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In 2014 and 2015, Southern Taiwan experienced two unprecedented outbreaks, with more than 10,000 laboratory-confirmed dengue cases in each outbreak. The present study was aimed to investigate the influence of meteorological and spatial factors on dengue outbreaks in Southern Taiwan and was conducted in Kaohsiung City, which is the most affected area in Taiwan. The distributed lag nonlinear model was used to investigate the role of climatic factors in the 2014 and 2015 dengue outbreaks. Spatial statistics in the Geographic Information System was applied to study the relationship between the dengue spreading pattern and locations of traditional markets (human motility) in the 2015 dengue outbreak. Meteorological analysis results suggested that the relative risk of dengue fever increased when the weekly average temperature was more than 15°C at lagged weeks 5 to 18. Elevated relative risk of dengue was observed when the weekly average rainfall was more than 150 mm at lagged weeks 12 to 20. The spatial analysis revealed that approximately 83% of dengue cases were located in the 1000 m buffer zone of traditional market, with statistical significance. These findings support the influence of climatic factors and human motility on dengue outbreaks. Furthermore, the study analysis may help authorities to identify hotspots and decide the timing for implementation of dengue control programs. [ABSTRACT FROM AUTHOR]

This observation provides further evidence to support that imported dengue cases from other countries are the source of local dengue transmission annually, and that continuous monitoring of dengue will be important as COVID-19-related restrictions are lifted in Taiwan as an endemic area. Dengue is considered to be an endemic disease in Taiwan, and a strong association between the COVID-19 epidemic and a reduced risk of dengue has been reported in endemic areas.1 A total of 34,722 cases of dengue local to Kaohsiung City were recorded from 2014 to 2015, however no local dengue cases were reported in 2020 or 2021.2 We believe that the major reason for the absence of locally transmitted dengue cases is due to border control. Another reason for the absence of locally transmitted dengue cases may be because the Kaohsiung City Government Health Bureau established an airport quarantine referral station in September 2016 to reduce the occurrence of dengue. [Extracted from the article]