New handbook for dengue outbreak contingency planning

TDR news item
30 September 2016

A new handbook has been published to help countries plan for dengue outbreaks. Produced by TDR with the World Health Organization, it provides the latest evidence on how best to establish early warning and response systems. A summary has also been published in PLOS NTD.

It is estimated that there are over 50-100 million cases of dengue worldwide each year, with 3 billion people living in dengue endemic countries. The disease is transmitted by the bite of a mosquito infected with one of the four dengue virus serotypes. Symptoms range from mild to incapacitating high fever, with severe headache, pain behind the eyes, muscle and joint pain, and rash. There is no vaccine or any specific medicine to treat dengue. Severe dengue is a potentially lethal complication.

Effective outbreak management diagram
Effective outbreak management diagram
From Technical Handbook for Surveillance, Dengue Outbreak Prediction/ Detection and Outbreak Response

Most countries do not have comprehensive, detailed contingency plans for dengue outbreaks. Countries tend to rely on intensifying their control of the mosquito, with minimal focus on integrated management of clinical care, epidemiological, laboratory and vector surveillance, and risk communication.

The Technical Handbook for Surveillance, Dengue Outbreak Prediction/ Detection and Outbreak Response lists evidence-based best practices. It was developed to provide a framework for public health providers and programme managers to develop a national plan. Guidance is provided on how to detect a dengue outbreak at an early stage through clearly defined and validated alarm signals; precisely define when a dengue outbreak has started; and organize an early response to the alarm signals or an “emergency response” once an outbreak has started. Programme components can be adapted to local needs and resources.

Extensive reviews of the literature, interviews with policy-makers and other stakeholders, an assessment of the current planning and outbreak management in 10 endemic countries, and a statistical analysis on early warning signs in 5 countries were all part of the process of developing the content.

The handbook was produced by TDR together with the World Health Organization’s Neglected Tropical Diseases Department and regional offices, with funding from the European Union-financed research programme, the International Research Consortium on Dengue Risk Assessment, Management and Surveillance (IDAMS).

For more information, contact Dr Piero Olliaro.