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A Large Dengue Outbreak in Taiwan, 2023: Driven by Imported Cases, Serotype Cocirculation, and Climate Variability.
Jie-Yu Huang1,2, Shih-Feng Weng3,4, Zih-Syuan Yang1,2
1Center for Tropical Medicine and Infectious Disease, Kaohsiung Medical University, Kaohsiung, Taiwan.
Open Forum Infectious Diseases
|March 9, 2026
Summary
Taiwan
Area of Science:
- Epidemiology
- Virology
- Climate Science
Background:
- Taiwan, traditionally non-endemic for dengue, faced a significant 2023 outbreak.
- The outbreak's drivers involved viral importation, serotype co-circulation, vector ecology, and climate variability.
Purpose of the Study:
- To investigate the multifactorial drivers of the 2023 dengue outbreak in Taiwan.
- To analyze the interplay of imported cases, vector indices, and climate factors on dengue transmission.
Main Methods:
- Analysis of national dengue surveillance data (2013-2023) and meteorological records.
- Molecular serotyping and whole-genome sequencing of Dengue virus (DENV) isolates.
- Time-lagged Poisson regression to identify transmission predictors in Kaohsiung and Tainan.
Main Results:
- Over 26,000 cases reported, concentrated in Tainan and Kaohsiung.
- Cocirculating DENV-1 and DENV-2 strains were identified, linked to Southeast Asian variants.
- Precipitation, Breteau Index (BI), and imported cases were significant predictors, with regional variations.
Conclusions:
- The 2023 dengue outbreak resulted from complex interactions between viral introductions, climate, and vector dynamics.
- Region-specific strategies for vector surveillance, climate-based early warning systems, and genomic monitoring are crucial for prevention.
