Region-wide synchrony and traveling waves of dengue across eight countries in Southeast Asia

Willem G. Van Panhuis, Marc Choisy, Xin Xiong, Nian Shong Chok, Pasakorn Akarasewi, Sopon Iamsirithaworn, Sai K. Lam, Chee K. Chong, Fook C. Lam, Bounlay Phommasak, Phengta Vongphrachanh, Khamphaphongphane Bouaphanh, Huy Rekol, Nguyen Tran Hien, Pham Quang Thai, Tran Nhu Duong, Jen Hsiang Chuang, Yu Lun Liu, Lee Ching Ng, Yuan ShiEnrique A. Tayag, Vito G. Roque, Lyndon L.Lee Suy, Richard G. Jarman, Robert V. Gibbons, John Mark S. Velasco, In Kyu Yoon, Donald S. Burke, Derek A.T. Cummings

Research output: Contribution to journalArticlepeer-review


Dengue is a mosquito-transmitted virus infection that causes epidemics of febrile illness and hemorrhagic fever across the tropics and subtropics worldwide. Annual epidemics are commonly observed, but there is substantial spatiotemporal heterogeneity in intensity. A better understanding of this heterogeneity in dengue transmission could lead to improved epidemic prediction and disease control. Time series decomposition methods enable the isolation and study of temporal epidemic dynamics with a specific periodicity (e.g., annual cycles related to climatic drivers and multiannual cycles caused by dynamics in population immunity). We collected and analyzed up to 18 y of monthly dengue surveillance reports on a total of 3.5 million reported dengue cases from 273 provinces in eight countries in Southeast Asia, covering 107km2. We detected strong patterns of synchronous dengue transmission across the entire region, mostmarkedly during a period of high incidence in 1997-1998,which was followed by a period of extremely low incidence in 2001-2002. This synchrony in dengue incidence coincided with elevated temperatures throughout the region in 1997-1998 and the strongest El Niño episode of the century. Multiannual dengue cycles (2-5 y) were highly coherent with the Oceanic Niño Index, and synchrony of these cycles increased with temperature. We also detected localized traveling waves of multiannual dengue epidemic cycles in Thailand, Laos, and the Philippines that were dependent on temperature. This study reveals forcing mechanisms that drive synchronization of dengue epidemics on a continental scale across Southeast Asia.

Original languageEnglish (US)
Pages (from-to)13069-13074
Number of pages6
JournalProceedings of the National Academy of Sciences of the United States of America
Issue number42
StatePublished - Oct 20 2015


  • Dengue
  • Dynamics
  • Epidemiology
  • Southeast Asia
  • Surveillance data

ASJC Scopus subject areas

  • General


Dive into the research topics of 'Region-wide synchrony and traveling waves of dengue across eight countries in Southeast Asia'. Together they form a unique fingerprint.

Cite this