Seroprevalence and Symptomatic Attack Rate of Chikungunya Virus Infection, United States Virgin Islands, 2014–2015

Morgan J. Hennessey Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado;
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia;

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Esther M. Ellis United States Virgin Islands Department of Health, St. Croix U.S. Virgin Islands;

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Mark J. Delorey Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado;

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Amanda J. Panella Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado;

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Olga I. Kosoy Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado;

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Hannah L. Kirking Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia;

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Grace D. Appiah Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia;

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Jin Qin Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia;

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Alison J. Basile Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado;

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Leora R. Feldstein Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington

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Brad J. Biggerstaff Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado;

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Robert S. Lanciotti Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado;

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Marc Fischer Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado;

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J. Erin Staples Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado;

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When introduced into a naïve population, chikungunya virus generally spreads rapidly, causing large outbreaks of fever and severe polyarthralgia. We randomly selected households in the U.S. Virgin Islands (USVI) to estimate seroprevalence and symptomatic attack rate for chikungunya virus infection at approximately 1 year following the introduction of the virus. Eligible household members were administered a questionnaire and tested for chikungunya virus antibodies. Estimated proportions were calibrated to age and gender of the population. We enrolled 509 participants. The weighted infection rate was 31% (95% confidence interval [CI]: 26–36%). Among those with evidence of chikungunya virus infection, 72% (95% CI: 65–80%) reported symptomatic illness and 31% (95% CI: 23–38%) reported joint pain at least once per week approximately 1 year following the introduction of the virus to USVI. Comparing rates from infected and noninfected study participants, 70% (95% CI: 62–79%) of fever and polyarthralgia and 23% (95% CI: 9–37%) of continuing joint pain in patients infected with chikungunya virus were due to their infection. Overall, an estimated 43% (95% CI: 33–52%) of the febrile illness and polyarthralgia in the USVI population during the outbreak was attributable to chikungunya virus and only 12% (95% CI: 7–17%) of longer term joint pains were attributed to chikungunya virus. Although the rates of infection, symptomatic disease, and longer term joint symptoms identified in USVI are similar to other outbreaks of the disease, a lower proportion of acute fever and joint pain was found to be attributable to chikungunya virus.

Author Notes

Address correspondence to J. Erin Staples, Arboviral Diseases Branch, Centers for Disease Control and Prevention, 3156 Rampart Rd., Fort Collins, CO 80521. E-mail: estaples@cdc.gov

Disclosure: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention or the U.S. Virgin Islands Department of Health.

Authors’ addresses: Morgan J. Hennessey, Center for Epidemiology and Animal Health, United States Department of Agriculture, Fort Collins, CO, E-mail: morgan.j.hennessey@aphis.usda.gov. Esther M. Ellis, United States Virgin Islands Department of Health, Charles Harwood Medical Complex, Christiansted, VI, E-mail: esther.ellis@doh.vi.gov. Mark J. Delorey, Amanda J. Panella, Olga I. Kosoy, Alison J. Basile, Brad J. Biggerstaff, Robert S. Lanciotti, Marc Fischer, and J. Erin Staples, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, E-mails: esy7@cdc.gov, ahf6@cdc.gov, oak3@cdc.gov, ajj1@cdc.gov, bkb5@cdc.gov, rsl2@cdc.gov, mxf2@cdc.gov, and auv1@cdc.gov. Hannah L. Kirking, Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: hrj7@cdc.gov. Grace D. Appiah, Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: ydg3@cdc.gov. Jin Qin, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: wyv0@cdc.gov. Leora R. Feldstein, Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: nqw5@cdc.gov.

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