TY  - BOOK
AU  - Salje,Henrik
AU  - Cauchemez,Simon
AU  - Alera,Maria Theresa
AU  - Rodriguez-Barraquer,Isabel
AU  - Thaisomboonsuk,Butsaya
AU  - Srikiatkhachorn,Anon
AU  - Lago,Catherine B.
AU  - Villa,Daisy
AU  - Klungthong,Chonticha
AU  - Tac-An,Ilya A.
AU  - Fernandez,Stefan
AU  - Velasco,John Mark
AU  - Roque,Vito G.,Jr
AU  - Nisalak,Ananda
AU  - Macareo,Louis R.
AU  - Levy,Jens W.
AU  - Cummings,Derek
AU  - Yoon,In-Kyu
TI  - Reconstruction of 60 years of chikungunya epidemiology in the Philippines demonstrates episodic and focal transmission
KW  - Chikungunya Fever
KW  - epidemiology
KW  - history
KW  - transmission
KW  - Disease Transmission, Infectious
KW  - Serological Study
N2  - 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
UR  - https://watermark.silverchair.com/jiv470.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAqAwggKcBgkqhkiG9w0BBwagggKNMIICiQIBADCCAoIGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMCFG-5xE2JVU14ufpAgEQgIICU2q0rPx0uLiM0Fs_yjAp7PAEuNAnQlOYVR9COgYE3fB6cYFNCfhOd53_JLIb-CcBZdVdkX4Fj-o1lC4IF6zNQQj9RJUwAz21SZ2RRH0LlF9TYXjRqWFi4JOBL6vAg72eTF7iielMENTImwR1Q6mOUZhhNIaauXJjs44Py4jkuT4hMfYRHQFTdsLcJHykwtXLi3mi1WHBDMP9ZusOpdJXrzYonJiwkPOlElkboc1pKNc4HPILrp6Uu5RBOSz68TiPd4ypvGw5TNVzd7wPSwpB0iHtQoelfNrj4ceH9ulh_AwgtFUi3oiNaCHQKc5dSRiyHRWeEZUpcxIZ8L473aEzbcLSfprc3EpsoSXOOOnzip-TcSQ4QGqCTd3LmMlaPBozXKl9VC3spVi8_yhPm1pn-liSkVfzLL7ox6X_JiXWpzAFAyAFQRVyiuU129S0-V15QeOEwxZ9cptt-safZaWlBIHaTmuo6BSPB6dD72V0JYwB9FCeaXFLaM-I3XPSB5_MI7U6T-oGxb1w4wEDhLvrYF0YttMgZM0dUsmTGK3FFuCMrA8rgFlHUPpjvsmnwuRxNwbTjHhP-53dKOPN5wbE44ylHRBkeN7LIOmI1M8QKyD797sw-EuHbKJeTeZfshswbXsVzJMXP_jGTYMUblcZuLmjMENybImkHR8lGFJpQa-LUL07S4EY_dQTXueXXvjYV-vaShh3l0qdu32AaIQZ--xieSXYHEVxx_ktQ1e8xX1cQcgAEtUa9vwAMiKB77F82k7T-OwphBsX2pHC1mez-KYB4SY
ER  -