TY - JOUR
T1 - Reconstruction of 60 years of chikungunya epidemiology in the philippines demonstrates episodic and focal transmission
AU - Salje, Henrik
AU - Cauchemez, Simon
AU - Alera, Maria Theresa
AU - Rodriguez-Barraquer, Isabel
AU - Thaisomboonsuk, Butsaya
AU - Srikiatkhachorn, Anon
AU - Lago, Catherine B.
AU - Villa, Daisy
AU - Klungthong, Chonticha
AU - Tac-An, Ilya A.
AU - Fernandez, Stefan
AU - Velasco, John Mark
AU - Roque, Vito G.
AU - Nisalak, Ananda
AU - Macareo, Louis R.
AU - Levy, Jens W.
AU - Cummings, Derek
AU - Yoon, In Kyu
N1 - Funding Information:
This work was supported by the National Institutes of Health (grant R01 AI102939-01A1) and the Armed Forces Health Surveillance Center–Global Emerging Infections Surveillance and Response System (grant P0149 14 AF).
Publisher Copyright:
© The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America.
PY - 2016/2/15
Y1 - 2016/2/15
N2 - 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.
AB - 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.
KW - Philippines
KW - chikungunya
KW - epidemiology
KW - modeling
KW - serological study
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U2 - 10.1093/infdis/jiv470
DO - 10.1093/infdis/jiv470
M3 - Article
C2 - 26410592
AN - SCOPUS:84960158859
SN - 0022-1899
VL - 213
SP - 604
EP - 610
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 4
ER -