Chikungunya Fever Cases Identified in the Veterans Health Administration System, 2014

Details

• Alternative Title:
  PLoS Negl Trop Dis
• Personal Author:
  Perti, Tara ; Lucero-Obusan, Cynthia A. ; Schirmer, Patricia L. ; Winters, Mark A. ; Holodniy, Mark
• Description:
  Background
  
  During December 2013, the first locally transmitted chikungunya virus (CHIKV) infections in the Americas were reported in the Caribbean. Although CHIKV infection is rarely fatal, risk for severe disease increases with age and medical comorbidities. Herein we describe characteristics of Veterans Health Administration (VHA) patients with CHIKV infection and, among those with infections diagnosed in Puerto Rico, investigated risk factors for hospitalization.
  
  Methodology
  
  We queried VHA’s national electronic medical records to identify patients with CHIKV testing during 2014. Demographics, clinical history, laboratory results, and outcomes were abstracted. We investigated risk factors for hospitalization among patients with laboratory-confirmed CHIKV infection in Puerto Rico.
  
  Principal Findings
  
  We identified 180 laboratory-confirmed CHIKV infections; 148 (82.2%) were diagnosed in Puerto Rico, and 32 (17.8%) were diagnosed among returning travelers elsewhere in the United States. In Puerto Rico, where more patients were hospitalized (55.4% versus 20.0%) and died (4.1% versus 0%), risk for hospitalization increased with age (relative risk [RR]/each 10-year increase, 1.19; 95% confidence interval [CI], 1.06–1.32) and, adjusted for age, increased among patients with congestive heart failure (RR, 1.58; 95% CI, 1.25–1.99), chronic kidney disease (RR, 1.52; 95% CI, 1.19–1.94), diabetes mellitus (RR, 1.39; 95% CI, 1.06–1.84), or chronic lung disease (RR, 1.37; 95% CI, 1.03–1.82).
  
  Conclusions/Significance
  
  CHIKV infection is an emerging problem among Veterans residing in or visiting areas with CHIKV transmission. Although overall mortality rates are low, clinicians in affected areas should be aware that older patients and patients with comorbidities may be at increased risk for severe disease.
  
  
• Subjects:
  Adult Aged Aged, 80 And Over Chikungunya Fever Female Humans Male Middle Aged Risk Factors Travel
• Source:
  PLoS Negl Trop Dis. 10(5).
• Pubmed ID:
  27144588
• Pubmed Central ID:
  PMC4856344
• Document Type:
  Journal Article
• Name as Subject:
  United States. Department of Veterans Affairs.
• Place as Subject:
  Puerto Rico
• Volume:
  10
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:dda0e9488448ce00d4ae62c1d28a0e1532576dc48829b4b68c8c3e896f6aad50
• Download URL:
  https://stacks.cdc.gov/view/cdc/39331/cdc_39331_DS1.pdf
• File Type:
  [PDF - 944.43 KB ]