TY - JOUR
T1 - Epidemic dengue transmission in southern Sumatra, Indonesia
AU - Corwin, Andrew Lee
AU - Larasati, Ria Purwita
AU - Bangs, Michael J.
AU - Wuryadi, Suharyono
AU - Arjoso, Sumarjati
AU - Sukri, Nono
AU - Listyaningsih, Erlin
AU - Hartati, Sri
AU - Namursa, Rozali
AU - Anwar, Zarkasih
AU - Chandra, Surya
AU - Loho, Benny
AU - Ahmad, Holani
AU - Campbell, James R.
AU - Porter, Kevin R.
N1 - Funding Information:
We expresso ur appreciationt o Dr Krisna from Paediatric Department,M . Hoesin General Hospital, Palembang,w ho assistedi n the coordinationo f specimenc ollection,M r John Master and Dr Masri from LITBANGKES, who contributedin the conducto f both field and clinical investigativee fforts. Financial support:T his study is under ST0 LB and DoD-Global EmergingI nfectiousS ystem( GEIS) funding. Disclaimer:T he viewso f the authorse xpressedh ereind o not purport to reflectt hoseo f the US Navy, the US Departmento f Defenseo r the IndonesianM inistry of Health. The researchp rotocole mployinghumans ubjectsin thiss tudy has been revieweda nd aDmovedb v the US Naval Medical ResearchI nstitute’sCorn&tee for ;he Protection of Human Subjects.
PY - 2001
Y1 - 2001
N2 - An outbreak of dengue fever (DF), dengue haemorrhagic fever (DHF), and dengue shock syndrome (DSS) in the city of Palembang, south Sumatra, Indonesia was investigated to (i) validate epidemic occurrence, (ii) confirm dengue virus aetiology and associated serotype (s), (iii) provide a demonstrable measure of community impact, and (iv) identify causative relationship (if any) with climatic El Niño Southern Oscillation (ENSO) influences. Trend analysis based on a 6-year retrospective review of hospital records demonstrates a 3-fold increase in clinical cases for the outbreak period (January-April 1998), relative to historical records. In the 2 hospitals surveyed, the monthly mean number of outbreak-related dengue cases over 4 months was 833 (range 650-995 cases/month); the mean monthly value for the previous 72 months was 107 (range 14-779 cases/month). An apparent trend in epidemic transmission was observed, evolving from a 5-year cyclic phenomenon to an annual occurrence, often indistinguishable from one year to the next. The proportional distribution of clinical outbreak cases into DF, DHF and DSS diagnostic categories was 24%, 66%, and 10%, respectively. The population aged 10-19 years accounted for the largest (35%) proportion of hospitalized DHF cases, followed by children aged 5-9 years (25%) and children aged 4 years (16%). Serum samples obtained during acute illness from 221 hospitalized patients were examined using serology, RT-PCR, and virus isolation in cell culture: 59% of samples had laboratory evidence of a dengue infection. All 4 dengue virus serotypes (DEN 1-4) were identified in epidemic circulation, with DEN 3 predominating (43%). DEN 1 was the principal serotype associated with less severe dengue illness, suggesting that virulence may be, in part, a function of infecting serotype. The climatic influence of ENSO on rainfall and temperature in the months leading up to and during the outbreak was dramatic, and is likely to contribute to favourable outbreak conditions.
AB - An outbreak of dengue fever (DF), dengue haemorrhagic fever (DHF), and dengue shock syndrome (DSS) in the city of Palembang, south Sumatra, Indonesia was investigated to (i) validate epidemic occurrence, (ii) confirm dengue virus aetiology and associated serotype (s), (iii) provide a demonstrable measure of community impact, and (iv) identify causative relationship (if any) with climatic El Niño Southern Oscillation (ENSO) influences. Trend analysis based on a 6-year retrospective review of hospital records demonstrates a 3-fold increase in clinical cases for the outbreak period (January-April 1998), relative to historical records. In the 2 hospitals surveyed, the monthly mean number of outbreak-related dengue cases over 4 months was 833 (range 650-995 cases/month); the mean monthly value for the previous 72 months was 107 (range 14-779 cases/month). An apparent trend in epidemic transmission was observed, evolving from a 5-year cyclic phenomenon to an annual occurrence, often indistinguishable from one year to the next. The proportional distribution of clinical outbreak cases into DF, DHF and DSS diagnostic categories was 24%, 66%, and 10%, respectively. The population aged 10-19 years accounted for the largest (35%) proportion of hospitalized DHF cases, followed by children aged 5-9 years (25%) and children aged 4 years (16%). Serum samples obtained during acute illness from 221 hospitalized patients were examined using serology, RT-PCR, and virus isolation in cell culture: 59% of samples had laboratory evidence of a dengue infection. All 4 dengue virus serotypes (DEN 1-4) were identified in epidemic circulation, with DEN 3 predominating (43%). DEN 1 was the principal serotype associated with less severe dengue illness, suggesting that virulence may be, in part, a function of infecting serotype. The climatic influence of ENSO on rainfall and temperature in the months leading up to and during the outbreak was dramatic, and is likely to contribute to favourable outbreak conditions.
KW - Age-groups
KW - Climate
KW - Dengue fever
KW - Dengue haemorrhagic fever
KW - Dengue shock syndrome
KW - Epidemic
KW - Indonesia
KW - Serotypes
KW - Time trends
UR - http://www.scopus.com/inward/record.url?scp=10644285812&partnerID=8YFLogxK
U2 - 10.1016/S0035-9203(01)90229-9
DO - 10.1016/S0035-9203(01)90229-9
M3 - Article
C2 - 11490992
AN - SCOPUS:10644285812
SN - 0035-9203
VL - 95
SP - 257
EP - 265
JO - Transactions of the Royal Society of Tropical Medicine and Hygiene
JF - Transactions of the Royal Society of Tropical Medicine and Hygiene
IS - 3
ER -