Epidemiology of Dengue, Chikungunya, and Zika Virus Disease in U.S. States and Territories, 2017

Laura E. Adams Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico;

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Stacey W. Martin Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado

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Nicole P. Lindsey Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado

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Jennifer A. Lehman Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado

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Aidsa Rivera Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico;

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Jonathan Kolsin Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado

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Kimberly Landry Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado

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J. Erin Staples Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado

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Tyler M. Sharp Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico;

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Gabriela Paz-Bailey Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico;

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Marc Fischer Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado

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Dengue, chikungunya, and Zika viruses, primarily transmitted by Aedes species mosquitoes, have caused large outbreaks in the Americas, leading to travel-associated cases and local mosquito-borne transmission in the United States. We describe the epidemiology of dengue, chikungunya, and noncongenital Zika virus disease cases reported from U.S. states and territories in 2017, including 971 dengue cases, 195 chikungunya cases, and 1,118 Zika virus disease cases. Cases of all three diseases reported from the territories were reported as resulting from local mosquito-borne transmission. Cases reported from the states were primarily among travelers, with only seven locally acquired mosquito-transmitted Zika virus disease cases reported from Texas (n = 5) and Florida (n = 2). In the territories, most dengue cases (n = 508, 98%) were reported from American Samoa, whereas the majority of chikungunya (n = 39, 100%) and Zika virus disease (n = 620, 93%) cases were reported from Puerto Rico. Temporally, the highest number of Zika virus disease cases occurred at the beginning of the year, followed by a sharp decline, mirroring decreasing case numbers across the Americas following large outbreaks in 2015 and 2016. Dengue and chikungunya cases followed a more seasonal pattern, with higher case numbers from July through September. Travelers to the United States and residents of areas with active virus transmission should be informed of both the ongoing risk from dengue, chikungunya, and Zika virus disease and personal protective measures to lower their risk of mosquito bites and to help prevent the spread of these diseases.

Author Notes

Address correspondence to Stacey W. Martin, Arboviral Diseases Branch, Centers for Disease Control and Prevention, 3156 Rampart Rd., Fort Collins, CO 80521. E-mail: smartin4@cdc.gov

Authors’ addresses: Laura E. Adams, Aidsa Rivera, Tyler M. Sharp, and Gabriela Paz-Bailey, Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico, E-mails: ipb2@cdc.gov, erj2@cdc.gov, iyp4@cdc.gov, and gmb5@cdc.gov. Stacey W. Martin, Nicole P. Lindsey, Jennifer A. Lehman, Jonathan Kolsin, Kimberly Landry, J. Erin Staples, and Marc Fischer, Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, CO, E-mails: zmt0@cdc.gov, frd3@cdc.gov, zjg3@cdc.gov, jonathan.kolsin@dshs.texas.gov, nrn8@cdc.gov, auv1@cdc.gov, and mxf2@cdc.gov.

These authors contributed equally to this work.

  • 1.

    Petersen LR, Jamieson DJ, Powers AM, Honein MA, 2016. Zika virus. N Engl J Med 374: 15521563.

  • 2.

    Staples JE, Breiman RF, Powers AM, 2009. Chikungunya fever: an epidemiological review of a re-emerging infectious disease. Clin Infect Dis 49: 942948.

  • 3.

    Brunkard JM, López JLR, Ramirez J, Cifuentes E, Rothenberg SJ, Hunsperger EA, Moore CG, Brussolo RM, Villarreal NA, Haddad BM, 2007. Dengue fever seroprevalence and risk factors, Texas–Mexico border, 2004. Emerg Infect Dis 13: 1477.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Yactayo S, Staples JE, Millot V, Cibrelus L, Ramon-Pardo P, 2016. Epidemiology of chikungunya in the Americas. J Infect Dis 214 (Suppl 5): S441S445.

  • 5.

    World Health Organization and the Special Programme for Research and Training in Tropical Diseases (TDR), 2009. Dengue Guidelines for Diagnosis, Treatment, Prevention and Control, New edition. Geneva, Switzerland: World Health Organization.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Feldstein LR, Rowhani-Rahbar A, Staples JE, Weaver MR, Halloran ME, Ellis EM, 2017. Persistent arthralgia associated with chikungunya virus outbreak, US Virgin Islands, December 2014–February 2016. Emerg Infect Dis 23: 673676.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    San Martin JL, Brathwaite O, Zambrano B, Solorzano JO, Bouckenooghe A, Dayan GH, Guzman MG, 2010. The epidemiology of dengue in the Americas over the last three decades: a worrisome reality. Am J Trop Med Hyg 82: 128135.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Pan American Health Organization, 2017. Dengue Fever in the Americas: Number of Reported Cases By Country or Territory. Available at: http://www.paho.org/data/index.php/en/mnu-topics/indicadores-dengue-en/dengue-nacional-en/252-dengue-pais-ano-en.html?showall=&start=1. Accessed November 1, 2018.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Jentes ES, Lash RR, Johansson MA, Sharp TM, Henry R, Brady OJ, Sotir MJ, Hay SI, Margolis HS, Brunette GW, 2016. Evidence-based risk assessment and communication: a new global dengue-risk map for travellers and clinicians. J Travel Med 23: taw062.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Centers for Disease Control and Prevention, 2010. Locally acquired dengue-key west, Florida, 2009–2010. MMWR Morb Mortal Wkly Rep 59: 577581.

  • 11.

    Effler PV, Pang L, Kitsutani P, Vorndam V, Nakata M, Ayers T, Elm J, Tom T, Reiter P, Rigau-Perez JG, 2005. Dengue fever, Hawaii, 2001–2002. Emerg Infect Dis 11: 742.

  • 12.

    Rigau-Perez JG, Gubler DJ, Vorndam AV, Clark GG, 1994. Dengue surveillance–United States, 1986–1992. MMWR CDC Surveill Summ 43: 719.

  • 13.

    Ramos MM et al. 2008. Epidemic dengue and dengue hemorrhagic fever at the Texas–Mexico border: results of a household-based seroepidemiologic survey, December 2005. Am J Trop Med Hyg 78: 364369.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Gibney KB, Fischer M, Prince HE, Kramer LD, St George K, Kosoy OL, Laven JJ, Staples JE, 2011. Chikungunya fever in the United States: a fifteen year review of cases. Clin Infect Dis 52: e121e126.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Centers for Disease Control and Prevention, 2018. Chikungunya Virus in the United States. Available at: https://www.cdc.gov/chikungunya/geo/united-states.html. Accessed July 3, 2018.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Lindsey NP, Staples JE, Fischer M, 2018. Chikungunya virus disease among travelers-United States, 2014–2016. Am J Trop Med Hyg 98: 192197.

  • 17.

    Pan American Health Organization, 2018. Chikungunya. Available at: https://www.paho.org/hq/index.php?option=com_topics&view=article&id=343&Itemid=40931&lang=en. Accessed July 3, 2018.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Hennessey MJ, Fischer M, Panella AJ, Kosoy OI, Laven JJ, Lanciotti RS, Staples JE, 2016. Zika virus disease in travelers returning to the United States, 2010–2014. Am J Trop Med Hyg 95: 212215.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Walker WL, Lindsey NP, Lehman JA, Krow-Lucal ER, Rabe IB, Hills SL, Martin SW, Fischer M, Staples JE, 2016. Zika virus disease cases–50 states and the District of Columbia, January 1–July 31, 2016. MMWR Morb Mortal Wkly Rep 65: 983986.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Adams L et al. 2016. Update: ongoing Zika virus transmission–Puerto Rico, November 1, 2015-July 7, 2016. MMWR Morb Mortal Wkly Rep 65: 774779.

  • 21.

    Hall V et al. 2018. Update: noncongenital Zika virus disease cases–50 U.S. States and the District of Columbia, 2016. MMWR Morb Mortal Wkly Rep 67: 265269.

  • 22.

    Hamer DH et al. 2017. Travel-associated Zika virus disease acquired in the Americas through February 2016: a GeoSentinel analysis. Ann Intern Med 166: 99108.

  • 23.

    Wilder-Smith A, Chang CR, Leong WY, 2018. Zika in travellers 1947–2017: a systematic review. J Travel Med 25: 110.

  • 24.

    Centers for Disease Control and Prevention, 2018. Surveillance Case Definitions for Current and Historical Conditions. Available at: https://wwwn.cdc.gov/nndss/conditions/. Accessed July 3, 2018.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Centers for Disease Control and Prevention, 2015. Dengue Virus Infections 2015 Case Definition. Available at: https://wwwn.cdc.gov/nndss/conditions/dengue/case-definition/2015/. Accessed July 3, 2018.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Centers for Disease Control and Prevention, Arboviral Diseases, 2015. Neuroinvasive and Non-neuroinvasive 2015 Case Definition. Available at: https://wwwn.cdc.gov/nndss/conditions/chikungunya-virus-disease/case-definition/2015/. Accessed July 3, 2018.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Centers for Disease Control and Prevention. Zika Virus Disease and Zika Virus Infection 2016 Case Definition. Available at: https://wwwn.cdc.gov/nndss/conditions/zika/case-definition/2016/06/. Accessed July 3, 2018.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Cotter CJ, Tufa AJ, Johnson S, Matai’a M, Sciulli R, Ryff KR, Hancock WT, Whelen C, Sharp TM, Anesi MS, 2018. Outbreak of dengue virus type 2—American Samoa, November 2016–October 2018. MMWR Morb Mortal Wkly Rep 67: 13191322.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Schwartz E, Weld LH, Wilder-Smith A, von Sonnenburg F, Keystone JS, Kain KC, Torresi J, Freedman DO, GeoSentinel Surveillance N, 2008. Seasonality, annual trends, and characteristics of dengue among ill returned travelers, 1997–2006. Emerg Infect Dis 14: 10811088.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Hsu CH et al. 2019. Risk factors for hospitalization of patients with chikungunya virus infection at sentinel hospitals in Puerto Rico. PLoS Negl Trop Dis 13: e0007084.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Kumar A, Best C, Benskin G, 2017. Epidemiology, clinical and laboratory features and course of chikungunya among a cohort of children during the first Caribbean epidemic. J Trop Pediatr 63: 4349.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Rolle A et al. 2016. Severe sepsis and septic shock associated with chikungunya virus infection, Guadeloupe, 2014. Emerg Infect Dis 22: 891894.

  • 33.

    van Genderen FT, Krishnadath I, Sno R, Grunberg MG, Zijlmans W, Adhin MR, 2016. First chikungunya outbreak in Suriname; clinical and epidemiological features. PLoS Negl Trop Dis 10: e0004625.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34.

    Sharp TM, Ryff KR, Alvarado L, Shieh WJ, Zaki SR, Margolis HS, Rivera-Garcia B, 2016. Surveillance for chikungunya and dengue during the first year of chikungunya virus circulation in Puerto Rico. J Infect Dis 214 (Suppl 5): S475S481.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Lozier MJ et al. 2018. Differences in prevalence of symptomatic Zika virus infection, by age and sex-Puerto Rico, 2016. J Infect Dis 217: 16781689.

  • 36.

    Lozier M et al. 2016. Incidence of Zika virus disease by age and sex—Puerto Rico, November 1, 2015–October 20, 2016. MMWR Morb Mortal Wkly Rep 65: 12191223.

  • 37.

    Gordon A et al. 2019. Prior dengue virus infection and risk of Zika: a pediatric cohort in Nicaragua. PLoS Med 16: e1002726.

  • 38.

    Lanciotti RS, Kosoy OL, Laven JJ, Velez JO, Lambert AJ, Johnson AJ, Stanfield SM, Duffy MR, 2008. Genetic and serologic properties of Zika virus associated with an epidemic, Yap state, Micronesia, 2007. Emerg Infect Dis 14: 12321239.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 39.

    Calisher CH, Karabatsos N, Dalrymple JM, Shope RE, Porterfield JS, Westaway EG, Brandt WE, 1989. Antigenic relationships between flaviviruses as determined by cross-neutralization tests with polyclonal antisera. J Gen Virol 70: 3743.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 40.

    Lindsey NP et al. 2018. Ability to serologically confirm recent Zika virus infection in areas with varying past incidence of dengue virus infection in the United States and U.S. territories in 2016. J Clin Microbiol 56: e01115e01117.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 41.

    Griffin I, Martin SW, Fischer M, Chambers TV, Kosoy O, Falise A, Ponomareva O, Gillis LD, Blackmore C, Jean R, 2019. Zika virus IgM detection and neutralizing antibody profiles 12–19 months after illness onset. Emerg Infect Dis 25: 299303.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 42.

    Bowman LR, Donegan S, McCall PJ, 2016. Is dengue vector control deficient in effectiveness or evidence?: Systematic review and meta-analysis. PLoS Negl Trop Dis 10: e0004551.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 43.

    Achee NL, Gould F, Perkins TA, Reiner RC Jr., Morrison AC, Ritchie SA, Gubler DJ, Teyssou R, Scott TW, 2015. A critical assessment of vector control for dengue prevention. PLoS Negl Trop Dis 9: e0003655.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 44.

    Monaghan AJ, Sampson KM, Steinhoff DF, Ernst KC, Ebi KL, Jones B, Hayden MH, 2018. The potential impacts of 21st century climatic and population changes on human exposure to the virus vector mosquito Aedes aegypti. Clim Change 146: 487500.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 45.

    Liu-Helmersson J, Stenlund H, Wilder-Smith A, Rocklov J, 2014. Vectorial capacity of Aedes aegypti: effects of temperature and implications for global dengue epidemic potential. PLoS One 9: e89783.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 46.

    Reiter P, Lathrop S, Bunning M, Biggerstaff B, Singer D, Tiwari T, Baber L, Amador M, Thirion J, Hayes J, 2003. Texas lifestyle limits transmission of dengue virus. Emerg Infect Dis 9: 86.

    • PubMed
    • Search Google Scholar
    • Export Citation
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