Duncan Jacqueline, Gordon-Johnson Kelly Ann, Tulloch-Reid Marshall K, Cunningham-Myrie Colette, Ernst Kacey, McMorris Nathlee, Grant Andriene, Graham Marcia, Chin Daisylyn, Webster-Kerr Karen
Kingston & St. Andrew Health Department, Kingston, Jamaica.
Ministry of Health, Kingston, Jamaica.
Rev Panam Salud Publica. 2017 Aug 21;41:e60. doi: 10.26633/RPSP.2017.60.
To describe the clinical presentation of chikungunya virus (CHIKV) illness in adults during the 2014 outbreak in Jamaica and to determine the predictive value of the case definition.
A cross-sectional study was conducted using clinical data from suspected cases of CHIKV that were reported to the Ministry of Health in April - December 2014. In addition, charts were reviewed of all individuals over 15 years of age with suspected CHIKV based on a diagnosis of CHIKV or "acute viral illness" that presented to four major health centers in Jamaica during the week prior to and the peak week of the epidemic. Data abstracted from these charts using a modified CHIKV Case Investigation Form included demographics, clinical findings, and laboratory tests.
In 2014, the Ministry of Health of Jamaica received 4 447 notifications of CHIKV infection. PCR testing was conducted on 137 suspected CHIKV cases (56 men and 81 women; median age 28 years) and was positive for 89 (65%) persons. In all, 205 health charts were identified that met the selection criteria (51 men and 154 women, median age 43 years). The most commonly reported symptoms were arthralgia (86%) and fever (76%). Of those who met the epidemiologic case definition for CHIKV as defined by the Pan American Health Organization, only 34% had this diagnosis recorded. Acute viral illness was the most frequently recorded diagnosis (n = 79; 58%).
Broader case definitions for acute CHIKV illness may be needed to identify suspected cases during an outbreak. Standardized data collection forms and validation of case definitions may be useful for future outbreaks.
描述2014年牙买加基孔肯雅病毒（CHIKV）疫情期间成人CHIKV疾病的临床表现，并确定病例定义的预测价值。
采用2014年4月至12月向卫生部报告的CHIKV疑似病例的临床数据进行横断面研究。此外，对15岁以上疑似CHIKV的所有个体的病历进行了回顾，这些个体在疫情爆发前一周和高峰期向牙买加四个主要医疗中心就诊，诊断为CHIKV或“急性病毒性疾病”。使用改良的CHIKV病例调查表格从这些病历中提取的数据包括人口统计学、临床发现和实验室检查。
2014年，牙买加卫生部收到4447例CHIKV感染通报。对137例CHIKV疑似病例（56名男性和81名女性；中位年龄28岁）进行了PCR检测，其中89例（65%）呈阳性。总共确定了205份符合选择标准的健康病历（51名男性和154名女性，中位年龄43岁）。最常报告的症状是关节痛（86%）和发热（76%）。在符合泛美卫生组织定义的CHIKV流行病学病例定义的患者中，只有34%记录了该诊断。急性病毒性疾病是最常记录的诊断（n = 79；58%）。
在疫情期间可能需要更广泛的急性CHIKV疾病病例定义来识别疑似病例。标准化的数据收集表格和病例定义的验证可能对未来的疫情有用。
