To the Editor: In their letter in response to our review, Godeart and colleagues have underlined the way by which we have estimated the potential burden of Chikungunya virus (CHIKV) infection in older people. Evidence from epidemiological, clinical, and laboratory studies suggest an age‐related defect in the immune system inducing a state of susceptibility and vulnerability to new or emerging pathogens. With respect to arboviral diseases, in addition to infants, older adults are often the first affected with the highest incidence of severe and atypical cases. For example, in the first outbreak of West Nile Virus in the United States in 1999, the median age was 71, with 73% of those affected aged 60 and older. In 2000 in Israel, all of the victims were aged 78 and older. Similar trends can be drawn in the United States with California encephalitis, dengue, Eastern equine encephalitis, St. Louis encephalitis, yellow fever, and Zika, which are also spread by mosquitoes. For CHIKV, data are less abundant and conclusive. As detailed by Godeart and colleagues and in our review, the effect of the age‐associated remodeling of the immune system probably contributes to the highest incidence of atypical presentation at the acute stage
Journal of American Geriatrics Society – Wiley
Published: Jan 1, 2018
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