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Chikungunya fever outbreak identified in North Bali, Indonesia.

ABSTRACT: Background:Chikungunya virus (CHIKV) infections have been reported sporadically within the last 5 years in several areas of Indonesia including Bali. Most of the reports, however, have lacked laboratory confirmation. Method:A recent fever outbreak in a village in the North Bali area was investigated using extensive viral diagnostic testing including both molecular and serological approaches. Results and conclusions:Ten out of 15 acute febrile illness samples were confirmed to have CHIKV infection by real-time PCR or CHIKV-specific IgM enzyme-linked immunosorbent assay (ELISA). The outbreak strain belonged to the Asian genotype with highest homology to other CHIKV strains currently circulating in Indonesia. The results are of public health concern particularly because Bali is a popular tourist destination in Indonesia and thereby the potential to spread the virus to non-endemic areas is high. GenBank accession numbers:KY885022, KY885023, KY885024, KY885025, KY885026, KY885027.

SUBMITTER: Sari K

PROVIDER: S-EPMC7064274 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature

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Chikungunya fever outbreak identified in North Bali, Indonesia.

Sari Kartika K Myint Khin Saw Aye KSA Andayani Ayu Rai AR Adi Putu Dwi PD Dhenni Rama R Perkasa Aditya A Ma'roef Chairin Nisa CN Witari Ni Putu Diah NPD Megawati Dewi D Powers Ann M AM Jaya Ungke Anton UA

Transactions of the Royal Society of Tropical Medicine and Hygiene 20170701 7

<h4>Background</h4>Chikungunya virus (CHIKV) infections have been reported sporadically within the last 5 years in several areas of Indonesia including Bali. Most of the reports, however, have lacked laboratory confirmation.<h4>Method</h4>A recent fever outbreak in a village in the North Bali area was investigated using extensive viral diagnostic testing including both molecular and serological approaches.<h4>Results and conclusions</h4>Ten out of 15 acute febrile illness samples were confirmed ...[more]

PMID: 29029262

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Project description:BackgroundChikungunya is an Aedes -borne disease characterised by febrile arthralgia and responsible for massive outbreaks. We present a prospective clinical cohort study and a retrospective serological study relating to a CHIK outbreak, in the Republic of Congo in 2011.Methodology and findingsWe analysed 317 suspected cases, of which 308 (97.2%) lived in the city of Brazzaville (66.6% in the South area). Amongst them, 37 (11.7%) were CHIKV+ve patients (i.e., biologically confirmed by a real-time RT-PCR assay), of whom 36 (97.3%) had fever, 22 (66.7%) myalgia and 32 (86.5%) arthralgia. All tested negative for dengue. The distribution of incident cases within Brazzaville districts was compared with CHIKV seroprevalence before the outbreak (34.4% in 517 blood donors), providing evidence for previous circulation of CHIKV. We applied a CHIK clinical score to 126 patients recruited within the two first day of illness (including 28 CHIKV+ves (22.2%)) with sensitivity (78.6%) and specificity (72.4%) values comparing with those of the referent study in Reunion Island. The negative predictive value was high (92%), but the positive predictive value (45%) indicate poor potential contribution to medical practice to identify CHIKV+ve patients in low prevalence outbreaks. However, the score allowed a slightly more accurate follow-up of the evolution of the outbreak than the criterion "fever+arthralgia". The complete sequencing of a Congolase isolate (Brazza_MRS1) demonstrated belonging to the East/Central/South African lineage and was further used for producing a robust genome-scale CHIKV phylogenetic analysis.Conclusions/significanceWe describe the first Chikungunya outbreak declared in the Republic of Congo. The seroprevalence study conducted amongst blood donors before outbreak provided evidence for previous CHIKV circulation. We suggest that a more systematic survey of the entomological situation and of arbovirus circulation is necessary in Central Africa for better understanding the environmental, microbiological and sociological determinants of emergence.

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Chikungunya fever outbreak identified in North Bali, Indonesia.

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Chikungunya fever outbreak identified in North Bali, Indonesia.

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