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Report on Outbreak Investigation of Dengue Fever in Phuntsholing, July-August 2016

Dengue is an infectious disease caused by one of the four dengue virus serotype (DEN-1, DEN-2, DEN-3 and DEN-4) which is transmitted by mosquito Aedes aegypti and Aedes albopictus. With an incubation period of 4-10 days (mean 7 days), patients may develop fever, headache, body ache, myaliga, arthralgia, nausea or vomiting. Dengue fever is self limiting disease but some patient may develop dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS) depending on re-infection with serotypes (1-6). The annual hospitalization and death rates caused by severe form of dengue are highest in South East Asia (7).
First dengue outbreak in Bhutan was reported in 2004 from Phuntsholing with more than 2000 cases. Since then, the dengue has become endemic in Phuntsholing. On July 29, 2016, three dengue positive cases were reported by Phuntsholing hospital to Vector-Borne Disease Control Program (VDCP), following which a team from VDCP immediately dispatched for conducting vector surveillance and controlling the spread of dengue. The team was later joined by public health official from Royal Centre for Disease Control and joint investigation was conducted with an objective to verify, estimate the magnitude of an outbreak and determine its determinants by epidemiological, entomological, and environmental for implementing timely control and prevention measures.