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Am. J. Trop. Med. Hyg., 77(3), 2007, pp. 534-537
Copyright © 2007 by The American Society of Tropical Medicine and Hygiene

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SHORT REPORT


Clinical Intervention and Molecular Characteristics of a Dengue Hemorrhagic Fever Outbreak in Timor Leste, 2005

Siripen Kalayanarooj, Hem Sagar Rimal, Alex Andjaparidze, Varunee Vatcharasaevee, Ananda Nisalak, Richard G. Jarman, Piyawan Chinnawirotpisan, Mammen P. Mammen, Edward C. Holmes, AND Robert V. Gibbons*
Queen Sirikit National Institute of Child Health, Bangkok, Thailand; National Hospital Guido Valadares, Dili, East Timor; Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; World Health Organization, Dili, Timor Leste, Department of Biology, The Pennsylvania State University, University Park, Pennsylvania

 

ABSTRACT

In response to a January 2005 report of dengue hemorrhagic fever (DHF) in Timor Leste, the World Health Organization sent a team to assist the National Hospital Guido Valadares (NHGV) in Dili with clinical case management and diagnostic support. The hospital reported 67 admissions including 8 deaths (case fatality rate approximately 12%) over the previous weeks with case histories clinically compatible with DHF. During the intervention, an additional 44 suspected dengue patients were admitted to the pediatric ward of NHGV. Among 41 patients with clinical diagnoses of dengue fever or DHF, 38 (93%) were laboratory confirmed. Although cause and effect cannot be definitely attributed, the case fatality rate decreased to 3.6% after the intervention with education about dengue management strategies.

Received November 27, 2006. Accepted for publication June 2, 2007.

Acknowledgments: Siripen Kalayanarooj and Varunee Vatcharasae-vee had been assigned as WHO short-term consultants by the Office of Alert and Response Operation, WHO Headquarters with the coordination of the WHO South East Asia Regional Office in response to the Global Outbreak Alert and Response Network.

Disclaimer: The views, opinions, and/or findings contained herein are those of the authors and should not be construed as an official Department of the Army position, policy, or decision.

* Address correspondence to Robert V. Gibbons, Department of Virology, Armed Forces Institute of Medical Sciences, 315/6 Rajvithi Road, Bangkok, Thailand 10400, E-mail: Robert.Gibbons{at}afrims.org

Authors’ addresses: Siripen Kalayanarooj and Varunee Vatcharasaevee, Queen Sirikit National Institute of Child Health, 420/8 Rajvithi Road, Rajthevi, Bangkok 10400, Thailand. Hem Sagar Rimal, National Hospital Guido Valadares, Dili, East Timor. Alex Andjaparidze, World Health Organization, UN House, Caicoli Street, PO Box 41, Dili, Timor Leste. Ananda Nisalak, Richard G. Jarman, Piyawan Chinnawirotpisan, and Robert V. Gibbons, Department of Virology, Armed Forces Research Institute of Medical Sciences, 315/6 Rajvithi Road, Bangkok 10400, Thailand. Mammen P. Mammen, U.S. Army Medical Materiel Development Activity, 1430 Veterans Drive, Fort Detrick, MD 21702. Edward C. Holmes, Department of Biology, The Pennsylvania State University, University Park, PA 16802.






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