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<teiHeader>
<fileDesc>
<titleStmt>
<title xml:lang="en">Investigating an outbreak of acute fever in Chuuk, Federated States of Micronesia</title>
<author>
<name sortKey="Hoy, Damian" sort="Hoy, Damian" uniqKey="Hoy D" first="Damian" last="Hoy">Damian Hoy</name>
<affiliation>
<nlm:aff id="aff1">Secretariat of the Pacific, Noumea,
<country>New Caledonia</country>
.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Yichiro, Yoster" sort="Yichiro, Yoster" uniqKey="Yichiro Y" first="Yoster" last="Yichiro">Yoster Yichiro</name>
<affiliation>
<nlm:aff id="aff2">Chuuk EpiNet Team, Department of Health, Chuuk, Federated States of
<country>Micronesia</country>
.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Otoko, Kasian" sort="Otoko, Kasian" uniqKey="Otoko K" first="Kasian" last="Otoko">Kasian Otoko</name>
<affiliation>
<nlm:aff id="aff2">Chuuk EpiNet Team, Department of Health, Chuuk, Federated States of
<country>Micronesia</country>
.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Heldart, Helden" sort="Heldart, Helden" uniqKey="Heldart H" first="Helden" last="Heldart">Helden Heldart</name>
<affiliation>
<nlm:aff id="aff2">Chuuk EpiNet Team, Department of Health, Chuuk, Federated States of
<country>Micronesia</country>
.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Meyshine, Andita" sort="Meyshine, Andita" uniqKey="Meyshine A" first="Andita" last="Meyshine">Andita Meyshine</name>
<affiliation>
<nlm:aff id="aff2">Chuuk EpiNet Team, Department of Health, Chuuk, Federated States of
<country>Micronesia</country>
.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Assito, Prisca" sort="Assito, Prisca" uniqKey="Assito P" first="Prisca" last="Assito">Prisca Assito</name>
<affiliation>
<nlm:aff id="aff2">Chuuk EpiNet Team, Department of Health, Chuuk, Federated States of
<country>Micronesia</country>
.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Pretrick, Moses" sort="Pretrick, Moses" uniqKey="Pretrick M" first="Moses" last="Pretrick">Moses Pretrick</name>
<affiliation>
<nlm:aff id="aff3">National EpiNet Team, Department of Health, Pohnpei, Federated States of
<country>Micronesia</country>
.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Souares, Yvan" sort="Souares, Yvan" uniqKey="Souares Y" first="Yvan" last="Souares">Yvan Souares</name>
<affiliation>
<nlm:aff id="aff1">Secretariat of the Pacific, Noumea,
<country>New Caledonia</country>
.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Hancock, Thane" sort="Hancock, Thane" uniqKey="Hancock T" first="Thane" last="Hancock">Thane Hancock</name>
<affiliation>
<nlm:aff id="aff4">Yap EpiNet Team, Department of Health, Yap, Federated States of
<country>Micronesia</country>
.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Durand, Mark" sort="Durand, Mark" uniqKey="Durand M" first="Mark" last="Durand">Mark Durand</name>
<affiliation>
<nlm:aff id="aff5">Pacific Island Health Officers Association, Hawaii,
<country>United States of America</country>
.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Roth, Adam" sort="Roth, Adam" uniqKey="Roth A" first="Adam" last="Roth">Adam Roth</name>
<affiliation>
<nlm:aff id="aff1">Secretariat of the Pacific, Noumea,
<country>New Caledonia</country>
.</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt>
<idno type="wicri:source">PMC</idno>
<idno type="pmid">25685599</idno>
<idno type="pmc">4318975</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4318975</idno>
<idno type="RBID">PMC:4318975</idno>
<idno type="doi">10.5365/WPSAR.2014.5.3.005</idno>
<date when="2014">2014</date>
<idno type="wicri:Area/Pmc/Corpus">000740</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000740</idno>
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<biblStruct>
<analytic>
<title xml:lang="en" level="a" type="main">Investigating an outbreak of acute fever in Chuuk, Federated States of Micronesia</title>
<author>
<name sortKey="Hoy, Damian" sort="Hoy, Damian" uniqKey="Hoy D" first="Damian" last="Hoy">Damian Hoy</name>
<affiliation>
<nlm:aff id="aff1">Secretariat of the Pacific, Noumea,
<country>New Caledonia</country>
.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Yichiro, Yoster" sort="Yichiro, Yoster" uniqKey="Yichiro Y" first="Yoster" last="Yichiro">Yoster Yichiro</name>
<affiliation>
<nlm:aff id="aff2">Chuuk EpiNet Team, Department of Health, Chuuk, Federated States of
<country>Micronesia</country>
.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Otoko, Kasian" sort="Otoko, Kasian" uniqKey="Otoko K" first="Kasian" last="Otoko">Kasian Otoko</name>
<affiliation>
<nlm:aff id="aff2">Chuuk EpiNet Team, Department of Health, Chuuk, Federated States of
<country>Micronesia</country>
.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Heldart, Helden" sort="Heldart, Helden" uniqKey="Heldart H" first="Helden" last="Heldart">Helden Heldart</name>
<affiliation>
<nlm:aff id="aff2">Chuuk EpiNet Team, Department of Health, Chuuk, Federated States of
<country>Micronesia</country>
.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Meyshine, Andita" sort="Meyshine, Andita" uniqKey="Meyshine A" first="Andita" last="Meyshine">Andita Meyshine</name>
<affiliation>
<nlm:aff id="aff2">Chuuk EpiNet Team, Department of Health, Chuuk, Federated States of
<country>Micronesia</country>
.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Assito, Prisca" sort="Assito, Prisca" uniqKey="Assito P" first="Prisca" last="Assito">Prisca Assito</name>
<affiliation>
<nlm:aff id="aff2">Chuuk EpiNet Team, Department of Health, Chuuk, Federated States of
<country>Micronesia</country>
.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Pretrick, Moses" sort="Pretrick, Moses" uniqKey="Pretrick M" first="Moses" last="Pretrick">Moses Pretrick</name>
<affiliation>
<nlm:aff id="aff3">National EpiNet Team, Department of Health, Pohnpei, Federated States of
<country>Micronesia</country>
.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Souares, Yvan" sort="Souares, Yvan" uniqKey="Souares Y" first="Yvan" last="Souares">Yvan Souares</name>
<affiliation>
<nlm:aff id="aff1">Secretariat of the Pacific, Noumea,
<country>New Caledonia</country>
.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Hancock, Thane" sort="Hancock, Thane" uniqKey="Hancock T" first="Thane" last="Hancock">Thane Hancock</name>
<affiliation>
<nlm:aff id="aff4">Yap EpiNet Team, Department of Health, Yap, Federated States of
<country>Micronesia</country>
.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Durand, Mark" sort="Durand, Mark" uniqKey="Durand M" first="Mark" last="Durand">Mark Durand</name>
<affiliation>
<nlm:aff id="aff5">Pacific Island Health Officers Association, Hawaii,
<country>United States of America</country>
.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Roth, Adam" sort="Roth, Adam" uniqKey="Roth A" first="Adam" last="Roth">Adam Roth</name>
<affiliation>
<nlm:aff id="aff1">Secretariat of the Pacific, Noumea,
<country>New Caledonia</country>
.</nlm:aff>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Western Pacific Surveillance and Response Journal : WPSAR</title>
<idno type="ISSN">2094-7321</idno>
<idno type="eISSN">2094-7313</idno>
<imprint>
<date when="2014">2014</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
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<profileDesc>
<textClass></textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">
<sec>
<title>Objective</title>
<p>In September 2012, there was an unexpected increase of acute febrile illness (AFI) in Chuuk State of the Federated States of Micronesia. At the same time, dengue outbreaks were occurring in two of the Federated States of Micronesia’s other three states. The cause of AFI was suspected to be dengue; however, by the end of October, only one of 39 samples was positive for dengue. The objective of the investigation was to establish the cause of the outbreak.</p>
</sec>
<sec>
<title>Methods</title>
<p>A line list was created and data analysed by time, place, person and clinical features. Reported symptoms were compared with the published symptoms of several diagnoses and laboratory testing undertaken.</p>
</sec>
<sec>
<title>Results</title>
<p>Of the 168 suspected cases, 62% were less than 20 years of age and 60% were male. The clinical features of the cases were not typical for dengue but suggestive of respiratory illness. Nasopharyngeal swabs were subsequently collected and found to be positive for influenza. Public health measures were undertaken and the AFI returned to expected levels.</p>
</sec>
<sec>
<title>Discussion</title>
<p>Clinical diagnosis of acute febrile illness (AFI) can often be difficult and misleading. This can mean that opportunities for preventive measures early on in an outbreak are missed. In any outbreak, descriptive epidemiological analyses are valuable in helping to ascertain the cause of the outbreak.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article">
<pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">Western Pac Surveill Response J</journal-id>
<journal-id journal-id-type="iso-abbrev">Western Pac Surveill Response J</journal-id>
<journal-id journal-id-type="publisher-id">WPSAR</journal-id>
<journal-title-group>
<journal-title>Western Pacific Surveillance and Response Journal : WPSAR</journal-title>
</journal-title-group>
<issn pub-type="ppub">2094-7321</issn>
<issn pub-type="epub">2094-7313</issn>
<publisher>
<publisher-name>World Health Organization</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">25685599</article-id>
<article-id pub-id-type="pmc">4318975</article-id>
<article-id pub-id-type="publisher-id">WPSAR.2014.5.4-005</article-id>
<article-id pub-id-type="doi">10.5365/WPSAR.2014.5.3.005</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Other Topic</subject>
<subj-group subj-group-type="article-subtype">
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Investigating an outbreak of acute fever in Chuuk, Federated States of Micronesia</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Hoy</surname>
<given-names>Damian</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>a</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Yichiro</surname>
<given-names>Yoster</given-names>
</name>
<xref ref-type="aff" rid="aff2">
<sup>b</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Otoko</surname>
<given-names>Kasian</given-names>
</name>
<xref ref-type="aff" rid="aff2">
<sup>b</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Heldart</surname>
<given-names>Helden</given-names>
</name>
<xref ref-type="aff" rid="aff2">
<sup>b</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Meyshine</surname>
<given-names>Andita</given-names>
</name>
<xref ref-type="aff" rid="aff2">
<sup>b</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Assito</surname>
<given-names>Prisca</given-names>
</name>
<xref ref-type="aff" rid="aff2">
<sup>b</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Pretrick</surname>
<given-names>Moses</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>c</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Souares</surname>
<given-names>Yvan</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>a</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Hancock</surname>
<given-names>Thane</given-names>
</name>
<xref ref-type="aff" rid="aff4">
<sup>d</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Durand</surname>
<given-names>Mark</given-names>
</name>
<xref ref-type="aff" rid="aff5">
<sup>e</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Roth</surname>
<given-names>Adam</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>a</sup>
</xref>
</contrib>
<aff id="aff1">
<label>a</label>
Secretariat of the Pacific, Noumea,
<country>New Caledonia</country>
.</aff>
<aff id="aff2">
<label>b</label>
Chuuk EpiNet Team, Department of Health, Chuuk, Federated States of
<country>Micronesia</country>
.</aff>
<aff id="aff3">
<label>c</label>
National EpiNet Team, Department of Health, Pohnpei, Federated States of
<country>Micronesia</country>
.</aff>
<aff id="aff4">
<label>d</label>
Yap EpiNet Team, Department of Health, Yap, Federated States of
<country>Micronesia</country>
.</aff>
<aff id="aff5">
<label>e</label>
Pacific Island Health Officers Association, Hawaii,
<country>United States of America</country>
.</aff>
</contrib-group>
<author-notes>
<corresp id="cor1">Correspondence to Damian Hoy (e-mail:
<email xlink:href="damehoy@yahoo.com.au">damehoy@yahoo.com.au</email>
).</corresp>
</author-notes>
<pub-date pub-type="collection">
<season>Oct-Dec</season>
<year>2014</year>
</pub-date>
<pub-date pub-type="epub">
<day>03</day>
<month>11</month>
<year>2014</year>
</pub-date>
<volume>5</volume>
<issue>4</issue>
<fpage>5</fpage>
<lpage>12</lpage>
<permissions>
<copyright-statement>(c) World Health Organization (WHO) 2014. All rights reserved.</copyright-statement>
<copyright-year>2014</copyright-year>
</permissions>
<abstract>
<sec>
<title>Objective</title>
<p>In September 2012, there was an unexpected increase of acute febrile illness (AFI) in Chuuk State of the Federated States of Micronesia. At the same time, dengue outbreaks were occurring in two of the Federated States of Micronesia’s other three states. The cause of AFI was suspected to be dengue; however, by the end of October, only one of 39 samples was positive for dengue. The objective of the investigation was to establish the cause of the outbreak.</p>
</sec>
<sec>
<title>Methods</title>
<p>A line list was created and data analysed by time, place, person and clinical features. Reported symptoms were compared with the published symptoms of several diagnoses and laboratory testing undertaken.</p>
</sec>
<sec>
<title>Results</title>
<p>Of the 168 suspected cases, 62% were less than 20 years of age and 60% were male. The clinical features of the cases were not typical for dengue but suggestive of respiratory illness. Nasopharyngeal swabs were subsequently collected and found to be positive for influenza. Public health measures were undertaken and the AFI returned to expected levels.</p>
</sec>
<sec>
<title>Discussion</title>
<p>Clinical diagnosis of acute febrile illness (AFI) can often be difficult and misleading. This can mean that opportunities for preventive measures early on in an outbreak are missed. In any outbreak, descriptive epidemiological analyses are valuable in helping to ascertain the cause of the outbreak.</p>
</sec>
</abstract>
</article-meta>
</front>
</pmc>
</record>

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