Research Article Volume 4 Issue 4 - May 2019 DOI: 10.19080/JOJPH.2019.04.555644 JOJ Pub Health Copyright © All rights are reserved by Hassan E El Bushra Outbreak of Chikungunya Fever in Sudan, 2018-2019 Hassan E El Bushra 1 *, Betigel W Habtewold 2 , Naeema Al Gasseer 3 , Rehab E Mohamed 4 , Salim A Mohamednour 5 , Mazza Abshar 6 and Babikir Al Magboul 7 1 Consultant Medical Epidemiologist, Khartoum, Sudan 2 Public Health Consultant, World Health Organization, Sudan 3 Country Representative and Head of Mission, World Health Organization, Sudan Country Office, Sudan 4 Virologist, National Public Health Laboratory, Khartoum, Sudan 5 National Health Coordinator, World Health Organization, Sudan 6 Head, Communicable Disease Surveillance and Event Unit, Federal Ministry of Health, Sudan. 7 Director, Health Emergency and Epidemic Control Directorate, Federal Ministry of Health, Sudan Submission: May 20, 2019; Published: June 03, 2019 *Corresponding author: Hassan E El Bushra, Consultant Medical Epidemiologist, Khartoum, Sudan JOJ Pub Health 4(4): JOJPH.MS.ID.555644 (2019) 001 Introduction Chikungunya Fever is an emerging disease caused by Chikungunya Virus (CHIKV), an arbovirus transmitted by the bite of infected female mosquitoes, Aedes aegypti and Aedes albopictus [1,2]. The disease is expanding at an alarming rate across the globe [1]. Millions of Chikungunya Fever cases have been reported across more than 60 countries. In the past decade, however, Chikungunya has re-emerged in Africa, Southern and South-eastern Asia, and the Indian Ocean Islands as the cause Abstract Introduction: During the period between 31 May 2018 and 30 March 2019, Sudan witnessed an unprecedented large outbreak of Chikungunya Fever that constituted a public health emergency of national concern. Objective: To describe the occurrence, spread, magnitude and the responses to the outbreak; and to document lessons learned. Material and methods: Sources of data included data from the national sentinel disease surveillance, laboratory investigation findings on the outbreak, summary of the discussions at the Emergency Operation Centres (EOC), and situation and field visit reports. Results: The disease surveillance system reported a total of 48,763 cases of Chikungunya Fever in Sudan. Molecular characterization of the virus indicated that the Chikungunya virus was of Southeast Asian origin. Almost all cases (99.7%) of Chikungunya Fever in the country occurred in Kassala and Red Sea States of eastern Sudan alone (19,902 and 28,861 cases respectively). Almost all cases concentrated in two major cities: Kassala City (95.5% of all cases in Kassala State) and Port Sudan City (94.2% of all cases in Red Sea State). Smaller outbreaks and sporadic cases of Chikungunya Fever were reported from seven other States; the sporadic cases were epidemiologically linked to the outbreak in eastern Sudan and did not result in outbreaks with locally acquired cases. Females were slightly more affected than males (51.2% compared to 48.8%). More than 75% of cases occurred among population aged 20-60 years.In both Kassala and Red Sea States, the Attack Rate (AR per 10,000 population) of Chikungunya Fever was consistently higher among females and the elderly; and, increased progressively with age. The AR among younger and older population showed no major difference among female and male population. Implementation of aggressive vector control measures in the affected localities in North Kordofan and West Darfur States succeeded in controlling smaller outbreak in short periods of time. Discussion: This outbreak was the largest outbreak of Chikungunya Fever ever occurred in Africa and the Eastern Mediterranean Region. Cases showed temporal, spatial, and population aggregation during the outbreak. It is most likely that the virus entered the Sudan through a ship that harboured in Sawakin seaport. The sentinel disease surveillance system succeeded in detecting the outbreak early but grossly underestimated the actual number of cases. Keywords: Chikungunya Fever; Outbreak; Sudan