Forty years of dengue surveillance at a tertiary pediatric hospital in Bangkok, Thailand, 1973-2012

Ananda Nisalak, Hannah E. Clapham, Siripen Kalayanarooj, Chonticha Klungthong, Butsaya Thaisomboonsuk, Stefan Fernandez, Julia Reiser, Anon Srikiatkhachorn, Louis R. Macareo, Justin T. Lessler, Derek A.T. Cummings, In Kyu Yoon

Research output: Contribution to journalArticlepeer-review


Long-term observational studies can provide valuable insights into overall dengue epidemiology. Here, we present analysis of dengue cases at a pediatric hospital in Bangkok, Thailand, during a 40-year period from 1973 to 2012. Data were analyzed from 25,715 hospitalized patients with laboratory-confirmed dengue virus (DENV) infection. Several long-term trends in dengue disease were identified including an increase in mean age of hospitalized cases from an average of 7-8 years, an increase after 1990 in the proportion of post-primary cases for DENV-1 and DENV-3, and a decrease in the proportion of dengue hemorrhagic fever and dengue shock syndrome cases in primary and post-primary cases over time. Exploratory mechanistic analysis of these observed trends considered changes in diagnostic methods, demography, force of infection, and Japanese encephalitis vaccination as possible explanations. Thailand is an important setting for studying DENV transmission as it has a "mature" dengue epidemiology with a strong surveillance system in place since the early 1970s. We characterized changes in dengue epidemiology over four decades, and possible impact of demographic and other changes in the human population. These results may inform other countries where similar changes in transmission and population demographics may now or may soon be occurring.

Original languageEnglish (US)
Pages (from-to)1342-1347
Number of pages6
JournalAmerican Journal of Tropical Medicine and Hygiene
Issue number6
StatePublished - Jun 2016

ASJC Scopus subject areas

  • Parasitology
  • Virology
  • Infectious Diseases


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