Unrecognized Emergence of Chikungunya Virus during a Zika Virus Outbreak in Salvador, Brazil

PLoS Negl Trop Dis. 2017 Jan 23;11(1):e0005334. doi: 10.1371/journal.pntd.0005334. eCollection 2017 Jan.

Abstract

Background: Chikungunya virus (CHIKV) entered Brazil in 2014, causing a large outbreak in Feira de Santana, state of Bahia. Although cases have been recorded in Salvador, the capital of Bahia, located ~100 km of Feira de Santana, CHIKV transmission has not been perceived to occur epidemically, largely contrasting with the Zika virus (ZIKV) outbreak and ensuing complications reaching the city in 2015.

Methodology/principal findings: This study aimed to determine the intensity of CHIKV transmission in Salvador between November 2014 and April 2016. Results of all the CHIKV laboratory tests performed in the public sector were obtained and the frequency of positivity was analyzed by epidemiological week. Of the 2,736 tests analyzed, 456 (16.7%) were positive. An increasing in the positivity rate was observed, starting in January/2015, and peaking at 68% in August, shortly after the exanthematous illness outbreak attributed to ZIKV.

Conclusions/significance: Public health authorities and health professionals did not immediately detect the increase in CHIKV cases, likely because all the attention was directed to the ZIKV outbreak and ensuing complications. It is important that regions in the world that harbor arbovirus vectors and did not experience intense ZIKV and CHIKV transmission be prepared for the potential co-emergence of these two viruses.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brazil / epidemiology
  • Chikungunya Fever / epidemiology
  • Chikungunya Fever / virology*
  • Chikungunya virus / genetics
  • Chikungunya virus / isolation & purification*
  • Chikungunya virus / physiology
  • Disease Outbreaks
  • Humans
  • Public Health
  • Seasons
  • Zika Virus / genetics
  • Zika Virus / isolation & purification
  • Zika Virus / physiology*
  • Zika Virus Infection / epidemiology
  • Zika Virus Infection / virology*

Grants and funding

Financial support was provided by the National Council for Scientific and Technological Development – CNPq (grant: 400830/2013-2 to GSR; and scholarships to: IADP, UK, MGR, GSR); the Bahia Foundation for Research Support – FAPESB (scholarship to: MMOS); and the Coordination for the Improvement of Higher Education Personnel – CAPES, Brazilian Ministry of Education (scholarship to: MK). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.