{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T14:33:23Z","timestamp":1779287603650,"version":"3.51.4"},"reference-count":30,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","license":[{"start":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T00:00:00Z","timestamp":1712102400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4,3]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Dengue viruses (DENV) continue to cause large outbreaks in tropical countries, while chikungunya and Zika (ZIKV) viruses have added complexity to <jats:italic>Aedes<\/jats:italic>-borne disease prevention and control efforts. Because these viruses are transmitted by the same vectors in urban areas, it is useful to understand if sequential outbreaks caused by these viruses have commonalities, such as similar seasonal and spatial patterns, that would help anticipate and perhaps prevent future outbreaks. We explored and analyzed the heterogeneity of confirmed cases of DENV (2010\u20132014 and 2015\u20132022) and ZIKV (2016\u20132017) during outbreaks in the San Juan metropolitan area of Puerto Rico to explore their degree of overlap and prioritize areas for <jats:italic>Aedes aegypti<\/jats:italic> control. Deidentified, georeferenced case data were aggregated into grid cells (500\u2009\u00d7\u2009500\u2009m) within a geographical information system of the study area and analyzed to calculate the degree of overlap between outbreaks. Spatial autocorrelations using local indicators of spatial associations were conducted to identify significant disease case hot spots and correlations between outbreaks. We found that 75% of cases during the three transmission periods were concentrated in 25% of the total number of grid cells covering the study area. We also found significant clustering of cases during each outbreak, enabling identification of consistent disease hot spots. Our results showed 85% spatial overlap between cases of ZIKV in 2015\u20132017 and DENV in 2010\u20132014 and 97% overlap between DENV cases in 2010\u20132014 and 2015\u20132022. These results reveal urban areas at greater risk of future arbovirus outbreaks that should be prioritized for vector control.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0627","type":"journal-article","created":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T18:35:04Z","timestamp":1709058904000},"page":"731-737","source":"Crossref","is-referenced-by-count":2,"title":["Historical Hot Spots of Dengue and Zika Viruses to Guide Targeted Vector Control in San Juan, Puerto Rico (2010\u20132022)"],"prefix":"10.4269","volume":"110","author":[{"given":"Roberto","family":"Barrera","sequence":"first","affiliation":[{"name":"Dengue Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose","family":"Ruiz","sequence":"additional","affiliation":[{"name":"Dengue Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura E.","family":"Adams","sequence":"additional","affiliation":[{"name":"Dengue Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Marzan-Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Health of Puerto Rico, San Juan, Puerto Rico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriela","family":"Paz-Bailey","sequence":"additional","affiliation":[{"name":"Dengue Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Nat Microbiol","first-page":"854","article-title":"Past and future spread of the arbovirus vectors Aedes aegypti and Aedes albopictus.","volume":"4","author":"Kraemer","year":"2019"},{"key":"b2","series-title":"Lancet","first-page":"243","article-title":"Zika virus: following the path of dengue and chikungunya?","volume":"386","author":"Musso","year":"2015"},{"key":"b3","series-title":"Euro Surveill","first-page":"20929","article-title":"Concurrent outbreaks of dengue, chikungunya and Zika virus infections \u2013 an unprecedented epidemic wave of mosquito-borne viruses in the Pacific 2012\u20132014","volume":"19","author":"Roth","year":"2014"},{"key":"b4","series-title":"Emerg Infect Dis","first-page":"2274","article-title":"Outbreak of exanthematous illness associated with Zika, chikungunya, and dengue viruses, Salvador, Brazil","volume":"21","author":"Cardoso","year":"2015"},{"key":"b5","series-title":"BMC Infect Dis","first-page":"61","article-title":"Co-circulation and simultaneous co-infection of dengue, chikungunya, and Zika viruses in patients with febrile syndrome at the Colombian-Venezuelan border","volume":"18","author":"Carrillo-Hern\u00e1ndez","year":"2018"},{"key":"b6","series-title":"Rev Panam Salud Publica","first-page":"225","article-title":"Estratificaci\u00f3n de una ciudad hiperend\u00e9mica en dengue hemorr\u00e1gico [Stratification of a hyperendemic city in hemorrhagic dengue]","volume":"8","author":"Barrera","year":"2000"},{"key":"b7","series-title":"PLoS Negl Trop Dis","first-page":"e0006298","article-title":"Spatio-temporal coherence of dengue, chikungunya and Zika outbreaks in Merida, Mexico","volume":"12","author":"Bisanzio","year":"2018"},{"key":"b8","series-title":"Lancet Planet Health","first-page":"e277","article-title":"Identifying urban hotspots of dengue, chikungunya, and Zika transmission in Mexico to support risk stratification efforts: a spatial analysis","volume":"5","author":"Dzul-Manzanilla","year":"2021"},{"key":"b9","series-title":"Am J Trop Med Hyg","first-page":"784","article-title":"Temporal and spatial patterns of malaria reinfection in northeastern Venezuela","volume":"61","author":"Barrera","year":"1999"},{"key":"b10","series-title":"Proc Natl Acad Sci USA","first-page":"338","article-title":"Heterogeneities in the transmission of infectious agents: implications for the design of control programs","volume":"94","author":"Woolhouse","year":"1997"},{"key":"b11","series-title":"Rev Panam Salud Publica","first-page":"e16","article-title":"Changing paradigms in Aedes control: considering the spatial heterogeneity of dengue transmission","volume":"41","author":"Vanlerberghe","year":"2017"},{"key":"b12","series-title":"Rev Saude Publica","first-page":"39","article-title":"ArboAlvo: stratification method for territorial receptivity to urban arboviruses","volume":"56","author":"Siqueira","year":"2022"},{"key":"b13","series-title":"Am J Trop Med Hyg","first-page":"235","article-title":"Sequential episodes of dengue \u2013 Puerto Rico, 2005\u20132010","volume":"91","author":"Sharp","year":"2014"},{"key":"b14","series-title":"J Infect Dis","first-page":"S868","article-title":"Epidemiology of Zika virus infection","volume":"216","author":"Hills","year":"2017"},{"key":"b15","year":"2023"},{"key":"b16","series-title":"Emerg Infect Dis","first-page":"764","article-title":"Chikungunya virus in US travelers returning from India, 2006","volume":"13","author":"Lanciotti","year":"2007"},{"key":"b17","series-title":"J Clin Microbiol","first-page":"1823","article-title":"Standardization of immunoglobulin M capture enzyme-linked immunosorbent assays for routine diagnosis of arboviral infections","volume":"38","author":"Martin","year":"2000"},{"key":"b18","series-title":"Nat Commun","first-page":"1391","article-title":"Performance of the Trioplex real-time RT-PCR assay for detection of Zika, dengue, and chikungunya viruses","volume":"9","author":"Santiago","year":"2018"},{"key":"b19","series-title":"PLoS Negl Trop Dis","first-page":"e2311","article-title":"Analytical and clinical performance of the CDC real time RT-PCR assay for detection and typing of dengue virus","volume":"7","author":"Santiago","year":"2013"},{"key":"b20","series-title":"Geogr Anal","first-page":"93","article-title":"Local indicators of spatial association \u2013 LISA","volume":"27","author":"Anselin","year":"1996"},{"key":"b21","series-title":"Procedia Environ Sci","first-page":"188","article-title":"Application of spatial analysis to the examination of dengue fever in Guayaquil, Ecuador","volume":"7","author":"Castillo","year":"2011"},{"key":"b22","series-title":"Geogr Anal","first-page":"5","article-title":"GeoDa: an introduction to spatial data analysis","volume":"38","author":"Anselin","year":"2006"},{"key":"b23","series-title":"Rev Bras Epidemiol","first-page":"907","article-title":"Geospatial analysis applied to epidemiological studies of dengue: a systematic review","volume":"16","author":"Oliveira","year":"2013"},{"key":"b24","series-title":"Trop Med Infect Dis","first-page":"30","article-title":"Spatio-temporal patterns of dengue incidence in Medan City, North Sumatera, Indonesia","volume":"6","author":"Pasaribu","year":"2021"},{"key":"b25","series-title":"Rev Saude Publica","first-page":"32","article-title":"High-risk spatial clusters for Zika, dengue, and chikungunya in Rio de Janeiro, Brazil","volume":"57","author":"Souza-Santos","year":"2023"},{"key":"b26","series-title":"Morb Mortal Wkly Rep","first-page":"774","article-title":"Update: ongoing Zika virus transmission \u2013 Puerto Rico, November 1, 2015\u2013July 7, 2016","volume":"65","author":"Adams","year":"2016"},{"key":"b27","series-title":"Vector Borne Zoonotic Dis","first-page":"75","article-title":"Zika virus: emergence and emergency","volume":"16","author":"Higgs","year":"2016"},{"key":"b28","series-title":"Proc Natl Acad Sci USA","first-page":"14688","article-title":"Asymptomatic humans transmit dengue virus to mosquitoes","volume":"112","author":"Duong","year":"2015"},{"key":"b29","series-title":"PLoS Negl Trop Dis","first-page":"e0007538","article-title":"Autocidal gravid ovitraps protect humans from chikungunya virus infection by reducing Aedes aegypti mosquito populations","volume":"13","author":"Sharp","year":"2019"},{"key":"b30","series-title":"Genetic Control of Malaria and Dengue","first-page":"103","author":"Barrera"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/110\/4\/article-p731.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/110\/4\/article-p731.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/110\/4\/article-p731.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T13:09:43Z","timestamp":1712149783000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/110\/4\/article-p731.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,3]]},"references-count":30,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.23-0627","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,3]]}}}