Transmission of epidemic dengue hemorrhagic fever in easternmost Indonesia.
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.
Sukri
Nono C
NC
United States Naval Medical Research Unit No. 2, Jakarta, Indonesia.
Laras
Kanti
K
Wandra
Toni
T
Didi
Sukman
S
Larasati
Ria P
RP
Rachdyatmaka
Josef R
JR
Osok
Stevie
S
Tjia
Petrus
P
Saragih
John M
JM
Hartati
Sri
S
Listyaningsih
Erlin
E
Porter
Kevin R
KR
Beckett
Charmagne G
CG
Prawira
Ingerani S
IS
Punjabi
Narain
N
Suparmanto
Sri A
SA
Beecham
H James
HJ
Bangs
Michael J
MJ
Corwin
Andrew L
AL
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