Cargando…

An Outbreak of Chikungunya in Rural Bangladesh, 2011

BACKGROUND: The first identified Chikungunya outbreak occurred in Bangladesh in 2008. In late October 2011, a local health official from Dohar Sub-district, Dhaka District, reported an outbreak of undiagnosed fever and joint pain. We investigated the outbreak to confirm the etiology, describe the cl...

Descripción completa

Detalles Bibliográficos
Autores principales: Khatun, Selina, Chakraborty, Apurba, Rahman, Mahmudur, Nasreen Banu, Nuzhat, Rahman, Mohammad Mostafizur, Hasan, S. M. Murshid, Luby, Stephen P., Gurley, Emily S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4498910/
https://www.ncbi.nlm.nih.gov/pubmed/26161995
http://dx.doi.org/10.1371/journal.pntd.0003907
_version_ 1782380705175568384
author Khatun, Selina
Chakraborty, Apurba
Rahman, Mahmudur
Nasreen Banu, Nuzhat
Rahman, Mohammad Mostafizur
Hasan, S. M. Murshid
Luby, Stephen P.
Gurley, Emily S.
author_facet Khatun, Selina
Chakraborty, Apurba
Rahman, Mahmudur
Nasreen Banu, Nuzhat
Rahman, Mohammad Mostafizur
Hasan, S. M. Murshid
Luby, Stephen P.
Gurley, Emily S.
author_sort Khatun, Selina
collection PubMed
description BACKGROUND: The first identified Chikungunya outbreak occurred in Bangladesh in 2008. In late October 2011, a local health official from Dohar Sub-district, Dhaka District, reported an outbreak of undiagnosed fever and joint pain. We investigated the outbreak to confirm the etiology, describe the clinical presentation, and identify associated vectors. METHODOLOGY: During November 2–21, 2011, we conducted house-to-house surveys to identify suspected cases, defined as any inhabitant of Char Kushai village with fever followed by joint pain in the extremities with onset since August 15, 2011. We collected blood specimens and clinical histories from self-selected suspected cases using a structured questionnaire. Blood samples were tested for IgM antibodies against Chikungunya virus. The village was divided into nine segments and we collected mosquito larvae from water containers in seven randomly selected houses in each segment. We calculated the Breteau index for the village and identified the mosquito species. RESULTS: The attack rate was 29% (1105/3840) and 29% of households surveyed had at least one suspected case: 15% had ≥3. The attack rate was 38% (606/1589) in adult women and 25% in adult men (320/1287). Among the 1105 suspected case-patients, 245 self-selected for testing and 80% of those (196/245) had IgM antibodies. In addition to fever and joint pain, 76% (148/196) of confirmed cases had rash and 38%(75/196) had long-lasting joint pain. The village Breteau index was 35 per 100 and 89%(449/504) of hatched mosquitoes were Aedes albopictus. CONCLUSION: The evidence suggests that this outbreak was due to Chikungunya. The high attack rate suggests that the infection was new to this area, and the increased risk among adult women suggests that risk of transmission may have been higher around households. Chikungunya is an emerging infection in Bangladesh and current surveillance and prevention strategies are insufficient to mount an effective public health response.
format Online
Article
Text
id pubmed-4498910
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-44989102015-07-17 An Outbreak of Chikungunya in Rural Bangladesh, 2011 Khatun, Selina Chakraborty, Apurba Rahman, Mahmudur Nasreen Banu, Nuzhat Rahman, Mohammad Mostafizur Hasan, S. M. Murshid Luby, Stephen P. Gurley, Emily S. PLoS Negl Trop Dis Research Article BACKGROUND: The first identified Chikungunya outbreak occurred in Bangladesh in 2008. In late October 2011, a local health official from Dohar Sub-district, Dhaka District, reported an outbreak of undiagnosed fever and joint pain. We investigated the outbreak to confirm the etiology, describe the clinical presentation, and identify associated vectors. METHODOLOGY: During November 2–21, 2011, we conducted house-to-house surveys to identify suspected cases, defined as any inhabitant of Char Kushai village with fever followed by joint pain in the extremities with onset since August 15, 2011. We collected blood specimens and clinical histories from self-selected suspected cases using a structured questionnaire. Blood samples were tested for IgM antibodies against Chikungunya virus. The village was divided into nine segments and we collected mosquito larvae from water containers in seven randomly selected houses in each segment. We calculated the Breteau index for the village and identified the mosquito species. RESULTS: The attack rate was 29% (1105/3840) and 29% of households surveyed had at least one suspected case: 15% had ≥3. The attack rate was 38% (606/1589) in adult women and 25% in adult men (320/1287). Among the 1105 suspected case-patients, 245 self-selected for testing and 80% of those (196/245) had IgM antibodies. In addition to fever and joint pain, 76% (148/196) of confirmed cases had rash and 38%(75/196) had long-lasting joint pain. The village Breteau index was 35 per 100 and 89%(449/504) of hatched mosquitoes were Aedes albopictus. CONCLUSION: The evidence suggests that this outbreak was due to Chikungunya. The high attack rate suggests that the infection was new to this area, and the increased risk among adult women suggests that risk of transmission may have been higher around households. Chikungunya is an emerging infection in Bangladesh and current surveillance and prevention strategies are insufficient to mount an effective public health response. Public Library of Science 2015-07-10 /pmc/articles/PMC4498910/ /pubmed/26161995 http://dx.doi.org/10.1371/journal.pntd.0003907 Text en © 2015 Khatun et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Khatun, Selina
Chakraborty, Apurba
Rahman, Mahmudur
Nasreen Banu, Nuzhat
Rahman, Mohammad Mostafizur
Hasan, S. M. Murshid
Luby, Stephen P.
Gurley, Emily S.
An Outbreak of Chikungunya in Rural Bangladesh, 2011
title An Outbreak of Chikungunya in Rural Bangladesh, 2011
title_full An Outbreak of Chikungunya in Rural Bangladesh, 2011
title_fullStr An Outbreak of Chikungunya in Rural Bangladesh, 2011
title_full_unstemmed An Outbreak of Chikungunya in Rural Bangladesh, 2011
title_short An Outbreak of Chikungunya in Rural Bangladesh, 2011
title_sort outbreak of chikungunya in rural bangladesh, 2011
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4498910/
https://www.ncbi.nlm.nih.gov/pubmed/26161995
http://dx.doi.org/10.1371/journal.pntd.0003907
work_keys_str_mv AT khatunselina anoutbreakofchikungunyainruralbangladesh2011
AT chakrabortyapurba anoutbreakofchikungunyainruralbangladesh2011
AT rahmanmahmudur anoutbreakofchikungunyainruralbangladesh2011
AT nasreenbanunuzhat anoutbreakofchikungunyainruralbangladesh2011
AT rahmanmohammadmostafizur anoutbreakofchikungunyainruralbangladesh2011
AT hasansmmurshid anoutbreakofchikungunyainruralbangladesh2011
AT lubystephenp anoutbreakofchikungunyainruralbangladesh2011
AT gurleyemilys anoutbreakofchikungunyainruralbangladesh2011
AT khatunselina outbreakofchikungunyainruralbangladesh2011
AT chakrabortyapurba outbreakofchikungunyainruralbangladesh2011
AT rahmanmahmudur outbreakofchikungunyainruralbangladesh2011
AT nasreenbanunuzhat outbreakofchikungunyainruralbangladesh2011
AT rahmanmohammadmostafizur outbreakofchikungunyainruralbangladesh2011
AT hasansmmurshid outbreakofchikungunyainruralbangladesh2011
AT lubystephenp outbreakofchikungunyainruralbangladesh2011
AT gurleyemilys outbreakofchikungunyainruralbangladesh2011