Chikungunya infection: self-reported rheumatic morbidity and impaired quality of life persist 6 years later

Abstract

This study presents the 6-year follow-up of French gendarmes exposed to the chikungunya (CHIK) infection in 2006 on Reunion Island. The aim was to see to what extent the subjective health differences observed in 2008 (30 months after infection) between CHIK infected (CHIK+) and noninfected (CHIK-) gendarmes still persisted in 2012, and to investigate a possible return to a pre-CHIK health status for CHIK+ subjects. Gendarmes were contacted by mail in 2012 and asked to complete a self-questionnaire asking for morbidity, health care and medicines consumption since the last follow-up in 2008. Quality of life (QoL) after 6 years was evaluated using the SF-36 scale. In comparison with CHIK- subjects (n = 171), CHIK+ (n = 81) presented with higher rheumatic but also nonspecific morbidity such as headaches and fatigue associated with a large psychological impact, frequent depressive moods and social disabilities, leading to a significant impairment of the QoL and higher health care consumption. When restricted to CHIK+ subjects, comparing the data with that of 2008 showed persistent but decreasing self-reported rheumatic morbidity, and an increase over time of chronic discomfort (headache, fatigue) and depressive moods, resulting in no overall improvement in QoL. Despite possible cohort attrition bias, the comparability of CHIK+/CHIK- subjects allows the assumption of a long-term impact of CHIK infection with less chance of returning to a previous health status. Although these results may be specific to the 2006 virus strain, we recommend that public health strategies in the epidemic-prone countries include a response to the consequences of chronic post-CHIK disorders.

Review: Chikungunya Arthritis: Implications of Acute and Chronic Inflammation Mechanisms on Disease Management

“…Chikungunya virus symptoms include a range of acute manifestations, among which fever, severe joint and muscle pain, headache, and rashes are prominent. However, there is mounting concern over the persistence of long‐lasting manifestations associated with debilitating effects of the disease and the deterioration of overall health and quality of life . Among these, chronic arthralgia/arthritis (joint pain/joint stiffness plus joint swelling, respectively), musculoskeletal injury, and fatigue—and, to a lesser extent, neurocognitive and sensorineural manifestations—have been shown to contribute significantly to the economic burden of the disease .…”

Chikungunya virus pathogenesis: From bedside to bench

“…Long-lasting symptoms are typically not observed in dengue fever, although asthenia can be intense in the days to weeks following the dengue fever. Chronic joint pain following chikungunya disease was first published in 1979 [34] and has been massively reported during all recent epidemics that have occurred since 2005 in the Indian Ocean notably in the Island of La Réunion [10,52,55,76,113,121,132] or in metropolitan France for imported cases [23, 66,119], in India or Southeast Asia [36,75,89,145], in Italy [84] and more recently in the Caribbean [32,82].…”

Interventions for treating patients with chikungunya virus infection-related rheumatic and musculoskeletal disorders: A systematic review

“…While a minority of CHIKV patients may not progress to the chronic stage, even the acute and post-acute stages result in very significant physical pain and disability, psychological suffering, worsened quality of life and reduced wellbeing for a period of three months. In patients progressing to the chronic stage, this pain, suffering and disability may continue for many years [20,22]. …”