{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T12:11:35Z","timestamp":1781007095950,"version":"3.54.1"},"reference-count":67,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Japan Agency of Medical Research and Development","award":["JP20wm0125006"],"award-info":[{"award-number":["JP20wm0125006"]}]},{"name":"Japan Agency of Medical Research and Development","award":["JP21wm0225017"],"award-info":[{"award-number":["JP21wm0225017"]}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Chikungunya virus (CHIKV) is a mosquito-borne virus known to cause acute febrile illness associated with debilitating polyarthritis. In 2019, several institutions in Myanmar reported a CHIKV outbreak. There are no official reports of CHIKV cases between 2011 and 2018. Therefore, this study sought to determine the seroprevalence of CHIKV infection before the 2019 outbreak.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A total of 1,544 serum samples were collected from healthy volunteers and patients with febrile illnesses in Yangon, Mandalay, and the Myeik district in 2013, 2015, and 2018. Participants ranged from one month to 65 years of age. Antibody screening was performed with in-house anti-CHIKV IgG and IgM ELISA. A neutralization assay was used as a confirmatory test.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The seroprevalence of anti-CHIKV IgM and anti-CHIKV IgG was 8.9% and 28.6%, respectively, with an overall seropositivity rate of 34.5%. A focus reduction neutralization assay confirmed 32.5% seroprevalence of CHIKV in the study population. Age, health status, and region were significantly associated with neutralizing antibodies (NAbs) and CHIKV seropositivity (<jats:italic>p<\/jats:italic> &lt; 0.05), while gender was not (<jats:italic>p<\/jats:italic> = 0.9). Seroprevalence in 2013, 2015, and 2018 was 32.1%, 28.8%, and 37.3%, respectively. Of the clinical symptoms observed in participants with fevers, arthralgia was mainly noted in CHIKV-seropositive patients.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The findings in this study reveal the circulation of CHIKV in Myanmar\u2019s Mandalay, Yangon, and Myeik regions before the 2019 CHIKV outbreak. As no treatment or vaccine for CHIKV exists, the virus must be monitored through systematic surveillance in Myanmar.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0009961","type":"journal-article","created":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T18:26:28Z","timestamp":1638383188000},"page":"e0009961","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":12,"title":["Evidence of Chikungunya virus seroprevalence in Myanmar among dengue-suspected patients and healthy volunteers in 2013, 2015, and 2018"],"prefix":"10.1371","volume":"15","author":[{"given":"Elizabeth Ajema Chebichi","family":"Luvai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1384-8030","authenticated-orcid":true,"given":"Aung Kyaw","family":"Kyaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8644-2066","authenticated-orcid":true,"given":"Nundu Sabiti","family":"Sabin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8804-2755","authenticated-orcid":true,"given":"Fuxun","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saw Wut","family":"Hmone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyaw Zin","family":"Thant","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shingo","family":"Inoue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8391-1157","authenticated-orcid":true,"given":"Kouichi","family":"Morita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8986-6307","authenticated-orcid":true,"given":"Mya Myat","family":"Ngwe Tun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,12,1]]},"reference":[{"key":"pntd.0009961.ref001","article-title":"Changing patterns of chikunya virus: Re-emergence of a zoonotic arbovirus","author":"AM Powers","year":"2007","journal-title":"Journal of General Virology"},{"key":"pntd.0009961.ref002","article-title":"Chikungunya: An emerging and spreading arthropod-borne viral disease","author":"F Cavrini","year":"2009","journal-title":"Journal of Infection in Developing Countries"},{"key":"pntd.0009961.ref003","article-title":"Chikungunya virus infection: An overview.","author":"C Caglioti","year":"2013","journal-title":"New Microbiologica"},{"key":"pntd.0009961.ref004","article-title":"Chikungunya: A re-emerging virus.","author":"FJ Burt","year":"2012","journal-title":"The Lancet"},{"key":"pntd.0009961.ref005","article-title":"Chikungunya fever: An epidemiological review of a re-emerging infectious disease","author":"J Erin Staples","year":"2009","journal-title":"Clinical Infectious Diseases"},{"key":"pntd.0009961.ref006","article-title":"A major epidemic of chikungunya virus infection on R\u00e9union Island, France, 2005\u20132006","author":"P Renault","year":"2007","journal-title":"Am J Trop Med Hyg"},{"key":"pntd.0009961.ref007","volume-title":"Introduction to the Regional Director\u2019s Annual Report on the Work of WHO in the South-East Asia Region covering the period 1 January-31 December 2014 (No. SEA\/RC68\/2)","author":"WHO","year":"2015"},{"key":"pntd.0009961.ref008","article-title":"An epidemic of virus disease in Southern Province, Tanganyika territory, in 1952\u20131953 II. General description and epidemiology","author":"WHR Lumsden","year":"1955","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"pntd.0009961.ref009","article-title":"Seroprevalence of Chikungunya virus (CHIKV) infection on Lamu Island, Kenya, October 2004.","author":"K Sergon","year":"2008","journal-title":"Am J Trop Med Hyg"},{"key":"pntd.0009961.ref010","article-title":"Chikungunya fever: Epidemiology, clinical syndrome, pathogenesis and therapy","author":"SD Thiberville","year":"2013","journal-title":"Antiviral Research"},{"key":"pntd.0009961.ref011","article-title":"Emergence and potential for spread of Chikungunya virus in Brazil.","author":"MRT Nunes","year":"2015","journal-title":"BMC Med"},{"key":"pntd.0009961.ref012","article-title":"Differing epidemiological dynamics of Chikungunya virus in the Americas during the 2014\u20132015 epidemic.","author":"Y Tan","year":"2018","journal-title":"PLoS Negl Trop Dis."},{"key":"pntd.0009961.ref013","first-page":"61779","article-title":"Infection with chikungunya virus in Italy: an outbreak in a temperate region","author":"G Rezza","year":"2007","journal-title":"Lancet"},{"key":"pntd.0009961.ref014","article-title":"Increased risk of chikungunya infection in travellers to thailand during ongoing outbreak in tourist areas: Cases imported to europe and the middle east, early 2019.","author":"E Javelle","year":"2019","journal-title":"Eurosurveillance"},{"key":"pntd.0009961.ref015","article-title":"Travel-associated chikungunya acquired in Myanmar in 2019.","author":"M D\u00edaz-Men\u00e9ndez","year":"2020","journal-title":"Eurosurveillance"},{"key":"pntd.0009961.ref016","article-title":"Chikungunya resurgence in the Maldives and risk for importation via tourists to Europe in 2019\u20132020: A GeoSentinel case series.","author":"P Dudouet","year":"2020","journal-title":"Travel Med Infect Dis"},{"key":"pntd.0009961.ref017","article-title":"Preliminary report of an autochthonous chikungunya outbreak in France, July to September 2017.","author":"C Calba","year":"2017","journal-title":"Eurosurveillance"},{"key":"pntd.0009961.ref018","article-title":"Secondary Autochthonous Outbreak of Chikungunya, Southern Italy, 2017.","author":"F Riccardo","year":"2019","journal-title":"Emerg Infect Dis"},{"key":"pntd.0009961.ref019","first-page":"276","article-title":"Epidemiological features of dengue and chikungunya infections in Burma.","volume":"6","author":"U Thaung","year":"1975","journal-title":"Southeast Asian J Trop Med Public Health"},{"key":"pntd.0009961.ref020","article-title":"Chikungunya virus in Asia\u2013Pacific: a systematic review.","author":"BMCR Wimalasiri-Yapa","year":"2019","journal-title":"Emerg Microbes Infect"},{"key":"pntd.0009961.ref021","doi-asserted-by":"crossref","first-page":"2268","DOI":"10.1017\/S095026881600056X","article-title":"Retrospective seroepidemiological study of chikungunya infection in South Asia, Southeast Asia and the Pacific region","volume":"144","author":"MMN Tun","year":"2016","journal-title":"Epidemiol Infect"},{"key":"pntd.0009961.ref022","article-title":"Detection of East\/Central\/South African genotype of chikungunya virus in Myanmar, 2010.","author":"MM Ngwe Tun","year":"2014","journal-title":"Emerg Infect Dis"},{"key":"pntd.0009961.ref023","unstructured":"Kyi Soe Aung Phay. Chikungunya reappears after 10 years. Myanmar Times. 2019. Available: https:\/\/www.mmtimes.com\/news\/chikungunya-reappears-after-10-years.html"},{"key":"pntd.0009961.ref024","article-title":"Chikungunya virus infection in blood donors and patients during outbreak, Mandalay, Myanmar, 2019.","author":"AK Kyaw","year":"2020","journal-title":"Emerg Infect Dis"},{"key":"pntd.0009961.ref025","first-page":"90358","article-title":"Disappearance of chikungunya virus from india and South East Asia","author":"K. Pavri","year":"1986","journal-title":"Transactions of the Royal Society of Tropical Medicine and Hygiene"},{"key":"pntd.0009961.ref026","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1093\/jhmas\/XXVI.3.243","article-title":"Chikungunya and dengue: A Case of Mistaken Identity?","volume":"XXVI","author":"E. Carey Donald","year":"1971","journal-title":"J Hist Med Allied Sci"},{"key":"pntd.0009961.ref027","article-title":"High rates of co-infection of Dengue and Chikungunya virus in Odisha and Maharashtra, India during 2013.","author":"T Saswat","year":"2015","journal-title":"Infect Genet Evol"},{"key":"pntd.0009961.ref028","article-title":"Concurrent isolation of chikungunya virus and dengue virus from a patient with coinfection resulting from a trip to Singapore","author":"SF Chang","year":"2010","journal-title":"J Clin Microbiol"},{"key":"pntd.0009961.ref029","article-title":"Imported chikungunya virus strains, Taiwan, 2006\u20132014.","author":"CF Yang","year":"2016","journal-title":"Emerg Infect Dis"},{"key":"pntd.0009961.ref030","doi-asserted-by":"crossref","DOI":"10.4038\/cmj.v53i3.252","article-title":"Laboratory confirmation of dengue and chikungunya co-infection.","author":"HA Hapuarachchi","year":"2008","journal-title":"Ceylon Med J"},{"key":"pntd.0009961.ref031","first-page":"335","article-title":"Co-infection of dengue virus and chikungunya virus in two patients with acute febrile illness.","volume":"62","author":"SK Nayar","year":"2007","journal-title":"Med J Malaysia"},{"key":"pntd.0009961.ref032","article-title":"Dengue and Chikungunya Fever among Viral Diseases in Outpatient Febrile Children in Kilosa District Hospital, Tanzania.","author":"B Chipwaza","year":"2014","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0009961.ref033","article-title":"Importance of case definition to monitor ongoing outbreak of chikungunya virus on a background of actively circulating dengue virus, St Martin, December 2013 TO January 2014.","author":"R Omarjee","year":"2014","journal-title":"Eurosurveillance"},{"key":"pntd.0009961.ref034","article-title":"Undetected Chikungunya virus co-infections in a Brazilian region presenting hyper-endemic circulation of Dengue and Zika","author":"FF Bagno","year":"2019","journal-title":"J Clin Virol"},{"key":"pntd.0009961.ref035","article-title":"Chikungunya virus diagnosis in the developing world: A pressing need.","author":"IC Sam","year":"2011","journal-title":"Expert Review of Anti-Infective Therapy"},{"key":"pntd.0009961.ref036","article-title":"Clinical, virological and epidemiological characterization of dengue outbreak in Myanmar, 2015.","author":"AK Kyaw","year":"2017","journal-title":"Epidemiol Infect"},{"key":"pntd.0009961.ref037","article-title":"Serological characterization of dengue virus infections observed among dengue hemorrhagic fever\/dengue shock syndrome cases in upper Myanmar","author":"MM Ngwe Tun","year":"2013","journal-title":"J Med Virol"},{"key":"pntd.0009961.ref038","article-title":"Inapparent dengue virus infection among students in Mandalay, Myanmar","author":"AK Kyaw","year":"2020","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"pntd.0009961.ref039","article-title":"Evaluation of a dengue IgG indirect enzyme-linked immunosorbent assay and a japanese encephalitis IgG indirect enzyme-linked immunosorbent assay for diagnosis of secondary dengue virus infection.","author":"S Inoue","year":"2010","journal-title":"Vector-Borne Zoonotic Dis"},{"key":"pntd.0009961.ref040","article-title":"Detection of chikungunya virus in Nepal","author":"BD Pandey","year":"2015","journal-title":"Am J Trop Med Hyg"},{"key":"pntd.0009961.ref041","article-title":"Development of an E2 ELISA methodology to assess chikungunya seroprevalence in patients from an endemic region of Mexico.","author":"YC Kim","year":"2019","journal-title":"Viruses"},{"key":"pntd.0009961.ref042","article-title":"Demographic and clinical characteristics of chikungunya patients from six Colombian cities, 2014\u20132015","author":"JC Rueda","year":"2019","journal-title":"Emerg Microbes Infect"},{"key":"pntd.0009961.ref043","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.jpainsymman.2014.06.006","article-title":"Comparison of ECOG\/WHO Performance Status and ASA Score as a Measure of Functional Status","volume":"49","author":"J Young","year":"2015","journal-title":"J Pain Symptom Manage"},{"key":"pntd.0009961.ref044","unstructured":"Williams. RK. Scalar measures of fit: Pseudo R2 and information measures (AIC & BIC). Univ Notre Dame. 2018;Notre Dame. Available: https:\/\/www3.nd.edu\/~rwilliam\/stats3\/L05.pdf"},{"key":"pntd.0009961.ref045","volume-title":"Fundamentals of Clinical Data Science","author":"FJWM Dankers","year":"2018"},{"key":"pntd.0009961.ref046","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pntd.0005712","article-title":"Suppression of chikungunya virus replication and differential innate responses of human peripheral blood mononuclear cells during co-infection with dengue virus","volume":"11","author":"M Ruiz Silva","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0009961.ref047","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1371\/journal.pntd.0007575","article-title":"Chikungunya-attributable deaths: A neglected outcome of a neglected disease.","volume":"13","author":"AS Lima Neto","year":"2019","journal-title":"PLoS Negl Trop 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Thailand"},{"key":"pntd.0009961.ref052","doi-asserted-by":"crossref","first-page":"e41","DOI":"10.1016\/S2666-5247(20)30175-0","article-title":"Seroprevalence of chikungunya virus infection in India, 2017: a cross-sectional population-based serosurvey","volume":"2","author":"MS Kumar","year":"2021","journal-title":"The Lancet Microbe"},{"key":"pntd.0009961.ref053","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0189879","article-title":"Chikungunya virus emergence in the Lao PDR, 2012\u20132013.","author":"S Somlor","year":"2017"},{"key":"pntd.0009961.ref054","article-title":"Chikungunya outbreak (2017) in Bangladesh: Clinical profile, economic impact and quality of life during the acute phase of the disease.","author":"MS Hossain","year":"2018","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0009961.ref055","doi-asserted-by":"crossref","first-page":"868","DOI":"10.4269\/ajtmh.17-0708","article-title":"Detection of zika virus infection in 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