Epidemiology of dengue in Sri lanka before and after the emergence of epidemic dengue hemorrhagic fever

William B. Messer, U. Tissa Vitarana, Kamalanayani Sivananthan, Jayanthi Elvtigala, L. D. Preethimala, R. Ramesh, Nalini Withana, Duane J. Gubler, Aravinda M. De Silva

Research output: Contribution to journalArticlepeer-review

122 Scopus citations


Before 1989, dengue epidemiology in Sri Lanka was characterized by frequent transmission of all four dengue serotypes but a low incidence of dengue hemorrhagic fever (DHF). After 1989, cases of DHF dramatically increased. Here we present the results of epidemiologic studies conducted in Colombo, Sri Lanka before and after epidemic emergence of DHF in 1989. We compared the proportion of dengue cases among people with fever attending clinics from 1980 to 1984 and in 1997 and 1998 to determine if an increase in dengue transmission was associated with more DHF cases being reported. We also compared the relative distribution of dengue virus serotypes circulating in Colombo before and after the emergence of DHF. We detected no significant differences in dengue as a proportion of fever cases or in serotype distribution between the pre and post-DHF periods. We conclude that an increase in virus transmission or a change in circulating serotypes does not explain the epidemic emergence of DHF in Sri Lanka.

Original languageEnglish (US)
Pages (from-to)765-773
Number of pages9
JournalAmerican Journal of Tropical Medicine and Hygiene
Issue number6
StatePublished - Jun 2002
Externally publishedYes

ASJC Scopus subject areas

  • Parasitology
  • Virology
  • Infectious Diseases


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