title: Transmission of epidemic dengue hemorrhagic fever in easternmost Indonesia.
abstract: In April 2001, a second suspected outbreak of dengue hemorrhagic fever in the easternmost region of Indonesia was investigated in Merauke, a town located in the southeastern corner of Papua, by the Indonesian Ministry of Health and the U.S. Naval Medical Research Unit No. 2. Principal case criteria of hemorrhagic disease provided for a study enrollment of 15 clinically acute and 37 convalescing subjects. Additionally, 32 comparable age/sex controls were selected from neighboring households. Laboratory diagnosis involved three testing methodologies: virus isolation by cell culture, a reverse transcriptase-polymerase chain reaction (RT-PCR) assay, and serologic assays. Antibody (IgM) to dengue virus was detected in 27% of the acute clinical cases, 30% of the convalescing cases, and only 3% of the matched controls. Dengue 3 was the only viral serotype detected from acute serum samples by the RT-PCR. The mean +/- SD age of the acute and convalescing cases was 7.8 +/- 5.4 years. Overall hospital records accounted for 172 suspected outbreak cases, all urban residents of Merauke with no recent travel history outside the area. The estimated outbreak-associated case fatality rate among all suspected dengue cases was 1.2%. A seven-year retrospective review of hospital records in Merauke showed negligible disease reporting involving hemorrhagic disease prior to the outbreak.
authors.affiliation: United States Naval Medical Research Unit No. 2, Jakarta, Indonesia.
authors.forename: Nono C
authors.initials: NC
authors.lastname: Sukri
authors.forename: Kanti
authors.initials: K
authors.lastname: Laras
authors.forename: Toni
authors.initials: T
authors.lastname: Wandra
authors.forename: Sukman
authors.initials: S
authors.lastname: Didi
authors.forename: Ria P
authors.initials: RP
authors.lastname: Larasati
authors.forename: Josef R
authors.initials: JR
authors.lastname: Rachdyatmaka
authors.forename: Stevie
authors.initials: S
authors.lastname: Osok
authors.forename: Petrus
authors.initials: P
authors.lastname: Tjia
authors.forename: John M
authors.initials: JM
authors.lastname: Saragih
authors.forename: Sri
authors.initials: S
authors.lastname: Hartati
authors.forename: Erlin
authors.initials: E
authors.lastname: Listyaningsih
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Porter
authors.forename: Charmagne G
authors.initials: CG
authors.lastname: Beckett
authors.forename: Ingerani S
authors.initials: IS
authors.lastname: Prawira
authors.forename: Narain
authors.initials: N
authors.lastname: Punjabi
authors.forename: Sri A
authors.initials: SA
authors.lastname: Suparmanto
authors.forename: H James
authors.initials: HJ
authors.lastname: Beecham
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Bangs
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Corwin
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007223:Infant; D008297:Male; D011891:Rain; D012189:Retrospective Studies; D012621:Seasons; D019595:Severe Dengue / Q000453:epidemiology* / Q000635:transmission; D017678:Sex Distribution; D013696:Temperature