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The 2022 dengue outbreak in Bangladesh: hypotheses for the late resurgence of cases and fatalities

Haider, Najmul; Hasan, Mohammad Nayeem; Khalil, Ibrahim; Tonge, Daniel; Hegde, Shivanand; Chowdhury, Muhammad Abdul Baker; Rahman, Mahbubur; Khan, Manjur Hossain; Ansumana, Rashid; Zumla, Alimuddin; Uddin, Md Jamal


Mohammad Nayeem Hasan

Ibrahim Khalil

Muhammad Abdul Baker Chowdhury

Mahbubur Rahman

Manjur Hossain Khan

Rashid Ansumana

Alimuddin Zumla

Md Jamal Uddin


Bangladesh reported the highest number of annual deaths (n = 281) related to dengue virus infection in 2022 since the virus reappeared in the country in 2000. Earlier studies showed that >92% of the annual cases occurred between the months of August and September. The 2022 outbreak is characterized by late onset of dengue cases with unusually higher deaths in colder months, that is, October–December. Here we present possible hypotheses and explanations for this late resurgence of dengue cases. First, in 2022, the rainfall started late in the season. Compared to the monthly average rainfall for September and October between 2003 and 2021, there was 137 mm of additional monthly rainfall recorded in September and October 2022. Furthermore, the year 2022 was relatively warmer with a 0.71°C increased temperature than the mean annual temperature of the past 20 yr. Second, a new dengue virus serotype, DENV-4, had recently reintroduced/reappeared in 2022 and become the dominant serotype in the country for a large naïve population. Third, the post-pandemic return of normalcy after 2 yr of nonpharmaceutical social measures facilitates extra mosquito breeding habitats, especially in construction sites. Community engagement and regular monitoring and destruction of Aedes mosquitoes’ habitats should be prioritized to control dengue virus outbreaks in Bangladesh.

Journal Article Type Article
Acceptance Date May 10, 2023
Online Publication Date May 18, 2023
Publication Date Jul 12, 2023
Deposit Date Jun 29, 2023
Journal Journal of Medical Entomology
Print ISSN 0022-2585
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 60
Issue 4
Pages 847-852
Keywords Infectious Diseases, Insect Science, General Veterinary, Parasitology
PMID 37202843