Evidence for Endemic Chikungunya Virus Infections in Bandung, Indonesia

Abstract

Chikungunya virus (CHIKV) is known to cause sporadic or explosive outbreaks. However, little is known about the endemic transmission of CHIKV. To ascertain the endemic occurrence of CHIKV transmission, we tested blood samples from patients with a non-dengue febrile illness who participated in a prospective cohort study of factory workers in Bandung, Indonesia. From August 2000 to June 2004, and September 2006 to April 2008, 1901 febrile episodes occurred and 231 (12.2%) dengue cases were identified. The remaining febrile cases were evaluated for possible CHIKV infection by measuring anti-CHIKV IgM and IgG antibodies in acute and convalescent samples. Acute samples of serologically positive cases were subsequently tested for the presence of CHIKV RNA by RT-PCR and/or virus isolation. A total of 135 (7.1%) CHIKV infections were identified, providing an incidence rate of 10.1/1,000 person years. CHIKV infections were identified all year round and tended to increase during the rainy season (January to March). Severe illness was not found and severe arthralgia was not a prominently reported symptom. Serial post-illness samples from nine cases were tested to obtain a kinetic picture of IgM and IgG anti-CHIKV antibodies. Anti-CHIKV IgM antibodies were persistently detected in high titers for approximately one year. Three patients demonstrated evidence of possible sequential CHIKV infections. The high incidence rate and continuous chikungunya cases in this adult cohort suggests that CHIKV is endemically transmitted in Bandung. Further characterization of the circulating strains and surveillance in larger areas are needed to better understand CHIKV epidemiology in Indonesia.

Outbreak of Chikungunya virus in the north Caribbean area of Colombia: clinical presentation and phylogenetic analysis

“…On the other hand, the clinical presentation of patients in the present study showed some slightly different features from those seen in African and Asian countries [1][2][3]5,9]. We found the same percentage of fever and arthralgia; however, we observed a lower incidence of myalgia and headache [1,4].…”

“…On Reunion Island, severe forms were reported, mainly in patients with underlying medical conditions [4]. These forms included neurological and cardiovascular disorders, hepatitis, skin diseases, and respiratory and renal failure [2,3,5]. Miscarriages and neonatal infections have been also described, and some deaths have been directly attributed to CHIKV [4].…”

Current Laboratory Biosecurity for Handling Pathogenic Viruses

“…This region is considered as one of the hot spots of emerging viral diseases (Gronvall et al, 2015). The circulation of pathogenic viruses such as Nipah (Lam, 2003;Looi and Chua, 2007), SARS (Goh et al, 2006), H5N1 (Adisasmito et al, 2013), West Nile (Myint et al, 2014), dengue (Sasmono et al, 2015), Chikungunya (Kosasih et al, 2013;Riswari et al, 2016), Zika and coxsackievirus (Wiyatno et al, 2016) has been reported in this region.…”

Detection and identification of coxsackievirus B3 from sera of an Indonesian patient with undifferentiated febrile illness

“…Sera were collected from factory workers who experienced febrile illnesses during a dengue cohort study in Bandung from 2006-2009 undertaken by Padjadjaran University in collaboration with US-NAMRU#2 [13,14]. In total, 209 sera underwent various testing panels to evaluate the presence of dengue and chikungunya infections.…”

“…Collections were made under institutional review board approvals from the National Institute of Health Research and Development, Indonesian Ministry of Health, and the United States Naval Medical Research Unit No. 2, Jakarta, Indonesia, and written informed consent was obtained as described in the earlier study [13,14]. This follow-up study of archived specimens was reviewed and approved by the ethical committee at the Eijkman Institute for Molecular Biology, Jakarta, Indonesia.…”