Clinical and Serological Insights from the Asian Lineage Chikungunya Outbreak in Grenada, 2014: An Observational Study

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...

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Bibliographic Details
Published in:The American journal of tropical medicine and hygiene 2016-10, Vol.95 (4), p.890-893
Main Authors: Macpherson, Calum, Noël, Trevor, Fields, Paul, Jungkind, Donald, Yearwood, Katherine, Simmons, Monika, Widjaja, Susana, Mitchell, George, Noel, Dolland, Bidaisee, Satesh, Myers, Todd E, LaBeaud, A Desiree
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Antibodies, Viral - immunology
Arbovirus
Arthralgia - etiology
Chikungunya Fever - blood
Chikungunya Fever - complications
Chikungunya Fever - epidemiology
Chikungunya Fever - immunology
Chikungunya virus
Chikungunya virus - genetics
Chikungunya virus - immunology
Child
Child, Preschool
Chills - etiology
Disease Outbreaks
Enzyme-Linked Immunosorbent Assay
Exanthema - etiology
Female
Fever - etiology
Grenada - epidemiology
Headache - etiology
Humans
Immunoglobulin M - immunology
Infant
Infant, Newborn
Male
Middle Aged
Multiplex Polymerase Chain Reaction
Myalgia - etiology
RNA, Viral - blood
Sex Factors
Young Adult
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Summary: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.
ISSN:0002-9637
1476-1645
DOI:10.4269/ajtmh.16-0122