Abstract
<strong>Background:</strong> Chikungunya is a serious emerging arbovirus in Indonesia. On 12 October 2013, an outbreak of chikungunya was reported in Serdang Bedagai District, North Sumatera, Indonesia. <strong>Objective</strong>: An epidemiological investigation was conducted to identify the risk factors for the outbreak and recommend control measures. <strong>Method</strong>: A 1:1 matched case-control study was conducted. A case of chikungunya was defined as a previously well resident of Sei Suka Subdistrict who had clinical symptoms of chikungunya fever such as fever, arthralgia, myalgia, rash and headache of at least two days duration between 8 August and 17 November 2013. Cases were identified by active case finding through the affected area; a control was defined as a neighbor of a case that did not have clinical signs and symptoms of chikungunya, matched for age and gender. Blood samples were tested using ELISA assay to confirm the presence of anti-CHIKV specific IgM antibody. <strong>Results</strong>: Total of 94 cases and 94 controls were included in the case control study. Age ranged from 1 year to 76 years (median 35 years) and 57% were female. In multivariate analyses, being a household contact of a chikungunya case (adjusted OR=11.4, 95%CI=4.69-27.55) and lack of routinely eliminating mosquito breeding sites were risk factors (adjusted OR=3.3, 95%CI=1.50-7.05). Six out of ten cases were positive for CHIKV IgM antibody. <strong>Conclusions</strong>: In this confirmed outbreak of chikungunya, using anti mosquito measures were protective, reinforcing the need for routine elimination of mosquito breeding sites as well as control measures in affected households and communities.
Highlights
Chikungunya fever is a viral illness caused by an arbovirus of the family Togaviridae and genus Alphavirus and can transmit to people through the bite of Aedes mosquito [1, 2]
The name chikungunya was derived from Kimakonde dialect of Makonde people, which translates to “that which bends up”, indicating the stooped appearance of patient with severe joint pain and a syndrome typically characterized by fever, headache, myalgia, and rash
East Kalimantan was the first area that reported chikungunya cases based on clinical symptoms in 1973, with the first virologically confirmed cases reported in Jambi in 1982 [10, 11]
Summary
Chikungunya fever is a viral illness caused by an arbovirus of the family Togaviridae and genus Alphavirus and can transmit to people through the bite of Aedes mosquito [1, 2]. Chikungunya fever is one of the most common emerging vector-borne diseases with a high morbidity rate, prolonged polyarthritis in some cases and substantial socioeconomic impact [4, 9]. It causes a large public health impact in countries in Africa and Southeast Asia. The disease rapidly moved to other provinces in Indonesia, and since 1985 all provinces have reported chikungunya outbreaks [6]. Many chikungunya outbreaks have been reported in North Sumatera, West Java, Central Java, West Kalimantan, Bali, and other parts of the country (1114). On 12 October 2013, an outbreak of chikungunya was reported in Serdang Bedagai District, North Sumatera, Indonesia
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