Chikungunya virus (CHIKV) seroprevalence in the South Pacific populations of the Cook Islands and Vanuatu with associated environmental and social factors

BACKGROUND: Arthropod-borne diseases pose a significant and increasing risk to global health. Given its rapid dissemination, causing large-scale outbreaks with severe human infections and economic loss, the Chikungunya virus (CHIKV) is one of the most important arboviruses worldwide. Despite its significance, the real global impact of CHIKV remains underestimated as outbreak data are often incomplete and based solely on syndromic surveillance. During 2011–2016, the South Pacific Region was severely affected by several CHIKV-epidemics, yet the area is still underrepresented in arboviral research. METHODS: 465 outpatient serum samples collected between 08/2016 and 04/2017 on three islands of the island states Vanuatu (Espiritu Santo) and the Cook Islands (Rarotonga, Aitutaki) were tested for anti-CHIKV specific antibodies using Enzyme-linked immunosorbent Assays. RESULTS: A total of 30% (Cook Islands) and 8% (Vanuatu) of specimens were found positive for anti-CHIKV specific antibodies with major variations in national and intranational immunity levels. Seroprevalence throughout all age groups was relatively constant. Four potential outbreak-protective factors were identified by comparing the different study settings: presence of Ae. albopictus (in absence of ECSA E1-A226V-mutation CHIKV), as well as low levels of human population densities, residents’ travel activity and tourism. CONCLUSION: This is the first seroprevalence study focussing on an arboviral disease in the Cook Islands and Vanuatu. It highlights the impact of the 2014/2015 CHIKV epidemic on the Cook Islands population and shows that a notable part of the Vanuatu test population was exposed to CHIKV although no outbreaks were reported. Our findings supplement the knowledge concerning CHIKV epidemics in the South Pacific Region and contribute to a better understanding of virus dissemination, including outbreak modifying factors. This study may support preventive and rapid response measures in affected areas, travel-related risk assessment and infection identification in returning travellers. TRIAL REGISTRATION: ClinicalTrials.gov Aachen: 051/16_09/05/2016 Cook Islands Ref.: #16-16 Vanuatu Ref.: MOH/DG 10/1/1-GKT/lr.