Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 24, Number 12—December 2018
Dispatch

Excess Mortality and Causes Associated with Chikungunya, Puerto Rico, 2014–2015

André Ricardo Ribas FreitasComments to Author , Maria Rita Donalisio, and Pedro María Alarcón-Elbal
Author affiliations: Secretaria de Saúde de Campinas, Campinas, Brazil (A.R.R. Freitas); Faculdade de Medicina São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas (A.R.R. Freitas); Universidade Estadual de Campinas, Campinas (M.R. Donalisio); Universidad Iberoamericana, Instituto de Medicina Tropical & Salud Global, Santo Domingo, Dominican Republic (P.M. Alarcón-Elbal)

Main Article

Table 2

Number of deaths from specific causes observed during chikungunya epidemic period, Puerto Rico, July–December 2010–2015, selected according to clinical presentation of severe chikungunya deaths in Réunion Island, 2005–2006*

Cause of death (code)† Difference between 2014 and mean of 2010–2013 Change, %
Year
2010 2011 2012 2013 2014 2015
Volume depletion, disorders of fluid, electrolyte and acid-base balance (E86–E87) 117 117 134 122 170 93 48 39
Emphysema (J43) 82 66 76 51 104 70 35 51
Conduction disorders and cardiac dysrhythmias (I44–I49) 155 146 140 154 182 142 33 22
Asthma (J45–J46) 33 45 13 24 53 37 24 84
Pneumonia (J12–J18) 419 401 339 364 402 283 21 6
Other and unspecified diseases of skin and sub-cutaneous tissue (L10–L98) 85 98 81 95 106 90 16 18
Other chronic liver disease and cirrhosis (K73–K74) 61 73 62 58 77 77 14 21
Alcoholic liver disease (K70) 45 37 49 50 58 51 13 28
Other and unspecified heart failure (I50.1–I50.9) 63 60 57 55 71 56 12 21
Diseases of pericardium and acute myocarditis (I30–I31, I40) 3 2 2 4 6 3 3 118
Meningitis and encephalitis (A83–A84, A85.2, G00, G03) 5 3 1 5 5 4 2 43
Congestive heart failure (I50.0) 229 199 207 222 204 162 −10 −5

*See reference (2).
†Except for pneumonia, the causes of death were grouped according to the List of 358 Selected Causes of Death of the National Center for Health Statistics (https://www.cdc.gov/nchs/data/dvs/Multiple_Cause_Record_Layout_2015.pdf). Codes are from the International Classification of Diseases, 10th Revision.

Main Article

References
  1. Pan American Health Organization, World Health Organization. Chikungunya: communicable diseases and health analysis. Data, maps and statistics [cited 2016 Dec 13]. http://www.paho.org/hq/index.php?option=com_topics&view=readall&cid=5927&Itemid=40931&lang=en
  2. Economopoulou  A, Dominguez  M, Helynck  B, Sissoko  D, Wichmann  O, Quenel  P, et al. Atypical Chikungunya virus infections: clinical manifestations, mortality and risk factors for severe disease during the 2005-2006 outbreak on Réunion. Epidemiol Infect. 2009;137:534–41. DOIPubMedGoogle Scholar
  3. Sharp  TM, Ryff  KR, Alvarado  L, Shieh  W-J, Zaki  SR, Margolis  HS, et al. Surveillance for chikungunya and dengue during the first year of chikungunya virus circulation in Puerto Rico. J Infect Dis. 2016;214(suppl 5):S475–81. DOIPubMedGoogle Scholar
  4. Renault  P, Solet  JL, Sissoko  D, Balleydier  E, Larrieu  S, Filleul  L, et al. A major epidemic of chikungunya virus infection on Reunion Island, France, 2005-2006. Am J Trop Med Hyg. 2007;77:727–31. DOIPubMedGoogle Scholar
  5. Josseran  L, Paquet  C, Zehgnoun  A, Caillere  N, Le Tertre  A, Solet  J-L, et al. Chikungunya disease outbreak, Reunion Island. Emerg Infect Dis. 2006;12:1994–5. DOIPubMedGoogle Scholar
  6. Mavalankar  D, Shastri  P, Bandyopadhyay  T, Parmar  J, Ramani  KV. Increased mortality rate associated with chikungunya epidemic, Ahmedabad, India. Emerg Infect Dis. 2008;14:412–5. DOIPubMedGoogle Scholar
  7. Freitas  ARR, Cavalcanti  L, Von Zuben  AP, Donalisio  MR. Excess mortality related to chikungunya epidemics in the context of co-circulation of other arboviruses in Brazil. PLoS Curr. 2017;9:pii: https://dx.doi.org/10.1371/currents.outbreaks.14608e586cd321d8d5088652d7a0d884PubMedGoogle Scholar
  8. US Census Bureau. Puerto Rico Commonwealth population totals tables: 2010–2016 [cited 2017 Apr 8]. https://www.census.gov/data/tables/2016/demo/popest/total-puerto-rico.html
  9. Centers for Disease Control and Prevention, National Center for Health Statistics. Vital statistics online. Mortality multiple cause files [cited 2017 Apr 8]. https://www.cdc.gov/nchs/data_access/vitalstatsonline.htm#Mortality_Multiple
  10. Tomashek  KM, Lorenzi  OD, Andújar-Pérez  DA, Torres-Velásquez  BC, Hunsperger  EA, Munoz-Jordan  JL, et al. Clinical and epidemiologic characteristics of dengue and other etiologic agents among patients with acute febrile illness, Puerto Rico, 2012-2015. PLoS Negl Trop Dis. 2017;11:e0005859. DOIPubMedGoogle Scholar
  11. Rohatgi  A. WebPlotDigitizer [cited 2017 Apr 8]. https://automeris.io/WebPlotDigitizer
  12. Departamento de Salud de Puerto Rico. Informe semanal de bigilancia del dengue—semana 52/2014 [cited 2017 Apr 8]. http://www.salud.gov.pr/Estadisticas-Registros-y-Publicaciones/Pages/Dengue.aspx
  13. Crosby  L, Perreau  C, Madeux  B, Cossic  J, Armand  C, Herrmann-Storke  C, et al. Severe manifestations of chikungunya virus in critically ill patients during the 2013-2014 Caribbean outbreak. Int J Infect Dis. 2016;48:78–80. DOIPubMedGoogle Scholar
  14. Freitas  ARR, Donalisio  MR. Excess of mortality in adults and elderly and circulation of subtypes of influenza virus in southern Brazil. Front Immunol. 2018;8:1903. DOIPubMedGoogle Scholar
  15. Hoshiko  S, English  P, Smith  D, Trent  R. A simple method for estimating excess mortality due to heat waves, as applied to the 2006 California heat wave. Int J Public Health. 2010;55:133–7. DOIPubMedGoogle Scholar

Main Article

Page created: November 19, 2018
Page updated: November 19, 2018
Page reviewed: November 19, 2018
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external