Corwin A L, Larasati R P, Bangs M J, Wuryadi S, Arjoso S, Sukri N, Listyaningsih E, Hartati S, Namursa R, Anwar Z, Chandra S, Loho B, Ahmad H, Campbell J R, Porter K R
US Naval Medical Research Unit No. 2 (US NAMRU-2), a WHO-SEARO Collaborating Centre for New and Emerging Diseases, Jakarta, Indonesia.
Trans R Soc Trop Med Hyg. 2001 May-Jun;95(3):257-65. doi: 10.1016/s0035-9203(01)90229-9.
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.
对印度尼西亚南苏门答腊省巨港市爆发的登革热（DF）、登革出血热（DHF）和登革休克综合征（DSS）进行了调查，目的是：（i）验证疫情的发生情况；（ii）确认登革病毒病因及相关血清型；（iii）提供对社区影响的可量化指标；（iv）确定与气候厄尔尼诺南方涛动（ENSO）影响之间的因果关系（如有）。基于对医院记录的6年回顾性分析进行的趋势分析表明，与历史记录相比，疫情爆发期间（1998年1月至4月）临床病例增加了两倍。在接受调查的两家医院中，4个月内与疫情相关的登革热病例月均数为833例（范围为650 - 995例/月）；前72个月的月均值为107例（范围为14 - 779例/月）。观察到疫情传播呈现出明显趋势，从5年周期性现象演变为每年发生，且每年情况常难以区分。临床疫情病例在DF、DHF和DSS诊断类别中的比例分布分别为24%、66%和10%。10 - 19岁人群占住院DHF病例的比例最大（35%），其次是5 - 9岁儿童（25%）和4岁儿童（16%）。对221例住院患者急性病期间采集的血清样本进行了血清学、逆转录聚合酶链反应（RT-PCR）和细胞培养病毒分离检测：59%的样本有登革热感染的实验室证据。在疫情传播中鉴定出了所有4种登革病毒血清型（DEN 1 - 4），其中DEN 3占主导（43%）。DEN 1是与病情较轻的登革热疾病相关的主要血清型，这表明毒力可能部分取决于感染的血清型。在疫情爆发前及爆发期间的几个月里，ENSO对降雨和温度的气候影响显著，很可能促成了有利于疫情爆发的条件。
