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Pathog Glob Health. 2019 Feb;113(1):27-31. doi: 10.1080/20477724.2019.1574111. Epub 2019 Feb 4.

Excess deaths associated with the 2014 chikungunya epidemic in Jamaica.

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a Faculdade de Medicina São Leopoldo Mandic , Instituto de Pesquisa São Leopoldo Mandic , Campinas , Brasil.
b Departamento de Vigilância em Saúde , Secretaria Municipal de Saúde de Campinas , Campinas , Brasil.
c Inserm Cic 1410 , CHU Réunion , Saint Pierre , France.
d UM 134 PIMIT Processus infectieux en Milieu Insulaire Tropical , Université de La Réunion, CNRS 919, INSERM U 1187, IRD 249), CYROI , Sainte Clotilde , France.
e Faculdade de Ciências Médicas , Universidade Estadual de Campinas , Campinas , Brasil.


Although traditionally chikungunya virus is considered non-fatal, recent studies suggest that there may be in fact underreporting of deaths in some situations. A major chikungunya epidemic hit Jamaica in 2014 but no chikungunya-associated deaths were reported. We assessed the excess of all-cause deaths during this epidemic. Excess deaths were estimated by difference between observed and expected mortality based on the average age-specific mortality rate of 2012-2013, using the 99% confidence interval. There was an excess of 2,499 deaths during the epidemic (91.9/100,000 population), and a strong positive correlation between the monthly incidence of chikungunya and the excess of deaths (Rho = 0.939, p < 0.005). No significant concomitant epidemiological or climatic phenomenon occurred. Chikungunya is a major contributor to morbidity during epidemics and may be an unrecognized cause of death. Thus, it is urgent to review clinical protocols and improve the investigations of specific-cause deaths during chikungunya epidemics. Excess deaths could be a strategic tool for epidemiological surveillance.


Chikungunya; Infectious diseases; Jamaica; arbovirus; epidemiological surveillance; excess deaths; intelligence tools; mortality

[Available on 2020-02-01]
[Indexed for MEDLINE]

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