Chikungunya: A Potentially Emerging Epidemic?

Chikungunya virus infection is a disease transmitted by vectors, in which vertical transmission was described in years [2005][2006]. An infection rate up to 49% in neonates born from mothers with active viremia during labor has been observed. Perinatal infection could results in serious complications and potential cognitive impairment. Objective: To describe a newborn with Chikungunya virus infection secundary to vertical transmission. Clínical case: A female newborn is analyzed. She presented with fever and exanthema during her first week of life, elevation of transaminases and thrombocytopenia. Her mother had had symptoms compatible with chikungunya virus infection on the day of the delivery. Specific IgM antibodies against chikungunya were documented and the diagnosis was confirmed. Conclusion: Given the high perinatal transmissibility rate of chikungunya virus, this diagnosis should be considered in every newborn child of a mother with suggestive symptoms of chikungunya in the days surrounding delivery.

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“…The transmission of the disease to humans is caused by a bite of an Aedes infected mosquito 1,4 . In the urban cycle, the major vector is Ae.…”

Section: Introductionmentioning

confidence: 99%

Reporte de caso de transmisión vertical de la infección por virus chikungunya

Cardona-Correa

Castaño-Jaramillo

Quevedo-Vélez

2017

Rev. chil. pediatr.

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“…The 2006 chikungunya (CHIK) virus epidemic originated in East Africa and rapidly spread to the Indian subcontinent (1)(2)(3). Unlike previous epidemics, thousands of new cases and patients with persistent musculoskeletal pain and arthritis continue to be reported.…”

mentioning

confidence: 99%

Effectiveness of Chloroquine and Inflammatory Cytokine Response in Patients With Early Persistent Musculoskeletal Pain and Arthritis Following Chikungunya Virus Infection

Chopra¹,

Saluja²,

Venugopalan³

2014

Arthritis & Rheumatology

114

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Objective. To evaluate whether chloroquine (CQ) is more effective than meloxicam for treating early musculoskeletal pain and arthritis following acute chikungunya (CHIK) virus infection.Methods. During the 2006 CHIK epidemic, 509 rural community cases of acute CHIK virus infection were identified in the district of Sholapur in India. Seventy consenting adult patients (seropositive for IgM/ IgG anti-CHIK antibody) with early persistent musculoskeletal pain and arthritis were randomized into a 24-week, 2-arm, parallel efficacy trial of CQ (250 mg/ day) and meloxicam (7.5 mg/day). Assessors completed a rheumatology evaluation in a blinded manner and collected blood samples in the patients' homes, as per protocol. Laboratory parameters included serum cytokine assay (interleukin-6 [IL-6], interferon-␥ [IFN␥], tumor necrosis factor ␣, CXCL10/IFN␥-inducible protein 10, and IL-13). Twenty-two patients who failed to meet the eligibility criteria (low pain cohort) were also followed up with similar evaluations. An intent-to-treat analysis was completed. At baseline, the 2 groups (38 patients randomized to receive CQ and 32 patients randomized to receive meloxicam) were well matched.Results. There were no significant efficacy differences between the meloxicam group and the CQ group (mean changes in the visual analog scale score for pain ؊3.9 and ؊4.2, respectively). Patients improved significantly. Cytokine levels remained several-fold increased, were disproportionate to the clinical response, and were not different from those in the low pain cohort. Seven patients withdrew. Adverse events were mild and infrequent. Conclusion. This exploratory community intervention trial failed to identify an advantage of CQ over meloxicam to treat early musculoskeletal pain and arthritis following acute CHIK virus infection, but therapeutic efficacy of CQ was not ruled out. The inflammatory cytokine response was intense and was not consistent with clinical status.The 2006 chikungunya (CHIK) virus epidemic originated in East Africa and rapidly spread to the Indian subcontinent (1-3). Unlike previous epidemics, thousands of new cases and patients with persistent musculoskeletal pain and arthritis continue to be reported. We previously observed a wide spectrum of post-CHIK virus musculoskeletal pain and arthritis, but the etiology remains unknown (4). Oral chloroquine (CQ) has been used extensively to treat acute and chronic musculoskeletal pain and arthritis following CHIK virus infection; however, clinical data remain sparse (3).Acute CHIK virus infection is a self-limiting, excruciatingly painful arboviral illness of short duration. In our experience, acute symptoms subsided within 10 days, and approximately two-thirds of patients recovered within 3 weeks (4). Against this background, we carried out a controlled evaluation of CQ to treat patients with early persistent musculoskeletal pain and arthritis following CHIK virus infection. Selected cytokine assays were carried out to study the inflammatory nature of musculoskeletal pain and ar...

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“…Chikungunya virus (CHIKV) is a mosquito-borne virus causing fever and severe joint pain [109]. The CHIKV proteome was analyzed by VaxiJen, identifying envelope protein 2 as the most immunogenic [110].…”

Section: Prediction Of Viral Immunogensmentioning

confidence: 99%