Dengue outbreak--Federated States of Micronesia, 2012-2013

Abstract

On September 26, 2012, a woman aged 35 years from Kosrae in the Federated States of Micronesia (FSM) was hospitalized with fever, headache, muscle pain, vomiting, leukopenia, and thrombocytopenia. A rapid diagnostic test (RDT) (Dengue Duo, Standard Diagnostics Inc.) was positive for dengue virus (DENV) nonstructural protein-1 (NS1). During the next week, seven more persons with suspected dengue were tested with the RDT, of whom three were RDT-positive for NS1 or anti-DENV immunoglobulin M (IgM). During October, the Kosrae State Department of Health Services, with support from the FSM Department of Health and Social Affairs and the World Health Organization (WHO), responded to the outbreak with enhanced surveillance, training in clinical management, analysis of hospital surge capacity, a rapid mosquito survey to identify species and distributions, and control measures. By March 14, 2013, approximately 3.7% of Kosrae State residents had been hospitalized with suspected dengue. The outbreak consumed scarce medical and public health services, including outpatient, inpatient, and laboratory services, resulting in redirection of human and material resources from other important medical and public health activities. Because the health consequences of dengue can be substantial in resource-limited settings, Pacific Island nations might wish to consider preparedness measures for dengue outbreaks such as developing and testing outbreak response plans and ensuring adequate capacity for epidemiologic surveillance and laboratory testing.

FIGURE 1

Number of suspected dengue cases (n = 728), by rapid diagnostic test (RDT) result and week of clinic visit — Kosrae State, Federated States of Micronesia, 2012–2013

FIGURE 2

Number (n = 728) and rate^* of suspected dengue cases, by age group and rapid diagnostic test (RDT) result — Kosrae State, Federated States of Micronesia, 2012–2013 ^* Per 1,000 population

FIGURE 3

Number of suspected dengue cases (n = 728) and hospitalizations, by week of clinic visit — Kosrae State, Federated States of Micronesia, 2012–2013 Abbreviation: WHO = World Health Organization.