Dengue Virus Infections among Peace Corps Volunteers in Timor-Leste, 2018-2019

Area of Science:

• Tropical Medicine
• Epidemiology
• Public Health

Background:

• Dengue fever presents an ongoing health concern for Peace Corps Volunteers (PCVs) stationed in tropical environments.
• A dengue outbreak among PCVs in Timor-Leste prompted an investigation by the Peace Corps Office of Health Services and the CDC.

Purpose of the Study:

• To characterize the clinical, demographic, and epidemiological features of dengue among PCVs.
• To recommend effective dengue prevention measures for PCVs.

Main Methods:

• Reviewed medical records of PCVs reporting fever between September 2018 and June 2019.
• Administered questionnaires on demographics, travel, and mosquito avoidance behaviors.
• Collected blood samples for dengue virus (DENV) antibody testing (anti-DENV IgM) to diagnose recent infections.

Main Results:

• Out of 35 PCVs, 11 (31%) tested positive for dengue; eight required hospitalization and medical evacuation.
• Among 27 participants, all reported recent mosquito bites, with 56% reporting bites at home.
• Inadequate use of mosquito bite prevention measures, such as window screens (59%) and daily repellent use (70%), was noted.

Conclusions:

• No specific behaviors were significantly associated with DENV infection, indicating a need for broader prevention strategies.
• Enhanced awareness of dengue risks and improved access to and consistent use of mosquito bite prevention methods are critical for PCVs.
• Peace Corps medical officers require ongoing training in dengue clinical management.