Reconstruction of 60 years of chikungunya epidemiology in the philippines demonstrates episodic and focal transmission

Henrik Salje, Simon Cauchemez, Maria Theresa Alera, Isabel Rodriguez-Barraquer, Butsaya Thaisomboonsuk, Anon Srikiatkhachorn, Catherine B. Lago, Daisy Villa, Chonticha Klungthong, Ilya A. Tac-An, Stefan Fernandez, John Mark Velasco, Vito G. Roque, Ananda Nisalak, Louis R. Macareo, Jens W. Levy, Derek Cummings, In Kyu Yoon

Research output: Contribution to journalArticlepeer-review

48 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)604-610
Number of pages7
JournalJournal of Infectious Diseases
Issue number4
StatePublished - Feb 15 2016


  • Philippines
  • chikungunya
  • epidemiology
  • modeling
  • serological study

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases


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