Reconstruction of 60 Years of Chikungunya Epidemiology in the Philippines Demonstrates Episodic and Focal Transmission
Salje, Henrik ; Srikiatkhachorn, Anon
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Abstract
Proper understanding of the long-term epidemiology of chikungunya has been hampered by poor surveillance. Outbreak years are unpredictable and cases often misdiagnosed. Here we analyzed age-specific data from 2 serological studies (from 1973 and 2012) in Cebu, Philippines, to reconstruct both the annual probability of infection and population-level immunity over a 60-year period (1952-2012). We also explored whether seroconversions during 2012-2013 were spatially clustered. Our models identified 4 discrete outbreaks separated by an average delay of 17 years. On average, 23% (95% confidence interval [CI], 16%-37%) of the susceptible population was infected per outbreak, with > 50% of the entire population remaining susceptible at any point. Participants who seroconverted during 2012-2013 were clustered at distances of < 230 m, suggesting focal transmission. Large-scale outbreaks of chikungunya did not result in sustained multiyear transmission. Nevertheless, we estimate that > 350,000 infections were missed by surveillance systems. Serological studies could supplement surveillance to provide important insights on pathogen circulation.
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J Infect Dis. 2016 Feb 15;213(4):604-10. doi: 10.1093/infdis/jiv470. Epub 2015 Sep 25. Link to article on publisher's site
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Full author list omitted for brevity. For the full list of authors see article.