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A Model for a Chikungunya Outbreak in a Rural Cambodian Setting: Implications for Disease Control in Uninfected Areas

Following almost 30 years of relative silence, chikungunya fever reemerged in Kenya in 2004. It subsequently spread to the islands of the Indian Ocean, reaching Southeast Asia in 2006. The virus was first detected in Cambodia in 2011 and a large outbreak occurred in the village of Trapeang Roka Kamp...

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Autores principales: Robinson, Marguerite, Conan, Anne, Duong, Veasna, Ly, Sowath, Ngan, Chantha, Buchy, Philippe, Tarantola, Arnaud, Rodó, Xavier
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4161325/
https://www.ncbi.nlm.nih.gov/pubmed/25210729
http://dx.doi.org/10.1371/journal.pntd.0003120
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author Robinson, Marguerite
Conan, Anne
Duong, Veasna
Ly, Sowath
Ngan, Chantha
Buchy, Philippe
Tarantola, Arnaud
Rodó, Xavier
author_facet Robinson, Marguerite
Conan, Anne
Duong, Veasna
Ly, Sowath
Ngan, Chantha
Buchy, Philippe
Tarantola, Arnaud
Rodó, Xavier
author_sort Robinson, Marguerite
collection PubMed
description Following almost 30 years of relative silence, chikungunya fever reemerged in Kenya in 2004. It subsequently spread to the islands of the Indian Ocean, reaching Southeast Asia in 2006. The virus was first detected in Cambodia in 2011 and a large outbreak occurred in the village of Trapeang Roka Kampong Speu Province in March 2012, in which 44% of the villagers had a recent infection biologically confirmed. The epidemic curve was constructed from the number of biologically-confirmed CHIKV cases per day determined from the date of fever onset, which was self-reported during a data collection campaign conducted in the village after the outbreak. All individuals participating in the campaign had infections confirmed by laboratory analysis, allowing for the identification of asymptomatic cases and those with an unreported date of fever onset. We develop a stochastic model explicitly including such cases, all of whom do not appear on the epidemic curve. We estimate the basic reproduction number of the outbreak to be 6.46 (95% C.I. [6.24, 6.78]). We show that this estimate is particularly sensitive to changes in the biting rate and mosquito longevity. Our model also indicates that the infection was more widespread within the population on the reported epidemic start date. We show that the exclusion of asymptomatic cases and cases with undocumented onset dates can lead to an underestimation of the reproduction number which, in turn, could negatively impact control strategies implemented by public health authorities. We highlight the need for properly documenting newly emerging pathogens in immunologically naive populations and the importance of identifying the route of disease introduction.
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spelling pubmed-41613252014-09-17 A Model for a Chikungunya Outbreak in a Rural Cambodian Setting: Implications for Disease Control in Uninfected Areas Robinson, Marguerite Conan, Anne Duong, Veasna Ly, Sowath Ngan, Chantha Buchy, Philippe Tarantola, Arnaud Rodó, Xavier PLoS Negl Trop Dis Research Article Following almost 30 years of relative silence, chikungunya fever reemerged in Kenya in 2004. It subsequently spread to the islands of the Indian Ocean, reaching Southeast Asia in 2006. The virus was first detected in Cambodia in 2011 and a large outbreak occurred in the village of Trapeang Roka Kampong Speu Province in March 2012, in which 44% of the villagers had a recent infection biologically confirmed. The epidemic curve was constructed from the number of biologically-confirmed CHIKV cases per day determined from the date of fever onset, which was self-reported during a data collection campaign conducted in the village after the outbreak. All individuals participating in the campaign had infections confirmed by laboratory analysis, allowing for the identification of asymptomatic cases and those with an unreported date of fever onset. We develop a stochastic model explicitly including such cases, all of whom do not appear on the epidemic curve. We estimate the basic reproduction number of the outbreak to be 6.46 (95% C.I. [6.24, 6.78]). We show that this estimate is particularly sensitive to changes in the biting rate and mosquito longevity. Our model also indicates that the infection was more widespread within the population on the reported epidemic start date. We show that the exclusion of asymptomatic cases and cases with undocumented onset dates can lead to an underestimation of the reproduction number which, in turn, could negatively impact control strategies implemented by public health authorities. We highlight the need for properly documenting newly emerging pathogens in immunologically naive populations and the importance of identifying the route of disease introduction. Public Library of Science 2014-09-11 /pmc/articles/PMC4161325/ /pubmed/25210729 http://dx.doi.org/10.1371/journal.pntd.0003120 Text en © 2014 Robinson et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Robinson, Marguerite
Conan, Anne
Duong, Veasna
Ly, Sowath
Ngan, Chantha
Buchy, Philippe
Tarantola, Arnaud
Rodó, Xavier
A Model for a Chikungunya Outbreak in a Rural Cambodian Setting: Implications for Disease Control in Uninfected Areas
title A Model for a Chikungunya Outbreak in a Rural Cambodian Setting: Implications for Disease Control in Uninfected Areas
title_full A Model for a Chikungunya Outbreak in a Rural Cambodian Setting: Implications for Disease Control in Uninfected Areas
title_fullStr A Model for a Chikungunya Outbreak in a Rural Cambodian Setting: Implications for Disease Control in Uninfected Areas
title_full_unstemmed A Model for a Chikungunya Outbreak in a Rural Cambodian Setting: Implications for Disease Control in Uninfected Areas
title_short A Model for a Chikungunya Outbreak in a Rural Cambodian Setting: Implications for Disease Control in Uninfected Areas
title_sort model for a chikungunya outbreak in a rural cambodian setting: implications for disease control in uninfected areas
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4161325/
https://www.ncbi.nlm.nih.gov/pubmed/25210729
http://dx.doi.org/10.1371/journal.pntd.0003120
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