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. 2016 Dec 15;214(suppl 5):S475-S481.
doi: 10.1093/infdis/jiw245.

Surveillance for Chikungunya and Dengue During the First Year of Chikungunya Virus Circulation in Puerto Rico

Tyler M Sharp  1 , Kyle R Ryff  2 , Luisa Alvarado  3   4 , Wun-Ju Shieh  5 , Sherif R Zaki  5 , Harold S Margolis  1 , Brenda Rivera-Garcia  2
Affiliations

Surveillance for Chikungunya and Dengue During the First Year of Chikungunya Virus Circulation in Puerto Rico

Tyler M Sharp et al. J Infect Dis. .

Abstract

After chikungunya virus (CHIKV) transmission was detected in Puerto Rico in May 2014, multiple surveillance systems were used to describe epidemiologic trends and CHIKV-associated disease. Of 28 327 cases reported via passive surveillance, 6472 were tested for evidence of CHIKV infection, and results for 4399 (68%) were positive. Of 250 participants in household cluster investigations, 70 (28%) had evidence of recent CHIKV infection. Enhanced surveillance for chikungunya at 2 hospitals identified 1566 patients who tested positive for CHIKV, of whom 10.9% were hospitalized. Enhanced surveillance for fatal cases enabled identification of 31 cases in which CHIKV was detected in blood or tissue specimens. All surveillance systems detected a peak incidence of chikungunya in September 2014 and continued circulation in 2015. Concomitant surveillance for dengue demonstrated low incidence, which had decreased before CHIKV was introduced. Multifaceted chikungunya surveillance in Puerto Rico resolved gaps in traditional passive surveillance and enabled a holistic description of the spectrum of disease associated with CHIKV infection.

Keywords: Puerto Rico; chikungunya; dengue; surveillance.

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Conflict of interest statement

Potential conflicts of interest. All authors: No reported conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1
Figure 1
Dengue and chikungunya cases detected through various surveillance systems, by month of illness onset, Puerto Rico, May 2012–April 2015. A, Cases of suspected dengue and chikungunya and cases with positive results of laboratory testing reported by passive surveillance to the Puerto Rico Department of Health. B, Cases of laboratory test–positive dengue and chikungunya detected through the Sentinel Enhanced Dengue Surveillance System. C, Fatal cases of dengue and chikungunya with positive results of laboratory testing detected through the Enhanced Fatal Acute Febrile Illness Surveillance System.
Figure 2
Figure 2
Cases of suspected chikungunya reported to the Passive Chikungunya Surveillance System, by municipality, Puerto Rico, May 2014–April 2015.
See this image and copyright information in PMC

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