Volume 99, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



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.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Jupp P, McIntosh B, , 1988. Chikungunya virus disease. The Arboviruses: Epidemiology and Ecology. Boca Raton, FL: CRC Press Inc. Vol. 2, 137–157.
  2. Moro ML, Gagliotti C, Silvi G, Angelini R, Sambri V, Rezza G, Massimiliani E, Mattivi A, Grilli E, Finarelli AC, , 2010. Chikungunya virus in north-eastern Italy: a seroprevalence survey. Am J Trop Med Hyg 82: 508511. [Google Scholar]
  3. Thonnon J, Spiegel A, Diallo M, Diallo A, Fontenille D, , 1999. Chikungunya virus outbreak in Senegal in 1996 and 1997. Bull Soc Pathol Exot 92: 7982. [Google Scholar]
  4. Sergon K, Yahaya AA, Brown J, Bedja SA, Mlindasse M, Agata N, Allaranger Y, Ball MD, Powers AM, Ofula V, , 2007. Seroprevalence of chikungunya virus infection on Grande Comore island, Union of the Comoros, 2005. Am J Trop Med Hyg 76: 11891193. [Google Scholar]
  5. Sergon K, Njuguna C, Kalani R, Ofula V, Onyango C, Konongoi LS, Bedno S, Burke H, Dumilla AM, Konde J, , 2008. Seroprevalence of chikungunya virus (CHIKV) infection on Lamu Island, Kenya, October 2004. Am J Trop Med Hyg 78: 333337. [Google Scholar]
  6. Sissoko D, Moendandze A, Malvy D, Giry C, Ezzedine K, Solet JL, Pierre V, , 2008. Seroprevalence and risk factors of chikungunya virus infection in Mayotte, Indian Ocean, 2005–2006: a population-based survey. PLoS One 3: e3066. [Google Scholar]
  7. Gérardin P, Guernier V, Perrau J, Fianu A, Le Roux K, Grivard P, Michault A, De Lamballerie X, Flahault A, Favier F, , 2008. Estimating chikungunya prevalence in La Reunion island outbreak by serosurveys: two methods for two critical times of the epidemic. BMC Infect Dis 8: 1. [Google Scholar]
  8. Simmons G, Brès V, Lu K, Liss NM, Brambilla DJ, Ryff KR, Bruhn R, Velez E, Ocampo D, Linnen JM, , 2016. High incidence of chikungunya virus and frequency of viremic blood donations during epidemic, Puerto Rico, USA, 2014. Emerg Infect Dis 22: 12211228. [Google Scholar]
  9. Gay N, Rousset D, Huc P, Matheus S, Ledrans M, Rosine J, Cassadou S, Noël H, , 2016. Seroprevalence of Asian lineage chikungunya virus infection on Saint Martin island, 7 months after the 2013 emergence. Am J Trop Med Hyg 94: 393396. [Google Scholar]
  10. Kuan G, Ramirez S, Gresh L, Ojeda S, Melendez M, Sanchez N, Collado D, Garcia N, Mercado JC, Gordon A, , 2016. Seroprevalence of anti-chikungunya virus antibodies in children and adults in Managua, Nicaragua, after the first chikungunya epidemic, 2014–2015. PLoS Negl Trop Dis 10: e0004773. [Google Scholar]
  11. Nakkhara P, Chongsuvivatwong V, Thammapalo S, , 2013. Risk factors for symptomatic and asymptomatic chikungunya infection. Trans R Soc Trop Med Hyg 107: 789796. [Google Scholar]
  12. Robinson MC, , 1955. An epidemic of virus disease in southern province, Tanganyika territory, in 1952–1953. Trans R Soc Trop Med Hyg 49: 2832. [Google Scholar]
  13. De Ranitz C, Myers R, Varkey M, Isaac Z, Carey D, , 1965. Clinical impressions of chikungunya in Vellore gained from study of adult patients. Indian J Med Res 53: 756. [Google Scholar]
  14. Staples JE, Breiman RF, Powers AM, , 2009. Chikungunya fever: an epidemiological review of a re-emerging infectious disease. Clin Infect Dis 49: 942948. [Google Scholar]
  15. Josseran L, Paquet C, Zehgnoun A, Caillere N, Le Tertre A, Solet JL, Ledrans M, , 2006. Chikungunya disease outbreak, Reunion island. Emerg Infect Dis 12: 19941995. [Google Scholar]
  16. Renault P, Josseran L, Pierre V, , 2008. Chikungunya-related fatality rates, Mauritius, India, and Reunion island. Emerg Infect Dis 14: 1327. [Google Scholar]
  17. Freitas ARR, Cavalcanti L, Von Zuben AP, Donalisio MR, , 2017. Excess mortality related to chikungunya epidemics in the context of co-circulation of other arboviruses in Brazil. PLoS Curr 9. [Google Scholar]
  18. Brito CAA, Teixeira MG, , 2017. Increased number of deaths during a chikungunya epidemic in Pernambuco, Brazil. Mem Inst Oswaldo Cruz 112: 650651. [Google Scholar]
  19. Schilte C, Staikovsky F, Couderc T, Madec Y, Carpentier F, Kassab S, Albert ML, Lecuit M, Michault A, , 2013. Chikungunya virus-associated long-term arthralgia: a 36-month prospective longitudinal study. PLoS Negl Trop Dis 7: e2137. [Google Scholar]
  20. Zim MM, Sam I-C, Omar SS, Chan Y, AbuBakar S, Kamarulzaman A, , 2013. Chikungunya infection in Malaysia: comparison with dengue infection in adults and predictors of persistent arthralgia. J Clin Virol 56: 141145. [Google Scholar]
  21. Win M, Chow A, Dimatatac F, Go C, Leo Y, , 2010. Chikungunya fever in Singapore: acute clinical and laboratory features, and factors associated with persistent arthralgia. J Clin Virol 49: 111114. [Google Scholar]
  22. Moro M, Grilli E, Corvetta A, Silvi G, Angelini R, Mascella F, Miserocchi F, Sambo P, Finarelli A, Sambri V, , 2012. Long-term chikungunya infection clinical manifestations after an outbreak in Italy: a prognostic cohort study. J Infect 65: 165172. [Google Scholar]
  23. Hoarau J-J, Bandjee M-CJ, Trotot PK, Das T, Li-Pat-Yuen G, Dassa B, Denizot M, Guichard E, Ribera A, Henni T, , 2010. Persistent chronic inflammation and infection by chikungunya arthritogenic alphavirus in spite of a robust host immune response. J Immunol 184: 59145927. [Google Scholar]
  24. Sissoko D, Malvy D, Ezzedine K, Renault P, Moscetti F, Ledrans M, Pierre V, , 2009. Post-epidemic chikungunya disease on Reunion island: course of rheumatic manifestations and associated factors over a 15-month period. PLoS Negl Trop Dis 3: e389. [Google Scholar]
  25. Gérardin P, Fianu A, Malvy D, Mussard C, Boussaïd K, Rollot O, Michault A, Gaüzere B-A, Bréart G, Favier F, , 2011. Perceived morbidity and community burden after a chikungunya outbreak: the TELECHIK survey, a population-based cohort study. BMC Med 9: 1. [Google Scholar]
  26. Essackjee K, Goorah S, Ramchurn SK, Cheeneebash J, Walker-Bone K, , 2013. Prevalence of and risk factors for chronic arthralgia and rheumatoid-like polyarthritis more than 2 years after infection with chikungunya virus. Postgrad Med J 89: 440447. [Google Scholar]
  27. Borgherini G, Poubeau P, Jossaume A, Gouix A, Cotte L, Michault A, Arvin-Berod C, Paganin F, , 2008. Persistent arthralgia associated with chikungunya virus: a study of 88 adult patients on Reunion island. Clin Infect Dis 47: 469475. [Google Scholar]
  28. Chopra A, Anuradha V, Lagoo‐Joshi V, Kunjir V, Salvi S, Saluja M, , 2008. Chikungunya virus aches and pains: an emerging challenge. Arthritis Rheum 58: 29212922. [Google Scholar]
  29. Larrieu S, Pouderoux N, Pistone T, Filleul L, Receveur M-C, Sissoko D, Ezzedine K, Malvy D, , 2010. Factors associated with persistence of arthralgia among chikungunya virus-infected travellers: report of 42 French cases. J Clin Virol 47: 8588. [Google Scholar]
  30. Thiberville S-D, Moyen N, Dupuis-Maguiraga L, Nougairede A, Gould EA, Roques P, de Lamballerie X, , 2013. Chikungunya fever: epidemiology, clinical syndrome, pathogenesis and therapy. Antiviral Res 99: 345370. [Google Scholar]
  31. Pan American Health Organization, 2015. Number of Reported Cases of Chikungunya Fever in the Americas, by Country or Territory, 2013–2014 Cumulative Cases. Available at: http://www.paho.org/hq/index.php?option=com_topics&view=rdmore&cid=7928&Itemid=40931&lang=en. Accessed May 23, 2017.
  32. U.S. Census Bureau, 2015. 2010 Census Island Areas: United States Virgin Islands. Available at: https://www.census.gov/2010census/news/press-kits/island-areas/island-areas.html. Accessed May 23, 2017.
  33. Ramful D, Sampériz S, Fritel X, Michault A, Jaffar-Bandjee MC, Rollot O, Boumahni B, Gérardin P, , 2014. Antibody kinetics in infants exposed to chikungunya virus infection during pregnancy reveals absence of congenital infection. J Infect Dis 209: 17261730. [Google Scholar]
  34. Johnson AJ, Martin DA, Karabatsos N, Roehrig JT, , 2000. Detection of anti-arboviral immunoglobulin G by using a monoclonal antibody-based capture enzyme-linked immunosorbent assay. J Clin Microbiol 38: 18271831. [Google Scholar]
  35. Beaty BJ, Calisher CH, Shope RE, Lennette EH, Lennette DA, Lennette ET, , 1995. Arboviruses. , eds. Diagnostic Procedures for Viral, Rickettsial and Chlamydial Infections. Seventh edition. Washington, DC: American Public Health Association, 189212. [Google Scholar]
  36. Lanciotti RS, Kosoy OL, Laven JJ, Panella AJ, Velez JO, Lambert AJ, Campbell GL, , 2006. Chikungunya virus in US travelers returning from India, 2006. Emerg Infect Dis 13: 764767. [Google Scholar]
  37. Harris PA, Taylor R, Thielke R, Payne P, Gonzalez N, Conde JG, , 2009. Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42: 377381. [Google Scholar]
  38. Angelini R, Finarelli A, Angelini P, Po C, Petropulacos K, Silvi G, Macini P, Fortuna C, Venturi G, Magurano F, , 2007. Chikungunya in north-eastern Italy: a summing up of the outbreak. Euro Surveill 12: E071122. [Google Scholar]
  39. Setbon M, Raude J, , 2008. Chikungunya on Reunion island: social, environmental, and behavioural factors in an epidemic context. Population-E 63: 491518. [Google Scholar]
  40. Fred A, SEROCHIK Group , 2018. Individual and contextual risk factors for chikungunya virus infection: the SEROCHIK cross-sectional population-based study. Epidemiol Infect 146: 10561064. [Google Scholar]
  41. Mulligan K, Dixon J, Joanna Sinn C-L, Elliott SJ, , 2015. Is dengue a disease of poverty? A systematic review. Pathog Glob Health 109: 1018. [Google Scholar]
  42. Marfin AA, Bleed DM, Lofgren JP, Olin AC, Savage HM, Smith GC, Moore PS, Karabatsos N, Tsai TF, , 1993. Epidemiologic aspects of a St. Louis encephalitis epidemic in Jefferson County Arkansas, 1991. Am J Trop Med Hyg 49: 3037. [Google Scholar]
  43. Raude J, Setbon M, , 2009. The role of environmental and individual factors in the social epidemiology of chikungunya disease on Mayotte island. Health Place 15: 659669. [Google Scholar]
  44. Barrera R, Amador M, Diaz A, Smith J, Munoz-Jordan J, Rosario Y, , 2008. Unusual productivity of Aedes aegypti in septic tanks and its implications for dengue control. Med Vet Entomol 22: 6269. [Google Scholar]
  45. Ayu SM, Lai LR, Chan YF, Hatim A, Hairi NN, Ayob A, Sam I-C, , 2010. Seroprevalence survey of chikungunya virus in Bagan Panchor, Malaysia. Am J Trop Med Hyg 83: 12451248. [Google Scholar]

Data & Media loading...

  • Received : 23 May 2018
  • Accepted : 04 Aug 2018
  • Published online : 17 Sep 2018

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error