Cervical lymphadenopathy occurs frequently, and parasthesiae and tenderness of palms and soles are present in a small percentage of cases. Fever is commonly absent. Public Health Significance and Occurrence Major outbreaks have occurred in Australia in the Murray Valley, Gippsland, coastal New South Wales, Northern Territory, Queensland and Western Australia, chiefly from January to May. Sporadic cases occur in other coastal regions of Australia and Papua New Guinea. In 1979, a major outbreak occurred in Fiji and spread to other Pacific islands, including Tonga and the Cook Islands.
Infection is rare in prepubertal children and increases with age.
In those affected, the disease can cause incapacity to work for two to three months and sometimes longer. Method of Diagnosis Serology can show a rise in antibody titre to Ross River virus. The virus may be isolated from the blood of acutely ill patients. Tests are usually necessary to distinguish it from other causes of arthritis. However, in the event of a local outbreak clinical diagnosis may be sufficient.