An epidemic of chikungunya in northwestern Bangladesh in 2011

Abstract

BackgroundIn November 2011, a government hospital physician in Shibganj sub-district of Bangladesh reported a cluster of patients with fever and joint pain or rash. A multi-disciplinary team investigated to characterize the outbreak; confirm the cause; and recommend control and prevention measures.MethodsShibganj's residents with new onset of fever and joint pain or rash between 1 September and 15 December 2011 were defined as chikungunya fever (CHIKF) suspect cases. To estimate the attack rate, we identified 16 outpatient clinics in 16 selected wards across 16 unions in Shibganj and searched for suspect cases in the 80 households nearest to each outpatient clinic. One suspect case from the first 30 households in each ward was invited to visit the nearest outpatient clinic for clinical assessment and to provide a blood sample for laboratory testing and analyses.ResultsWe identified 1,769 CHIKF suspect cases from among 5,902 residents surveyed (30%). Their median age was 28 (IQR:15−42) years. The average attack rate in the sub-district was 30% (95% CI: 27%−33%). The lowest attack rate was found in children <5 years (15%). Anti-CHIKV IgM antibodies were detected by ELISA in 78% (264) of the 338 case samples tested. In addition to fever, predominant symptoms of serologically-confirmed cases included joint pain (97%), weakness (54%), myalgia (47%), rash (42%), itching (37%) and malaise (31%). Among the sero-positive patients, 79% (209/264) sought healthcare from outpatient clinics. CHIKV was isolated from two cases and phylogenetic analyses of full genome sequences placed these viruses within the Indian Ocean Lineage (IOL). Molecular analysis identified mutations in E2 and E1 glycoproteins and contained the E1 A226V point mutation.ConclusionThe consistently high attack rate by age groups suggested recent introduction of chikungunya in this community. Mosquito control efforts should be enhanced to reduce the risk of continued transmission and to improve global health security.

Chikungunya outbreak in Bangladesh (2017): Clinical and hematological findings

“…No fatal cases were reported; the clinical manifestations of this outbreak remained consistent with the classical forms of CHIKV infection, though the attack rate (~30%) within the circulation area was high [24,26]. Although there is inconsistency regarding data on which age and gender group underwent most sufferings, children were less vulnerable and showed better recovery [21,26]. Reports of sporadic cases of CHIKV infection continued to come in 2013, 2015, and 2016 [27].…”

“…Later, in November 2011, another chikungunya outbreak was reported in the Dohar-Dhaka area [24]. No fatal cases were reported; the clinical manifestations of this outbreak remained consistent with the classical forms of CHIKV infection, though the attack rate (~30%) within the circulation area was high [24,26]. Although there is inconsistency regarding data on which age and gender group underwent most sufferings, children were less vulnerable and showed better recovery [21,26].…”

A Novel Sub-Lineage of Chikungunya Virus East/Central/South African Genotype Indian Ocean Lineage Caused Sequential Outbreaks in Bangladesh and Thailand

“…In mid-2015, the new IOL CHIKV sub-lineage carrying E1-K211E and E2-V264A in the background of E1-226A was introduced to Bangladesh and replaced the old IOL CHIKV that was reported earlier in 2008–2011 in rural areas such as the Dohar sub-district in Dhaka and the Chapainababganj district located in northwestern Bangladesh [ 54 , 55 ]. This new sub-lineage caused the largest CHIKV outbreak in 2017.…”

Molecular Epidemiology, Evolution and Reemergence of Chikungunya Virus in South Asia

“…Larger outbreaks involving more cases in India, Bangladesh, Pakistan, Sri Lanka, and Maldives have been documented recently ( Powers and Logue, 2007 ; Wimalasiri-Yapa et al, 2019 ). About 85% of cases of CHIKV had been detected after 2000 in South Asian countries ( Padbidri and Gnaneswar, 1979 ; Powers and Logue, 2007 ; Hapuarachchi et al, 2010 ; Manimunda et al, 2010 ; Haque et al, 2019 ; Vairo et al, 2019 ; Wimalasiri-Yapa et al, 2019 ). After 2007, CHIKV outbreaks in SEA and SA regions were larger and longer that infected millions of people in India, Bangladesh, Bhutan, Nepal, Thailand, and Philippines ( Supplementary Table 1 ; Centers for Disease Control and Prevention (CDC), 2021 ).…”

“…After 2007, CHIKV outbreaks in SEA and SA regions were larger and longer that infected millions of people in India, Bangladesh, Bhutan, Nepal, Thailand, and Philippines ( Supplementary Table 1 ; Centers for Disease Control and Prevention (CDC), 2021 ). In SA, seven countries (Bangladesh, Bhutan, India, Pakistan, Sri Lanka, Nepal, and Maldives) out of eight have reported the local outbreaks and epidemics of CHIKV during 2010 to 2020 ( Figures 1A–C , 2 ; Mallhi et al, 2017 ; Wahid et al, 2017 ; Haque et al, 2019 ; Wimalasiri-Yapa et al, 2019 ; Centers for Disease Control and Prevention (CDC), 2021 ).…”