TY - JOUR
T1 - An epidemic of chikungunya in northwestern Bangladesh in 2011
AU - Haque, Farhana
AU - Rahman, Mahmudur
AU - Banu, Nuzhat Nasreen
AU - Sharif, Ahmad Raihan
AU - Jubayer, Shamim
AU - Shamsuzzaman, Akm
AU - Alamgir, Asm
AU - Erasmus, Jesse H.
AU - Guzman, Hilda
AU - Forrester, Naomi
AU - Luby, Stephen P.
AU - Gurley, Emily S.
N1 - Funding Information:
This investigation was funded by the Centers for Disease Control and Prevention (CDC), Grant No: 1U51GH001209. icddr,b acknowledges with gratitude the commitment of Centers for Disease Control and Prevention (CDC) to its research efforts. icddr,b is also grateful to the Governments of Bangladesh, Canada, Sweden and the UK for providing core/unrestricted support. The authors would like to thank all the study participants for their contributions. We are also grateful to the Civil Surgeon of Chapainababganj District. We are particularly thankful to the Upazila Health and Family Planning Officer of Shibganj Upazila. Ms. Diana DiazGranados deserve special thanks for her contribution in reviewing the manuscript. We are also grateful to Md Kamal Hossain for his statistical guidance and support.
Publisher Copyright:
© 2019 Haque et al. 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 credited.
PY - 2019/3
Y1 - 2019/3
N2 - Background In November 2011, a government hospital physician in Shibganj sub-district of Bangladesh reported a cluster of patients with fever and joint pain or rash. A multi-disciplinary team investigated to characterize the outbreak; confirm the cause; and recommend control and prevention measures. Methods Shibganj’s residents with new onset of fever and joint pain or rash between 1 September and 15 December 2011 were defined as chikungunya fever (CHIKF) suspect cases. To estimate the attack rate, we identified 16 outpatient clinics in 16 selected wards across 16 unions in Shibganj and searched for suspect cases in the 80 households nearest to each outpatient clinic. One suspect case from the first 30 households in each ward was invited to visit the nearest outpatient clinic for clinical assessment and to provide a blood sample for laboratory testing and analyses. Results We identified 1,769 CHIKF suspect cases from among 5,902 residents surveyed (30%). Their median age was 28 (IQR:15−42) years. The average attack rate in the sub-district was 30% (95% CI: 27%−33%). The lowest attack rate was found in children <5 years (15%). Anti-CHIKV IgM antibodies were detected by ELISA in 78% (264) of the 338 case samples tested. In addition to fever, predominant symptoms of serologically-confirmed cases included joint pain (97%), weakness (54%), myalgia (47%), rash (42%), itching (37%) and malaise (31%). Among the sero-positive patients, 79% (209/264) sought healthcare from outpatient clinics. CHIKV was isolated from two cases and phylogenetic analyses of full genome sequences placed these viruses within the Indian Ocean Lineage (IOL). Molecular analysis identified mutations in E2 and E1 glycoproteins and contained the E1 A226V point mutation. Conclusion The consistently high attack rate by age groups suggested recent introduction of chikungunya in this community. Mosquito control efforts should be enhanced to reduce the risk of continued transmission and to improve global health security.
AB - Background In November 2011, a government hospital physician in Shibganj sub-district of Bangladesh reported a cluster of patients with fever and joint pain or rash. A multi-disciplinary team investigated to characterize the outbreak; confirm the cause; and recommend control and prevention measures. Methods Shibganj’s residents with new onset of fever and joint pain or rash between 1 September and 15 December 2011 were defined as chikungunya fever (CHIKF) suspect cases. To estimate the attack rate, we identified 16 outpatient clinics in 16 selected wards across 16 unions in Shibganj and searched for suspect cases in the 80 households nearest to each outpatient clinic. One suspect case from the first 30 households in each ward was invited to visit the nearest outpatient clinic for clinical assessment and to provide a blood sample for laboratory testing and analyses. Results We identified 1,769 CHIKF suspect cases from among 5,902 residents surveyed (30%). Their median age was 28 (IQR:15−42) years. The average attack rate in the sub-district was 30% (95% CI: 27%−33%). The lowest attack rate was found in children <5 years (15%). Anti-CHIKV IgM antibodies were detected by ELISA in 78% (264) of the 338 case samples tested. In addition to fever, predominant symptoms of serologically-confirmed cases included joint pain (97%), weakness (54%), myalgia (47%), rash (42%), itching (37%) and malaise (31%). Among the sero-positive patients, 79% (209/264) sought healthcare from outpatient clinics. CHIKV was isolated from two cases and phylogenetic analyses of full genome sequences placed these viruses within the Indian Ocean Lineage (IOL). Molecular analysis identified mutations in E2 and E1 glycoproteins and contained the E1 A226V point mutation. Conclusion The consistently high attack rate by age groups suggested recent introduction of chikungunya in this community. Mosquito control efforts should be enhanced to reduce the risk of continued transmission and to improve global health security.
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U2 - 10.1371/journal.pone.0212218
DO - 10.1371/journal.pone.0212218
M3 - Article
C2 - 30856200
AN - SCOPUS:85062845778
SN - 1932-6203
VL - 14
JO - PloS one
JF - PloS one
IS - 3
M1 - e0212218
ER -