Guangzhou, bites aggressively during the day outdoors. The chance of being bitten by A. albopictus was reduced by staying all day indoors. Moreover, some research revealed that viremia occurred 6 to 18 hours before symptoms appeared and lasted as long as 12 days [4]. After the 14-day quarantine, viremia had almost subsided. Therefore, imported dengue cases were unlikely to be transmitted. The impact of imported dengue cases was limited by the quarantine, which provided a rare opportunity to identify the local epidemic.The epidemiology investigation showed that the 2 local cases, who were living in the same building, had no travel history outside Guangzhou in 2020 and had symptoms successively. Two dengue virus serotype 2 (DENV-2) strains were isolated from them. The envelope gene sequences were obtained and deposited in GenBank under accession numbers {"type":"entrez-nucleotide","attrs":{"text":"MW295818","term_id":"1937783612"}}MW295818 and {"type":"entrez-nucleotide","attrs":{"text":"MW345921","term_id":"1941099997"}}MW345921. Reference sequences, which were downloaded from GenBank, and sequences of Guangzhou strains identified in the previous years, were used to construct a phylogenetic tree. The 2 isolated strains in 2020 were identical. The tree () shows that the 2 strains belonged to the Malaysia/Indian subcontinent genotype, which was the prevailing genotype in Guangzhou [5]. However, they were neither identical with nor derived from the Guangzhou strains obtained from the previous years. Using the Basic Local Alignment Search Tool in GenBank, the 2 strains were found to be highly similar to those identified in Zhejiang (China), Singapore, and Guangdong (China) in 2017. These results imply that the local cases may be secondary to some undiscovered cases imported from other cities in China, as no restriction and quarantine was imposed for domestic travels.Open in a separate windowMaximum-likelihood phylogenetic tree shows the evolutionary relationships of DENV-2 detected in the sera of 2 local cases along with 45 other sequences.The reference sequences are named using the GenBank accession number, country, and year. The sequences of strains isolated in Guangzhou are named using the GenBank accession number, year, and our lab number. Bootstrap support values are shown in the notes. Strains isolated in 2020 are indicated with a black triangle.When the impact of imported dengue cases was limited by quarantine, dengue did not spread in Guangzhou during 2020, with the MOI still at median risk level and without any changes in the prevention and control strategies. Moreover, serotype 1 had been prevalent in Guangzhou since 2011 [6,7]. However, there was no local infection of serotype 1 detected in 2020. These observations may provide further evidence that dengue fever is not endemic in Guangzhou.In conclusion, the number of dengue cases decreased during the COVID-19 epidemic in Guangzhou in 2020. Thus, we believe that dengue fever is not endemic in Guangzhou. |
