Long-Term Impact of Chikungunya Virus Infections—Florida, 2014

Monday, June 20, 2016: 2:18 PM
Tikahtnu B, Dena'ina Convention Center
Katherine Kendrick , Florida Department of Health, Tallahassee, FL
Danielle Stanek , Florida Department of Health, Tallahassee, FL
Carina Blackmore , Florida Department of Health, Tallahassee, FL
BACKGROUND: Since the introduction of chikungunya virus to the Americas in December 2013, there has been a sharp increase in the number of chikungunya fever cases reported in Florida. In Africa and Asia, chikungunya virus infections have been reported to cause persistent symptoms including arthralgia and myalgia that last months in some patients. Given the large number of cases and the possibility of long-lasting symptoms, the potential burden of chikungunya virus on Florida’s health care resources could be significant. To better understand the impact of chikungunya virus in Florida, reported cases were followed twelve months after initial infection.

METHODS: The Florida Department of Health interviewed patients by telephone during the acute phase of infection as well as three months after illness onset. Those patients reporting persistent symptoms were interviewed again six months after onset, and again twelve months after onset if still symptomatic at six months. During each follow-up interview, patients were asked if they were still experiencing symptoms, and if so, a variety of questions about health care visits, medication use, loss of work days, and disruption to their daily routines.

RESULTS: Florida reported 510 imported and 12 locally acquired chikungunya fever cases with disease onset in 2014. Of these 522 cases, 393 (88%) were interviewed during the acute phase of infection, and 376 (72%) were interviewed three months after illness onset. One hundred and sixty-nine (45%) patients were still experiencing symptoms at three months, 77 of 329 interviewed (23%) at six months, and 34 of 304 interviewed (11%) at 12 months after illness onset, assuming that once symptoms resolved they did not return. Among patients symptomatic at three months, 67 (52%) sought additional care from a health care provider since their original visit, 96 (75%) took medications to manage their symptoms, 40 (31%) lost some ability to perform work related duties, and 93 (72%) reported that their symptoms disrupted their daily routines. 

CONCLUSIONS: A large proportion of Florida’s chikungunya fever cases are still experiencing symptoms months to a year after infection. These persistent symptoms are not only disruptive to daily lives, but also require additional medical resources to manage. These significant public health impacts would be underestimated if only acute health impacts were assessed.