{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T18:46:41Z","timestamp":1785523601948,"version":"3.56.0"},"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mexico has experienced escalating dengue transmission driven by the co\u2011circulation of four antigenically distinct serotypes (DENV\u20111 through DENV\u20114). Multi\u2011serotype transmission is epidemiologically relevant, yet its spatiotemporal patterns at sub\u2011national resolution remain poorly characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed 103,426 PCR\u2011confirmed, serotyped dengue cases across 1,547 of 2,471 Mexican municipalities from January 2020 to December 2025. Kulldorff\u2019s space\u2011time scan statistic under a discrete Poisson model was applied independently to each serotype and to all serotypes combined. Co\u2011circulation was defined as the spatiotemporal overlap of significant clusters from at least two serotypes within the same municipality for \u2265 1 epidemiological week.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 159 statistically significant clusters across all serotypes combined. DENV\u20113 was dominant (64.4% of cases; annual incidence 59.9\/100,000), consistent with the reemergence of a long\u2011absent serotype. The 2024\u20132025 season produced a nationally synchronized epidemic across geographically distant regions. Co\u2011circulation of at least two serotypes occurred in 1,545 municipalities; 217 experienced simultaneous clustering of all four serotypes. Active co\u2011circulation was present in 275 of 311 study weeks. Mean pairwise temporal overlap ranged from 8.0 to 12.0 weeks, with maximum overlaps of 29\u201330 weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Four\u2011serotype co\u2011circulation was documented at municipal resolution, concentrated in the Gulf coast, the Yucat\u00e1n Peninsula, and northeastern Mexico. The 217 municipalities with simultaneous clustering of all four serotypes may represent areas of epidemiological interest for further investigation. This municipality\u2011level spatiotemporal framework offers operationally relevant resolution for tracking multi\u2011serotype activity and supporting serotype\u2011aware dengue monitoring at sub\u2011national scale.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0354885","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T17:26:31Z","timestamp":1785518791000},"page":"e0354885","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Spatiotemporal co-circulation of four dengue serotypes across Mexico, 2020\u20132025: A space-time scan analysis"],"prefix":"10.1371","volume":"21","author":[{"given":"Oliver","family":"Mendoza-Cano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"X\u00f3chitl","family":"Trujillo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00f3nica","family":"R\u00edos-Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime Alberto","family":"Bricio-Barrios","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agustin","family":"Lugo-Radillo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Tapia-Vargas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Venegas-Ram\u00edrez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eder Fernando","family":"R\u00edos-Bracamontes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0788-4312","authenticated-orcid":true,"given":"Herguin Benjamin","family":"Cuevas-Arellano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yolitzy","family":"C\u00e1rdenas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8242-0695","authenticated-orcid":true,"given":"Ra\u00fal","family":"Aquino-Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris Anecxi","family":"Jim\u00e9nez-Vieyra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Manuel","family":"Uribe-Ramos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ver\u00f3nica","family":"Benites-God\u00ednez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa Evangelina","family":"Mart\u00ednez-D\u00edaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"L\u00f3pez-Rojas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annel","family":"Garc\u00eda-Sol\u00f3rzano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1118-498X","authenticated-orcid":true,"given":"Efr\u00e9n","family":"Murillo-Zamora","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"pone.0354885.ref001","author":"World Health Organization","year":"2025"},{"issue":"3","key":"pone.0354885.ref002","article-title":"Assessing the global dengue burden: Incidence, mortality, and disability trends over three decades","volume":"19","author":"W-X Zhang","year":"2025","journal-title":"PLoS Negl Trop Dis"},{"key":"pone.0354885.ref003","author":"European Centre for Disease Prevention and Control","year":"2026"},{"key":"pone.0354885.ref004","doi-asserted-by":"crossref","first-page":"1362780","DOI":"10.3389\/fimmu.2024.1362780","article-title":"Approaches of dengue control: vaccine strategies and future aspects","volume":"15","author":"R Akter","year":"2024","journal-title":"Front Immunol"},{"issue":"10427","key":"pone.0354885.ref005","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1016\/S0140-6736(23)02576-X","article-title":"Dengue","volume":"403","author":"G Paz-Bailey","year":"2024","journal-title":"Lancet"},{"key":"pone.0354885.ref006","doi-asserted-by":"crossref","first-page":"107940","DOI":"10.1016\/j.ijid.2025.107940","article-title":"Global dengue epidemic worsens with record 14 million cases and 9000 deaths reported in 2024","volume":"158","author":"N Haider","year":"2025","journal-title":"Int J Infect Dis"},{"issue":"1","key":"pone.0354885.ref007","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1186\/s41182-025-00783-9","article-title":"Leveraging geographic information system for dengue surveillance: a scoping review","volume":"53","author":"P Prakash Nayak","year":"2025","journal-title":"Trop Med Health"},{"issue":"1","key":"pone.0354885.ref008","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1038\/s41467-022-28231-w","article-title":"Fine-scale heterogeneity in population density predicts wave dynamics in dengue epidemics","volume":"13","author":"V Romeo-Aznar","year":"2022","journal-title":"Nat Commun"},{"issue":"3","key":"pone.0354885.ref009","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.0020059","article-title":"A space-time permutation scan statistic for disease outbreak detection","volume":"2","author":"M Kulldorff","year":"2005","journal-title":"PLoS Med"},{"key":"pone.0354885.ref010","doi-asserted-by":"crossref","first-page":"100441","DOI":"10.1016\/j.ijregi.2024.100441","article-title":"Space-time scanning statistics in the prediction and evaluation of dengue epidemic clusters","volume":"13","author":"TT Le","year":"2024","journal-title":"IJID Reg"},{"key":"pone.0354885.ref011","doi-asserted-by":"crossref","first-page":"1620914","DOI":"10.3389\/fpubh.2025.1620914","article-title":"Geospatial clustering reveals dengue hotspots across Brazilian municipalities","volume":"13","author":"BF Sena","year":"2025","journal-title":"Front Public Health"},{"issue":"3","key":"pone.0354885.ref012","doi-asserted-by":"crossref","first-page":"97","DOI":"10.3390\/ijgi13030097","article-title":"A Review of Bayesian Spatiotemporal Models in Spatial Epidemiology","volume":"13","author":"Y Wang","year":"2024","journal-title":"IJGI"},{"issue":"3","key":"pone.0354885.ref013","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1111\/tgis.13042","article-title":"Spatial autocorrelation mixtures in geospatial disease data: An important global epidemiologic\/public health assessment ingredient?","volume":"27","author":"DA Griffith","year":"2023","journal-title":"Transactions in GIS"},{"key":"pone.0354885.ref014","author":"Secretar\u00eda de Salud M of H, Direcci\u00f3n General de Epidemiolog\u00eda GD of E"},{"issue":"7","key":"pone.0354885.ref015","doi-asserted-by":"crossref","first-page":"1482","DOI":"10.3201\/eid2907.230595","article-title":"Reemergence of Dengue Virus Serotype 3, Brazil, 2023","volume":"29","author":"FG Naveca","year":"2023","journal-title":"Emerg Infect Dis"},{"issue":"2","key":"pone.0354885.ref016","doi-asserted-by":"crossref","first-page":"376","DOI":"10.3201\/eid3002.231615","article-title":"Introduction and spread of dengue virus 3, Florida, USA, May 2022-April 2023","volume":"30","author":"FK Jones","year":"2024","journal-title":"Emerg Infect Dis"},{"key":"pone.0354885.ref017","author":"Secretar\u00eda de Salud M of H, Direcci\u00f3n General de Epidemiolog\u00eda GD of E","year":"2025"},{"key":"pone.0354885.ref018","author":"Consejo Nacional de Poblaci\u00f3n"},{"key":"pone.0354885.ref019","author":"G Instituto Nacional de Estad\u00edstica y Geograf\u00eda NI of S and"},{"key":"pone.0354885.ref020","article-title":"Spatiotemporal-based clusters as a method for dengue surveillance","volume":"41","author":"M Romero Canal","year":"2017","journal-title":"Rev Panam Salud Publica"},{"issue":"11","key":"pone.0354885.ref021","doi-asserted-by":"crossref","first-page":"2391","DOI":"10.3201\/eid3011.241031","article-title":"Dengue outbreak caused by multiple virus serotypes and lineages, Colombia, 2023-2024","volume":"30","author":"ND Grubaugh","year":"2024","journal-title":"Emerg Infect Dis"},{"issue":"2","key":"pone.0354885.ref022","doi-asserted-by":"crossref","DOI":"10.3390\/pathogens15020190","article-title":"Epidemiological Characteristics of Dengue Disease in Mexico (2014-2025): A Descriptive Analysis of a Hyperendemic Country","volume":"15","author":"R Cremades","year":"2026","journal-title":"Pathogens"},{"key":"pone.0354885.ref023","author":"Pan American Health Organization","year":"2025"},{"issue":"1","key":"pone.0354885.ref024","doi-asserted-by":"crossref","first-page":"8179","DOI":"10.1038\/s41467-023-43954-0","article-title":"Interactions between climate change, urban infrastructure and mobility are driving dengue emergence in Vietnam","volume":"14","author":"R Gibb","year":"2023","journal-title":"Nat Commun"},{"issue":"9","key":"pone.0354885.ref025","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0009631","article-title":"The role of urbanisation in the spread of Aedes mosquitoes and the diseases they transmit-A systematic review","volume":"15","author":"A Kolimenakis","year":"2021","journal-title":"PLoS Negl Trop Dis"},{"issue":"21","key":"pone.0354885.ref026","doi-asserted-by":"crossref","first-page":"2009","DOI":"10.1056\/NEJMoa1903869","article-title":"Efficacy of a Tetravalent Dengue Vaccine in Healthy Children and Adolescents","volume":"381","author":"S Biswal","year":"2019","journal-title":"N Engl J Med"},{"issue":"1","key":"pone.0354885.ref027","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1186\/s12942-020-00228-y","article-title":"Detecting multiple spatial disease clusters: information criterion and scan statistic approach","volume":"19","author":"K Takahashi","year":"2020","journal-title":"Int J Health Geogr"},{"issue":"6","key":"pone.0354885.ref028","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.3201\/eid3006.231553","article-title":"Introduction of new dengue virus lineages of multiple serotypes after COVID-19 pandemic, Nicaragua, 2022","volume":"30","author":"C Cerpas","year":"2024","journal-title":"Emerg Infect Dis"},{"issue":"11","key":"pone.0354885.ref029","doi-asserted-by":"crossref","first-page":"2153","DOI":"10.3201\/eid3111.250746","article-title":"Shifting Dynamics of Dengue Virus Serotype 2 and Emergence of Cosmopolitan Genotype, Costa Rica, 2024","volume":"31","author":"M Gonz\u00e1lez-Elizondo","year":"2025","journal-title":"Emerg Infect Dis"},{"issue":"2","key":"pone.0354885.ref030","doi-asserted-by":"crossref","DOI":"10.1093\/ve\/vead059","article-title":"Multiple introductions and country-wide spread of DENV-2 genotype II (Cosmopolitan) in Brazil","volume":"9","author":"T Graf","year":"2023","journal-title":"Virus Evol"},{"issue":"1","key":"pone.0354885.ref031","doi-asserted-by":"crossref","first-page":"1810","DOI":"10.1038\/s41467-021-21888-9","article-title":"Reconstructing unseen transmission events to infer dengue dynamics from viral sequences","volume":"12","author":"H Salje","year":"2021","journal-title":"Nat Commun"},{"issue":"1","key":"pone.0354885.ref032","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1080\/14760584.2024.2395550","article-title":"Regional molecular epidemiology of dengue and the potential optimization of its control through the use of vaccines. Report of the Arbovirus Committee of the Latin American Society of Pediatric Infectious Diseases, SLIPE","volume":"23","author":"JR Torres","year":"2024","journal-title":"Expert Rev Vaccines"},{"key":"pone.0354885.ref033","doi-asserted-by":"crossref","first-page":"1200195","DOI":"10.3389\/fimmu.2023.1200195","article-title":"Dengue virus neutralizing antibody: a review of targets, cross-reactivity, and antibody-dependent enhancement","volume":"14","author":"A Sarker","year":"2023","journal-title":"Front Immunol"},{"issue":"6365","key":"pone.0354885.ref034","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1126\/science.aan6836","article-title":"Antibody-dependent enhancement of severe dengue disease in humans","volume":"358","author":"LC Katzelnick","year":"2017","journal-title":"Science"},{"issue":"11","key":"pone.0354885.ref035","doi-asserted-by":"crossref","first-page":"2575","DOI":"10.3390\/v14112575","article-title":"Immune-Mediated Pathogenesis in Dengue Virus Infection","volume":"14","author":"A Khanam","year":"2022","journal-title":"Viruses"},{"issue":"12","key":"pone.0354885.ref036","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.3390\/v17121539","article-title":"Monitoring Dengue Virus in Aedes aegypti to Improve Dengue Surveillance and Control in Puerto Rico","volume":"17","author":"LM Otero","year":"2025","journal-title":"Viruses"},{"key":"pone.0354885.ref037","doi-asserted-by":"crossref","first-page":"100485","DOI":"10.1016\/j.lansea.2024.100485","article-title":"Evolving dengue serotype distribution with dominance of dengue virus- 3 in Bangalore: critical insights for vaccine efficacy and implementation","volume":"30","author":"S Uppoor","year":"2024","journal-title":"Lancet Reg Health Southeast Asia"},{"issue":"10","key":"pone.0354885.ref038","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1000171","article-title":"A prospective nested case-control study of Dengue in infants: rethinking and refining the antibody-dependent enhancement dengue hemorrhagic fever model","volume":"6","author":"DH Libraty","year":"2009","journal-title":"PLoS Med"},{"issue":"5","key":"pone.0354885.ref039","doi-asserted-by":"crossref","first-page":"483","DOI":"10.3390\/vaccines13050483","article-title":"Dengue Vaccine Development and Deployment into Routine Immunization","volume":"13","author":"A Wilder-Smith","year":"2025","journal-title":"Vaccines (Basel)"},{"key":"pone.0354885.ref040","first-page":"1481","volume-title":"A Spatial Scan Statistic In Communications in Statistics-Theory and Methods","author":"M Kulldorff","year":"1997"},{"issue":"1","key":"pone.0354885.ref041","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s12942-019-0170-3","article-title":"Incorporating geography into a new generalized theoretical and statistical framework addressing the modifiable areal unit problem","volume":"18","author":"M Tuson","year":"2019","journal-title":"Int J Health Geogr"},{"issue":"1","key":"pone.0354885.ref042","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/s12942-020-00236-y","article-title":"Overcoming inefficiencies arising due to the impact of the modifiable areal unit problem on single-aggregation disease maps","volume":"19","author":"M Tuson","year":"2020","journal-title":"Int J Health Geogr"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0354885","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T17:26:39Z","timestamp":1785518799000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0354885"}},"subtitle":[],"editor":[{"given":"Gabriel","family":"Trueba","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,7,31]]},"references-count":42,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,31]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0354885","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,31]]}}}