Chikungunya: important lessons from the Jamaican experience

• Published in: Revista panamericana de salud pública Vol. 41; p. e60
• Main Authors: Duncan, Jacqueline, Gordon-Johnson, Kelly Ann, Tulloch-Reid, Marshall K, Cunningham-Myrie, Colette, Ernst, Kacey, McMorris, Nathlee, Grant, Andriene, Graham, Marcia, Chin, Daisylyn, Webster-Kerr, Karen
• Format: Journal Article
• Language: English
• Published: United States Pan American Health Organization (Organizacion Panamericana de la Salud) 01-01-2017; Organización Panamericana de la Salud
• Subjects: Adolescent; Adult; Age; Aged; Aged, 80 and over; Chikungunya Fever - diagnosis; Chikungunya Fever - epidemiology; Chikungunya virus; Child; Child, Preschool; Cross-Sectional Studies; Epidemics; Female; Health facilities; Health Policy & Services; Humans; Infant; Jamaica - epidemiology; Male; Medical diagnosis; Middle Aged; Original Research; Public health; Retrospective Studies; Selection criteria; Validity; Viral infections; Young Adult; Jamaica; epidemiología; epidemics; Chikungunya virus; Virus chikungunya; prevention & control; Jamaica; chikungunya
• ISSN: 1020-4989; 1680-5348; 1680-5348
• DOI: 10.26633/RPSP.2017.60

To describe the clinical presentation of chikungunya virus (CHIKV) illness in adults during the 2014 outbreak in Jamaica and to determine the predictive value of the case definition.
A cross-sectional study was conducted using clinical data from suspected cases of CHIKV that were reported to the Ministry of Health in April - December 2014. In addition, charts were reviewed of all individuals over 15 years of age with suspected CHIKV based on a diagnosis of CHIKV or "acute viral illness" that presented to four major health centers in Jamaica during the week prior to and the peak week of the epidemic. Data abstracted from these charts using a modified CHIKV Case Investigation Form included demographics, clinical findings, and laboratory tests.
In 2014, the Ministry of Health of Jamaica received 4 447 notifications of CHIKV infection. PCR testing was conducted on 137 suspected CHIKV cases (56 men and 81 women; median age 28 years) and was positive for 89 (65%) persons. In all, 205 health charts were identified that met the selection criteria (51 men and 154 women, median age 43 years). The most commonly reported symptoms were arthralgia (86%) and fever (76%). Of those who met the epidemiologic case definition for CHIKV as defined by the Pan American Health Organization, only 34% had this diagnosis recorded. Acute viral illness was the most frequently recorded diagnosis (n = 79; 58%).
Broader case definitions for acute CHIKV illness may be needed to identify suspected cases during an outbreak. Standardized data collection forms and validation of case definitions may be useful for future outbreaks.