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A LARGE OUTBREAK OF PROBABLE ROTAVIRUS IN NUSA TENGGARA TIMUR, INDONESIA

An outbreak of acute diarrheal disease was reported in Kupang, Nusa Tenggara, Indonesia, in August 2002. An investigative team carried out a retrospective historical review of records, and a case-control study involving data and specimen collections. Etiologic determination involving stool specimens was based on an enzyme-linked immunosorbent assay, with a reverse transcriptase–polymerase chain reaction performed for serotyping purposes. Two thousand six hundred probable cases were identified from hospital records during the outbreak months of June, July, August, and September 2002. Previous enteric outbreaks were recognized from the same months in the preceding years and all annual outbreak episodes following a period of prolonged, low rainfall. In contrast to previous outbreaks discerned from trend analysis, the overwhelming burden of disease fell upon the pediatric population versus the young and old in previous outbreak instances. Rotavirus was found to be the causative etiology, with serotype 1 predominating.

Received June 30, 2004. Accepted for publication September 25, 2004.

Acknowledgments: We gratefully acknowledge the cooperation of the Health Authority Offices in Kupang, Nusa Tenggara Timur (East Nusa Tenggara) and all participating Government Community Health Centers and other institutions for assisting in the investigations. Special thanks are given to the laboratory technicians from the U.S. NAMRU-2 Enteric Disease Program for providing laboratory assistance. This investigation could not have been conducted without the full support of Umar F. Achmadi (Centers for Communicable Diseases Prevention and Environmental Health) (P2M-PLP) and Soemarjati Arjoso (National Institute of Health Research and Development [Litbangkes], Indonesian Ministry of Health, Jakarta).

Financial support: This study was supported by the Department of Defense-Global Emerging Infections System (D0016).

Disclaimer: The views of the authors expressed herein do not purport to reflect those of the U.S. Navy, the U.S. Department of Defense, or the Indonesian Ministry of Health

Authors’ addresses: Andrew L. Corwin, Decy Subekti, Nono C. Sukri, Ronald J. Willy, and Kanti Laras, U.S. Naval Medical Research Unit No. 2, Box 3, Unit 8132, Jakarta, Indonesia, FPO AP 96520-8132. John Master, National Institute of Health Research and Development, Indonesian Ministry of Health, Jakarta, Indonesia. Eko Priyanto, Centers for Communicable Diseases Prevention and Environmental Health (P2M-PLP), Indonesian Ministry of Health, Jl. Percetakan Negara No. 29, Jakarta Pusat 10560, Indonesia.

Reprint requests: Andrew L. Corwin, Emerging Diseases Program, U.S. Naval Medical Research Unit No. 2, FPO AP 96520-8132, Telephone: +62-21-421-4457, Fax: 62-21-424-4507, E-mail: corwinal{at}namru2.org and corwinal2e{at}yahoo.com.