title: Impact of epidemic influenza A-like acute respiratory illness in a remote jungle highland population in Irian Jaya, Indonesia.
abstract: A suspected epidemic of unknown etiology was investigated in April/May 1996 in the remote jungle highlands of easternmost Indonesia. Trend analysis demonstrates the area-wide occurrence of a major respiratory infection outbreak in November 1995 through February 1996. The monthly mean rate of respiratory infection episodes for the peak outbreak months (2,477 episodes/100,000 persons) was significantly higher (P < .0001) than for the 34 months leading up to the outbreak (109 episodes/100,000 persons). Notable were the high attack rates, particularly among adults: 202 episodes/1,000 persons aged 20-50 years in one community. Excess morbidity attributed to the outbreak was an estimated 4,338 episodes. The overall case-fatality rate was 15.1% of outbreak cases. Laboratory evidence confirmed the circulation of influenza A/Taiwan/1/86-like viruses in the study population, and high hemagglutination inhibition titer responses were indicative of recent infections. Historical documents from neighboring Papua New Guinea highlight the role of influenza A virus in repeated area outbreaks.
authors.affiliation: U.S. Naval Medical Research Unit No. 2, Jakarta, Indonesia.
authors.forename: A L
authors.initials: AL
authors.lastname: Corwin
authors.forename: C H
authors.initials: CH
authors.lastname: Simanjuntak
authors.forename: G
authors.initials: G
authors.lastname: Ingkokusumo
authors.forename: N
authors.initials: N
authors.lastname: Sukri
authors.forename: R P
authors.initials: RP
authors.lastname: Larasati
authors.forename: B
authors.initials: B
authors.lastname: Subianto
authors.forename: H Z
authors.initials: HZ
authors.lastname: Muslim
authors.forename: E
authors.initials: E
authors.lastname: Burni
authors.forename: K
authors.initials: K
authors.lastname: Laras
authors.forename: M P
authors.initials: MP
authors.lastname: Putri
authors.forename: C
authors.initials: C
authors.lastname: Hayes
authors.forename: N
authors.initials: N
authors.lastname: Cox
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007223:Infant; D009980:Influenza A virus / Q000302:isolation & purification*; D007251:Influenza, Human / Q000453:epidemiology* / Q000821:virology; D008875:Middle Aged; D012189:Retrospective Studies; D012424:Rural Population