Reconstruction of 60 Years of Chikungunya Epidemiology in the Philippines Demonstrates Episodic and Focal Transmission.
Reconstruction of 60 Years of Chikungunya Epidemiology in the Philippines Demonstrates Episodic and Focal Transmission.
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DOI：
10.1093/infdis/jiv470
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发表时间：
2016-02-15
期刊：
影响因子：
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通讯作者：
Yoon IK
中科院分区：
文献类型：
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作者：
Salje H;Cauchemez S;Alera MT;Rodriguez-Barraquer I;Thaisomboonsuk B;Srikiatkhachorn A;Lago CB;Villa D;Klungthong C;Tac-An IA;Fernandez S;Velasco JM;Roque VG Jr;Nisalak A;Macareo LR;Levy JW;Cummings D;Yoon IK
对基孔肯雅热长期流行病学的正确理解因监测不力而受到阻碍。暴发年份不可预测，病例经常被误诊。在这里，我们分析了来自菲律宾宿务的2项血清学研究（1973年和2012年）的年龄特异性数据，以重建60年期间（1952-2012年）的年度感染概率和人群水平免疫力。我们还探讨了2012-2013年期间的血清转换是否在空间上聚集。我们的模型确定了4个离散的爆发，平均延迟17年。平均而言，每次爆发时，23%（95%置信区间[CI]，16%-37%）的易感人群被感染，在任何时候，整个人群的50%以上仍然易感。在2012-2013年期间血清转化的参与者聚集在<230 m的距离处，表明局灶性传播。基孔肯雅热的大规模爆发并没有导致持续多年的传播。然而，我们估计监测系统遗漏了35万例以上的感染。血清学研究可以补充监测，为病原体循环提供重要的见解。
Proper understanding of the long-term epidemiology of chikungunya has been hampered by poor surveillance. Outbreak years are unpredictable and cases often misdiagnosed. Here we analyzed age-specific data from 2 serological studies (from 1973 and 2012) in Cebu, Philippines, to reconstruct both the annual probability of infection and population-level immunity over a 60-year period (1952–2012). We also explored whether seroconversions during 2012–2013 were spatially clustered. Our models identified 4 discrete outbreaks separated by an average delay of 17 years. On average, 23% (95% confidence interval [CI], 16%–37%) of the susceptible population was infected per outbreak, with >50% of the entire population remaining susceptible at any point. Participants who seroconverted during 2012–2013 were clustered at distances of <230 m, suggesting focal transmission. Large-scale outbreaks of chikungunya did not result in sustained multiyear transmission. Nevertheless, we estimate that >350 000 infections were missed by surveillance systems. Serological studies could supplement surveillance to provide important insights on pathogen circulation.