RESUMEN
Based on the clinical, epidemiologic, and laboratory findings, the investigation team was of the considered opinion that the cause of the outbreak was food infection rather than intoxication. The grouping of cases in relation to a particular event; the explosive nature of the outbreak; the equal susceptibility of all ages, sexes, and occupational groups; the median incubation period of 13 hours; the clinical picture of gastroenteritis with fever, chills, and headache, the fever being high in range and with an average duration of 2 days; the isolation of the Ballerup-Bethesda group of organisms from stools of some cases; the serologic study which showed significantly higher titer of antibodies among cases than among a control group which was not infected; and the presence of conditions ideal for contamination and subsequent bacterial growth during the preparation of the food items suspected as the probable vehicle of infection all tend to to support the hypothesis of food infectionThe actual source of infections has not been determined with absolute certainly and the manner of contamination and transmission of the causative organisms are only matters of conjecture, because delayed reporting had made their demonstration by direct evidence technically difficult. However, these should not detract from the soundness of the conclusions drawn. After all, epidemiologic investigations in actual working situations are perhaps seldom, if ever, perfect and complete. As Wade Hampton Frost had written, "Epidemiology is something more than the total of its established facts......it includes ......chains of inferences which extend more or less beyond the bounds of direct observation." (Conclusion)
RESUMEN
An epidemic of probable chikungunya disease occured in Amlan, Negros Oriental from March to October 1968. Six hundred ninety-eight (698) cases were recorded in a post-epidemic survey conducted between October 14-19, 1968The trial of fever, skin rashes, an arthralgia was the prominent feature of the disease. Fever usually began abruptly and usually lasted 2-5 days, but in some cases persisted intermittently over a one to two week period. The skin rashes were mostly described by respondents as either maculopapular or morbilliform. These rashes frequently appeared during defervescence and lasted 2 to 4 days, but reappeared after apparent clinical recovery in some casesArthralgia and occasionally frank arthritis involving large and small joints usually accompanied the onset of pyrexia. Arthralgia frequently persisted for several weeksOne case from Amlan admitted to the Silliman University Medical Center was presented to call attention to the clinical features of the disease. Initial results of serological tests performed on sera collected from this hospitalized patient and other patients in Amlan suggest that the epidemic was due to ckikungunya virus infection.(Summary)
RESUMEN
Based on the clinical, epidemiologic, and laboratory findings, the investigating team was of the considered opinion that the cause of the outbreak was food infection rather than intoxication. The grouping of cases in relation to a particular event; the explosive nature of the outbreak; the equal susceptibility of all ages, sexes, and occupational groups; the median incubation period of 13 hours; the clinical picture of gastroenteritis with fever, chills, and headache, the fever being high in range and with an average duration of 2 days; the isolation of the Ballerup-Bethesda group of organisms from stools of some cases; the serologic study which showed significantly higher titer of antibodies among cases than among a control group which was not infected; and the presence of conditions ideal for contamination and subsequent bacterial growth during the preparation of the food items suspected as the probable vehicle of infection all tend to support the hypothesis of food infectionThe actual source of infection has not been determined with absolute certainty and the manner of contamination and transmission of the causative organisms are only matters of conjecture, because delayed reporting had made their demonstration by direct evidence technically difficult. However, these should not detract from the soundness of the conclusions drawn. After all, epidemiologic investigations in actual working situations are perhaps seldom, if ever, perfect and complete. As Wade Hampton Frost had written, "Epidemiology is something more than the total of its estblished facts ... it includes ... chains of inferences which extend more or less beyond the bounds of direct observation." (Conclusion)