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Clin Infect Dis. 2019 Mar 5;68(6):919-926. doi: 10.1093/cid/ciy582.

Clinical and Epidemiologic Patterns of Chikungunya Virus Infection and Coincident Arboviral Disease in a School Cohort in Haiti, 2014-2015.

Author information

1
Emerging Pathogens Institute, College of Public Health and Health Professions and College of Medicine.
2
Department of Epidemiology, College of Public Health and Health Professions and College of Medicine.
3
Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville.
4
Christianville School Clinic, Christianville Foundation, Gressier, Haiti.
5
Department of Biology, College of Liberal Arts and Sciences.
6
Department of Medicine, College of Medicine.
7
Department of Health Services Research, Management, and Policy, College of Public Health and Health Professions, University of Florida, Gainesville.

Abstract

BACKGROUND:

Beginning in December 2013, an epidemic of chikungunya virus (CHIKV) infection spread across the Caribbean and into virtually all countries in the Western hemisphere, with >2.4 million cases reported through the end of 2017.

METHODS:

We monitored a cohort of school children in rural Haiti from May 2014, through February 2015, for occurrence of acute undifferentiated febrile illness, with clinical and laboratory data available for 252 illness episodes.

RESULTS:

Our findings document passage of the major CHIKV epidemic between May and July 2014, with 82 laboratory-confirmed cases. Subsequent peaks of febrile illness were found to incorporate smaller outbreaks of dengue virus serotypes 1 and 4 and Zika virus, with identification of additional infections with Mayaro virus, enterovirus D68, and coronavirus NL63. CHIKV and dengue virus serotype 1 infections were more common in older children, with a complaint of arthralgia serving as a significant predictor for infection with CHIKV (odds ratio, 16.2; 95% confidence interval, 8.0-34.4; positive predictive value, 66%; negative predictive value, 80%).

CONCLUSIONS:

Viral/arboviral infections were characterized by a pattern of recurrent outbreaks and case clusters, with the CHIKV epidemic representing just one of several arboviral agents moving through the population. Although clinical presentations of these agents are similar, arthralgias are highly suggestive of CHIKV infection.

KEYWORDS:

Haiti; arbovirus; chikungunya virus

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