title: Investigating an outbreak of acute fever in Chuuk, Federated States of Micronesia.
abstract: OBJECTIVE
  In September 2012, there was an unexpected increase of acute febrile illness (AFI) in Chuuk State of the Federated States of Micronesia. At the same time, dengue outbreaks were occurring in two of the Federated States of Micronesia's other three states. The cause of AFI was suspected to be dengue; however, by the end of October, only one of 39 samples was positive for dengue. The objective of the investigation was to establish the cause of the outbreak.
  
  
  METHODS
  A line list was created and data analysed by time, place, person and clinical features. Reported symptoms were compared with the published symptoms of several diagnoses and laboratory testing undertaken.
  
  
  RESULTS
  Of the 168 suspected cases, 62% were less than 20 years of age and 60% were male. The clinical features of the cases were not typical for dengue but suggestive of respiratory illness. Nasopharyngeal swabs were subsequently collected and found to be positive for influenza. Public health measures were undertaken and the AFI returned to expected levels.
  
  
  CONCLUSIONS
  Clinical diagnosis of acute febrile illness (AFI) can often be difficult and misleading. This can mean that opportunities for preventive measures early on in an outbreak are missed. In any outbreak, descriptive epidemiological analyses are valuable in helping to ascertain the cause of the outbreak.
authors: Secretariat of the Pacific, Noumea, New Caledonia .
authors: Damian
authors: D
authors: Hoy
authors: Chuuk EpiNet Team, Department of Health, Chuuk, Federated States of Micronesia .
authors: Yoster
authors: Y
authors: Yichiro
authors: Chuuk EpiNet Team, Department of Health, Chuuk, Federated States of Micronesia .
authors: Kasian
authors: K
authors: Otoko
authors: Chuuk EpiNet Team, Department of Health, Chuuk, Federated States of Micronesia .
authors: Helden
authors: H
authors: Heldart
authors: Chuuk EpiNet Team, Department of Health, Chuuk, Federated States of Micronesia .
authors: Andita
authors: A
authors: Meyshine
authors: Chuuk EpiNet Team, Department of Health, Chuuk, Federated States of Micronesia .
authors: Prisca
authors: P
authors: Assito
authors: National EpiNet Team, Department of Health, Pohnpei, Federated States of Micronesia .
authors: Moses
authors: M
authors: Pretrick
authors: Secretariat of the Pacific, Noumea, New Caledonia .
authors: Yvan
authors: Y
authors: Souares
authors: Yap EpiNet Team, Department of Health, Yap, Federated States of Micronesia .
authors: Thane
authors: T
authors: Hancock
authors: Pacific Island Health Officers Association, Hawaii, United States of America .
authors: Mark
authors: M
authors: Durand
authors: Secretariat of the Pacific, Noumea, New Caledonia .
authors: Adam
authors: A
authors: Roth
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005334:Fever / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D009980:Influenza A virus / Q000302:isolation & purification; D007251:Influenza, Human / Q000150:complications / Q000453:epidemiology; D008297:Male; D008849:Micronesia / Q000453:epidemiology; D008875:Middle Aged; D011159:Population Surveillance; D055815:Young Adult