TY - JOUR
T1 - The first confirmed outbreak of chikungunya reported in Timor-Leste, 2024
AU - Machado, Filipe de Neri
AU - Draper, Anthony D.K.
AU - Monteiro Fernandes, Anferida
AU - Dos Santos, Frederico Bosco Alves
AU - Mali, Marcelo Amaral
AU - Pereira Tilman, Ari J.
AU - Soares da Silva, Endang
AU - Hornay, Elizabeth
AU - Salles de Sousa, Antonio
AU - Oakley, Tessa
AU - Cruz, Edinha da
AU - Sarmento, Nevio
AU - Niha, Maria A.V.
AU - Soares, Ana Fatima
AU - Cardoso Gomes, Eva Estrelita
AU - de Deus Alves, Jose
AU - Soares, Jose Paulo
AU - Francis, Joshua R.
AU - Yan, Jennifer
AU - Monteiro, Merita Antonio
N1 - Publisher Copyright:
© Commonwealth of Australia CC BY-NC-ND.
PY - 2024/4/10
Y1 - 2024/4/10
N2 - Timor-Leste is a mountainous, half-island nation with a population of 1.3 million, which shares a land border with Indonesia and is 550 km from Darwin, Australia. Since independence in 2002, Timor-Leste has achieved significant development; however, high levels of poverty remain. Chikungunya virus (CHIKV) is endemic in over 100 countries in Africa, Asia, Europe and in the Americas. It is transmitted by the bite of infected Aedes aegypti or Ae. albopictus mosquitoes, which are present in Timor-Leste and which contribute to annual rainy-season dengue virus (DENV) outbreaks. Symptomatic people typically suffer from acute onset of fever, usually accompanied by severe arthritis or arthralgia. Joint pain can be debilitating for several days, and may sometimes last for weeks, months or years. Unlike DENV infection which has significant mortality, most people recover completely. Between 2002 and 2023, there were 26 cases of CHIKV notified in Australia who acquired their infection in Timor-Leste; however, laboratory testing capability for CHIKV in Timor-Leste only became available in 2021 using polymerase chain reaction (PCR). The first locally diagnosed case was notified in November 2023. In January 2024, an outbreak of CHIKV was recognised in Timor-Leste for the first time, with 195 outbreak cases reported during 1-31 January 2024; all were PCR positive. There were no cases hospitalised, and no deaths. The median age of cases was 17 years (range 1-76 years); 51% were males. Cases were reported across the country; most (88/195) were from Dili, although the highest incidence was seen in the neighbouring municipality of Ermera (monthly incidence rate of 58.8 cases per 100,000 population). This first reported outbreak of CHIKV in Timor-Leste highlights the need for improved mosquito-borne illness control and response strategies, including minimising breeding sites and promoting early presentation for treatment and differential diagnosis from DENV, and consideration of the deployment of Wolbachia-infected mosquitoes, particularly as they have shown to reduce the transmission of CHIKV, DENV and Zika virus, all of which pose threats in Timor-Leste.
AB - Timor-Leste is a mountainous, half-island nation with a population of 1.3 million, which shares a land border with Indonesia and is 550 km from Darwin, Australia. Since independence in 2002, Timor-Leste has achieved significant development; however, high levels of poverty remain. Chikungunya virus (CHIKV) is endemic in over 100 countries in Africa, Asia, Europe and in the Americas. It is transmitted by the bite of infected Aedes aegypti or Ae. albopictus mosquitoes, which are present in Timor-Leste and which contribute to annual rainy-season dengue virus (DENV) outbreaks. Symptomatic people typically suffer from acute onset of fever, usually accompanied by severe arthritis or arthralgia. Joint pain can be debilitating for several days, and may sometimes last for weeks, months or years. Unlike DENV infection which has significant mortality, most people recover completely. Between 2002 and 2023, there were 26 cases of CHIKV notified in Australia who acquired their infection in Timor-Leste; however, laboratory testing capability for CHIKV in Timor-Leste only became available in 2021 using polymerase chain reaction (PCR). The first locally diagnosed case was notified in November 2023. In January 2024, an outbreak of CHIKV was recognised in Timor-Leste for the first time, with 195 outbreak cases reported during 1-31 January 2024; all were PCR positive. There were no cases hospitalised, and no deaths. The median age of cases was 17 years (range 1-76 years); 51% were males. Cases were reported across the country; most (88/195) were from Dili, although the highest incidence was seen in the neighbouring municipality of Ermera (monthly incidence rate of 58.8 cases per 100,000 population). This first reported outbreak of CHIKV in Timor-Leste highlights the need for improved mosquito-borne illness control and response strategies, including minimising breeding sites and promoting early presentation for treatment and differential diagnosis from DENV, and consideration of the deployment of Wolbachia-infected mosquitoes, particularly as they have shown to reduce the transmission of CHIKV, DENV and Zika virus, all of which pose threats in Timor-Leste.
KW - arbovirus
KW - chikungunya
KW - mosquito-borne disease
KW - outbreak low-resource setting
KW - surveillance
KW - Timor-Leste
UR - http://www.scopus.com/inward/record.url?scp=85190411625&partnerID=8YFLogxK
U2 - 10.33321/cdi.2024.48.17
DO - 10.33321/cdi.2024.48.17
M3 - Article
C2 - 38594795
AN - SCOPUS:85190411625
SN - 2209-6051
VL - 48
SP - 1
EP - 9
JO - Communicable diseases intelligence (2018)
JF - Communicable diseases intelligence (2018)
ER -