Epidemiology, clinical manifestations, and long-term outcomes of a major outbreak of Chikungunya in a Hamlet in Sri Lanka, in 2007: A longitudinal cohort study

Abstract

Chikungunya outbreaks occurred in the central province, Sri Lanka in 2006. This community-based study reports the epidemiology and the natural history of the infection from an affected village. Of the 199 families and 1001 individuals in the village, 159 (80) and 513 (51) were affected, respectively, comprising 237 (46) males with peak incidence at 4050 years. The acute illness caused polyarthritis in 233 (46), and of them 230 (98) progressed to chronic arthritic disability (CAD). Of the CAD patients, 102 (44) had recovered in 141 days (range 30-210 days) from the disability state whilst 128 (56) had persisting disability which lasted 12, 24, and 36 months in 41 (17.8), 22 (9.5), and 14 (6.1) individuals, respectively. Carpal tunnel syndrome (CTS) manifested in 110 (21). Females showed preponderance for complications over males: acute arthritis 147 versus 86, P=0.001; CAD 136 versus 84, P=0.029; CTS 88 versus 22, P=0.001; relapses 105 versus 68, P=0.001. Chikungunya was highly communicable and caused lasting crippling complications. Copyright 2012 Senanayake A. M. Kularatne et al.