A major chikungunya epidemic with high mortality in northeastern Brazil.

Introduction: Chikungunya causes fever and severe and persistent joint pain.

Methods: We reported a chikungunya outbreak that occurred in Ceará State, Brazil between 2016 and 2017 with emphasis on epidemiological characterization of cases, high number of deaths, mortality-associated factors, and spatial and temporal spread of the epidemic among municipalities.

Results: In November 2015, the first autochthonous cases of chikungunya were confirmed in Ceará, Brazil. In 2016-2017, 195,993 cases were reported, with an incidence of 2,186.5/100,000 inhabitants and 244 confirmed deaths.

Conclusions: Rapid transmission and high mortality rate are serious problems, especially in regions with co-circulating arboviruses.