TRANSMISSION OF EPIDEMIC DENGUE HEMORRHAGIC FEVER IN EASTERNMOST INDONESIA

NONO C. SUKRI United States Naval Medical Research Unit No. 2, Jakarta, Indonesia; Directorate General of Communicable Diseases Control and Environmental Health, and National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia; Regency Health Service, Merauke, Papua, Indonesia; Merauke Public Hospital, Papua, Indonesia

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KANTI LARAS United States Naval Medical Research Unit No. 2, Jakarta, Indonesia; Directorate General of Communicable Diseases Control and Environmental Health, and National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia; Regency Health Service, Merauke, Papua, Indonesia; Merauke Public Hospital, Papua, Indonesia

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TONI WANDRA United States Naval Medical Research Unit No. 2, Jakarta, Indonesia; Directorate General of Communicable Diseases Control and Environmental Health, and National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia; Regency Health Service, Merauke, Papua, Indonesia; Merauke Public Hospital, Papua, Indonesia

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SUKMAN DIDI United States Naval Medical Research Unit No. 2, Jakarta, Indonesia; Directorate General of Communicable Diseases Control and Environmental Health, and National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia; Regency Health Service, Merauke, Papua, Indonesia; Merauke Public Hospital, Papua, Indonesia

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RIA P. LARASATI United States Naval Medical Research Unit No. 2, Jakarta, Indonesia; Directorate General of Communicable Diseases Control and Environmental Health, and National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia; Regency Health Service, Merauke, Papua, Indonesia; Merauke Public Hospital, Papua, Indonesia

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JOSEF R. RACHDYATMAKA United States Naval Medical Research Unit No. 2, Jakarta, Indonesia; Directorate General of Communicable Diseases Control and Environmental Health, and National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia; Regency Health Service, Merauke, Papua, Indonesia; Merauke Public Hospital, Papua, Indonesia

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STEVIE OSOK United States Naval Medical Research Unit No. 2, Jakarta, Indonesia; Directorate General of Communicable Diseases Control and Environmental Health, and National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia; Regency Health Service, Merauke, Papua, Indonesia; Merauke Public Hospital, Papua, Indonesia

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PETRUS TJIA United States Naval Medical Research Unit No. 2, Jakarta, Indonesia; Directorate General of Communicable Diseases Control and Environmental Health, and National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia; Regency Health Service, Merauke, Papua, Indonesia; Merauke Public Hospital, Papua, Indonesia

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JOHN M. SARAGIH United States Naval Medical Research Unit No. 2, Jakarta, Indonesia; Directorate General of Communicable Diseases Control and Environmental Health, and National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia; Regency Health Service, Merauke, Papua, Indonesia; Merauke Public Hospital, Papua, Indonesia

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SRI HARTATI United States Naval Medical Research Unit No. 2, Jakarta, Indonesia; Directorate General of Communicable Diseases Control and Environmental Health, and National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia; Regency Health Service, Merauke, Papua, Indonesia; Merauke Public Hospital, Papua, Indonesia

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ERLIN LISTYANINGSIH United States Naval Medical Research Unit No. 2, Jakarta, Indonesia; Directorate General of Communicable Diseases Control and Environmental Health, and National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia; Regency Health Service, Merauke, Papua, Indonesia; Merauke Public Hospital, Papua, Indonesia

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KEVIN R. PORTER United States Naval Medical Research Unit No. 2, Jakarta, Indonesia; Directorate General of Communicable Diseases Control and Environmental Health, and National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia; Regency Health Service, Merauke, Papua, Indonesia; Merauke Public Hospital, Papua, Indonesia

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CHARMAGNE G. BECKETT United States Naval Medical Research Unit No. 2, Jakarta, Indonesia; Directorate General of Communicable Diseases Control and Environmental Health, and National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia; Regency Health Service, Merauke, Papua, Indonesia; Merauke Public Hospital, Papua, Indonesia

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INGERANI S. PRAWIRA United States Naval Medical Research Unit No. 2, Jakarta, Indonesia; Directorate General of Communicable Diseases Control and Environmental Health, and National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia; Regency Health Service, Merauke, Papua, Indonesia; Merauke Public Hospital, Papua, Indonesia

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NARAIN PUNJABI United States Naval Medical Research Unit No. 2, Jakarta, Indonesia; Directorate General of Communicable Diseases Control and Environmental Health, and National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia; Regency Health Service, Merauke, Papua, Indonesia; Merauke Public Hospital, Papua, Indonesia

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SRI A. SUPARMANTO United States Naval Medical Research Unit No. 2, Jakarta, Indonesia; Directorate General of Communicable Diseases Control and Environmental Health, and National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia; Regency Health Service, Merauke, Papua, Indonesia; Merauke Public Hospital, Papua, Indonesia

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H. JAMES BEECHAM United States Naval Medical Research Unit No. 2, Jakarta, Indonesia; Directorate General of Communicable Diseases Control and Environmental Health, and National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia; Regency Health Service, Merauke, Papua, Indonesia; Merauke Public Hospital, Papua, Indonesia

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MICHAEL J. BANGS United States Naval Medical Research Unit No. 2, Jakarta, Indonesia; Directorate General of Communicable Diseases Control and Environmental Health, and National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia; Regency Health Service, Merauke, Papua, Indonesia; Merauke Public Hospital, Papua, Indonesia

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ANDREW L. CORWIN United States Naval Medical Research Unit No. 2, Jakarta, Indonesia; Directorate General of Communicable Diseases Control and Environmental Health, and National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia; Regency Health Service, Merauke, Papua, Indonesia; Merauke Public Hospital, Papua, Indonesia

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DOI:
https://doi.org/10.4269/ajtmh.2003.68.529
Volume/Issue:
Volume 68: Issue 5
Page(s):
529–535
Restricted access
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In April 2001, a second suspected outbreak of dengue hemorrhagic fever in the easternmost region of Indonesia was investigated in Merauke, a town located in the southeastern corner of Papua, by the Indonesian Ministry of Health and the U.S. Naval Medical Research Unit No. 2. Principal case criteria of hemorrhagic disease provided for a study enrollment of 15 clinically acute and 37 convalescing subjects. Additionally, 32 comparable age/sex controls were selected from neighboring households. Laboratory diagnosis involved three testing methodologies: virus isolation by cell culture, a reverse transcriptase–polymerase chain reaction (RT-PCR) assay, and serologic assays. Antibody (IgM) to dengue virus was detected in 27% of the acute clinical cases, 30% of the convalescing cases, and only 3% of the matched controls. Dengue 3 was the only viral serotype detected from acute serum samples by the RT-PCR. The mean ± SD age of the acute and convalescing cases was 7.8 ± 5.4 years. Overall hospital records accounted for 172 suspected outbreak cases, all urban residents of Merauke with no recent travel history outside the area. The estimated outbreak-associated case fatality rate among all suspected dengue cases was 1.2%. A seven-year retrospective review of hospital records in Merauke showed negligible disease reporting involving hemorrhagic disease prior to the outbreak.

Copyright:
Copyright 2003 The American Society of Tropical Medicine 2003
Received:
02 Oct 2002
|
Accepted:
03 Jan 2003
|
Published Online:
May 2003
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
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