1921
Volume 69, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Between January and June 1995, an outbreak of dengue fever occurred in Palau, an island nation of 32,000 inhabitants in the Western Pacific. To determine the magnitude of this outbreak and to determine modifiable risk factors to guide control strategies, we established active surveillance at the national hospital and private clinics, reviewed available clinical records, and conducted serologic and entomologic surveys. Between January 1 and July 1, 1995, 817 case-patients with acute febrile illness with body or joint aches and one of the following: headache, rash, nausea, vomiting, or hemorrhagic manifestations presented to health facilities in Palau. The epidemic peaked in the second week of April 1995. Of 338 case-patients tested, 254 (75%) had positive serologic results by an IgM capture enzyme-linked immunosorbent assay. Dengue 4 virus was isolated from 78 (51%) of 154 serum samples tested. Blood samples collected during a cross-sectional survey were tested for IgM antibody and yielded an attack ratio of 27% (95% confidence interval = 23–31%). Potential vectors included the introduced species and and the native species . Significant risk factors ( ≤ 0.05) for infection included age < 20 years, the presence of food or water pans for animals on the property, taro farming, the presence of on the property, and presence of group mosquitoes (, , and a native species). This was the first outbreak of dengue 4 virus in the Western Pacific, and the first documented epidemic of dengue in Palau since 1988.

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2003-08-01
2017-11-21
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References

  1. Halstead SB, 1992. The XXth century dengue pandemic: need for surveillance and research. World Health Stat Q 45 : 292–298.
  2. Gubler DJ, 1998. Dengue and dengue hemorrhagic fever. Clin Microbiol Rev 11 : 480–496.
  3. Siler JF, Hall MW, Hitchens AP, 1926. Dengue, its history, epidemiology, mechanism of transmission, etiology, clinical manifestations, immunity and prevention. Philippine J Sci 29 : 1–304.
  4. Gubler DJ, Suharyono W, Tan R, Abidin M, Sie A. Viremia in patients with naturally acquired dengue infection. Bull World Health Organ 59 : 623–630.
  5. Waterman SH, Gubler DJ, 1989. Dengue fever. Clin Dermatol 7 : 117–122.
  6. Rosen L, 1983. The global importance of dengue infection and disease. Pang T, Pahtmanthan R, eds. Proceedings of the International Conference on DHF. Kuala Lampur, Malaysia: University of Malaysia, 1–6.
  7. World Health Organization, 1986. Dengue Hemorrhagic Fever: Diagnosis, Treatment, and Control. Geneva: World Health Organization, 55–58.
  8. Gubler DJ, 1991. Dengue hemorrhagic fever: a global update. Virus Information Exchange News 8 : 2–3.
  9. Gubler DJ, Clark GG, 1995. Dengue hemorrhagic fever: the emergence of a global public health problem. Emerging Infect Dis 1 : 55–57.
  10. Gubler DJ, 1988. Epidemic of dengue 2 in the Republic of Palau associated with severe and fatal disease. Dengue Surveillance Summary 54 : 1–10.
  11. Burke DS, Nisalak A, Gentry MK, 1987. Detection of flavivirus antibodies in human serum by epitope-blocking immunoassay. J Med Virol 23 : 165–173.
  12. Chungue E, Boutin JP, Roux J, 1989. Significance of IgM titration by an immunoenzyme technique for the serodiagnosis and epidemiological surveillance of dengue in French Polynesia. Res Virol 140 : 229–240.
  13. Rosen L, Gubler DJ, 1974. The use of mosquitoes to detect and propagate dengue viruses. Am J Trop Med Hyg 23 : 1153–1160.
  14. Gubler DJ, Kuno DJ, Sather G, Velez M, Oliver A, 1984. Mosquito cell cultures and specific monoclonal antibodies in surveillance for dengue viruses. Am J Trop Med Hyg 33 : 158–165.
  15. Bohart RM, 1956. Insects of Micronesia, Diptera: Culicidae. BP Bishop Museum 12 : 1–85.
  16. Huang Y-M, 1972. The subgenus Stegomyia of Aedes in Southeast Asia. I. - The Scutellaris Group of species. Contrib Am Entomol Inst 9 : 1–109.
  17. Nasci RS, 1981. A lightweight battery-powered aspirator for collecting resting mosquitoes in the field. Mosq News 41 : 808–811.
  18. Dean AG, Dean AJ, Coulumbier D, Brendel KA, Smith DC, Burton AH, Dicker RC, Sullivan K, Fagan RF, Arner TG, 1994. EpiInfo Version 6: A Word Processing, Database, and Statistics Program for Epidemiology and Microcomputers. Atlanta, GA: Centers for Disease Control and Prevention.
  19. Zeger SL, Liang KY, 1986. The analysis of discrete and continuous longitudinal data. Biometrics 42 : 121–130.
  20. Lorono-Pino MA, Farfan-Ale JA, Rosado-Paredes EP, Kuno G, Gubler DJ, 1993. Epidemic dengue 4 in the Yucatan, Mexico, 1984. Rev Inst Med Sao Paulo 35 : 449–455.
  21. Laille PM, Huerre M, Dubordieu H, Sainte-Marie FF, 1993. Epidemic de dengue en Nouvelle Caledonia (1989): Facteures environmentaux et prevention. Bull Soc Pathol Exot 86 : 442–449.
  22. Hayes EB, Gubler DJ, 1992. Dengue and dengue hemorrhagic fever. Pediatr Infect Dis J 11 : 311–317.
  23. Sumarmo O, Wulur H, Jahja E, Gubler DJ, Suuryono W, Sorensen K, 1983. Clinical observations on virologically confirmed fatal dengue infections in Jakarta, Indonesia. Bull World Health Organ 61 : 693–701.
  24. Savage HM, Fritz CL, Rutstein D, Yolwa A, Vorndam V, Gubler DJ, 1998. Epidemic of dengue-4 virus in Yap State, Federated States of Micronesia, and implication of Aedes hensilli as an epidemic vector. Am J Trop Med Hyg 58 : 519–524.
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  • Received : 07 Dec 2002
  • Accepted : 17 Apr 2003

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