Clinical Manifestations Associated with Peripheral Joint Involvement in Patients with Acute Chikungunya Virus Infection

Abstract

Abstract. Chikungunya virus (CHIKV) causes an acute febrile illness usually accompanied by severe polyarthralgia and polyarthritis. Previous studies have shown that older age, female gender, and some comorbid conditions are associated with chronic CHIKV arthritis. However, the factors associated with acute arthralgia and arthritis are not well known. Thus, we studied the clinical manifestations associated with acute peripheral joint involvement in a group of CHIKV patients from Puerto Rico. Patients with a history of fever for < 7 days evaluated at the emergency department of a university-based hospital were tested for several pathogens including CHIKV. All patients with laboratory-positive CHIKV infection were studied. Demographic features, clinical manifestations, and comorbidities were determined. Patients with and without peripheral joint involvement were compared using bivariable and multivariable analyses. In total, 172 patients with CHIKV fever were evaluated; 52.9% were women. The mean (standard deviation) age was 21.1 years (19.3). Peripheral arthralgia and/or arthritis were seen in 156 (90.7%) patients. In the multivariable analysis adjusted for age and gender, peripheral joint involvement was associated with myalgia (odds ratio [OR] = 4.65, 95% confidence interval [CI] = 1.48-14.72), back pain (OR = 16.77, 95% CI = 3.07-313.82), ocular pain (OR = 8.88, 95% CI = 1.65-165.19), headache (OR = 3.63, 95% CI = 1.06-12.53), anorexia (OR = 5.68, 95% CI = 1.87-18.97), and nausea (OR = 6.88, 95% CI = 2.05-31.49). In conclusion, in this population of patients with acute CHIKV infection, peripheral joint involvement was associated with myalgia and back pain as well as nonmusculoskeletal manifestations such as headache, ocular pain, anorexia, and nausea.

Prevalence of chronic comorbidities in chikungunya: A systematic review and meta-analysis

“…Systematic analysis of studies that described the epidemiological, demographic and clinical features of CHIKV cases and reported the prevalence of a number of chronic diseases in the infectious disease, has identified 11 reports (Arroyo-Avila et al, 2017;Economopoulou et al, 2009;Padmakumar et al, 2010;Jean-Baptiste et al, 2016;Sá deOliveira et al, 2017;Perti et al, 2016;Crosby et al, 2016;Chusri et al, 2014;Couturier et al, 2012;Tandale et al, 2009;Borgherini et al, 2007) with 2,773 patients (Table 1). This limited number of reports is the result of our strict search strategy and selection criteria and our focus only on the studies recording the prevalence of comorbidities in CHIKV.…”

“…Ten articles were excluded at the full text review stage as they were either not related to the study objectives (4 studies), not reporting prevalence of chronic disease in CHIKV (3 studies), case reports with small numbers of cases (i.e., <3 cases; 2 reports), or a review article (see Figure 1 and Supplementary Table S1). After identifying one study through bibliography searching, 11 reports were included for systematic review and meta-analysis (Arroyo-Avila et al, 2017;Economopoulou et al, 2009;Padmakumar et al, 2010;Jean-Baptiste et al, 2016;Sá deOliveira et al, 2017;Perti et al, 2016;Crosby et al, 2016;Chusri et al, 2014;Couturier et al, 2012;Tandale et al, 2009;Borgherini et al, 2007).…”

“…When developed, these conditions can persist for several months or years after acute infection Brighton et al, 1983;Soumahoro et al, 2009;Borgherini et al, 2008;Larrieu et al, 2010). Furthermore, CHIKV is a common cause of virus-induced arthritis in the Eastern Hemisphere, with documented epidemics in Africa, Southeast Asia, and the Indian Ocean islands (Staples et al, 2009;Arroyo-Avila et al, 2017;Economopoulou et al, 2009;Leparc-Goffart et al, 2014b).…”

Clinical and Laboratory Characteristics of an Acute Chikungunya Outbreak in Bangladesh in 2017

“…Chikungunya fever is a viral illness caused by a single-stranded RNA virus belonging to the Alphavirus family. 1 The virus is transmitted between humans through the bites of infected female, Aedes mosquitoes. 2 The first documented case of chikungunya virus (CHIKV) infection in humans was in 1952–1953 at Tanganyika, East Africa, and the first outbreak occurred in Bangkok, Thailand, in 1958.…”

Leptospirosis Cases Infected with Uncommon Serogroups, Puerto Rico, 2013–2015

“…Clinical specimens were collected upon enrollment and upon hospital discharge or follow-up visit, and diagnostic testing was performed as previously described. 14 All patients enrolled in SEDSS provided informed consent. Additional data were collected through chart abstraction for leptospirosis patients.…”