Dengue outbreaks and the geographic distribution of dengue vectors in Taiwan: A 20-year epidemiological analysis

Dengue fever is an important mosquito-borne viral infectious disease that mostly occurs in tropical and subtropical areas of the world. According to epidemiological data from the Center for Disease Control of Taiwan, more than 98.62% of outbreaks of indigenous total dengue cases were reported in the southern part of Taiwan. Southern Taiwan is an aggregate area encompassing Tainan, Kaohsiung, and Pingtung, all of which are located below the Tropic of Cancer (23 degrees 35'N). With a few exceptions, dengue outbreaks mainly occur in southern Taiwan which is highly associated or overlaps with the prevalence of Aedes aegypti. A. aegypti is presumed to be absent from the northern part of Taiwan, while Aedes albopictus breeds in areas throughout the island. According a collection of 20 years of epidemiological data from Taiwan, the inability of A. aegypti to survive the winter weather in northern Taiwan may account for its restricted geographical distribution and that of dengue outbreaks it transmits. A. aegypti, unlike temperate strains of A. albopictus, lacks embryonic diapause signaled by a short photoperiod which thus reduces its cold-hardiness. Therefore it is intolerant of low temperatures that frequently accompany rains and unable to survive during winter in the northern part of Taiwan.