Travelling waves in the occurrence of dengue haemorrhagic fever in Thailand

Derek A.T. Cummings, Rafael A. Irizarry, Norden E. Huang, Timothy P. Endy, Ananda Nisalak, Kumnuan Ungchusak and Donald S. Burke ()
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Derek A.T. Cummings: Johns Hopkins University
Rafael A. Irizarry: Johns Hopkins Bloomberg School of Public Health
Norden E. Huang: NASA Goddard Space Flight Center
Timothy P. Endy: United States Army Medical Research Institute in Infectious Disease
Ananda Nisalak: Armed Forces Research Institute of Medical Sciences
Kumnuan Ungchusak: Ministry of Public Health
Donald S. Burke: Johns Hopkins Bloomberg School of Public Health

Nature, 2004, vol. 427, issue 6972, 344-347

Abstract: Abstract Dengue fever is a mosquito-borne virus that infects 50–100 million people each year1. Of these infections, 200,000–500,000 occur as the severe, life-threatening form of the disease, dengue haemorrhagic fever (DHF)2. Large, unanticipated epidemics of DHF often overwhelm health systems3. An understanding of the spatial–temporal pattern of DHF incidence would aid the allocation of resources to combat these epidemics. Here we examine the spatial–temporal dynamics of DHF incidence in a data set describing 850,000 infections occurring in 72 provinces of Thailand during the period 1983 to 1997. We use the method of empirical mode decomposition4 to show the existence of a spatial–temporal travelling wave in the incidence of DHF. We observe this wave in a three-year periodic component of variance, which is thought to reflect host–pathogen population dynamics5,6. The wave emanates from Bangkok, the largest city in Thailand, moving radially at a speed of 148 km per month. This finding provides an important starting point for detecting and characterizing the key processes that contribute to the spatial–temporal dynamics of DHF in Thailand.

Date: 2004
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DOI: 10.1038/nature02225

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