The First confirmed outbreak of chikungunya reported in Timor-Leste, 2024

Authors

  • Filipe de Neri Machado Instituto Nacional de Saúde Pública de Timor-Leste, Comoro, Timor-Leste
  • Anthony DK Draper Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste; National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia; Centre for Disease Control, Public Health Unit, Top End Health Service, Northern Territory Government Department of Health, Darwin, Northern Territory, Australia
  • Anferida Monteiro Fernandes Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
  • Frederico Bosco Alves dos Santos Instituto Nacional de Saúde Pública de Timor-Leste, Comoro, Timor-Leste
  • Marcelo Amaral Mali Instituto Nacional de Saúde Pública de Timor-Leste, Comoro, Timor-Leste
  • Ari J Pereira Tilman Laboratorio Nacional da Saude, Bidau, Timor-Leste
  • Endang Soares da Silva Laboratorio Nacional da Saude, Bidau, Timor-Leste
  • Elizabeth Hornay Laboratorio Nacional da Saude, Bidau, Timor-Leste
  • Antonio Salles de Sousa Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste; Laboratorio Nacional da Saude, Bidau, Timor-Leste
  • Tessa Oakley Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste; Laboratorio Nacional da Saude, Bidau, Timor-Leste
  • Edinha da Cruz Centro de Saude Internamento, Ermera, Timor-Leste
  • Nevio Sarmento Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
  • Maria AV Niha Surveillance Department, Ministry of Health, Comoro, Timor-Leste; World Health Organization, Timor-Leste Office, Caicoli, Timor-Leste
  • Ana Fatima Soares Surveillance Department, Ministry of Health, Comoro, Timor-Leste
  • Eva Estrelita Cardoso Gomes World Health Organization, Timor-Leste Office, Caicoli, Timor-Leste
  • Jose de Deus Alves Centro de Saude Comoro, Comoro, Timor-Leste
  • Jose Paulo Soares Centro de Saude Internamento, Ermera, Timor-Leste
  • Joshua R Francis Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
  • Jennifer Yan Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
  • Merita Antonio Monteiro Instituto Nacional de Saúde Pública de Timor-Leste, Comoro, Timor-Leste

DOI:

https://doi.org/10.33321/cdi.2024.48.17

Keywords:

chikungunya, arbovirus, mosquito-borne disease, surveillance, Timor-Leste, outbreak, ow-resource setting

Abstract

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.

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Published

10/04/24

How to Cite

Machado, Filipe de Neri, Anthony DK Draper, Anferida Monteiro Fernandes, Frederico Bosco Alves dos Santos, Marcelo Amaral Mali, Ari J Pereira Tilman, Endang Soares da Silva, et al. 2024. “The First Confirmed Outbreak of Chikungunya Reported in Timor-Leste, 2024”. Communicable Diseases Intelligence 48 (April). https://doi.org/10.33321/cdi.2024.48.17.

Issue

Vol. 48 (2024)

Section

Outbreak report

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