Syed Nadeem-ur Rehman, Uzma Hafeez, Tamkeen Ghafoor, Jawad Asghar Rana.
Outbreak Investigation of Dengue Fever in Gojra, Muzaffarabad City, Azad Jammu & Kashmir, Pakistan-2016.
Int J Pathol Jan ;15(4):167-70.

Background: Dengue has emerged pandemic-prone tropical viral disease in recent decades. The Directorate of Communicable Diseases Control was reported an upsurge of Dengue cases in Gogra, Muzaffarabad City, since 25th September 2016. An outbreak investigation was carried out to assess the magnitude of the problem, identify associated risk factors and to suggest measures for its control. Methodology: A case was defined as ?any resident of Gogra, Muzaffarabad City, presenting with fever and having any two of the symptoms; Headache, retro-orbital pain, myalgia, arthralgia, nausea, vomiting, abdominal pain, bleeding, and found positive on screening with Immune-chromatographic IgM/IgG rapid test or NS1Ag between 21st September - 30th November 2016?. For the case control study, equal number of age and sex matched controls were taken from neighborhood households. A structured questionnaire was administered to collect information about demography and risk factors. Descriptive statistics and univariate analysis were carried out. Results: A total of 55 cases were identified with active home search in which 36 (65%) were males. The median age of cases was 26 years (range 8-70 years). The overall attack rate was 18.3/10,000 population. Age group 20-29 years was the most affected group (34. 5%).The Epi-curve showed multiple peaks. Open water tanks for storage of water and presence of larvae in and around houses were associated with the illness. (OR, 4.6; 95% CI, 2-10.4; P < 0.001 & OR, 3.0; 95% CI, 1.4-6.7; P < 0.001 respectively), whereas protective association with use of mosquito repellents, screening of doors and windows and use of insecticide spray at home were found in this study. Conclusions: Open over head water tanks at houses and potential Aedes aegypti larvae breeding sites in and around houses were the causes of dengue outbreak. Community awareness about dengue, appropriate vector control measures and effective dengue surveillance were taken successfully to control the outbreak and prevent future outbreaks in Muzaffarabad AJ&K.

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