title: Chikungunya virus disease outbreak in Yap State, Federated States of Micronesia.
abstract: Chikungunya virus is a mosquito-borne alphavirus which causes an acute febrile illness associated with polyarthralgia. Beginning in August 2013, clinicians from the Yap State Department of Health in the Federated States of Micronesia (FSM) identified an unusual cluster of illness which was subsequently confirmed to be chikungunya virus disease. Chikungunya virus disease previously had not been recognized in FSM.
  
  
  
  Information from patients presenting to healthcare facilities was collected and analyzed. During August 11, 2013, to August 10, 2014, a total of 1,761 clinical cases were reported for an attack rate of 155 clinical cases per 1,000 population. Among residents of Yap Main Island, 3% were hospitalized. There were no deaths. The outbreak began on Yap Main Island and rapidly spread throughout Yap Main Island and to three neighboring islands.
  
  
  
  Chikungunya virus can cause explosive outbreaks with substantial morbidity. Given the increasing globalization of chikungunya virus, strong surveillance systems and access to laboratory testing are essential to detect outbreaks.
authors.affiliation: Epidemic Intelligence Service Program Office, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America.|Arboviral Diseases Branch, Division of Vector-Borne Diseases (DVBD), CDC, Fort Collins, Colorado, United States of America.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Pastula
authors.affiliation: Yap State Department of Health, Colonia, Yap State, Federated States of Micronesia.
authors.forename: W Thane
authors.initials: WT
authors.lastname: Hancock
authors.affiliation: Yap State Department of Health, Colonia, Yap State, Federated States of Micronesia.
authors.forename: Martin
authors.initials: M
authors.lastname: Bel
authors.affiliation: Epidemic Intelligence Service Program Office, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America.|Rickettsial Zoonoses Branch, DVBD, CDC, Atlanta, Georgia, United States of America.
authors.forename: Holly
authors.initials: H
authors.lastname: Biggs
authors.affiliation: Yap State Department of Health, Colonia, Yap State, Federated States of Micronesia.
authors.forename: Maria
authors.initials: M
authors.lastname: Marfel
authors.affiliation: Arboviral Diseases Branch, Division of Vector-Borne Diseases (DVBD), CDC, Fort Collins, Colorado, United States of America.
authors.forename: Robert
authors.initials: R
authors.lastname: Lanciotti
authors.affiliation: Arboviral Diseases Branch, Division of Vector-Borne Diseases (DVBD), CDC, Fort Collins, Colorado, United States of America.
authors.forename: Janeen
authors.initials: J
authors.lastname: Laven
authors.affiliation: Division of Global Migration and Quarantine, CDC, Honolulu, Hawaii, United States of America.
authors.forename: Tai-Ho
authors.initials: TH
authors.lastname: Chen
authors.affiliation: Arboviral Diseases Branch, Division of Vector-Borne Diseases (DVBD), CDC, Fort Collins, Colorado, United States of America.
authors.forename: J Erin
authors.initials: JE
authors.lastname: Staples
authors.affiliation: Arboviral Diseases Branch, Division of Vector-Borne Diseases (DVBD), CDC, Fort Collins, Colorado, United States of America.
authors.forename: Marc
authors.initials: M
authors.lastname: Fischer
authors.affiliation: Arboviral Diseases Branch, Division of Vector-Borne Diseases (DVBD), CDC, Fort Collins, Colorado, United States of America.
authors.forename: Susan L
authors.identifier: 0000-0003-1408-6047
authors.initials: SL
authors.lastname: Hills
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D065632:Chikungunya Fever / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008849:Micronesia / Q000453:epidemiology; D008875:Middle Aged; D055815:Young Adult