Dengue fever in Saudi Arabia: A review of environmental and population factors impacting emergence and spread

Kholood K Altassan; Cory Morin; Marta S Shocket; Kris Ebi; Jeremy Hess

doi:10.1016/j.tmaid.2019.04.006

Dengue fever in Saudi Arabia: A review of environmental and population factors impacting emergence and spread

Travel Med Infect Dis. 2019 Jul-Aug:30:46-53. doi: 10.1016/j.tmaid.2019.04.006. Epub 2019 Apr 10.

Authors

Kholood K Altassan¹, Cory Morin², Marta S Shocket³, Kris Ebi⁴, Jeremy Hess⁵

Affiliations

¹ Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, 98195, USA. Electronic address: ktassan@uw.edu.
² Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, WA, 98105, USA. Electronic address: cwmorin@uw.edu.
³ Department of Biology, Stanford University, 371 Serra Mall Stanford, CA, 94305, USA. Electronic address: mshocket@stanford.edu.
⁴ Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, 98195, USA; Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, WA, 98105, USA. Electronic address: krisebi@uw.edu.
⁵ Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, 98195, USA; Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, WA, 98105, USA; Department of Environmental and Occupational Health Sciences, University of Washington, Box 357234 1959 NE Pacific Street, Seattle, WA, 98195, USA; Department of Emergency Medicine, School of Medicine, University of Washington, Seattle, WA, 98195, USA. Electronic address: jjhess@uw.edu.

PMID: 30978417
DOI: 10.1016/j.tmaid.2019.04.006

Abstract

Dengue fever (DF) is the most important mosquito-transmitted viral disease causing a large economic and disease burden in many parts of the world. Most DF research focuses on Latin America and Asia, where burdens are highest. There is a critical need for studies in other regions where DF is an important public health problem but less well-characterized and can differ, such as the Middle East. The first documented case of DF in Saudi Arabia occurred in 1993. After a decade of sporadic outbreaks, the disease was declared endemic in 2004 and this designation persists. Climate, sociodemographic factors, and increasing urbanization impact the spread of DF in Saudi Arabia, as in other areas. However, DF transmission in Saudi Arabia is also affected by several unique factors, including large numbers of migrant workers and religious pilgrims from other dengue endemic areas across the Middle East, North Africa, and Asia. Important knowledge gaps relate to the role of climatic factors as drivers of DF in Saudi Arabia and the role of foreign workers and pilgrims in the original and continuous importation of dengue virus. Filling these gaps would improve health system preparedness.

Keywords: Arbovirus; Dengue virus; Middle east and North Africa; Mosquito-borne disease.

Publication types

Review

MeSH terms

Communicable Diseases, Emerging / epidemiology*
Dengue / epidemiology*
Environment*
Humans
Risk Factors
Saudi Arabia / epidemiology