Chikungunya Infection in Hospitalized Febrile Infants Younger Than 3 Months of Age

Elenga, Narcisse; Folin, Marion; Vandamme, Yves-Marie; Cuadro-Alvarez, Emma; Long, Laurence; Njuieyon, Falucar; Martin, Élise; Kom-Tchameni, Rémi; Defo, Antoine; Razafindrakoto, Sitraka Herinantenaina; Mrsic, Yajaira; Couppié, Pierre; Dufour, Julie

doi:10.1097/inf.0000000000001541

Cited by 12 publications

(11 citation statements)

References 24 publications

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“…Interestingly, in contrast to patients of all other age groups, infants with CHIKV infection were hospitalized more frequently than those with a non-CHIKV etiology of AFI, suggesting increased disease severity (e.g., higher fever, irritability). A recent study of hospitalized febrile infants with CHIKV infection found that the highest frequency of signs and symptoms included irritability, rash, and edema, all of which were similar to our findings [42].…”

Section: Discussionsupporting

confidence: 91%

“…These observations are similar to what has been reported for patients who experienced severe manifestations of disease associated with CHIKV infection during outbreaks in the Americas and elsewhere [2, 23, 27–29, 36, 40]. The highest frequency of hospitalization by age group was among infants, who have been demonstrated to be at higher risk for severe manifestations of disease associated with CHIKV infection, particularly neonates and those infected through perinatal transmission [2, 36, 42]. Interestingly, in contrast to patients of all other age groups, infants with CHIKV infection were hospitalized more frequently than those with a non-CHIKV etiology of AFI, suggesting increased disease severity (e.g., higher fever, irritability).…”

Section: Discussionsupporting

confidence: 85%

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Risk factors for hospitalization of patients with chikungunya virus infection at sentinel hospitals in Puerto Rico

et al. 2019

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BackgroundHospitalization of patients during outbreaks of chikungunya virus has been reported to be uncommon (0.5–8.7%), but more frequent among infants and the elderly. CHIKV was first detected in Puerto Rico in May 2014. We enrolled patients with acute febrile illness (AFI) presenting to two hospital emergency departments in Puerto Rico and tested them for CHIKV infection to describe the frequency of detection of CHIKV-infected patients, identify risk factors for hospitalization, and describe patients with severe manifestations.Methodology/Principal findingsSerum specimens were collected from patients with AFI and tested by rRT-PCR. During May–December 2014, a total of 3,035 patients were enrolled, and 1,469 (48.4%) had CHIKV infection. A total of 157 (10.7%) CHIKV-infected patients were hospitalized, six (0.4%) were admitted to the intensive care unit, and two died (0.1%). Common symptoms among all CHIKV-infected patients were arthralgia (82.6%), lethargy (80.6%), and myalgia (80.5%). Compared to patients aged 1–69 years (7.3%), infant (67.2%) and elderly (17.3%) patients were nine and two times more likely to be hospitalized, respectively (relative risk [RR] and 95% confidence interval [CI] = 9.16 [7.05–11.90] and 2.36 [1.54–3.62]). Multiple symptoms of AFI were associated with decreased risk of hospitalization, including arthralgia (RR = 0.31 [0.23–0.41]) and myalgia (RR = 0.29 [0.22–0.39]). Respiratory symptoms were associated with increased risk of hospitalization, including rhinorrhea (RR = 1.68 [1.24–2.27) and cough (RR = 1.77 [1.31–2.39]). Manifestations present among <5% of patients but associated with patient hospitalization included cyanosis (RR = 2.20 [1.17–4.12) and seizures (RR = 3.23 [1.80–5.81).DiscussionAmong this cohort of CHIKV-infected patients, hospitalization was uncommon, admission to the ICU was infrequent, and death was rare. Risk of hospitalization was higher in patients with symptoms of respiratory illness and other manifestations that may not have been the result of CHIKV infection.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 85%

Risk factors for hospitalization of patients with chikungunya virus infection at sentinel hospitals in Puerto Rico

et al. 2019

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“…While neonates may experience physiological symptoms associated with postnatal CHIKV infection (e.g., febrile seizures, diarrhea, vomiting, arthralgia/arthritis, acrocyanosis, uremia, lymphopenia, cytolysis, etc.) [10, 13, 15-17, 19, 21, 24, 25], existing evidence indicates that the vast majority of older children will recover and not experience any long-term impact of CHIKV infection [38][39][40][41][42][43][44]. Results from the current study indicate no negative impact of postnatal CHIKV infection on neurodevelopment in children at two years of age.…”

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 67%

Pre and postnatal exposure to Chikungunya virus does not affect child neurodevelopmental outcomes at two years of age

et al. 2020

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Background The 2005-06 chikungunya virus (CHIKV) outbreak in La Ré union suggested that mothers could transmit CHIKV to their neonates while viremic during the intrapartum period, and more than half of the infected neonates showed impaired neurodevelopment at two years of age. However, data sparsity precluded an overview of the developmental impact of vertical infection within the whole prenatal period. Objective & methods The current study assessed two-year old children born to mothers who were infected during the 2014 CHIKV outbreak in Grenada to determine the neurodevelopmental impact of perinatal CHIKV infection throughout gestation. Mother and child infection status were confirmed by serologic testing (IgG and IgM) for CHIKV. Cognitive, fine motor, gross motor, language and behavioral outcomes were assessed at two years of age on the INTER-GROWTH-21 st Neurodevelopment Assessment (INTER-NDA). Results No differences in neurodevelopmental outcomes were observed between two-year-old children born to mothers infected with CHIKV during gestation (n = 149) and those born to mothers not infected with CHIKV (n = 161). No differences were found in INTER-NDA scores PLOS NEGLECTED TROPICAL DISEASES

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Section: Chikv In Neonates and Children After Global Expansionmentioning

confidence: 99%

“…During the 2014–2015 outbreak in Guiana, 26 febrile children under three months of age infected with CHIKV-WH with a R99Q substitution at nsP4 were hospitalized [76]. The most common symptoms reported were fever, rash and edema of the hands and feet indicating possible problems with perfusion [76]. The nsP4 gene is the most highly conserved gene of the alphaviruses and encodes an RNA-dependent-RNA-polymerase that functions in producing the synthetic properties of the viral replicase complex [130,141].…”

Section: Chikv In Neonates and Children After Global Expansionmentioning

confidence: 99%

Chikungunya in Infants and Children: Is Pathogenesis Increasing?

Barr

Vaidhyanathan

2019

Viruses

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Chikungunya virus (CHIKV) was first extensively described in children during outbreaks in India and South Asia during the mid-1960s. Prior to the 2005 emergence of CHIKV on Reunion Island, CHIKV infection was usually described as a dengue-like illness with arthralgia in Africa and febrile hemorrhagic disease in Asia. Soon after the 2005 emergence, severe CNS consequences from vertical and perinatal transmission were described and as CHIKV continued to emerge in new areas over the next 10 years, severe manifestation of infection and sequelae were increasingly reported in infants and neonates. The following review describes the global reemergence and the syndromes of Chikungunya fever (CHIKF) in infants and children. The various manifestations of CHIKF are described and connected to the viral lineage that was documented in the area at the time the disease was described. The data show that certain manifestations of CHIKF occur with specific viral lineages and genetic motifs, which suggests that severe manifestations of CHIKF in the very young may be associated with the emergence of new viral lineages.

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Chikungunya Infection in Hospitalized Febrile Infants Younger Than 3 Months of Age

Abstract: Our results confirm that Chikunguyna infection is a cause of high fever in infants younger than 3 months. Our data should be confirmed by larger studies.

Cited by 12 publications

References 24 publications

Risk factors for hospitalization of patients with chikungunya virus infection at sentinel hospitals in Puerto Rico

Risk factors for hospitalization of patients with chikungunya virus infection at sentinel hospitals in Puerto Rico

Pre and postnatal exposure to Chikungunya virus does not affect child neurodevelopmental outcomes at two years of age

Chikungunya in Infants and Children: Is Pathogenesis Increasing?

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