title: Epidemic of dengue-4 virus in Yap State, Federated States of Micronesia, and implication of Aedes hensilli as an epidemic vector.
abstract: A dengue fever/dengue hemorrhagic fever (DF/DHF) outbreak in Yap State caused by dengue-4 virus was confirmed serologically and by virus isolation from serum samples collected on each of three island groups. Most DF/DHF cases occurred during a three-month period between mid-May and early August 1995. Five fatal cases, three of which were in children between the ages of four and 11, occurred between June 20 and July 26. A serosurvey conducted in late August revealed anti-dengue IgM prevalence rates of 18% on Yap, 36% on Eauripik, and 6% on Woleai. The majority of residents (93-100%) on the three islands were positive for anti-dengue IgG antibodies, indicating widespread exposure to dengue viruses. The IgG titers indicative of secondary antibody response were noted on Eauripik (6.5%) and Woleai (17%), but were rare on Yap (0.7%). Entomologic investigations implicated the native mosquito species, Aedes hensilli, a member of the Scutellaris Group of Aedes (Stegomyia), as a previously unrecognized epidemic vector of dengue viruses. Aedes hensilli was the most abundant and widespread member of Ae. (Stegomyia) in Yap State, the only species of Ae. (Stegomyia) on Woleai, and the only mosquito species present on Eauripik. New distribution records for mosquito species are reported.
authors.affiliation: Division of Vector-Borne Infectious Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado 80522, USA.
authors.forename: H M
authors.initials: HM
authors.lastname: Savage
authors.forename: C L
authors.initials: CL
authors.lastname: Fritz
authors.forename: D
authors.initials: D
authors.lastname: Rutstein
authors.forename: A
authors.initials: A
authors.lastname: Yolwa
authors.forename: V
authors.initials: V
authors.lastname: Vorndam
authors.forename: D J
authors.initials: DJ
authors.lastname: Gubler
mesh_terms: D000293:Adolescent; D000328:Adult; D000330:Aedes / Q000821:virology*; D000818:Animals; D000914:Antibodies, Viral / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003465:Culex / Q000821:virology; D003715:Dengue / Q000453:epidemiology* / Q000635:transmission; D003716:Dengue Virus / Q000145:classification* / Q000276:immunology / Q000302:isolation & purification; D004196:Disease Outbreaks; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006385:Hemagglutination Inhibition Tests; D006798:Housing; D006801:Humans; D007136:Immunoglobulins / Q000097:blood; D007303:Insect Vectors / Q000821:virology*; D008297:Male; D008849:Micronesia / Q000453:epidemiology; D011891:Rain; D012307:Risk Factors
chemical_list: D000914:Antibodies, Viral; D007136:Immunoglobulins