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. 2018 Nov 30;67(47):1319-1322.
doi: 10.15585/mmwr.mm6747a5.

Outbreak of Dengue Virus Type 2 - American Samoa, November 2016-October 2018

Caitlin J Cotter, A John Tufa, Stephanie Johnson, Mary Matai'a, Rebecca Sciulli, Kyle R Ryff, W Thane Hancock, Christian Whelen, Tyler M Sharp, Magele Scott Anesi

Outbreak of Dengue Virus Type 2 - American Samoa, November 2016-October 2018

Caitlin J Cotter et al. MMWR Morb Mortal Wkly Rep. .

Abstract

The U.S. territory of American Samoa has experienced recent outbreaks of illnesses caused by viruses transmitted by Aedes species mosquitoes, including dengue, chikungunya, and Zika virus. In November 2016, a traveler from the Solomon Islands tested positive for infection with dengue virus type 2 (DENV-2). Additional dengue cases were identified in the subsequent weeks through passive and active surveillance. Suspected dengue cases were tested locally with a dengue rapid diagnostic test (RDT) for DENV nonstructural protein 1 (NS1). Specimens from RDT-positive cases and patients meeting the dengue case definition were tested by real-time reverse transcription-polymerase chain reaction (real-time RT-PCR) at Hawaii State Laboratories. During November 2016-October 2018, a total of 3,240 patients were tested for evidence of DENV infection (118 by RDT-NS1 alone, 1,089 by real-time RT-PCR alone, and 2,033 by both methods), 1,081 (33.4%) of whom tested positive for dengue (19.5 per 1,000 population). All 941 real-time RT-PCR-positive specimens were positive for DENV-2. The monthly number of laboratory-confirmed cases peaked at 120 during December 2017. Among laboratory-confirmed dengue cases, 380 (35.2%) patients were hospitalized; one patient, who was transferred to American Samoa for care late in his illness, died. The public health response to this outbreak included disposal of solid waste to remove mosquito breeding sites, indoor residual spraying of pesticides in schools, reinforcement of dengue patient management education, and public education on mosquito avoidance and seeking medical care for symptoms of dengue.

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Conflict of interest statement

All authors have completed and submitted the ICMJE form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.

Figures

FIGURE 1
FIGURE 1
Laboratory-confirmed dengue cases (N = 1,079), by month of reported illness onset — American Samoa, November 2016–October 2018
FIGURE 2
FIGURE 2
Number of laboratory-confirmed dengue cases per 1,000 persons, by county of residence — American Samoa, November 2016–October 2018
See this image and copyright information in PMC

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References

    1. World Health Organization. Dengue: guideline for diagnosis, treatment, prevention and control. Geneva, Switzerland: World Health Organization; 2009. http://www.who.int/tdr/publications/documents/dengue-diagnosis.pdf - PubMed
    1. Hunsperger EA, Sharp TM, Lalita P, et al. Use of a rapid test for diagnosis of dengue during suspected dengue outbreaks in resource-limited regions. J Clin Microbiol 2016;54:2090–5. 10.1128/JCM.00521-16 - DOI - PMC - PubMed
    1. Santiago GA, Vergne E, Quiles Y, et al. Analytical and clinical performance of the CDC real time RT-PCR assay for detection and typing of dengue virus. PLoS Negl Trop Dis 2013;7:e2311. 10.1371/journal.pntd.0002311 - DOI - PMC - PubMed
    1. Stanaway JD, Shepard DS, Undurraga EA, et al. The global burden of dengue: an analysis from the Global Burden of Disease Study 2013. Lancet Infect Dis 2016;16:712–23. 10.1016/S1473-3099(16)00026-8 - DOI - PMC - PubMed
    1. Clapham HE, Cummings DAT, Johansson MA. Immune status alters the probability of apparent illness due to dengue virus infection: evidence from a pooled analysis across multiple cohort and cluster studies. PLoS Negl Trop Dis 2017;11:e0005926. 10.1371/journal.pntd.0005926 - DOI - PMC - PubMed