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. 2018 Nov 13;67(11):1760-1767.
doi: 10.1093/cid/ciy356.

Differences in Transmission and Disease Severity Between 2 Successive Waves of Chikungunya

Aubree Gordon  1 , Lionel Gresh  2 , Sergio Ojeda  2 , Gerardo Chowell  3 , Karla Gonzalez  2   4 , Nery Sanchez  2 , Saira Saborio  2   4 , Juan Carlos Mercado  2   4 , Guillermina Kuan  2   5 , Angel Balmaseda  2   4 , Eva Harris  1   6
Affiliations

Differences in Transmission and Disease Severity Between 2 Successive Waves of Chikungunya

Aubree Gordon et al. Clin Infect Dis. .

Abstract

Background: Chikungunya, an arboviral disease, caused massive epidemics in Central and South America in 2014-2016. In a prospective pediatric cohort study, we examined the introduction of chikungunya in a naive population and investigated transmission and clinical characteristics.

Methods: Children presenting to the study health center with a chikungunya-like illness or undifferentiated fever were tested for chikungunya virus (CHIKV) infection by reverse transcriptase-polymerase chain reaction (RT-PCR) and serological assays. Inapparent CHIKV infections in the intervening year were determined by seroconversion in healthy blood samples collected annually.

Results: A total of 4353 children participated in the cohort study from March 2014 to February 2016 during the 2 epidemic waves of chikungunya. A total of 539 cases of chikungunya were documented, for an incidence rate of 80.2 cases per 1000 person-years (95% confidence interval [CI]: 73.7, 87.2); and a total of 893 CHIKV infections were documented, for an incidence rate of 137.1 infections per 1000 person-years (95% CI: 128.4, 146.4). The seroprevalence of anti-CHIKV antibodies increased linearly with age, with seroprevalence of >45% in 14-year-old children at the end of Epidemic 2. Symptom presentation varied between the epidemics, with Epidemic 2 exhibiting both a higher symptomatic-to-inapparent ratio (1:1.20 in Epidemic 1 vs. 1:0.65 in Epidemic 2) and more severe clinical presentation among cases. The mean reproduction number was also greater in Epidemic 2 than in Epidemic 1.

Conclusions: The intensity of transmission and severity of clinical presentation varied between the 2 epidemics, with higher transmission intensity associated with greater disease severity.

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Figures

Figure 1.
Figure 1.
Incidence of chikungunya cases in the cohort by study year and month, March 2014–February 2016.
Figure 2.
Figure 2.
Age effect on case incidence, infection incidence, and the number of symptomatic cases per infection.
Figure 3.
Figure 3.
Seroprevalence of anti-chikungunya virus antibodies by age in the cohort in 2016.
See this image and copyright information in PMC

Comment in

References

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