Volume 28, Number 8—August 2022
Seroprevalence of Chikungunya Virus, Jamaica, and New Tools for Surveillance
To the Editor: We read with great interest the recent article by Anzinger et al. (1), who found a seroprevalence of 83.6% for chikungunya in pregnant women in the metropolitan region of Kingston, Jamaica. These data are similar to the seroprevalence found nationwide by the Jamaica Health and Lifestyle Survey III, 2016–2017 (Ministry of Health and Welfare, Jamaica), which was 82% among women, 78.5% among men, and 80.4% overall. These values enable estimating a total of 2,187,325 chikungunya infections in Jamaica during the 2014 epidemic. The government of Jamaica reported 1,420 cases of chikungunya to PAHO in 2014 and no deaths (2), even correcting for the proportion of unapparent infections, the proportion of cases captured by passive surveillance was <0.1%. Although there were no officially reported deaths in Jamaica, 2 cases of newborn deaths from chikungunya were reported (3), and 1 study found 2,499 excess deaths (2) during the epidemic period. The increase in mortality was greater for the extremes of age, but it occurred in several age groups (2).
Anzinger et al.’s results reinforce the findings of Sharp et al. (4), who showed the importance of active surveillance to assess chikungunya burden. Through active surveillance implemented in Puerto Rico, it was possible to verify that 8% of symptomatic cases of chikungunya identified were captured by passive surveillance. In addition, passive surveillance identified 7 deaths, whereas active surveillance was able to confirm 31 deaths from chikungunya. However, 1,310 excess deaths were reported during the Puerto Rico epidemic in 2014 (5).
The introduction of chikungunya in the Americas has brought greater complexity to surveillance in the region, which includes some low-resource countries. It is essential to establish active and viable surveillance tools and, perhaps, new case definitions in order to better assess the population burden of this disease and the complications of acute and chronic cases.
- Anzinger JJ, Mears CD, Ades AE, Francis K, Phillips Y, Leys YE, et al.; ZIKAction Consortium1,2. ZIKAction Consortium1,2. Antenatal seroprevalence of Zika and chikungunya viruses, Kingston metropolitan area, Jamaica, 2017–2019. Emerg Infect Dis. 2022;28:473–5. DOIPubMedGoogle Scholar
- Freitas ARR, Gérardin P, Kassar L, Donalisio MR. Excess deaths associated with the 2014 chikungunya epidemic in Jamaica. Pathog Glob Health. 2019;113:27–31. DOIPubMedGoogle Scholar
- Evans-Gilbert T. Chikungunya and neonatal immunity: fatal vertically transmitted chikungunya infection. Am J Trop Med Hyg. 2017;96:913–5. DOIPubMedGoogle Scholar
- Sharp TM, Ryff KR, Alvarado L, Shieh W-J, Zaki SR, Margolis HS, et al. Surveillance for chikungunya and dengue during the first year of chikungunya virus circulation in Puerto Rico. J Infect Dis. 2016;214(suppl 5):S475–81. DOIPubMedGoogle Scholar
- Freitas ARR, Donalisio MR, Alarcón-Elbal PM. Excess mortality and causes associated with chikungunya, Puerto Rico, 2014–2015. Emerg Infect Dis. 2018;24:2352–5. DOIPubMedGoogle Scholar
Original Publication Date: July 11, 2022
Table of Contents – Volume 28, Number 8—August 2022
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Please use the form below to submit correspondence to the authors or contact them at the following address:
Andre Ricardo Ribas Freitas, School of Medicine San Leopoldo Mandic—Department of Social Medicine, R. Dr. José Rocha Junqueira, 13—Swift, Campinas, SP, São Paulo 13045-755, Brazil