Temporal trends and regional variability of 2001-2002 multiwave DENV-3 epidemic in Havana City: did Hurricane Michelle contribute to its severity?

Objectives To investigate the temporal and regional variability of the 2001-2002 dengue outbreak in Havana City where 12889 cases, mostly of DENV-3 type, were reported over a period of 7months. Methods A simple mathematical model, the Richards model, was used to fit the weekly reported dengue case data by municipality, in order to quantify the transmissibility and temporal changes in the epidemic in each municipality via the basic reproduction number R0. Results Model fits indicate either a 2-wave or 3-wave outbreak in all municipalities. Estimates for R0 varied greatly, from 1.97 (95% CI: 1.94, 2.01), for Arroyo Naranjo, to 61.06 (60.44, 61.68), for Boyeros, most likely due to heterogeneity in community structure, geographical locations and social networking. Conclusions Our results illustrate the potential impact of climatological events on disease spread, further highlighting the need to be well prepared for potentially worsening disease spread in the aftermath of natural disasters such as hurricanes/typhoons.