A household serosurvey to estimate the magnitude of a dengue outbreak in Mombasa, Kenya, 2013.
Dengue appears to be endemic in Africa with a number of reported outbreaks. In February 2013, several individuals with dengue-like illnesses and negative malaria blood smears were identified in Mombasa, Kenya. Dengue was laboratory confirmed and an investigation was conducted to estimate the magnitude of local transmission including a serologic survey to determine incident dengue virus (DENV) infections. Consenting household members provided serum and were questioned regarding exposures and medical history. RT-PCR was used to identify current DENV infections and IgM anti-DENV ELISA to identify recent infections. Of 1,500 participants from 701 households, 210 (13%) had evidence of current or recent DENV infection. Among those infected, 93 (44%) reported fever in the past month. Most (68, 73%) febrile infected participants were seen by a clinician and all but one of 32 participants who reportedly received a diagnosis were clinically diagnosed as having malaria. Having open windows at night (OR = 2.3; CI: 1.1-4.8), not using daily mosquito repellent (OR = 1.6; CI: 1.0-2.8), and recent travel outside of Kenya (OR = 2.5; CI: 1.1-5.4) were associated with increased risk of DENV infection. This survey provided a robust measure of incident DENV infections in a setting where cases were often unrecognized and misdiagnosed.
Dengue Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico.
Esther M
EM
Ellis
Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Nairobi, Kenya.
John C
JC
Neatherlin
Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, United States of America.
Mark
M
Delorey
Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Nairobi, Kenya.
Melvin
M
Ochieng
Center for Global Health Research, Kenya Medical Research Institute, Nairobi, Kenya.
Abdinoor Haji
AH
Mohamed
Center for Global Health Research, Kenya Medical Research Institute, Nairobi, Kenya.
Daniel Ondari
DO
Mogeni
Dengue Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico.
Elizabeth
E
Hunsperger
Ministry of Health, Mombasa, Kenya.
Shem
S
Patta
Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, United States of America.
Stella
S
Gikunju
Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Nairobi, Kenya.
Lilian
L
Waiboic
Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Nairobi, Kenya.
Barry
B
Fields
Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya.
Victor
V
Ofula
Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya.
Samson Limbaso
SL
Konongoi
Dengue Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico.
Brenda
B
Torres-Velasquez
Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Nairobi, Kenya.
Nina
N
Marano
Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya.
Rosemary
R
Sang
Dengue Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico.
Harold S
HS
Margolis
Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Nairobi, Kenya.
Joel M
JM
Montgomery
Dengue Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico.
Kay M
KM
Tomashek
D000328:Adult; D003715:Dengue / Q000453:epidemiology*; D003716:Dengue Virus / Q000235:genetics* / Q000276:immunology; D004196:Disease Outbreaks / Q000266:history* / Q000706:statistics & numerical data; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D049674:History, 21st Century; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D007630:Kenya / Q000453:epidemiology; D008297:Male; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012307:Risk Factors; D014195:Travel
D007075:Immunoglobulin M