title: Clinical and Serological Insights from the Asian Lineage Chikungunya Outbreak in Grenada, 2014: An Observational Study.
abstract: Chikungunya virus (CHIKV) spread rapidly throughout the Caribbean region in 2014, and the first serologically confirmed case was seen in Grenada in July. This study investigated the outbreak of CHIKV in Grenada to identify the distinguishing clinical manifestations and the symptoms that corresponded the closest with serological test results. Sera were tested by IgM enzyme-linked immunosorbent assay and polymerase chain reaction to distinguish between cases positive or negative for CHIKV. Of 493 cases, 426 (86%) tested positive for CHIKV. The diagnostic decision rule, "Define as CHIKV positive a patient presenting with joint pain and any combination of fever, body pain, or rash," produced the closest agreement (85%) with the serological test results (Cohen's kappa, k = 0.289, P value < 0.001). When laboratory facilities are not available for diagnostic confirmation, syndromic surveillance using these four symptoms could be useful to define cases during a CHIKV outbreak when CHIKV is the predominant circulating arbovirus.
authors.affiliation: St. George's University School of Medicine, Saint George, Grenada. Windward Islands Research and Education Foundation, Saint George, Grenada. cmacpherson@sgu.edu.
authors.forename: Calum
authors.initials: C
authors.lastname: Macpherson
authors.affiliation: St. George's University School of Medicine, Saint George, Grenada. Windward Islands Research and Education Foundation, Saint George, Grenada.
authors.forename: Trevor
authors.initials: T
authors.lastname: Noël
authors.affiliation: Windward Islands Research and Education Foundation, Saint George, Grenada.
authors.forename: Paul
authors.initials: P
authors.lastname: Fields
authors.affiliation: St. George's University School of Medicine, Saint George, Grenada.
authors.forename: Donald
authors.initials: D
authors.lastname: Jungkind
authors.affiliation: St. George's University School of Medicine, Saint George, Grenada.
authors.forename: Katherine
authors.initials: K
authors.lastname: Yearwood
authors.affiliation: Naval Medical Research Center, Silver Spring, Maryland.
authors.forename: Monika
authors.initials: M
authors.lastname: Simmons
authors.affiliation: Naval Medical Research Center, Silver Spring, Maryland.
authors.forename: Susana
authors.initials: S
authors.lastname: Widjaja
authors.affiliation: Ministry of Health, Saint George, Grenada.
authors.forename: George
authors.initials: G
authors.lastname: Mitchell
authors.affiliation: St. George's University School of Medicine, Saint George, Grenada. Ministry of Health, Saint George, Grenada.
authors.forename: Dolland
authors.initials: D
authors.lastname: Noel
authors.affiliation: St. George's University School of Medicine, Saint George, Grenada. Windward Islands Research and Education Foundation, Saint George, Grenada.
authors.forename: Satesh
authors.initials: S
authors.lastname: Bidaisee
authors.affiliation: Naval Medical Research Center, Silver Spring, Maryland.
authors.forename: Todd E
authors.initials: TE
authors.lastname: Myers
authors.affiliation: Stanford University, Stanford, California.
authors.forename: A Desiree
authors.initials: AD
authors.lastname: LaBeaud
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000276:immunology*; D018771:Arthralgia / Q000209:etiology; D065632:Chikungunya Fever / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000276:immunology; D002646:Chikungunya virus / Q000235:genetics / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D023341:Chills / Q000209:etiology; D004196:Disease Outbreaks; D004797:Enzyme-Linked Immunosorbent Assay; D005076:Exanthema / Q000209:etiology; D005260:Female; D005334:Fever / Q000209:etiology; D019425:Grenada / Q000453:epidemiology; D006261:Headache / Q000209:etiology; D006801:Humans; D007075:Immunoglobulin M / Q000276:immunology*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D060885:Multiplex Polymerase Chain Reaction; D063806:Myalgia / Q000209:etiology; D012367:RNA, Viral / Q000097:blood*; D012737:Sex Factors; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D007075:Immunoglobulin M; D012367:RNA, Viral