Spatial and Temporal Characteristics of 2014 Dengue Outbreak in Guangdong, China.

The record-breaking number of dengue cases reported in Guangdong, China in 2014 has been topic for many studies. However, the spatial and temporal characteristics of this unexpectedly explosive outbreak are still poorly understood. We adopt an integrated approach to ascertain the spatial-temporal progression of the outbreak in each city in Guangdong as well as in each district in Guangzhou, where the majority of cases occurred. We utilize the Richards model, which determines the waves of reported cases at each location and identifies the turning point for each wave, in combination with a spatial association analysis conducted by computing the standardized G* statistic that measures the degree of spatial autocorrelation of a set of geo-referenced data from a local perspective. We found that Yuexiu district in Guangzhou was the initial hot spot for the outbreak, subsequently spreading to its neighboring districts in Guangzhou and other cities in Guangdong province. Hospital isolation of cases during early stage of outbreak in neighboring Zhongshan (in effort to prevent disease transmission to the vectors) might have played an important role in the timely mitigation of the disease. Integration of modeling approach and spatial association analysis allows us to pinpoint waves that spread the disease to communities beyond the borders of the initially affected regions.