Imported Chikungunya Infection, Italy

Beltrame, Anna; Angheben, Andrea; Bisoffi, Zeno; Monteiro, Geraldo Badona; Marocco, Stefania; Calleri, Guido; Lipani, Filippo; Gobbi, Federico; Canta, Francesca; Castelli, Francesco; Gulletta, Maurizio; Bigoni, Sara; Punta, Veronica Del; Iacovazzi, Tiziana; Romi, Roberto; Nicoletti, Loredana; Ciufolini, Maria Grazia; Rorato, Giada; Negri, Camilla; Viale, Pierluigi

doi:10.3201/eid1308.070161

Cited by 96 publications

(59 citation statements)

References 6 publications

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“…The main clinical symptoms mentioned by Robinson et al in his original report were fever, incapacitating arthralgia, myalgia, headache, and diffuse maculopapular rash [2]. Other clinical symptoms such as diarrhoea, vomiting, persistent arthralgia, and on rare occasions bleeding, have also been described, during outbreaks or in cohorts of travellers [6,[11][12][13]. Only a few case reports have been published suggesting that Chikungunya fever can be exceptionally associated with hepatitis, meningitis, encephalitis [14,15], myocarditis and arrhythmias [16,17].…”

Section: Discussionmentioning

confidence: 99%

Atypical Chikungunya virus infections: clinical manifestations, mortality and risk factors for severe disease during the 2005–2006 outbreak on Réunion

et al. 2008

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SUMMARYIn April 2005, an outbreak of Chikungunya fever occurred on the island of Re´union in the Indian Ocean. During winter 2005, six patients developed meningoencephalitis and acute hepatitis due to Chikungunya virus. Our objectives were to determine the incidence and mortality of atypical Chikungunya viral infections and to identify risk factors for severe disease. A hospital-based surveillance system was established to collect data on atypical Chikungunya cases. Case reports, medical records and laboratory results were reviewed and analysed. We defined an atypical case as one in which a patient with laboratory-confirmed Chikungunya virus infection developed symptoms other than fever and arthralgia. We defined a severe atypical case as one which required maintenance of at least one vital function. We recorded 610 atypical cases of Chikungunya fever : 222 were severe cases, 65 affected patients died. Five hundred and forty-six cases had underlying medical conditions (of which 226 suffered from cardiovascular, 147 from neurological and 150 from respiratory disorders). Clinical features that had never been associated with Chikungunya fever were recorded, such as bullous dermatosis, pneumonia, and diabetes mellitus. Hypertension, and underlying respiratory or cardiological conditions were independent risk factors for disease severity. The overall mortality rate was 10 . 6 % and it increased with age. This is the first time that severe cases and deaths due to Chikungunya fever have been documented. The information presented in this article may assist clinicians in identifying the disease, selecting the treatment strategy, and anticipating the course of illness.

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Section: Discussionmentioning

confidence: 99%

Atypical Chikungunya virus infections: clinical manifestations, mortality and risk factors for severe disease during the 2005–2006 outbreak on Réunion

et al. 2008

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“…23 The virus also established a focal autochthonous outbreak in Italy, the first report of CHIKV activity in Europe. 24 In addition to the magnitude of the epidemic, previously unreported neurological manifestations in adults and fetal encephalopathy have been reported. [25][26][27][28][29] CHIKV infection of the human central nervous system was first described in the 1960s.…”

Section: Introductionmentioning

confidence: 99%

Comparative Pathogenesis of Epidemic and Enzootic Chikungunya Viruses in a Pregnant Rhesus Macaque Model

Chen¹,

Clark²,

Pesavento³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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Abstract. Since 2004, an East African genotype of Chikungunya virus (CHIKV) has emerged, causing significant epidemics of an arthralgic syndrome. In addition, this virus has been associated for the first time with neonatal transmission and neurological complications. In the current study, pregnant Rhesus macaques were inoculated with an enzootic or epidemic strain of CHIKV to compare pathogenesis and transplacental transmission potential. Viremias were similar for both strains and peaked at 2-3 days post-inoculation (dpi). Viral RNA was detected at necropsy at 21 dpi in maternal lymphoid, joint-associated, and spinal cord tissues. The absence of detectable viral RNA and the lack of germinal center development in fetuses indicated that transplacental transmission did not occur. Neutralizing antibodies were detected in all dams and fetuses. Our study establishes a non-human primate model for evaluating vaccines and antiviral therapies and indicates that Rhesus macaques could serve as a competent enzootic reservoir.

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“…[17][18][19] Following these waves of outbreaks spreading from east Africa to southeast Asia, chikungunya infection has been reported increasingly in travellers or workers returning from visits to their home countries during the last years. [20][21][22][23][24][25] The virus was contracted undoubtedly in Dhaka, Bangladesh. To our knowledge, this is the first imported case of Chikungunya in Morocco and north Africa.…”

Section: Discussionmentioning

confidence: 99%

Chikungunya infection confirmed in a Moroccan traveller returning from Bangladesh

et al. 2017

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Recently, several countries reported imported cases of infection with chikungunya virus (CHIKV). We report the first case of chikungunya virus infection in Morocco. A 37-year old woman returned to Morocco on 15 August 2017, after she stayed in Dhaka-Bangladesh for 18months. She developed severe arthralgias and rash, fever up to 39°c. In next day’s symptoms progressively subsided but arthralgias remained for 3weeks. Laboratory findings didn't show lymphopenia, thrombocytopenia or elevated liver transaminases. Serological tests were positive for CHIKV IgM and negative for IgG antibodies. CHIKV-RNA was detected by RT-PCR. The patient was treated with non-steroid anti-inflammatory drugs and paracetamol. After 15days of hospitalization, symptoms ameliorated but arthralgias persists. The vector is established in Morocco and since the virus is diagnosed in returning travellers, chikungunya has a potential for autochthonous transmission in Morocco, that’s why CHIKV must be included in the differential diagnosis of arthralgia in all travellers returning from countries with documented transmission of the virus.

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Imported Chikungunya Infection, Italy

Cited by 96 publications

References 6 publications

Atypical Chikungunya virus infections: clinical manifestations, mortality and risk factors for severe disease during the 2005–2006 outbreak on Réunion

Atypical Chikungunya virus infections: clinical manifestations, mortality and risk factors for severe disease during the 2005–2006 outbreak on Réunion

Comparative Pathogenesis of Epidemic and Enzootic Chikungunya Viruses in a Pregnant Rhesus Macaque Model

Chikungunya infection confirmed in a Moroccan traveller returning from Bangladesh

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