title: The First Reported Outbreak of Chikungunya in the U.S. Virgin Islands, 2014-2015.
abstract: The chikungunya virus (CHIKV) epidemic in the Americas is of significant public health importance due to the lack of effective control and prevention strategies, severe disease morbidity among susceptible populations, and potential for persistent arthralgia and long-term impaired physical functionality. Using surveillance data of suspected CHIKV cases, we describe the first reported outbreak in the U.S. Virgin Islands. CHIKV incidence was highest among individuals aged 55-64 years (13.1 cases per 1,000 population) and lowest among individuals aged 0-14 years (1.8 cases per 1,000 population). Incidence was higher among women compared to men (6.6 and 5.0 cases per 1,000 population, respectively). More than half of reported laboratory-positive cases experienced fever lasting 2-7 days, chills/rigor, myalgia, anorexia, and headache. No clinical symptoms apart from the suspected case definition of fever ≥ 38°C and arthralgia were significantly associated with being a reported laboratory-positive case. These results contribute to our knowledge of demographic risk factors and clinical manifestations of CHIKV disease and may aid in mitigating future CHIKV outbreaks in the Caribbean.
authors.affiliation: Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington.|Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: Leora R
authors.initials: LR
authors.lastname: Feldstein
authors.affiliation: U.S. Virgin Islands Department of Health, Saint Croix, U.S. Virgin Islands.
authors.forename: Esther M
authors.initials: EM
authors.lastname: Ellis
authors.affiliation: Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington.
authors.forename: Ali
authors.initials: A
authors.lastname: Rowhani-Rahbar
authors.affiliation: Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.|Center for Inference and Dynamics of Infectious Diseases, Fred Hutchinson Cancer Research Center, Seattle, Washington.|Department of Biostatistics, School of Public Health, University of Washington, Seattle, Washington.
authors.forename: M Elizabeth
authors.initials: ME
authors.lastname: Halloran
authors.affiliation: U.S. Virgin Islands Department of Health, Saint Croix, U.S. Virgin Islands.
authors.forename: Brett R
authors.initials: BR
authors.lastname: Ellis
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000855:Anorexia / Q000209:etiology; D018771:Arthralgia / Q000209:etiology; D065632:Chikungunya Fever / Q000150:complications / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D023341:Chills / Q000209:etiology; D003430:Cross-Sectional Studies; D004196:Disease Outbreaks; D005260:Female; D005334:Fever / Q000209:etiology; D006261:Headache / Q000209:etiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D063806:Myalgia / Q000209:etiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D014767:United States Virgin Islands / Q000453:epidemiology; D055815:Young Adult