Table 2

Proposed alert signals (triggers for early response) as suggested by the WHO-TDR expert meeting (June 2012)
Trigger Evidence or expert opinion** Feasibility Further research needed***
New predominant serotype introduced +++ Most countries +++
Changes in age group distribution ++ Most countries +++
Increased number of hospitalised/outpatient fever cases/probable dengue* +++ Most countries +++
Increase in vector presence ++ Most countries +++
Increase in news reporting dengue outbreaks, social network comments + Few countries ++++
Climate changes: increase in rainfall/temperature/humidity ++ Most countries +++
Increase in % positive serology* ++++ Most countries +
Increase internal displacement/population mobility + Context dependent ++++
Cluster identified through GIS mapping ++ Few countries ++
Identification of outbreak in a neighboring geographical unit (state, district, province, country)* ++++ Most countries ++

*Particularly useful indicators/ triggers.

** ++++ very strong; +++ strong; ++fairly strong; + weak.

*** ++++highest priority; +++ high priority; ++ necessary.

Badurdeen et al.

Badurdeen et al. BMC Public Health 2013 13:607   doi:10.1186/1471-2458-13-607

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