Table 1.
Demographic Characteristics, Clinical Signs and Symptoms, and Outcomes of People or Patients With Evidence of Chikungunya Virus Infection, as Gathered by Multiple Surveillance Systems, Puerto Rico, May 2014 – April 2015
| Variable | Household Investigations (n = 59) |
Passive Chikungunya Surveillance System (n = 4399) |
Sentinel Enhanced Dengue Surveillance System (n = 1566) |
Enhanced Fatal AFI Surveillance System (n = 31) |
|---|---|---|---|---|
| Diagnostic methods | ||||
| RT-PCR | 10 (17) | 4397 (100) | 1498 (96) | 31 (100) |
| MAC ELISA | 52 (88) | 2 (<0.1) | 148 (9) | 14 (45) |
| Immunohistochemistry | NT | NT | NT | 11 (35) |
| Demographic characteristics | ||||
| Age | 46 y (9 y–94 y) | 38 y (0 d–101 y) | 25 y (0 d–97 y) | 61 y (6 d–85 y) |
| Male sex | 32 (54) | 1876 (42.6)a | 739 (47.2) | 19 (61) |
| Pregnantb | 1 (2) | 8 (0.2) | 55 (4) | 1 (3) |
| Comorbidities | ||||
| Diabetes | 11 (19) | NC | 170 (11) | 15 (48) |
| Hypertension | 22 (37) | NC | 286 (18) | 16 (52) |
| Obesity | NC | NC | NC | 14 (45) |
| Asthma | 11 (19) | NC | 234 (15) | 4 (13) |
| Joint disease/arthritis | 15 (25) | NC | NC | 4 (13) |
| Lupus | NC | NC | NC | 2 (6) |
| Heart disease | 6 (10) | NC | 91 (6) | 4 (13) |
| Kidney disease | NC | NC | 24 (2) | 5 (16) |
| Signs and symptomsb | ||||
| Fever | 55 (93) | 712 (90) | 1459 (99.6) | 25 (81) |
| Arthralgia | 56 (95) | 627 (79) | 1294 (83) | 19 (61) |
| Myalgia | 48 (81) | 635 (80) | 1263 (81) | 15 (48) |
| Headache | 41 (69) | 544 (68) | 1120 (72) | 8 (26) |
| Eye pain | 18 (31) | 344 (43) | 718 (46) | 3 (10) |
| Anorexia | NC | 157 (20) | 888 (57) | 11 (35) |
| Lethargy | NC | 30 (4) | 1270 (81) | 19 (61) |
| Nausea/vomiting | 19 (32) | 226 (28) | 893 (57) | 7 (26) |
| Rash | 32 (54) | 327 (41) | 970 (62) | 12 (39) |
| Arthritis | 29 (42) | 114 (14) | 694 (44) | 6 (19) |
| Bleeding manifestations | 7 (12) | 220 (28) | 632 (40) | 11 (35) |
| Minorc | 7 (12) | 214 (27) | 102 (6.5) | 11 (35) |
| Majord | 0 (0) | 10 (1) | 1 (<0.1) | 2 (6) |
| Severe manifestationse | 0 (0) | 29 (4) | 46 (2.9) | 14 (27) |
| Clinical outcomesb | ||||
| Duration of illness, d | 6 (2–21) | NC | NC | 6 (1–28) |
| Sought medical care | 25 (63)f | NA | NA | 24 (77) |
| Hospitalized | 3 (12)f | 263 (12) | 171 (10.9) | 12 (39) |
| Duration of hospitalization, d |
7 (3–15)f | NC | … | 2 (0–23) |
| Admitted to ICU | 0 (0) | NC | 8 (0.5) | 8 (26) |
| Death | 0 (0) | 7 (0.1) | 2 (0.1) | 27 (100) |
Data are no. (%) of individuals or median value (range).
Abbreviations: AFI, acute febrile illness; ICU, intensive care unit; MAC ELISA, immunoglobulin M antibody capture enzyme-linked immunosorbent assay; NA, not applicable; NC, not captured; NT, none tested; RT-PCR, reverse transcription–polymerase chain reaction.
Sex was not provided for 472 cases (10.7%).
Cases detected by the Passive Chikungunya Surveillance System only include 795 for which clinical and demographic data were available or 2171 cases for which status of hospitalization was reported. Cases detected by the Enhanced Fatal AFI Surveillance System only include 27 for which data from medical records or family interviews were available.
Petechiae, bleeding gums, epistaxis, unspecified mucosal bleeding, and hematuria.
Purpura/ecchymoses, melena, hematemesis, and vaginal bleeding.
Jaundice, convulsions, effusion, edema, encephalitis, and hepatomegaly.
Data exclude index case patients who were reported to the Puerto Rico Department of Health and associated with subsequently initiated household investigations.