{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T19:10:22Z","timestamp":1790795422286,"version":"4.1.0"},"reference-count":44,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2021,10,3]],"date-time":"2021-10-03T00:00:00Z","timestamp":1633219200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Department of Economy, Science and Innovation (EWI) of the Flemish Government (Belgium)","award":["Grant agreement for scientific research (2013-2019) between the Flemish Community and the Institute of Tropical Medicine, Antwerp, Belgium"],"award-info":[{"award-number":["Grant agreement for scientific research (2013-2019) between the Flemish Community and the Institute of Tropical Medicine, Antwerp, Belgium"]}]},{"name":"Belgian Directorate-general Development Cooperation (DGD)","award":["Framework Agreement (FA-4) between DGD, Institute of Tropical Medicine, Antwerp, Belgium and the Institut National de Recherche Biom\u00e9dicale, Democratic Republic of the Congo"],"award-info":[{"award-number":["Framework Agreement (FA-4) between DGD, Institute of Tropical Medicine, Antwerp, Belgium and the Institut National de Recherche Biom\u00e9dicale, Democratic Republic of the Congo"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Early March 2019, health authorities of Matadi in the Democratic Republic of the Congo alerted a sudden increase in acute fever\/arthralgia cases, prompting an outbreak investigation. We collected surveillance data, clinical data, and laboratory specimens from clinical suspects (for CHIKV-PCR\/ELISA, malaria RDT), semi-structured interviews with patients\/caregivers about perceptions and health seeking behavior, and mosquito sampling (adult\/larvae) for CHIKV-PCR and estimation of infestation levels. The investigations confirmed a large CHIKV outbreak that lasted February\u2013June 2019. The total caseload remained unknown due to a lack of systematic surveillance, but one of the two health zones of Matadi notified 2686 suspects. Of the clinical suspects we investigated (n = 220), 83.2% were CHIKV-PCR or IgM positive (acute infection). One patient had an isolated IgG-positive result (while PCR\/IgM negative), suggestive of past infection. In total, 15% had acute CHIKV and malaria. Most adult mosquitoes and larvae (&gt;95%) were Aedes albopictus. High infestation levels were noted. CHIKV was detected in 6\/11 adult mosquito pools, and in 2\/15 of the larvae pools. This latter and the fact that 2\/6 of the CHIKV-positive adult pools contained only males suggests transovarial transmission. Interviews revealed that healthcare seeking shifted quickly toward the informal sector and self-medication. Caregivers reported difficulties to differentiate CHIKV, malaria, and other infectious diseases resulting in polypharmacy and high out-of-pocket expenditure. We confirmed a first major CHIKV outbreak in Matadi, with main vector Aedes albopictus. The health sector was ill-prepared for the information, surveillance, and treatment needs for such an explosive outbreak in a CHIKV-na\u00efve population. Better surveillance systems (national level\/sentinel sites) and point-of-care diagnostics for arboviruses are needed.<\/jats:p>","DOI":"10.3390\/v13101988","type":"journal-article","created":{"date-parts":[[2021,10,11]],"date-time":"2021-10-11T01:59:47Z","timestamp":1633917587000},"page":"1988","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["A Multidisciplinary Investigation of the First Chikungunya Virus Outbreak in Matadi in the Democratic Republic of the Congo"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9377-4766","authenticated-orcid":false,"given":"Anja","family":"De Weggheleire","sequence":"first","affiliation":[{"name":"Outbreak Research Team, Institute of Tropical Medicine, 2000 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2850-7498","authenticated-orcid":false,"given":"Antoine","family":"Nkuba-Ndaye","sequence":"additional","affiliation":[{"name":"Department of Virology, National Institute of Biomedical Research, B.P. 1197 Kinshasa I, Democratic Republic of the Congo"},{"name":"Department of Medical Biology, University of Kinshasa, B.P. 127 Kinshasa IX, Democratic Republic of the Congo"},{"name":"TransVIHMI, Institut de Recherche pour le D\u00e9veloppement, Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM), Montpellier University, 34090 Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Placide","family":"Mbala-Kingebeni","sequence":"additional","affiliation":[{"name":"Department of Virology, National Institute of Biomedical Research, B.P. 1197 Kinshasa I, Democratic Republic of the Congo"},{"name":"Department of Medical Biology, University of Kinshasa, B.P. 127 Kinshasa IX, Democratic Republic of the Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"Mari\u00ebn","sequence":"additional","affiliation":[{"name":"Outbreak Research Team, Institute of Tropical Medicine, 2000 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esaie","family":"Kindombe-Luzolo","sequence":"additional","affiliation":[{"name":"Department of Virology, National Institute of Biomedical Research, B.P. 1197 Kinshasa I, Democratic Republic of the Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gillon","family":"Ilombe","sequence":"additional","affiliation":[{"name":"Department of Entomology, National Institute of Biomedical Research, B.P. 1197 Kinshasa I, Democratic Republic of the Congo"},{"name":"Global Health Institute, Antwerp University, 2000 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donatien","family":"Mangala-Sonzi","sequence":"additional","affiliation":[{"name":"Department of Medical Biology, University of Kinshasa, B.P. 127 Kinshasa IX, Democratic Republic of the Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Binene-Mbuka","sequence":"additional","affiliation":[{"name":"Department of Entomology, National Institute of Biomedical Research, B.P. 1197 Kinshasa I, Democratic Republic of the Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1790-1900","authenticated-orcid":false,"given":"Birgit","family":"De Smet","sequence":"additional","affiliation":[{"name":"Outbreak Research Team, Institute of Tropical Medicine, 2000 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Vogt","sequence":"additional","affiliation":[{"name":"Outbreak Research Team, Institute of Tropical Medicine, 2000 Antwerp, Belgium"},{"name":"The Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia"},{"name":"National Centre for Epidemiology and Population Health, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, ACT 2601, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Selhorst","sequence":"additional","affiliation":[{"name":"Outbreak Research Team, Institute of Tropical Medicine, 2000 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathy","family":"Matungala-Pafubel","sequence":"additional","affiliation":[{"name":"Department of Medical Biology, University of Kinshasa, B.P. 127 Kinshasa IX, Democratic Republic of the Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frida","family":"Nkawa","sequence":"additional","affiliation":[{"name":"Department of Virology, National Institute of Biomedical Research, B.P. 1197 Kinshasa I, Democratic Republic of the Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4295-223X","authenticated-orcid":false,"given":"Fabien","family":"Vulu","sequence":"additional","affiliation":[{"name":"Department of Medical Biology, University of Kinshasa, B.P. 127 Kinshasa IX, Democratic Republic of the Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Mossoko","sequence":"additional","affiliation":[{"name":"Direction de Lutte contre la Maladie, Ministry of Health, B.P. 3040 Kinshasa I, Democratic Republic of the Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Pukuta-Simbu","sequence":"additional","affiliation":[{"name":"Department of Virology, National Institute of Biomedical Research, B.P. 1197 Kinshasa I, Democratic Republic of the 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vectors","volume":"15","author":"Higgs","year":"2015","journal-title":"Vector Borne Zoonotic Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"234","DOI":"10.4001\/003.026.0234","article-title":"First Report of Aedes albopictus (Diptera: Culicidae) in the Democratic Republic of Congo","volume":"26","author":"Bobanga","year":"2018","journal-title":"Afr. \u00c8ntomol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.antiviral.2013.06.009","article-title":"Chikungunya fever: Epidemiology, clinical syndrome, pathogenesis and therapy","volume":"99","author":"Thiberville","year":"2013","journal-title":"Antivir. Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1590\/0074-02760170044","article-title":"Chikungunya virus: Clinical aspects and treatment\u2014A Review","volume":"112","author":"Trinta","year":"2017","journal-title":"Mem\u00f3rias Inst. Oswaldo Cruz"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1093\/trstmh\/try063","article-title":"Chikungunya chronic disease: A systematic review and meta-analysis","volume":"112","author":"Paixao","year":"2018","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Galatas, B., Ly, S., Duong, V., Baisley, K., Nguon, K., Chan, S., Huy, R., Ly, S., Sorn, S., and Som, L. (2016). Long-lasting immune protection and other epidemiological findings after chikungunya emergence in a cambodian rural community, April 2012. PLoS Negl. Trop. Dis., 10.","DOI":"10.1371\/journal.pntd.0004281"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1186\/1743-422X-11-183","article-title":"Long-term persistence of Chikungunya virus neutralizing antibodies in human populations of North Eastern Thailand","volume":"11","author":"Nitatpattana","year":"2014","journal-title":"Virol. J."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"G\u00e9rardin, P., Guernier, V., Perrau, J., Fianu, A., Le Roux, K., Grivard, P., Michault, A., De Lamballerie, X., Flahault, A., and Favier, F. (2008). Estimating Chikungunya prevalence in La R\u00e9union Island outbreak by serosurveys: Two methods for two critical times of the epidemic. BMC Infect. Dis., 8.","DOI":"10.1186\/1471-2334-8-99"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1086\/605496","article-title":"Chikungunya fever: An epidemiological review of a re-emerging infectious disease","volume":"49","author":"Staples","year":"2009","journal-title":"Clin. Infect. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"S441","DOI":"10.1093\/infdis\/jiw390","article-title":"Epidemiology of Chikungunya in the Americas","volume":"214","author":"Yactayo","year":"2016","journal-title":"J. Infect. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.antiviral.2019.03.009","article-title":"GloPID-R report on Chikungunya, O\u2019nyong-nyong and Mayaro virus, Part I: Biological diagnostics","volume":"166","author":"Pezzi","year":"2019","journal-title":"Antivir. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e00350-19","DOI":"10.1128\/JCM.00350-19","article-title":"Beyond fever and pain: Diagnostic methods for chikungunya virus","volume":"57","author":"Natrajan","year":"2019","journal-title":"J. Clin. Microbiol."},{"key":"ref_13","first-page":"199","article-title":"Research on the Chikungunya virus in the Belgian Congo. I. Isolation of the virus in upper Uele","volume":"40","author":"Osterrieth","year":"1960","journal-title":"Ann. Soc. Belg.Med. Trop."},{"key":"ref_14","first-page":"207","article-title":"Simultaneous isolation of the yellow fever and Chikungunya viruses at Bili (Haut-Uele, Belgian Congo)","volume":"41","author":"Osterrieth","year":"1961","journal-title":"Ann. Soc. Belg. Med. Trop."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"885","DOI":"10.4269\/ajtmh.1999.61.885","article-title":"An outbreak of West Nile fever among migrants in Kisangani, Democratic Republic of Congo","volume":"61","author":"Nur","year":"1999","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_16","first-page":"637","article-title":"Epidemic of Chikungunya virus in 1999 and 200 in the Democratic Republic of the Congo","volume":"63","author":"Peyrefitte","year":"2003","journal-title":"Med. Trop. Rev. Corps Sante Colon."},{"key":"ref_17","first-page":"2","article-title":"Cas de dengue chez les patients suspects de Chikungunya \u00e0 Kinshasa","volume":"7","author":"Malekani","year":"2014","journal-title":"Ann. Afr. M\u00e9d."},{"key":"ref_18","unstructured":"Radio Okapi (2021, March 28). February 2019. Available online: https:\/\/www.radiookapi.net\/2019\/02\/14\/actualite\/sante\/la-maladie-virale-de-chikungunya-declaree-en-rdc."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/22221751.2020.1810135","article-title":"Molecular Characterization of Chikungunya Virus during the 2019 Outbreak in the Democratic Republic of the Congo","volume":"9","author":"Selhorst","year":"2020","journal-title":"Emerg. Microbes Infect."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13071-020-3985-7","article-title":"Mosquito-borne viral diseases in the Democratic Republic of the Congo: A review","volume":"13","author":"Mbanzulu","year":"2020","journal-title":"Parasites Vectors"},{"key":"ref_21","unstructured":"(2020, August 05). WHO country profile DRC\u2014Malaria. Available online: https:\/\/www.who.int\/malaria\/publications\/country-profiles\/profile_cod_en.pdf?ua=1."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"416","DOI":"10.3201\/eid1403.070906","article-title":"Chikungunya fever in travelers returning to europe from the indian ocean region, 2006","volume":"14","author":"Panning","year":"2008","journal-title":"Emerg. Infect. Dis."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Huits, R., De Kort, J., Berg, R.V.D., Chong, L., Tsoumanis, A., Eggermont, K., Bartholomeeusen, K., Arien, K.K., Jacobs, J., and Van Esbroeck, M. (2018). Chikungunya virus infection in Aruba: Diagnosis, clinical features and predictors of post-chikungunya chronic polyarthralgia. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0196630"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1007\/s10096-008-0556-9","article-title":"The development of a qualitative real-time RT-PCR assay for the detection of hepatitis C virus","volume":"27","author":"Clancy","year":"2008","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_25","unstructured":"(2021, September 22). Walter Reed Mosquito Identification Keys. Available online: https:\/\/www.wrbu.si.edu\/vectorspecies\/mosquitoes\/albopictus."},{"key":"ref_26","first-page":"1","article-title":"High Aedes spp. larval indices in Kinshasa, Democratic Republic of Congo","volume":"14","author":"Tezzo","year":"2021","journal-title":"Parasites Vectors"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Mari\u00ebn, J., Laurent, N., Smitz, N., and Gombeer, S. (2021). First observation of Aedes albopictus in the Tshuapa province (Boende) of the Democratic Republic of the Congo. bioRxiv.","DOI":"10.1101\/2021.08.03.454759"},{"key":"ref_28","unstructured":"World Health Organization (WHO) (2020, September 15). Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control: New Edition. Available online: https:\/\/apps.who.int\/iris\/handle\/10665\/44188."},{"key":"ref_29","unstructured":"Biggerstaff, B. (2009). PooledInfRate, Version 4.0: A Microsoft Office Add-in to Compute Prevalence Estimates from Pooled Samples, Fort Collins Centers Dis Control Prevention."},{"key":"ref_30","unstructured":"Nekwa, A. (2020, August 05). Kongo Central: Le Bois d\u2019or ne Lutte Pas Contre le Chikungunya. Available online: https:\/\/www.infobascongo.net\/beta\/2019\/03\/24\/kongo-centralle-bois-dor-ne-lutte-pas-contre-le-chikungunia\/."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.medmal.2015.05.007","article-title":"French guidelines for the management of chikungunya (acute and persistent presentations). November 2014","volume":"45","author":"Simon","year":"2015","journal-title":"M\u00e9d. Mal. Infect."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"S471","DOI":"10.1093\/infdis\/jiw274","article-title":"Laboratory diagnosis of chikungunya virus infections and commercial sources for diagnostic assays","volume":"214","author":"Johnson","year":"2016","journal-title":"J. Infect. Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.ijid.2021.06.043","article-title":"Diagnosis of Chikungunya virus in febrile patients from a malaria holoendemic area","volume":"109","author":"Ingoba","year":"2021","journal-title":"Int. J. Infect. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Bower, H., el Karsany, M., Adam, A.A.A.H., Idriss, M.I., Alzain, M.A., Alfakiyousif, M.E.A., Mohamed, R., Mahmoud, I., Albadri, O., and Mahmoud, S.A.A. (2021). \u201cKankasha\u201d in Kassala: A prospective observational cohort study of the clinical characteristics, epidemiology, genetic origin, and chronic impact of the 2018 epidemic of Chikungunya virus infection in Kassala, Sudan. PLoS Negl. Trop. Dis., 15.","DOI":"10.1371\/journal.pntd.0009387"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.cmi.2017.06.004","article-title":"Diagnostic accuracy of a rapid E1-antigen test for chikungunya virus infection in a reference setting","volume":"24","author":"Huits","year":"2018","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1016\/j.cmi.2021.05.047","article-title":"Challenges towards serologic diagnostics of emerging arboviruses","volume":"27","author":"Fischer","year":"2021","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_37","unstructured":"UNITAID (2021, March 28). Fever Diagnostic Technology Landscape, 1st edition, February 2018. Available online: https:\/\/unitaid.org\/assets\/Fever_diagnostic_technology_and_market_landscape.pdf."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.4269\/ajtmh.16-0798","article-title":"Surveillance of Vector-Borne Infections (Chikungunya, Dengue, and Malaria) in Bo, Sierra Leone, 2012\u20132013","volume":"97","author":"Dariano","year":"2017","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1108","DOI":"10.3201\/eid1907.121563","article-title":"Reemergence of Chikungunya Virus in Bo, Sierra Leone","volume":"19","author":"Ansumana","year":"2013","journal-title":"Emerg. Infect. Dis."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"ofx259","DOI":"10.1093\/ofid\/ofx259","article-title":"Chikungunya Outbreak in Kedougou, Southeastern Senegal in 2009\u20132010","volume":"5","author":"Sow","year":"2018","journal-title":"Open Forum Infect. Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"105468","DOI":"10.1016\/j.actatropica.2020.105468","article-title":"Aedes-borne disease outbreaks in West Africa: A call for enhanced surveillance","volume":"209","author":"Buchwald","year":"2020","journal-title":"Acta Trop."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Raulino, R., Thaurignac, G., Butel, C., Villabona-Arenas, C.J., Foe, T., Loul, S., Ndimbo-Kumugo, S.-P., Mbala-Kingebeni, P., Makiala-Mandanda, S., and Ahuka-Mundeke, S. (2021). Multiplex detection of antibodies to Chikungunya, O\u2019nyong-nyong, Zika, Dengue, West Nile and Usutu viruses in diverse non-human primate species from Cameroon and the Democratic Republic of Congo. PLoS Negl. Trop. Dis., 15.","DOI":"10.1371\/journal.pntd.0009028"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.ijid.2019.05.013","article-title":"Re-emergence of chikungunya in the Republic of the Congo in 2019 associated with a possible vector-host switch","volume":"84","author":"Fritz","year":"2019","journal-title":"Int. J. Infect. Dis."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Hon\u00f3rio, N.A., Wiggins, K., Eastmond, B., C\u00e2mara, D.C.P., and Alto, B.W. (2019). Experimental vertical transmission of chikungunya virus by brazilian and florida aedes albopictus populations. Viruses, 11.","DOI":"10.3390\/v11040353"}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/13\/10\/1988\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:09:13Z","timestamp":1760166553000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/13\/10\/1988"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,3]]},"references-count":44,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2021,10]]}},"alternative-id":["v13101988"],"URL":"https:\/\/doi.org\/10.3390\/v13101988","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,3]]}}}