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Epidemiological Characterization of Chikungunya Outbreak in Lahj Governorate, Southern Yemen

Ahmed AK Thabet, Samira MA Al-Eryani, Najib Abdul Aziz, Maha Obadi, Mohammed Saleh, Abdulhakeem Al-Kohlani and Adel Al- Samei

Background and Objective: An outbreak of Chikungunya fever was poorly documented in the twenty three countries of the Eastern Mediterranean Region of the World Health Organization. The first case of Chikungunya fever was reported in Northern Yemen in the beginning of January 2011. This paper documents the first outbreak of Chikungunya fever in Southern Yemen and highlights the activities and findings of the epidemiology and laboratory team investigation during the outbreak. Methods: This was a case-series investigation in which the response teams conducted epidemiological and laboratory investigations on suspect cases. The cases identified were line-listed and a data analysis was undertaken regularly to guide the outbreak response. Results: Overall, 234 cases meeting the Chikungunya fever suspected case definition, were reported between 21st March and 8th May, 2012, from 19 areas in Al-Hawtah district, Lahj Governorate, Southern Yemen. Only 30 (12.8%) of the suspected Chikungunya cases underwent laboratory testing and only 13(43.33%) of them were laboratory confirmed as Chikungunya. Suspected Chikungunya cases had fever (100%) and arthralgia and joint swelling were reported in 95% and 64% of the cases, respectively. The overall attack rate was 7.52 cases/1000 populations. All age group and gender were affected. Conclusion: This is the first isolation of Chikungunya virus in Al-Hawtah district of Lahj governorate, Southern Yemen. The risk of expansion of Chikungunya fever to other governorates in Yemen and also to neighboring countries remains considerably high, as many of these governorates and countries are dengue prone, host large number of travelers from abroad and competent vectors for indigenous transmission of both dengue and Chikungunya exist in these countries. The location of this outbreak, in a coastal area of the country, makes the spread of the disease a further possibility.