Analyzing the Spread of Chikungunya in the Caribbean 2013-2015

This work examines one dimension of the effect that complex human transport systems have on the spread of Chikungunya Virus (CHIKV) in the Caribbean from 2013 to 2015. CHIKV is transmitted by mosquitos and its novel spread through the Caribbean islands provided a chance to examine disease transmission through complex human transportation systems. Previous work by Cauchemez et al. had shown a simple distance-based model successfully predict CHIKV spread in the Caribbean using Markov chain Monte Carlo (MCMC) statistical methods. A MCMC simulation is used to evaluate different transportation methods (air travel, cruise ships, and local maritime traffic) for the primary transmission patterns through linear regression. Other metrics including population density to account for island size variation and dengue fever incidence rates as a proxy for vector control and health spending were included. Air travel and cruise travel were gathered from monthly passenger arrivals by island. Local maritime traffic is approximated with a gravity model proxy incorporating GDP-per-capita and distance and historic dengue rates were used for determine existing vector control measures for the islands. The Caribbean represents the largest cruise passenger market in the world, cruise ship arrivals were expected to show the strongest signal; however, the gravity model representing local traffic was the best predictor of infection routes. The early infected islands (<30 days) showed a heavy trend towards an alternate primary transmission but our consensus model able to predict the time until initial infection reporting with 94.5% accuracy for islands 30 days post initial reporting. This result can assist public health entities in enacting measures to mitigate future epidemics and provide a modelling basis for determining transmission modes in future CHIKV outbreaks.