Predicting re-emergence times of dengue epidemics at low reproductive numbers: DENV1 in Rio de Janeiro, 1986-1990

Rahul Subramanian, Victoria Romeo-Aznar, Edward Ionides, Claudia T. Codeco, Mercedes Pascual

Research output: Contribution to journalArticlepeer-review


Predicting arbovirus re-emergence remains challenging in regions with limited off-season transmission and intermittent epidemics. Current mathematical models treat the depletion and replenishment of susceptible (non-immune) hosts as the principal drivers of re-emergence, based on established understanding of highly transmissible childhood diseases with frequent epidemics. We extend an analytical approach to determine the number of 'skip' years preceding re-emergence for diseases with continuous seasonal transmission, population growth and under-reporting. Re-emergence times are shown to be highly sensitive to small changes in low R0 (secondary cases produced from a primary infection in a fully susceptible population). We then fit a stochastic Susceptible-Infected-Recovered (SIR) model to observed case data for the emergence of dengue serotype DENV1 in Rio de Janeiro. This aggregated city-level model substantially over-estimates observed reemergence times either in termsof skips oroutbreak probability under forward simulation. The inability of susceptible depletion and replenishment to explain re-emergence under 'well-mixed' conditions at a city-wide scale demonstrates a key limitation of SIR aggregated models, including those applied to other arboviruses. The predictive uncertainty and high skip sensitivity to epidemiological parameters suggest a need to investigate the relevant spatial scales of susceptible depletion and the scaling of microscale transmission dynamics to formulate simpler models that apply at coarse resolutions.

Original languageEnglish (US)
Article number20200273
JournalJournal of the Royal Society Interface
Issue number167
StatePublished - Jun 1 2020


  • Dengue
  • Population immunity
  • Predicting disease re-emergence
  • Transmission dynamics
  • Urban health
  • Vector-borne diseases

ASJC Scopus subject areas

  • Biotechnology
  • Biophysics
  • Bioengineering
  • Biomaterials
  • Biochemistry
  • Biomedical Engineering


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