Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Nov 14;107(6):1226-1233.
doi: 10.4269/ajtmh.22-0296. Print 2022 Dec 14.

A Chikungunya Outbreak in a Dengue-endemic Region in Rural Northern Coastal Ecuador

Sully Márquez  1 , Gwenyth O Lee  2 , Paulina Andrade  3   4 , Julio Zuniga  2 , Gabriel Trueba  1 , Joseph N S Eisenberg  2 , Josefina Coloma  4
Affiliations

A Chikungunya Outbreak in a Dengue-endemic Region in Rural Northern Coastal Ecuador

Sully Márquez et al. Am J Trop Med Hyg. .

Abstract

Dengue virus (DENV) reemerged in the Americas in the 1980s and 1990s, whereas chikungunya virus (CHIKV) emerged in 2014. Although CHIKV produced large epidemics from 2014 to 2017, dengue fever has been the prominent arboviral disease identified through passive surveillance, bringing to question the degree to which cases are misdiagnosed. To address this concern, we conducted an active household-based surveillance of arboviral-like illnesses in six rural and remote communities in northern coastal Ecuador from May 2019 to February 2020. Although passive surveillance conducted by the Ecuadorian Ministry of Health reported only DENV cases in the region, more than 70% of the arbovirus-like illnesses detected by active surveillance in our study were positive for CHIKV. These findings underline the need for active surveillance of arboviral infections with laboratory confirmation, especially in rural communities where arboviral illnesses are more likely to be underreported.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Map of the study area. The towns of Borbón, Maldonado, Colon Eloy, Timbire, Santa Maria, and Santo Domingo are located approximately 100 kilometers north of the provincial capital of Esmeraldas.
Figure 2.
Figure 2.
Prevalence of reported symptoms from DENV+ and CHIKV+ arbovirus cases. The prevalence of symptoms reported by participants in active surveillance who were confirmed to have a dengue virus (DENV) infection, a chikungunya virus (CHIKV) infection, a coinfection, or neither a DENV nor a CHIKV infection. *** Statistically significant difference in symptom prevalence between DENV and CHIKV cases.
Figure 3.
Figure 3.
Number of dengue cases reported according the passive surveillance from the Ministry of Health; number of Dengue and Chikungunya cases reported by active Surveillance from May 2019 to February 2020.
See this image and copyright information in PMC

References

    1. Wijesinghe C, Gunatilake J, Kusumawathie PHD, Sirisena PDNN, Daulagala SWPL, Iqbal BN, Noordeen F, 2021. Circulating dengue virus serotypes and vertical transmission in Aedes larvae during outbreak and inter-outbreak seasons in a high dengue risk area of Sri Lanka. Parasit Vectors 14: 614. - PMC - PubMed
    1. Harapan H, Michie A, Mudatsir M, Nusa R, Yohan B, Wagner AL, Sasmono RT, Imrie A, 2019. Chikungunya virus infection in Indonesia: a systematic review and evolutionary analysis. BMC Infect Dis 19: 243. - PMC - PubMed
    1. World Health Organization , 2022. Dengue and severe dengue. Available at: https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue. Accessed November 1, 2021.
    1. Guzman MG, Gubler DJ, Izquierdo A, Martinez E, Halstead SB, 2016. Dengue infection. Nat Rev Dis Primers 2: 16055. - PubMed
    1. McFee RB, 2018. Selected mosquito-borne illnesses-Chikungunya. Dis Mon 64: 222–234. - PMC - PubMed

Publication types