Discriminable roles of Aedes aegypti and Aedes albopictus in establishment of dengue outbreaks in Taiwan.

Aedes aegypti and Aedes albopictus were reported to be significant as vectors of dengue fever. In Taiwan, the latter is distributed throughout the island while the former appears only south of the Tropic of Cancer; i.e., 23.5°N. In the past decade, there were five outbreaks with over 1000 cases of dengue fever in Taiwan. Without exception, these outbreaks all occurred in the south where the two Aedes mosquitoes are sympartic. According to the Center for Disease Control of Taiwan, imported cases are thought to provide the seeds of dengue outbreaks every year. Mostly, the number of imported cases is greater in northern island, probably due to a larger population of travelers and imported workers from endemic countries. Looking at the example in 2002, northern, central, and southern parts of Taiwan reported 28, 11, and 13 imported cases, respectively. However, 54, 21, and 5309 total cases were confirmed in the corresponding regions over the entire year, indicating a significant skew of case distributions. A hypothesis is thus inspired that the existence of Ae. aegypti is a prerequisite to initiate a dengue outbreak, while participation of Ae. albopictus expands or maintains the scale until the de novo herd immunity reaches high level.