Outbreak of Chikungunya in the French Caribbean Islands of Martinique and Guadeloupe: Findings from a Hospital-Based Surveillance System (2013–2015)

Abstract

Abstract.Chikungunya virus (CHIKV) emerged in the Caribbean island of Saint-Martin in December 2013. We implemented a hospital-based surveillance system to detect and describe CHIKV cases including severe forms of the infection and deaths in the islands of Martinique and Guadeloupe. A case was defined as a patient with a CHIKV laboratory confirmation cared for in a public hospital for chikungunya for at least 24 hours, and a severe CHIKV case was defined as a CHIKV case presenting one or more organ failures. Sociodemographic, clinical, and laboratory data were collected and cases classified into severe or nonsevere based on medical records. From December 2013 to January 2015, a total of 1,836 hospitalized cases were identified. Rate of hospital admissions for CHIKV infection was 60 per 10,000 suspected clinical CHIKV cases and severity accounted for 12 per 10,000. A total of 74 deaths related to CHIKV infection occurred. Infants and elderly people were more frequently hospitalized compared with others and severity was more frequently reported in elderly subjects and subjects with underlying health condition. Fifteen neonatal infections consecutive to mother-to-child transmission were diagnosed, seven of which were severe. The most vulnerable groups of the population, such as the elderly, infants, individuals with comorbidities, and pregnant women, should remain the main targets of public health priorities.

Combining anti‐IgM and IgG immunoassays for comprehensive chikungunya virus diagnostic testing

“…CHIKV continues to cause disease in humans for which there remains no licensed treatment or vaccine (Alfaro-Toloza, Clouet-Huerta, & Rodríguez-Morales, 2015). A practical and comprehensive protocol is necessary for the diagnosis of cases that occur via travel to regions experiencing ongoing outbreaks (Davidas et al, 2018;Ng et al, 2017).…”

Chikungunya arthritis

“…2,3 Blood investigations in the initial stages can show transient anaemia, leukopenia, lymphopenia, mild thrombocytopenia, raised liver enzymes and serum creatinine levels. 15,34 Chikungunya virus can be detected by the reverse transcription (RT) -PCR method from 0 to 7 days of infection, after which PCR detection becomes unreliable. 12 IgM becomes detectable in 5-10 days after the onset of infection; positivity is at a maximum after 3 weeks and it remains positive up to 2-3 months.…”

Long‐term survival and clinical forms in the acute phase of Chikungunya virus infection in older Caribbeans

“…We previously reported an in‐hospital mortality rate of 9.1% in a population of subjects aged 65 years or older with CVI , vs . only 4% in the overall population of subjects admitted to hospital for CVI . While data exist regarding mortality in the acute phase, there are no available data regarding the medium‐ to long‐term mortality.…”

“…Several authors have identified age as a risk factor for death during the acute phase of infection [10,11]. It has been shown that older subjects more frequently present atypical or severe form than younger patients [7,10], although data remain sparse and results are sometimes contradictory [12]. We previously reported an in-hospital mortality rate of 9.1% in a population of subjects aged 65 years or older with CVI [13], vs. only 4% in the overall population of subjects admitted to hospital for CVI [7].…”

“…It has been shown that older subjects more frequently present atypical or severe form than younger patients [7,10], although data remain sparse and results are sometimes contradictory [12]. We previously reported an in-hospital mortality rate of 9.1% in a population of subjects aged 65 years or older with CVI [13], vs. only 4% in the overall population of subjects admitted to hospital for CVI [7]. While data exist regarding mortality in the acute phase, there are no available data regarding the medium-to long-term mortality.…”