Excess deaths associated with the 2014 chikungunya epidemic in Jamaica

Freitas, André Ricardo Ribas; Gérardin, Patrick; Kassar, Luiza; Donalísio, Maria Rita

doi:10.1080/20477724.2019.1574111

Cited by 20 publications

(16 citation statements)

References 26 publications

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“…Arthritogenic alphaviruses produce a disease that is characterized by fever, myalgia, and polyarthralgia, which can last for months or even years [6,7]. Recent CHIKV epidemics have been associated with an increased number of deaths, suggesting that severe disease may be more common than is typically thought [8–10]. While the rise in global travel, the spread of mosquito vectors, and climate change are likely involved in the expansion of these viruses, it is conceivable that changes in human health have also facilitated spread.…”

Section: Introductionmentioning

confidence: 99%

Host nutritional status affects alphavirus virulence, transmission, and evolution

et al. 2019

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Malnourishment, specifically overweight/obesity and undernourishment, affects more than 2.5 billion people worldwide, with the number affected ever-increasing. Concurrently, emerging viral diseases, particularly those that are mosquito-borne, have spread dramatically in the past several decades, culminating in outbreaks of several viruses worldwide. Both forms of malnourishment are known to lead to an aberrant immune response, which can worsen disease outcomes and reduce vaccination efficacy for viral pathogens such as influenza and measles. Given the increasing rates of malnutrition and spread of arthropod-borne viruses (arboviruses), there is an urgent need to understand the role of host nutrition on the infection, virulence, and transmission of these viruses. To address this gap in knowledge, we infected lean, obese, and undernourished mice with arthritogenic arboviruses from the genus Alphavirus and assessed morbidity, virus replication, transmission, and evolution. Obesity and undernourishment did not consistently influence virus replication in the blood of infected animals except for reductions in virus in obese mice late in infection. However, morbidity was increased in obese mice under all conditions. Using Mayaro virus (MAYV) as a model arthritogenic alphavirus, we determined that both obese and undernourished mice transmit virus less efficiently to mosquitoes than control (lean) mice. In addition, viral genetic diversity and replicative fitness were reduced in virus isolated from obese compared to lean controls. Taken together, nutrition appears to alter the course of alphavirus infection and should be considered as a critical environmental factor during outbreaks.

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Section: Introductionmentioning

confidence: 99%

Host nutritional status affects alphavirus virulence, transmission, and evolution

et al. 2019

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“…These findings are consistent with reporting of mortality in previous unexpected epidemics or catastrophic events. During the Chikungunya epidemic in Jamaica, no chikungunya-associated deaths were reported despite an excess of 2499 deaths [ 16 ]. The mortality burden of 1139 excess deaths due to Hurricane Maria in Puerto Rico in 2017 was higher than the official death toll of 64 [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Underestimation of COVID-19 mortality during the pandemic

et al. 2020

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BackgroundThere has been considerable international variation in mortality during the COVID-19 pandemic. The objective of this study was to investigate the differences between mortality registered as due to COVID-19 and the excess all-cause mortality reported in countries worldwide during the COVID-19 pandemic.MethodsEcological analysis of 22 countries compared five-year historical all-cause mortality, reported all-cause mortality and expected all-cause mortality (calculated as the historical mortality plus the reported deaths attributed to COVID-19). Data available from the first week of January 2020 to that most recently available were analysed.ResultsCompared to the preceding five years, there was an excess of 716 616 deaths of which 64.3% were attributed to COVID-19. The proportion of deaths registered as COVID-19 related/excess deaths varied markedly between countries, ranging between 30% and 197% in those countries that had an excess of deaths during the period of observation. In most countries where a definite peak in COVID-19 related deaths occurred, the increase in reported all-cause mortality preceded the increase in COVID-19 reported mortality. During the latter period of observation, a few countries reported fewer all-cause deaths than the historical figures.ConclusionThe increases in all-cause mortality preceded the increase in COVID-19 mortality in most countries that had definite spikes in COVID-19 mortality. The number of deaths attributed to COVID-19 was underestimated by at least 35%. Together these findings suggest that calculation of excess all-cause mortality is a better predictor of COVID-19 mortality than the reported rates, in those countries experiencing definite increases in mortality.

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“…The 2014 Jamaican CHIKV-WH strain caused excessive deaths, especially in children under four years of age, during the 2014 outbreak [70]. The death toll in Jamaica was 10 times greater than the reported CHIKV-fatalities of all Western hemisphere reports combined [70]. Many infants and children presented with fever, arthralgia, and a marked absence of rash or other cutaneous symptoms [68].…”

Section: Chikv In Neonates and Children After Global Expansionmentioning

confidence: 99%

Chikungunya in Infants and Children: Is Pathogenesis Increasing?

Barr

Vaidhyanathan

2019

Viruses

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Chikungunya virus (CHIKV) was first extensively described in children during outbreaks in India and South Asia during the mid-1960s. Prior to the 2005 emergence of CHIKV on Reunion Island, CHIKV infection was usually described as a dengue-like illness with arthralgia in Africa and febrile hemorrhagic disease in Asia. Soon after the 2005 emergence, severe CNS consequences from vertical and perinatal transmission were described and as CHIKV continued to emerge in new areas over the next 10 years, severe manifestation of infection and sequelae were increasingly reported in infants and neonates. The following review describes the global reemergence and the syndromes of Chikungunya fever (CHIKF) in infants and children. The various manifestations of CHIKF are described and connected to the viral lineage that was documented in the area at the time the disease was described. The data show that certain manifestations of CHIKF occur with specific viral lineages and genetic motifs, which suggests that severe manifestations of CHIKF in the very young may be associated with the emergence of new viral lineages.

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Excess deaths associated with the 2014 chikungunya epidemic in Jamaica

Cited by 20 publications

References 26 publications

Host nutritional status affects alphavirus virulence, transmission, and evolution

Host nutritional status affects alphavirus virulence, transmission, and evolution

Underestimation of COVID-19 mortality during the pandemic

Chikungunya in Infants and Children: Is Pathogenesis Increasing?

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