Long-term chikungunya infection clinical manifestations after an outbreak in Italy: A prognostic cohort study

Moro, Maria Luisa; Grilli, E.; Corvetta, A; Silvi, Giuliano; Angelini, Raffaella; Mascella, F; F, Miserocchi; Sambo, Paola; Finarelli, A C; Sambri, Vittorio; Gagliotti, Carlo; Massimiliani, Erika; Mattivi, Andrea; Pierro, Anna; Macini, P

doi:10.1016/j.jinf.2012.04.005

Cited by 104 publications

(85 citation statements)

References 14 publications

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“…A high percentage of CHIKV-infected individuals suffer from chronic arthralgia (13,14,16,17,58,59), and chronic CHIKV disease can be debilitating with severe economic consequences (17,58,60,61). Accordingly, an improved understanding of the molecular mechanisms of chronic CHIKV disease and the development of effective therapies to prevent or treat viral persistence are critical.…”

Section: Discussionmentioning

confidence: 99%

Chronic Joint Disease Caused by Persistent Chikungunya Virus Infection Is Controlled by the Adaptive Immune Response

Hawman

Stoermer

Montgomery

et al. 2013

J Virol

203

224

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f Chikungunya virus (CHIKV) is a reemerging mosquito-borne pathogen that causes incapacitating disease in humans characterized by intense joint pain that can persist for weeks, months, or even years. Although there is some evidence of persistent CHIKV infection in humans suffering from chronic rheumatologic disease symptoms, little is known about chronic disease pathogenesis, and no specific therapies exist for acute or chronic CHIKV disease. To investigate mechanisms of chronic CHIKV-induced disease, we utilized a mouse model and defined the duration of CHIKV infection in tissues and the associated histopathological changes. Although CHIKV RNA was readily detectable in a variety of tissues very early after infection, CHIKV RNA persisted specifically in joint-associated tissues for at least 16 weeks. Inoculation of Rag1 ؊/؊ mice, which lack T and B cells, resulted in higher viral levels in a variety of tissues, suggesting that adaptive immunity controls the tissue specificity and persistence of CHIKV infection. The presence of CHIKV RNA in tissues of wild-type and Rag1 ؊/؊ mice was associated with histopathological evidence of synovitis, arthritis, and tendonitis; thus, CHIKV-induced persistent arthritis is not mediated primarily by adaptive immune responses. Finally, we show that prophylactic administration of CHIKV-specific monoclonal antibodies prevented the establishment of CHIKV persistence, whereas therapeutic administration had tissue-specific efficacy. These findings suggest that chronic musculoskeletal tissue pathology is caused by persistent CHIKV infection and controlled by adaptive immune responses. Our results have significant implications for the development of strategies to mitigate the disease burden associated with CHIKV infection in humans.

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Section: Discussionmentioning

confidence: 99%

Chronic Joint Disease Caused by Persistent Chikungunya Virus Infection Is Controlled by the Adaptive Immune Response

Hawman

Stoermer

Montgomery

et al. 2013

J Virol

203

224

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“…However, it should be noted that because 80% of Zika infections are asymptomatic [43], time to detection of an outbreak and response could be longer than for other diseases. Chikungunya, on the other hand, is highly symptomatic (around 80-90% of those infected exhibit symptoms, [61,62]), so it is more likely to be detected and motivate mitigation efforts. Finally, the model assumes that within the square-mile area considered, mosquitoes and humans are homogeneous in space and can be characterized by mean densities.…”

Section: Discussionmentioning

confidence: 99%

Defining the risk of Zika and chikungunya virus transmission in human population centers of the eastern United States

Manore

Ostfeld

Agusto

et al. 2016

Preprint

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The recent spread of mosquito-transmitted viruses and associated disease to the Americas motivates a new, data-driven evaluation of risk in temperate population centers. Temperate regions are generally expected to pose low risk for significant mosquito-borne disease; however, the spread of the Asian tiger mosquito (Aedes albopictus) across densely populated urban areas has established a new landscape of risk. We use a model informed by field data to assess the conditions likely to facilitate local transmission of chikungunya and Zika viruses from an infected traveler to Ae. albopictus and then to other humans in USA cities with variable human densities and seasonality. Mosquito-borne disease occurs when specific combinations of conditions maximize virus-to-mosquito and mosquito-to-human contact rates. We develop a mathematical model that captures the epidemiology and is informed by current data on vector ecology from urban sites. The model demonstrates that under specific but realistic conditions, fifty-percent of introductions by infectious travelers to a high human, high mosquito density city could initiate local transmission and 10% of the introductions could result in 100 or more people infected. Despite the propensity for Ae. albopictus to bite non-human vertebrates, we also demonstrate that local virus transmission and human outbreaks may occur when vectors feed from humans even just 40% of the time. Inclusion of human behavioral changes and mitigations were not incorporated into the models and would likely reduce predicted infections. This work demonstrates how a conditional series of non-average events can result in local arbovirus transmission and outbreaks of human disease, even in temperate cities.

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“…Other less common symptoms include neuropathy, cerebral disorder, neurosensory deficiency, burning mouth syndrome, paresthesia, cubital tunnel syndrome, gastrointestinal disorders, exanthema, pruritus, bursitis, and synovitis 28,36,44,[47][48][49] .…”

Section: Chronic Phasementioning

confidence: 99%

Chikungunya: Molecular Aspects, Clinical Outcomes and Pathogenesis

Bautista-Reyes

Núñez-Avellaneda

Alonso-Palomares

et al. 2017

RIC

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The alarming worldwide emergence of the chikungunya virus began in the last decade. Since the first autochthonous transmission in Mexico in November of 2014, the virus has spread throughout the country, resulted in multiple outbreaks. This virus produces an acute and self-limiting disease characterized by fever, polyarthralgia, myalgia, exanthema, and general malaise. It is transmitted to humans by the bite of Aedes aegypti and A. albopictus mosquitoes. The fact that the clinical presentation is similar to that produced by other arboviruses complicates its clinical diagnosis. The chronic stage of the disease can cause severe consequences lasting months or years, from local arthralgia to rheumatoid arthritis. In this review, we emphasize the public health threat posed by this highly disabling emerging disease, the clinical outcomes, and its possible physiopathological process. We outline the diagnosis and the impact that this virus has had in Mexico since its introduction.

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Long-term chikungunya infection clinical manifestations after an outbreak in Italy: A prognostic cohort study

Cited by 104 publications

References 14 publications

Chronic Joint Disease Caused by Persistent Chikungunya Virus Infection Is Controlled by the Adaptive Immune Response

Chronic Joint Disease Caused by Persistent Chikungunya Virus Infection Is Controlled by the Adaptive Immune Response

Defining the risk of Zika and chikungunya virus transmission in human population centers of the eastern United States

Chikungunya: Molecular Aspects, Clinical Outcomes and Pathogenesis

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