Excess deaths associated with the chikungunya epidemic of 2014 in Jamaica were higher among children under 5 and over 40 years of age, an analysis based on official data

Abstract

Excess deaths associated with the chikungunya epidemic of 2014 in Jamaica were higher among children under 5 and over 40 years of age, an analysis based on official data. Running title:Mortality associated chikungunya Jamaica Title:Excess deaths associated with the chikungunya epidemic of 2014 in Jamaica were higher among children under 5 and over 40 years of age, an analysis based on official data. peer-reviewed) is the author/funder. It is made available under a The copyright holder for this preprint (which was not . http://dx.doi.org/10.1101/227579 doi: bioRxiv preprint first posted online Dec. 8, 2017; Abstract:We assessed the excess of all causes of mortality by age groups during the chikungunya epidemics in Jamaica, 2014. Excess mortality was estimated by subtracting deaths observed in 2014 from that expected based on the average mortality rate of 2012-2013, with confidence interval of 99%.Overall mortality 91.9 / 100,000 population, 2,499 additional deaths than expected coincided with the peak of the epidemic, there was a strong correlation between the monthly incidence and the excess of deaths (Spearman Rho = 0.939; p <0.005). No other significant epidemiological phenomenon occurred on that island that could explain this increase in mortality. Thus, we suggest that mortality associated with chikungunya is underestimated in Jamaica, as in other countries.The excess of deaths could be a strategic tool for the epidemiological surveillance of chikungunya as it has already been used in influenza and respiratory syncytial.

Dengue, chikungunya and zika arbovirus infections in Caribbean children

“…After an incubation period of 3-7 days (range 1-12), chikungunya presents abruptly with high fever, rash and arthralgia or arthritis, lasting for weeks, months or years, and maybe recurrent. Chikungunya has been described in children from several Caribbean islands [32][33][34][35][36][37][38]. In Jamaica, hospitalized children came from households with multiple symptomatic cases and presented with high fever, maculopapular rash, joint pains and varied specific age-related manifestations (Fig.…”

“…In Jamaica, mother-to-child transmission of chikungunya presented within 72 h of life with neonatal hypotension, acrocyanosis and respiratory distress, which resulted in death within 24-48 h in two children [36]. Children aged less than 5 years and the elderly had the highest risk for chikungunya morbidity among hospitalized cases in Puerto Rico and excess mortality in Jamaica using data acquired from population-based death certificates [37,38].…”

“…This togavirus, primarily of the Asian genotype, was first isolated in the Americas from two autochthonous cases in the Caribbean Island of Martinique in late 2013 with explosive epidemics developing rapidly in the region and over 1.6 million chikungunya cases were reported by October 2015 [3]. The Caribbean was not spared (Table 1) [25–30,31 ▪▪ ,32–38]. Anzinger et al [31 ▪▪ ] reported an 83.6% chikungunya seroprevalence in Jamaican antenatal populations.…”

“…Chikungunya has been described in children from several Caribbean islands [32–38]. In Jamaica, hospitalized children came from households with multiple symptomatic cases and presented with high fever, maculopapular rash, joint pains and varied specific age-related manifestations (Fig.…”

Severity and Outcomes of Dengue in Hospitalized Jamaican Children in 2018–2019 During an Epidemic Surge in the Americas

“…In Jamaica, an upper middle-developing Caribbean islandnation, with population 2.97 million, national surveillance data are available from 1977 for dengue epidemics, where seroprevalence rates approach 99-100% in pregnancy, which is a readily-accessible representative Jamaican subpopulation (8). In 2014, an epidemic with several thousands of suspected cases of chikungunya virus (CHIKV) infections were reported with an 83.6% seropositivity (9)(10)(11)(12). In 2016, Jamaica experienced its maiden Zika virus (ZIKV) epidemic, when all three arboviruses co-circulated endemically (13)(14)(15)(16).…”