The first edpidemic occured in Tanzania in 1952. India faced its first epidemic in 1960 and then in 2006. Almost 1.4 million cases were reported across 13 states and 151 districts. A recent outbreak occured in 2016 in Delhi, the capital of India. 58,136 cases were reported all over the country with the capital city contributing 12,221 cases. Though deaths were reported, no study has still come up with statistics of the mortality.
Methods: We conducted a retrospective study in the central part of Delhi, India, to estimate the fatality rate associated with Chikungunya outbreak 2016. Our study included patients who were admitted with acute febrile illness during the year 2016 and were diagnosed to have Chikungunya fever by a positive RT PCR or serological (IgM ELISA) test or both. Inpatient records of such patients were reviewed for their outcome. Mortality at day 28 of hospitalization was recorded and fatality rate was calculated from number of deaths caused directly or indirectly by Chikungunya. Cause of death and the co-morbidities associated were also noted down.
Results: There were 410 Laboratory confirmed cases of Chikungunya between August to December 2016. Out of 410 in patients, 39 died within 28 days with a case fatality rate of 9.5%. Mortality was found to be more prevalent among men (82%) than women (18%) and 84.6% were elderly. Kidney was found to be the most commonly affected organ leading to death (95%), followed by Central Nervous System involvement (48.7%) and coronary involvement (23%). All 39 patients, who expired, were managed in the intensive care unit and required mechanical ventillatory support. 49% of deceased patients required dialysis. Hypertension and Diabetes Mellitus were found in 17 (43.5%) and 16 (41%) cases respectively.
Conclusion: Deaths due to Chikungunya, though not very common, does occur in patients with severe infection and those with atypical presentation, especially in elderly. Mortality in Chikungunya has not been widely studied so far and ours is the largest study highlighting mortality in such patients. However, more studies need to be done to validate our data thereby helping to identify the patients with higher risk and also implement more effective preventive measures in the society.
A. Kakar, None