title: Perceived morbidity and community burden after a Chikungunya outbreak: the TELECHIK survey, a population-based cohort study.
abstract: BACKGROUND
  Persistent disabilities are key manifestations of Chikungunya virus (CHIKV) infection, especially incapacitating polyarthralgia and fatigue. So far, little is known about their impact on health status. The present study aimed at describing the burden of CHIKV prolonged or late-onset symptoms on the self-perceived health of La Réunion islanders.
  
  
  METHODS
  At 18 months after an outbreak of Chikungunya virus, we implemented the TELECHIK survey; a retrospective cohort study conducted on a random sample of the representative SEROCHIK population-based survey. A total of 1,094 subjects sampled for CHIKV-specific IgG antibodies in the setting of La Réunion island in the Indian Ocean, between August 2006 and October 2006, were interviewed about current symptoms divided into musculoskeletal/rheumatic, fatigue, cerebral, sensorineural, digestive and dermatological categories.
  
  
  RESULTS
  At the time of interview, 43% of seropositive (CHIK+) subjects reported musculoskeletal pain (vs 17% of seronegative (CHIK-) subjects, P < 0.001), 54% fatigue (vs 46%, P = 0.04), 75% cerebral disorders (vs 57%, P < 0.001), 49% sensorineural impairments (vs 37%, P = 0.001), 18% digestive complaints (vs 15%, P = 0.21), and 36% skin involvement (vs 34%, P = 0.20) on average 2 years after infection (range: 15-34 months). After controlling for confounders such as age, gender, body mass index or major comorbidities in different Poisson regression models, 33% of joint pains were attributable to CHIKV, 10% of cerebral disorders and 7.5% of sensorineural impairments, while Chikungunya did not enhance fatigue states, digestive and skin disorders.
  
  
  CONCLUSIONS
  On average, 2 years after infection 43% to 75% of infected people reported prolonged or late-onset symptoms highly attributable to CHIKV. These manifestations carry a significant burden in the community in the fields of rheumatology, neurology and sensorineural health.
authors.affiliation: Centre for Clinical Investigation-Clinical Epidemiology (CIC-EC) of La Réunion (INSERM/CHR/URMLR), Saint Pierre, La Réunion, France. patrick.gerardin@chr-reunion.fr
authors.forename: Patrick
authors.initials: P
authors.lastname: Gérardin
authors.forename: Adrian
authors.initials: A
authors.lastname: Fianu
authors.forename: Denis
authors.initials: D
authors.lastname: Malvy
authors.forename: Corinne
authors.initials: C
authors.lastname: Mussard
authors.forename: Karim
authors.initials: K
authors.lastname: Boussaïd
authors.forename: Olivier
authors.initials: O
authors.lastname: Rollot
authors.forename: Alain
authors.initials: A
authors.lastname: Michault
authors.forename: Bernard-Alex
authors.initials: BA
authors.lastname: Gaüzere
authors.forename: Gérard
authors.initials: G
authors.lastname: Bréart
authors.forename: François
authors.initials: F
authors.lastname: Favier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018354:Alphavirus Infections / Q000150:complications / Q000453:epidemiology; D065632:Chikungunya Fever; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D017281:Cost of Illness; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D005221:Fatigue / Q000150:complications / Q000453:epidemiology; D006306:Health Surveys / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D015995:Prevalence; D012111:Residence Characteristics; D017508:Reunion / Q000453:epidemiology; D012216:Rheumatic Diseases / Q000150:complications / Q000453:epidemiology; D013689:Telephone; D013997:Time Factors; D055815:Young Adult