Simulation models of dengue transmission in Funchal, Madeira Island: influence of seasonality

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The recent emergence and established presence of Aedes aegypti in the Autonomous Region of Madeira, Portugal, was responsible for the first autochthonous outbreak of dengue in Europe. The island has not reported any dengue cases since the outbreak in 2012. However, there is a high risk that an introduction of the virus would result in another autochthonous outbreak given the presence of the vector and permissive environmental conditions. Understanding the dynamics of a potential epidemic is critical for targeted local control strategies. Here, we adopt a deterministic model for the transmission of dengue in Aedes aegypti mosquitoes. The model integrates empirical and mechanistic parameters for virus transmission, under seasonally varying temperatures for Funchal, Madeira Island. We examine the epidemic dynamics as triggered by the arrival date of an infectious individual; the influence of seasonal temperature mean and variation on the epidemic dynamics; and performed a sensitivity analysis on the following quantities of interest: the epidemic peak size, time to peak and the final epidemic size. Our results demonstrate the potential for summer to early winter transmission of dengue, with the arrival date significantly affecting the distribution of the timing and peak size of the epidemic. Mid-summer to early autumn arrivals are more likely to produce larger epidemics within a short peak time. Epidemics within this favorable period had an average of 18% of the susceptible population infected at the peak, at an average peak time of 70 days. We also demonstrated that seasonal temperature variation dramatically affects the epidemic dynamics, with warmer starting temperatures producing peaks more quickly after an introduction and larger epidemics. Overall, our quantities of interest were most sensitive to variance in the date of arrival, seasonal temperature, biting rate, transmission rates, and the mosquito population; the magnitude of sensitivity differs across quantities. Our model could serve as a useful guide in the development of effective local control and mitigation strategies for dengue fever in Madeira Island.Competing Interest StatementThe authors have declared no competing interest.Funding StatementThis work was partially funded by Fundac cão para a Ciência e a Tecnologia, Portugal (Project Warden - PTDC/SAU-PUB/30089/2017 and GHTM – UID/Multi/04413/2013). DS has a PhD grant from the Fundac cão para a Ciência e a Tecnologia, Portugal (PD/BD/128084/2016).Author DeclarationsAll relevant ethical guidelines have been followed and any necessary IRB and/or ethics committee approvals have been obtained.Not ApplicableAll necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.Not ApplicableAny clinical trials involved have been registered with an ICMJE-approved registry such as and the trial ID is included in the manuscript.Not ApplicableI have followed all appropriate research reporting guidelines and uploaded the relevant Equator, ICMJE or other checklist(s) as supplementary files, if applicable.Not ApplicableEntomological data for Madeira Island are available from: ; Historical temperature data for Funchal, Madeira Island are available from:; All other relevant data are within the paper and its Supporting Information files.
Original languageEnglish
Number of pages44
Publication statusSubmitted - 15 Apr 2020

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