Spatiotemporal transmission dynamics of co-circulating dengue, Zika, and chikungunya viruses in Fortaleza, Brazil: 2011-2017

PLoS Negl Trop Dis. 2020 Oct 26;14(10):e0008760. doi: 10.1371/journal.pntd.0008760. eCollection 2020 Oct.

Abstract

The mosquito-borne viruses dengue (DENV), Zika (ZIKV), and chikungunya (CHIKV), now co-endemic in the Americas, pose growing threats to health worldwide. However, it remains unclear whether there exist interactions between these viruses that could shape their epidemiology. This study advances knowledge by assessing the transmission dynamics of co-circulating DENV, ZIKV, and CHIKV in the city of Fortaleza, Brazil. Spatiotemporal transmission dynamics of DENV, ZIKV, and CHIKV were analyzed using georeferenced data on over 210,000 reported cases from 2011 to 2017 in Fortaleza, Brazil. Local spatial clustering tests and space-time scan statistics were used to compare transmission dynamics across all years. The transmission of co-circulating viruses in 2016 and 2017 was evaluated at fine spatial and temporal scales using a measure of spatiotemporal dependence, the τ-statistic. Results revealed differences in the diffusion of CHIKV compared to previous DENV epidemics and spatially distinct transmission of DENV/ZIKV and CHIKV during the period of their co-circulation. Significant spatial clustering of viruses of the same type was observed within 14-day time intervals at distances of up to 6.8 km (p<0.05). These results suggest that arbovirus risk is not uniformly distributed within cities during co-circulation. Findings may guide outbreak preparedness and response efforts by highlighting the clustered nature of transmission of co-circulating arboviruses at the neighborhood level. The potential for competitive interactions between the arboviruses should be further investigated.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brazil / epidemiology
  • Chikungunya Fever / epidemiology*
  • Chikungunya Fever / transmission
  • Chikungunya Fever / virology
  • Chikungunya virus / genetics
  • Chikungunya virus / physiology
  • Coinfection / epidemiology
  • Coinfection / transmission
  • Coinfection / virology
  • Dengue / epidemiology*
  • Dengue / transmission
  • Dengue / virology
  • Dengue Virus / genetics
  • Dengue Virus / physiology
  • Disease Outbreaks
  • Humans
  • Spatio-Temporal Analysis
  • Zika Virus / genetics
  • Zika Virus / physiology
  • Zika Virus Infection / epidemiology*
  • Zika Virus Infection / transmission
  • Zika Virus Infection / virology

Grants and funding

LK thanks the Michael von Clemm Travelling Fellowship and the Department of Global Health and Population at the Harvard T.H. Chan School of Public Health for travel support. This study was partially funded by the Harvard University Lemann Brazil Research Fund (PI: MCC). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.