Emergence and potential for spread of Chikungunya virus in Brazil

Abstract

BackgroundIn December 2013, an outbreak of Chikungunya virus (CHIKV) caused by the Asian genotype was notified in the Caribbean. The outbreak has since spread to 38 regions in the Americas. By September 2014, the first autochthonous CHIKV infections were confirmed in Oiapoque, North Brazil, and in Feira de Santana, Northeast Brazil.MethodsWe compiled epidemiological and clinical data on suspected CHIKV cases in Brazil and polymerase-chain-reaction-based diagnostic was conducted on 68 serum samples from patients with symptom onset between April and September 2014. Two imported and four autochthonous cases were selected for virus propagation, RNA isolation, full-length genome sequencing, and phylogenetic analysis. We then followed CDC/PAHO guidelines to estimate the risk of establishment of CHIKV in Brazilian municipalities.ResultsWe detected 41 CHIKV importations and 27 autochthonous cases in Brazil. Epidemiological and phylogenetic analyses indicated local transmission of the Asian CHIKV genotype in Oiapoque. Unexpectedly, we also discovered that the ECSA genotype is circulating in Feira de Santana. The presumed index case of the ECSA genotype was an individual who had recently returned from Angola and developed symptoms in Feira de Santana. We estimate that, if CHIKV becomes established in Brazil, transmission could occur in 94% of municipalities in the country and provide maps of the risk of importation of each strain of CHIKV in Brazil.ConclusionsThe etiological strains associated with the early-phase CHIKV outbreaks in Brazil belong to the Asian and ECSA genotypes. Continued surveillance and vector mitigation strategies are needed to reduce the future public health impact of CHIKV in the Americas.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-015-0348-x) contains supplementary material, which is available to authorized users.

Chikungunya infection in infants

“…3 In Brazil, the first autochthonous case of the disease was confirmed in 2014. 4 In 2016, 64.349 cases of chikungunya were reported up to the 16 Epidemiological week (Jan. 3,2016 to April 23, 2016), of those 64.349 cases, 11.182 were confirmed. 5 The horizontal transmission of chikungunya infection occurs in children and adults through the vector mosquito´s bite.…”

Encephalitis associated with inappropriate antidiuretic hormone secretion due to chikungunya infection in Recife, State of Pernambuco, Brazil

“…1 In Brazil, although cases of CHIKV infection are frequently under reported, in the first four months of 2016, there were 122,762 cases of chikungunya fever (incidence rate of 60 cases/100 million inhabitants), most of them in the Northeast region. In the State of Pernambuco, there were 40,627 cases, 26 confirmed deaths, and 238 deaths under investigation 12 .…”

“…The first cases of chikungunya virus (CHIKV) infection in Brazil were reported in 2014 1 , continuing through 2015 during the epidemic of newborns with microcephaly and adults with Guillain-Barré syndrome caused by Zika virus infection. The clinical symptoms of arbovirus infections include high fever, headache, muscle aches, vomiting, and skin rash.…”

A real-time RT-PCR for rapid detection and quantification of mosquito-borne alphaviruses

“…EEEV, VEEV and WEEV are known to cause human and equine encephalomyelitis with high fatality rates and the development of neurological sequelae in survivors [38]. Presently, alphaviruses are an important public health problem in the Americas [17,20,29,34,38]. These viruses have been introduced into new areas as a consequence of the rapid expansion of international travel.…”

“…Consequentially, the wide variety of reservoirs coupled with the spreading of both vectors and viruses through international travel has led to the global distribution of these viruses. Moreover, the lack of effective antiviral treatments or human vaccines have enabled alphaviruses to become a threat that can result in explosive epidemics, as recently described for CHIKV in the Americas [5,20,36].…”