[Source: PLoS Neglected Tropical Diseases, full page: (LINK). Abstract, edited.]
OPEN ACCESS / PEER-REVIEWED / RESEARCH ARTICLE
Epidemiology of Chikungunya Virus Outbreaks in Guadeloupe and Martinique, 2014: An Observational Study in Volunteer Blood Donors
Pierre Gallian , Isabelle Leparc-Goffart, Pascale Richard, Françoise Maire, Olivier Flusin, Rachid Djoudi, Jacques Chiaroni, Remi Charrel, Pierre Tiberghien, Xavier de Lamballerie
Published: January 12, 2017 / http://dx.doi.org/10.1371/journal.pntd.0005254
During Dec-2013, a chikungunya virus (CHIKV) outbreak was first detected in the French-West Indies. Subsequently, the virus dispersed to other Caribbean islands, continental America and many islands in the Pacific Ocean. Previous estimates of the attack rate were based on declaration of clinically suspected cases.
Individual testing for CHIKV RNA of all (n = 16,386) blood donations between Feb-24th 2014 and Jan-31st 2015 identified 0·36% and 0·42% of positives in Guadeloupe and Martinique, respectively. The incidence curves faithfully correlated with those of suspected clinical cases in the general population of Guadeloupe (abrupt epidemic peak), but not in Martinique (flatter epidemic growth). No significant relationship was identified between CHIKV RNA detection and age-classes or blood groups. Prospective (Feb-2014 to Jan-2015; n = 9,506) and retrospective (Aug-2013 to Feb-2014; n = 6,559) seroepidemiological surveys in blood donors identified a final seroprevalence of 48·1% in Guadeloupe and 41·9% in Martinique. Retrospective survey also suggested the absence or limited “silent” CHIKV circulation before the outbreak. Parameters associated with increased seroprevalence were: Gender (M>F), KEL-1, [RH+1/KEL-1], [A/RH+1] and [A/RH+1/KEL-1] blood groups in Martiniquan donors. A simulation model based on observed incidence and actual seroprevalence values predicted 2·5 and 2·3 days of asymptomatic viraemia in Martiniquan and Guadeloupian blood donors respectively.
This study, implemented promptly with relatively limited logistical requirements during CHIKV emergence in the Caribbean, provided unique information regarding retrospective and prospective epidemiology, infection risk factors and natural history of the disease. In the stressful context of emerging infectious disease outbreaks, blood donor-based studies can serve as robust and cost-effective first-line tools for public health surveys.
Chikungunya virus (CHIKV) is an emerging mosquito-borne arbovirus responsible of a large outbreak since December 2013 in the Americas from French islands in the Caribbean. Documentation of the epidemic was based on the survey of clinically suspected cases, providing limited information on the incidence of the disease overtime and the herd immunity of the general population at the end of the outbreak. Our study improved blood donors specimen collection and data obtained from the Nucleic Acid Testing (NAT) screening implemented during the outbreak in order to prevent CHIKV transmission by blood products. After an 11 month follow up, we determine for Martinique and Guadeloupe islands the CHIKV-RNA positive rate: 0.42% and 0.36% respectively and the final IgG seroprevalence: 41.2% and 48.1%. Using a simulation model, we estimate the CHIKV duration of asymptomatic viremia to be between 2.3 and 2.5 days. Our findings will help in the comprehension of the natural history of infection and provide helpful data for prevention of Transfusion transmitted infections. Our study provides evidence that monitoring of Chikungunya infection based on NAT screening of voluntary blood donors can be implemented rapidly and provides real-time epidemiological information. This should be of specific relevance to the case of epidemics caused by viral infections with high numbers of asymptomatic forms such as observed with the currently emerging Zika virus.
Citation: Gallian P, Leparc-Goffart I, Richard P, Maire F, Flusin O, Djoudi R, et al. (2017) Epidemiology of Chikungunya Virus Outbreaks in Guadeloupe and Martinique, 2014: An Observational Study in Volunteer Blood Donors. PLoS Negl Trop Dis 11(1): e0005254. doi:10.1371/journal.pntd.0005254
Editor: Marilia Sá Carvalho, Oswaldo Cruz Foundation, BRAZIL
Received: June 9, 2016; Accepted: December 13, 2016; Published: January 12, 2017
Copyright: © 2017 Gallian et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: All relevant data are within the paper and its Supporting Information files.
Funding: This work was supported by Etablissement Français du Sang (EFS), Alliance pour les sciences de la vie et de la santé (AVIESAN), Institut National de la Santé et de la Recherche Médicale (INSERM) and in part by the European programmes PREDEMICS (FP7-n°278433), European Virus Archive goes Global (EVAg, H2020-n°653316) and European Network for Diagnostics of Imported Viral Diseases (ENIVD, European Centre for Disease Prevention and Control). The work of RC was done under the frame of EurNegVec COST Action TD1303. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
Keywords: Chikungunya; Martinique; Guadeloupe.