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Spatiotemporal dynamics and recurrence of chikungunya virus in Brazil: an epidemiological study.
de Souza, William M; de Lima, Shirlene T S; Simões Mello, Leda M; Candido, Darlan S; Buss, Lewis; Whittaker, Charles; Claro, Ingra M; Chandradeva, Nilani; Granja, Fabiana; de Jesus, Ronaldo; Lemos, Poliana S; Toledo-Teixeira, Daniel A; Barbosa, Priscilla P; Firmino, Antonio Carlos L; Amorim, Mariene R; Duarte, Larissa M F; Pessoa, Ivan B; Forato, Julia; Vasconcelos, Irihane L; Maximo, Ana Carolina B M; Araújo, Emerson L L; Perdigão Mello, Liana; Sabino, Ester C; Proença-Módena, José Luiz; Faria, Nuno R; Weaver, Scott C.
Afiliação
  • de Souza WM; Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, USA; World Reference Center for Emerging Viruses and Arboviruses, University of Texas Medical Branch, Galveston, TX, USA. Electronic address: wmdesouz@utmb.edu.
  • de Lima STS; Laboratório Central de Saúde Pública do Ceará, Fortaleza, Brazil; Laboratory of Emerging Viruses, Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas, Brazil.
  • Simões Mello LM; Laboratório Central de Saúde Pública do Ceará, Fortaleza, Brazil.
  • Candido DS; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK; Department of Zoology, University of Oxford, Oxford, UK; Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo,
  • Buss L; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK.
  • Whittaker C; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK; The Abdul Latif Jameel Institute for Disease and Emergency Analytics, School of Public Health, Imperial College London, London, UK.
  • Claro IM; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK; Department of Zoology, University of Oxford, Oxford, UK; Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo,
  • Chandradeva N; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK.
  • Granja F; Laboratory of Emerging Viruses, Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas, Brazil; Biodiversity Research Centre, Federal University of Roraima, Boa Vista, Brazil.
  • de Jesus R; Ministério da Saúde, Departamento de Articulação Estratégica de Vigilância em Saúde, Brasilia, Brazil; Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
  • Lemos PS; Ministério da Saúde, Departamento de Articulação Estratégica de Vigilância em Saúde, Brasilia, Brazil.
  • Toledo-Teixeira DA; Laboratory of Emerging Viruses, Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas, Brazil.
  • Barbosa PP; Laboratory of Emerging Viruses, Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas, Brazil.
  • Firmino ACL; Laboratório Central de Saúde Pública do Ceará, Fortaleza, Brazil.
  • Amorim MR; Laboratory of Emerging Viruses, Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas, Brazil.
  • Duarte LMF; Laboratório Central de Saúde Pública do Ceará, Fortaleza, Brazil.
  • Pessoa IB; Laboratório Central de Saúde Pública do Ceará, Fortaleza, Brazil.
  • Forato J; Laboratory of Emerging Viruses, Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas, Brazil.
  • Vasconcelos IL; Laboratório Central de Saúde Pública do Ceará, Fortaleza, Brazil.
  • Maximo ACBM; Laboratório Central de Saúde Pública do Ceará, Fortaleza, Brazil.
  • Araújo ELL; Ministério da Saúde, Departamento de Articulação Estratégica de Vigilância em Saúde, Brasilia, Brazil.
  • Perdigão Mello L; Laboratório Central de Saúde Pública do Ceará, Fortaleza, Brazil.
  • Sabino EC; Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
  • Proença-Módena JL; Laboratory of Emerging Viruses, Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas, Brazil; Hub of Global Health, University of Campinas, Campinas, Brazil.
  • Faria NR; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK; Department of Zoology, University of Oxford, Oxford, UK; Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo,
  • Weaver SC; Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, USA; World Reference Center for Emerging Viruses and Arboviruses, University of Texas Medical Branch, Galveston, TX, USA; Institute for Human Infections and Immunity, University of Texas Medical Branch, Gal
Lancet Microbe ; 4(5): e319-e329, 2023 05.
Article em En | MEDLINE | ID: mdl-37031687
ABSTRACT

BACKGROUND:

Chikungunya virus (CHIKV) is an Aedes mosquito-borne virus that has caused large epidemics linked to acute, chronic, and severe clinical outcomes. Currently, Brazil has the highest number of chikungunya cases in the Americas. We aimed to investigate the spatiotemporal dynamics and recurrence pattern of chikungunya in Brazil since its introduction in 2013.

METHODS:

In this epidemiological study, we used CHIKV genomic sequencing data, CHIKV vector information, and aggregate clinical data on chikungunya cases from Brazil. The genomic data comprised 241 Brazilian CHIKV genome sequences from GenBank (n=180) and the 2022 CHIKV outbreak in Ceará state (n=61). The vector data (Breteau index and House index) were obtained from the Brazilian Ministry of Health for all 184 municipalities in Ceará state and 116 municipalities in Tocantins state in 2022. Epidemiological data on laboratory-confirmed cases of chikungunya between 2013 and 2022 were obtained from the Brazilian Ministry of Health and Laboratory of Public Health of Ceará. We assessed the spatiotemporal dynamics of chikungunya in Brazil via time series, mapping, age-sex distribution, cumulative case-fatality, linear correlation, logistic regression, and phylogenetic analyses.

FINDINGS:

Between March 3, 2013, and June 4, 2022, 253 545 laboratory-confirmed chikungunya cases were reported in 3316 (59·5%) of 5570 municipalities, mainly distributed in seven epidemic waves from 2016 to 2022. To date, Ceará in the northeast has been the most affected state, with 77 418 cases during the two largest epidemic waves in 2016 and 2017 and the third wave in 2022. From 2016 to 2022 in Ceará, the odds of being CHIKV-positive were higher in females than in males (odds ratio 0·87, 95% CI 0·85-0·89, p<0·0001), and the cumulative case-fatality ratio was 1·3 deaths per 1000 cases. Chikungunya recurrences in the states of Ceará, Tocantins (recurrence in 2022), and Pernambuco (recurrence in 2021) were limited to municipalities with few or no previously reported cases in the previous epidemic waves. The recurrence of chikungunya in Ceará in 2022 was associated with a new East-Central-South-African lineage. Population density metrics of the main CHIKV vector in Brazil, Aedes aegypti, were not correlated spatially with locations of chikungunya recurrence in Ceará and Tocantins.

INTERPRETATION:

Spatial heterogeneity of CHIKV spread and population immunity might explain the recurrence pattern of chikungunya in Brazil. These results can be used to inform public health interventions to prevent future chikungunya epidemic waves in urban settings.

FUNDING:

Global Virus Network, Burroughs Wellcome Fund, Wellcome Trust, US National Institutes of Health, São Paulo Research Foundation, Brazil Ministry of Education, UK Medical Research Council, Brazilian National Council for Scientific and Technological Development, and UK Royal Society. TRANSLATION For the Portuguese translation of the abstract see Supplementary Materials section.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Vírus Chikungunya / Aedes / Febre de Chikungunya Tipo de estudo: Observational_studies Limite: Animals / Female / Humans / Male País/Região como assunto: America do sul / Brasil Idioma: En Revista: Lancet Microbe Ano de publicação: 2023 Tipo de documento: Article
Texto completo
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Vírus Chikungunya / Aedes / Febre de Chikungunya Tipo de estudo: Observational_studies Limite: Animals / Female / Humans / Male País/Região como assunto: America do sul / Brasil Idioma: En Revista: Lancet Microbe Ano de publicação: 2023 Tipo de documento: Article