What caused the 2012 dengue outbreak in Pucallpa, Peru? A socio-ecological autopsy

摘要: Dengue is highly endemic in Peru, with increases transmission particularly since vector re-infestation of the country 1980s. Pucallpa, second largest city Peruvian Amazon, experienced a large outbreak 2012 that caused more than 10,000 cases and 13 deaths. To date, there has been limited research on dengue Amazon outside Iquitos, no published review or critical analysis Pucallpa outbreak. This study describes incidence, surveillance, control Ucayali to understand factors contributed We employed socio-ecological autopsy approach consider distal proximal contributing factors, drawing existing literature interviews key personnel involved control, surveillance treatment Ucayali. Spatio-temporal showed relative risk was higher northern districts Calleria (RR = 2.18), Manantay 1.49) Yarinacocha 1.25) compared all other between 2004 2014. The seasonal occurrence consistent typical patterns for incidence region. Our assessment suggests proximally triggered by introduction new virus serotype (DENV-2 Asian/America) Increased travel, rapid urbanization, inadequate water management facilitated potential spread transmission, both within regionally. These triggers occurred context failures programming, including underfunded ad hoc control. findings have implications future prevention as diseases such chikungunya Zika threaten