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A sudden increase in patients with acute febrile illness (AFI) in Rangamati General Hospital in June 2018 prompted an investigation to confirm the unusual occurrence of this condition, to identify the cause, and to recommend control measures. All patients had acute onset of fever and joint pain. We used our review of hospital records, interviews of active cases in hospital and the community, and environmental and entomological investigations to generate a hypothesis of possible etiologic agents. Blood samples were tested by Polymerase Chain Reaction (PCR) for chikungunya, dengue and Zika viruses. We identified 51 AFI cases in Rangamati Hill District, of which 64.7% were male, 25.5% were aged 21-30 years, and 76.5% were in the community. The outbreak lasted from 27 May to 19 Jun 2018. We concluded that chikungunya caused the outbreak in Rangamati because the AFI cases had fever, joint pain, rash and headache. Twenty-one (41.1%) of the cases were positive for chikungunya virus and Aedes aegypti larvae were found in the households near the cases. This was the first report of chikungunya in this municipal area. We recommended increased public awareness to reduce mosquito breeding places near houses, distributing leaflets on chikungunya disease and using insecticide treated nets.
Keywords: AFI, acute febrile illness, chikungunya, outbreak, Bangladesh
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