ABSTRACT
OBJECTIVE: In September 2012, there was an unexpected increase of acute febrile illness (AFI) in Chuuk State of the Federated States of Micronesia. At the same time, dengue outbreaks were occurring in two of the Federated States of Micronesia's other three states. The cause of AFI was suspected to be dengue; however, by the end of October, only one of 39 samples was positive for dengue. The objective of the investigation was to establish the cause of the outbreak. METHODS: A line list was created and data analysed by time, place, person and clinical features. Reported symptoms were compared with the published symptoms of several diagnoses and laboratory testing undertaken. RESULTS: Of the 168 suspected cases, 62% were less than 20 years of age and 60% were male. The clinical features of the cases were not typical for dengue but suggestive of respiratory illness. Nasopharyngeal swabs were subsequently collected and found to be positive for influenza. Public health measures were undertaken and the AFI returned to expected levels. DISCUSSION: Clinical diagnosis of acute febrile illness (AFI) can often be difficult and misleading. This can mean that opportunities for preventive measures early on in an outbreak are missed. In any outbreak, descriptive epidemiological analyses are valuable in helping to ascertain the cause of the outbreak.
Subject(s)
Disease Outbreaks , Fever/epidemiology , Acute Disease , Adolescent , Adult , Child , Child, Preschool , Fever/virology , Humans , Influenza A virus/isolation & purification , Influenza, Human/complications , Influenza, Human/epidemiology , Male , Micronesia/epidemiology , Middle Aged , Population Surveillance , Young AdultABSTRACT
Objective:In September 2012, there was an unexpected increase of acute febrile illness (AFI) in Chuuk State of the Federated States of Micronesia. At the same time, dengue outbreaks were occurring in two of the Federated States of Micronesia’s other three states. The cause of AFI was suspected to be dengue; however, by the end of October, only one of 39 samples was positive for dengue. The objective of the investigation was to establish the cause of the outbreak.Methods:A line list was created and data analysed by time, place, person and clinical features. Reported symptoms were compared with the published symptoms of several diagnoses and laboratory testing undertaken.Results:Of the 168 suspected cases, 62% were less than 20 years of age and 60% were male. The clinical features of the cases were not typical for dengue but suggestive of respiratory illness. Nasopharyngeal swabs were subsequently collected and found to be positive for influenza. Public health measures were undertaken and the AFI returned to expected levels.Discussion:Clinical diagnosis of acute febrile illness (AFI) can often be difficult and misleading. This can mean that opportunities for preventive measures early on in an outbreak are missed. In any outbreak, descriptive epidemiological analyses are valuable in helping to ascertain the cause of the outbreak.
ABSTRACT
Between May and December 2004,Yap State experienced an outbreak of Dengue Fever, type 1 with a final total of 658 recorded clinically compatible cases, including 42 hospitalisations and 12 cases of dengue haemorrhagic fever/shock syndrome. There were no fatalities. Lessons learned from this outbreak include: the importance maintaining a high index of suspicion and on-site diagnostic capability for dengue fever, the importance of prompt in-service training for health care workers, the danger posed to neighbors by local lapses in outbreak prone disease surveillance and the utility of the Pacific Public Health Surveillance Network in responding to such diseases, the importance of active disease surveillance in outer island populations, and the importance of instituting preventive measures against the nosocomial spread of dengue fever.
