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.