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\begin{document}

\title{The Mosquito, the Virus, the Climate: An Unforeseen R\selectlanguage{ngerman}éunion in 2018\selectlanguage{english}}



\author[1]{Laurel Anne DiSera}%
\author[2]{Henrik Sjodin}%
\author[2]{Joacim Rocklov}%
\author[3]{Yesim Tozan}%
\author[4]{Jan C Semenza}%
\author[5]{Bertrand Sudre}%
\author[5]{Herve Zeller}%
\author[6]{Angel Munoz}%
\affil[1]{International Research Institute for Climate and Society}%
\affil[2]{Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University}%
\affil[3]{New York University}%
\affil[4]{EDCD}%
\affil[5]{ECDC}%
\affil[6]{International Research Institute for Climate and Society, Columbia University}%


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  \date{May 27, 2024}


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\selectlanguage{english}
\begin{abstract}
The 2018 outbreak of dengue in the French overseas department of R\selectlanguage{ngerman}éunion
was unprecedented in size and mobility across the island. This research
focuses on the cause of the outbreak, asserting that climate played a
large role in both the proliferation of the mosquitoes, which
transmitted the disease, and the vulnerability of the island's
occupants. Additionally, this study analyses if this outbreak could have
been forecast in the sub-seasonal time scale. A stage-structured model
was run using observed temperature and rainfall data to simulate the
lifecycle and abundance of the mosquito. Further, the model was forced
with uncalibrated sub-seasonal forecasts to determine if the event could
have been forecast up to four weeks in advance. With unseasonably warm
temperatures remaining above 25 degrees C, along with large
tropical-cyclone-related rainfall events accumulating 10-15 mm per
event, the modeled mosquito abundance did not decrease during the second
half of 2017, contrary to the normal behavior, likely contributing to
the large dengue outbreak in early 2018. Although sub-seasonal forecasts
of rainfall for the Dec-Jan period in Réunion are skillful up to four
weeks in advance, the outbreak could only have been forecast two weeks
in advance, which along with seasonal forecast information could have
provided enough time to enhance preparedness measures. Our research
demonstrates the potential of using state-of-the-art sub-seasonal
climate forecasts to produce actionable sub-seasonal dengue predictions.
To the best of the authors' knowledge, this is the first time
sub-seasonal forecasts have been used this way.%
\end{abstract}\selectlanguage{ngerman}%



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