Mathematical Biosciences and Engineering (MBE)

The basic reproduction number $R_0$ and effectiveness of reactive interventions during dengue epidemics: The 2002 dengue outbreak in Easter Island, Chile

Pages: 1455 - 1474, Volume 10, Issue 5/6, October/December 2013      doi:10.3934/mbe.2013.10.1455

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Gerardo Chowell - Mathematical, Computational & Modeling Sciences Center, School of Human Evolution and Social Change, Arizona State University, Box 872402, Tempe, AZ 85287, United States (email)
R. Fuentes - Department of Epidemiology, Ministerio de Salud, Santiago, Chile (email)
A. Olea - Universidad del Desarrollo, Santiago, Chile (email)
X. Aguilera - Universidad del Desarrollo, Santiago, Chile (email)
H. Nesse - School of Human Evolution and Social Change, Arizona State University, Tempe, AZ 85287, United States (email)
J. M. Hyman - Tulane University, New Orleans, LA, 70118, United States (email)

Abstract: We use a stochastic simulation model to explore the effect of reactive intervention strategies during the 2002 dengue outbreak in the small population of Easter Island, Chile. We quantified the effect of interventions on the transmission dynamics and epidemic size as a function of the simulated control intensity levels and the timing of initiation of control interventions. Because no dengue outbreaks had been reported prior to 2002 in Easter Island, the 2002 epidemic provided a unique opportunity to estimate the basic reproduction number $R_0$ during the initial epidemic phase, prior to the start of control interventions. We estimated $R_0$ at $27.2$ ($95 \%$CI: $14.8$, $49.3$). We found that the final epidemic size is highly sensitive to the timing of start of interventions. However, even when the control interventions start several weeks after the epidemic onset, reactive intervention efforts can have a significant impact on the final epidemic size. Our results indicate that the rapid implementation of control interventions can have a significant effect in reducing the epidemic size of dengue epidemics.

Keywords:  Dengue, dengue hemorrhagic fever, epidemic, Easter Island, Chile, 2002 outbreak, mathematical model, reproduction number.
Mathematics Subject Classification:  Primary: 92D30, 92C60; Secondary: 37N25.

Received: September 2012;      Accepted: February 2013;      Available Online: August 2013.