epidemiology Epidemiology is the study and analysis of the distribution (who, when, and where), patterns and determinants of health and disease conditions in a defined population. It is a cornerstone of public health, and shapes policy decisions and evidenc ...

, the term hyperendemic disease is used to refer to a

disease A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that a ...

which is constantly and persistently present in a population at a high rate of incidence and/or

prevalence In epidemiology, prevalence is the proportion of a particular population found to be affected by a medical condition (typically a disease or a risk factor such as smoking or seatbelt use) at a specific time. It is derived by comparing the number o ...

(occurrence) and which equally affects (i.e. which is equally

endemic Endemism is the state of a species being found in a single defined geographic location, such as an island, state, nation, country or other defined zone; organisms that are indigenous to a place are not endemic to it if they are also found elsew ...

in) all

age group Demographic profiling is a form of demographic analysis used by marketers so that they may be as efficient as possible with advertising products or services and identifying any possible gaps in their marketing strategy. Demographic profiling can e ...

s of that population. It is one of the various degrees of endemicity (i.e. degrees of transmission of an infectious disease).

Definitions

According to a more precise definition given by the

Robert Koch Institute The Robert Koch Institute (RKI) is a German federal government agency and research institute responsible for disease control and prevention. It is located in Berlin and Wernigerode. As an upper federal agency, it is subordinate to the Federal ...

in Germany, hyperendemicity is not necessarily associated with a high incidence rate. A hyperendemic disease is one which is ubiquitously present with ongoing circulation in an endemic region with a high prevalence rate. As a result, a hyperendemic region shows a relatively low incidence rate but at the same time it poses a high risk of infection to people coming into the region. According to another definition discussing malaria, a hyperendemic region is defined to be one with a seasonally high degree of endemicity where immunity does not succeed to prevent the effects of a disease for all age groups.

Examples

In the discussion of the

dengue fever Dengue fever is a mosquito-borne tropical disease caused by the dengue virus. Symptoms typically begin three to fourteen days after infection. These may include a high fever, headache, vomiting, muscle and joint pains, and a characterist ...

, a hyperendemic state is characterized by the continuous circulation of multiple viral

serotype A serotype or serovar is a distinct variation within a species of bacteria or virus or among immune cells of different individuals. These microorganisms, viruses, or cells are classified together based on their surface antigens, allowing the epi ...

s in an area where a large pool of

susceptible Susceptibility may refer to: Physics and engineering In physics the susceptibility is a quantification for the change of an extensive property under variation of an intensive property. The word may refer to: * In physics, the susceptibility of a ...

host A host is a person responsible for guests at an event or for providing hospitality during it. Host may also refer to: Places * Host, Pennsylvania, a village in Berks County People *Jim Host (born 1937), American businessman * Michel Host ...

s and a competent

vector Vector most often refers to: *Euclidean vector, a quantity with a magnitude and a direction *Vector (epidemiology), an agent that carries and transmits an infectious pathogen into another living organism Vector may also refer to: Mathematic ...

(with or without

seasonal variation In time series data, seasonality is the presence of variations that occur at specific regular intervals less than a year, such as weekly, monthly, or quarterly. Seasonality may be caused by various factors, such as weather, vacation, and holidays a ...

) are constantly present. In another example,

World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...

defines

malaria Malaria is a mosquito-borne infectious disease that affects humans and other animals. Malaria causes symptoms that typically include fever, tiredness, vomiting, and headaches. In severe cases, it can cause jaundice, seizures, coma, or death. S ...

to be hyperendemic if the percentage of persons with an enlarged

spleen The spleen is an organ found in almost all vertebrates. Similar in structure to a large lymph node, it acts primarily as a blood filter. The word spleen comes .

(spleen rate) is constantly greater than 50% for all age groups.

Difference with similar epidemiological concepts

Difference with holoendemic

disease is one with a continuous occurrence at an expected frequency over a certain period of time and in a certain geographical location. Two terms are used when the degree of transmission or infection of an endemic disease is high: hyperendemic and

holoendemic A disease is holoendemic when essentially every individual in a population is infected. Although the infection is ubiquitous, symptoms of disease do not appear equally across age groups. The young are more likely to express pathogenic responses, wh ...

. One of the differences between hyperendemic and holoendemic diseases is that hyperendemic diseases show a seasonally intense

transmission Transmission may refer to: Medicine, science and technology * Power transmission ** Electric power transmission ** Propulsion transmission, technology allowing controlled application of power *** Automatic transmission *** Manual transmission *** ...

in all age groups with a period of low or no transmission, whereas in holoendemic diseases, there is perennial (year-round) high level of transmission predominantly among young population with higher

immunity Immunity may refer to: Medicine * Immunity (medical), resistance of an organism to infection or disease * ''Immunity'' (journal), a scientific journal published by Cell Press Biology * Immune system Engineering * Radiofrequence immunity desc ...

among adults.

Difference with hotspot

Justin Lessler and others from Johns Hopkins University reported a rise in the usage of the ambiguous term "hotspot" in research and policy documents in late 2010s. Hotspots have been variously described as areas of elevated incidence or prevalence, higher transmission efficiency or risk, or higher probability of disease emergence. Lessler and others suggest that a hyperendemic region or synonymously a ''"burden hotspot"'' (defined as an area of elevated disease incidence or prevalence) should be distinguished from an ''"emergence hotspot"'' (defined as an area with a high frequency of emergence or reemergence of diseases or drug-resistant strains) and a ''"transmission hotspot"'' (defined as an area of elevated transmission efficiency i.e., an elevated

reproductive number In epidemiology, the basic reproduction number, or basic reproductive number (sometimes called basic reproduction ratio or basic reproductive rate), denoted R_0 (pronounced ''R nought'' or ''R zero''), of an infection is the expected number of ...

, R).

References

{{Concepts in infectious disease Infectious diseases Epidemiology