Contribution of Research in the West Indies and Northeast Amazonia to Knowledge of the 2014–2015 Chikungunya Epidemic in the Americas

Abstract

Purpose of Review Although the chikungunya virus was discovered more than 60 years ago, it has only really been studied since the outbreak in La Reunion in 2005–2006. Ten years later, between 2014 and 2015, the chikungunya virus spread throughout the Americas, affecting millions of people. The objective of this review is to describe the contributions of research on chikungunya virus infection gained from epidemic in the West Indies and the Guiana Shield. Recent Findings Prevalence data were similar to those found in the Indian Ocean or Asia during epidemics. Clinically, there is now a better understanding of the typical, atypical, and severe forms. Several studies have insisted on the presence of neurological forms of chikungunya infection, such as encephalitis or Guillain–Barré syndrome. Cases of septic shock due to chikungunya virus as well as thrombotic thrombocytopenic purpura were described for the first time. Given the magnitude of the epidemic and the large number of people affected, this has led to a better description and new classifications of chikungunya virus infections in specific populations such as pregnant women, the elderly, and children. Several studies also described the behavior of populations faced with an emerging disease. Summary Current epidemiological data from tropical regions highlights the risk of spreading emerging diseases at higher latitudes, especially concerning arboviruses, since the vector Aedes albopictus is already established in many parts of northern countries. A better understanding of the disease and its epidemic dynamics will foster better management, the crucial importance of which was demonstrated during the COVID-19 epidemic.

Review on Main Arboviruses Circulating on French Guiana, An Ultra-Peripheric European Region in South America

“…DENV belongs to the Flaviviridae family and the genus Flavivirus . Currently, Aedes aegypti is the primary vector identified for DENV transmission in FG [ 5 ]. When looking at the past dengue fever epidemics recorded in FG, the etiology should be considered with a certain distrust; indeed, until the 1980s, dengue diagnosis was based only on clinical manifestations.…”

“…The reported symptoms were relatively similar to those described in La Reunion Island, Indian Ocean, with a picture of high-grade fever and distal joint pain at the onset of the disease. However, atypical and/or severe cases were notified with neurological forms, encephalitis or Guillain-Barré syndrome, septic shock due to CHIKV or thrombotic thrombocytopenic purpura [ 5 , 18 ]. Although CHIKV has not been reported in FG and the West Indies since 2016, apart from rare, imported cases, the risk of a new epidemic in the mid-term remains real.…”

Panorama des pathologies infectieuses et non infectieuses de Guyane en 2022

“…Les cas notifiés en interépidémie, diagnostiqués par sérologie (IgM), sont étiquetés comme probables, mais peuvent traduire des infections passées à travers des réactivations immunologiques, même s'il peut aussi s'agir de cas importés ou de petits clusters. Aedes aegypti est le principal vecteur identifié, Aedes albopictus n’étant pas présent sur le territoire [ 35 ]. Au cours des dernières années, on a assisté à des épidémies de plus en plus fréquentes (2006, 2009-2010, 2013, 2020-2021) avec un nombre de cas cliniquement évocateurs variant de 10 000 à 18 000 selon les épidémies.…”

“…aegypti a été le principal vecteur de l’épidémie américaine de 2013-2014 avec la souche asiatique, et une deuxième souche, ECSA, a circulé de façon concomitante au Brésil. Si la symptomatologie rapportée en Guyane était relativement superposable aux formes décrites à La Réunion, avec un tableau regroupant fièvre et arthralgies distales au premier plan, des cas atypiques et ou sévères ont été rapportés: formes neurologiques, encéphalite ou syndrome de Guillain-Barré, chocs septiques dus au CHIKV ou encore purpura thrombocytopénique thrombotique [ 35 , 36 ]. Si le CHIKV ne semble plus circuler sur le territoire guyanais et aux Antilles où il n'a plus été détecté depuis 2016 en dehors de rares cas importés, le risque à moyen terme d'une nouvelle épidémie est réel.…”