Chikungunya outbreak in Bangladesh (2017): Clinical and hematological findings

Abstract

Introduction A massive outbreak of chikungunya virus (CHIKV) occurred in Bangladesh during the period of April-September 2017, and over two million people were at risk of getting infected by the virus. A prospective cohort of viremic patients was constituted and analyzed to define the clinical, hematological, and long-term aspects of this outbreak. Methods A 35-day long comprehensive survey was conducted in two major, neighboring cities, Dhaka and Mymensingh. One-hundred and eighty-seven laboratory-confirmed CHIKV cases were enrolled in the cross-sectional cohort study. Additionally, a smaller group of 48 chikungunya patients was monitored for post-infection effects for 12 months. Results Clinical data revealed that a combination of fever and arthralgia (oligoarthralgia and/or polyarthralgia) was the cardinal hallmark (97.9% of cases) of the infection. Hematological analysis showed that irrespective of age and sex groups, CHIKV patients had a decreased level of hemoglobin (n = 64, p < 0.01) and elevated erythrocyte sedimentation rate (n = 131, p < 0.01). Besides, a significant portion of the patients represented abnormal values for RBC (n = 38, p = 0.0005) and WBC (n = 63, p < 0.01) counts. The post-infection study revealed that children had an early recovery from the infection compared to the adults. Moreover, postinfection weakness, successive relapse of arthralgic pain, and memory problems were the most significant aftereffects, which had an impact on the daily activities of patients.

A Novel Sub-Lineage of Chikungunya Virus East/Central/South African Genotype Indian Ocean Lineage Caused Sequential Outbreaks in Bangladesh and Thailand

“…This new sub-lineage caused the largest CHIKV outbreak in 2017. More than one thousand confirmed cases were reported in Dhaka city, and numbers of cases peaked in July during the monsoon season [ 56 , 57 ]. Although Ae.…”

Clinical Features of Acute Chikungunya Virus Infection in Children and Adults during an Outbreak in the Maldives

“…14 Overall,24.4% of children were reportedly affected during the 2019 outbreak in the Maldives, and in our cohort, we observed 20% with confirmed infection, compared with 17% of children reportedly affected in an outbreak on the Indian subcontinent. 25,39 These data indicate that the approximate proportion of children affected during outbreaks is generally less than one-fourth of all cases. We also observed similarity between the mean age of children affected in our cohort and data reported regarding an outbreak in South America.…”

“…Similarly, arthritogenic manifestations are reportedly much less common in children than in adults. 39 This might be due to the robust nature of the immune system of children, which enables more rapid clearance of the infection. 44 Febrile exanthema is a challenge for clinicians because a wide range of viral and bacterial infections can produce a rash.…”

Clinical Features and Hematological Parameters in Some Chikungunya Patients, Yemen

“…In children reported rash on face, hands and legs. Several studies reported that, the fever lasts from several days up to a week is about 76-100 % of symptomatic patients, it can be continuous or intermittent with mild fever [14, 15, 16, 17, 18].The headache, muscular pain, and joint pain of both upper and lower limbs were reported in previous studies associated by chikungunya infection [19,12].…”

“…In adult patients (25-60 years) were suffering myalgia accompanied by arthralgia after 3 days of infection (table 1). The previously published reports have indicated that the combination of fever and severe arthralgia (present in more than 95% of cases) [12,13]. Other clinical manifestations reported as, headache, joint pain, redness of joints , swelling of joints vomiting and fatigue for 3 to 5 days.…”