Misdiagnosis of Chikungunya Virus Infection: Comparison of Old and Younger Adults

Godaert, Lidvine; Bartholet, Seendy; Gazeuse, Yannick; Brouste, Yannick; Najioullah, Fatiha; Kanagaratnam, Lukshe; Césaire, Raymond; Fanon, Jean Luc; Dramé, Moustapha

doi:10.1111/jgs.15492

Cited by 15 publications

(10 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The rate of lost to follow-up was high, though phone calls helped to reduce it. Second, the study cohort did not fully reflect the population affected by the epidemic because subjects were not sampled from the general population; thus, data for elders may be missing as their symptoms are atypical and easily misdiagnosed [87,88]. Third, the plasma viral load of CCA and no CCA patients could not be measured due to a lack of funding; however, future studies could exploit our biological bank to assess this variable and to conduct other immunological and virological investigations.…”

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 99%

Prevalence of chronic chikungunya and associated risks factors in the French West Indies (La Martinique): A prospective cohort study

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background The chikungunya virus (CHIKV) is a re-emerging alphavirus that can cause chronic and potentially incapacitating rheumatic musculoskeletal disorders known as chronic chikungunya arthritis (CCA). We conducted a prospective cohort study of CHIKV-infected subjects during the 2013 chikungunya outbreak in Martinique. The aim of this study was to assess the prevalence of CCA at 12 months and to search for acute phase factors significantly associated with chronicity. Methodology/Principal findings A total of 193 patients who tested positive for CHIKV RNA via qRT-PCR underwent clinical investigations in the acute phase (<21 days), and then 3, 6, and 12 months after inclusion. The Asian lineage was identified as the circulating genotype. A total of 167 participants were classified as either with or without CCA, and were analyzed using logistic regression models. The overall prevalence of CCA at 12 months was 52.1% (95%CI: 44.5-59.7). In

show abstract

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 99%

Prevalence of chronic chikungunya and associated risks factors in the French West Indies (La Martinique): A prospective cohort study

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…It has been observed that young children present with arthralgia less frequently than older children and adults (52,54,57,72). Patients older than 65 years of age may present a more complicated clinical picture during acute chikungunya, with more frequent manifestations other than arthralgia, including high rates of neurological complaints (73). Limited data are available from immunocompromised hosts, but chikungunya manifestations and severity do not appear to differ among solid organ transplant recipients (74).…”

Section: Acute Clinical Presentation and Differential Diagnosismentioning

confidence: 99%

Beyond Fever and Pain: Diagnostic Methods for Chikungunya Virus

2019

View full text Add to dashboard Cite

Chikungunya virus (CHIKV) is an alphavirus that is primarily transmitted by Aedes species mosquitoes. Though reports of an illness consistent with chikungunya date back over 200 years, CHIKV only gained worldwide attention during a massive pandemic that began in East Africa in 2004. Chikungunya, the clinical illness caused by CHIKV, is characterized by a rapid onset of high fever and debilitating joint pain, though in practice, etiologic confirmation of CHIKV requires the availability and use of specific laboratory diagnostics. Similar to infections caused by other arboviruses, CHIKV infections are most commonly detected with a combination of molecular and serological methods, though cell culture and antigen detection are reported. This review provides an overview of available CHIKV diagnostics and highlights aspects of basic virology and epidemiology that pertain to viral detection. Although the number of chikungunya cases has decreased since 2014, CHIKV has become endemic in countries across the tropics and will continue to cause sporadic outbreaks in naive individuals. Consistent access to accurate diagnostics is needed to detect individual cases and initiate timely responses to new outbreaks.

show abstract

“…In the context of CVI, Godaert et al . showed that diagnostic errors were more frequent in elderly subjects than in their younger counterparts. The authors hypothesised that the atypical presentation of CVI in this population contributes to diagnostic uncertainty, and may induce a delay in management that could be prejudicial for the patient.…”

Section: Discussionmentioning

confidence: 98%

“…The occurrence of intercurrent signs during CVI can complicate the patient's clinical course and/or reveal latent disease that had not previously been diagnosed. In the context of CVI, Godaert et al [30] showed that diagnostic errors were more frequent in elderly subjects than in their younger counterparts. The authors hypothesised that the atypical presentation of CVI in this population contributes to diagnostic uncertainty, and may induce a delay in management that could be prejudicial for the patient.…”

Section: Discussionmentioning

confidence: 99%

Long‐term survival and clinical forms in the acute phase of Chikungunya virus infection in older Caribbeans

Godaert

Bartholet

Najioullah

et al. 2019

Tropical Med Int Health

Self Cite

View full text Add to dashboard Cite

Objective To investigate whether the long‐term survival in elderly patients with prior Chikungunya virus infection (CVI) is associated with the clinical form presented in the acute phase, as defined by the WHO classification. Methods Retrospective cohort study performed in Martinique University Hospitals. Patients who attended the emergency department for suspected CVI, and who had a positive biological diagnosis of CVI by reverse transcription‐polymerase chain reaction on a plasma sample between 10 January and 31 December 2014 were eligible for inclusion. Time‐to‐death was the primary outcome. The independent relationship between clinical forms and time‐to‐death was analysed using a Cox model. Results In total, 268 patients were included. Mean age was 80 ± 8 years, 53% were women. Median length of follow‐up was 28 months (range: 0–39). During follow‐up, 53 (19.8%) patients died. Median survival time was 13.2 months (range: 0–33.6). At the end of follow‐up, death rates were 4.6% for acute clinical cases, 19.0% for atypical cases, 19.2% for severe acute cases and 23.5% for unclassifiable cases. By multivariable analysis, the clinical form of CVI at admission was found to be independently associated with long‐term survival (atypical form: HR = 2.38; 95% CI = 2.15–2.62; severe acute form: HR = 2.40; 95% CI = 2.17–2.64; unclassifiable form: HR = 2.28; 95% CI = 2.06–2.51). Conclusion The clinical form at presentation with CVI has a significant impact on long‐term survival. Management of CVI patients should be tailored according to their clinical form at admission.

show abstract

Misdiagnosis of Chikungunya Virus Infection: Comparison of Old and Younger Adults

Cited by 15 publications

References 16 publications

Prevalence of chronic chikungunya and associated risks factors in the French West Indies (La Martinique): A prospective cohort study

Prevalence of chronic chikungunya and associated risks factors in the French West Indies (La Martinique): A prospective cohort study

Beyond Fever and Pain: Diagnostic Methods for Chikungunya Virus

Long‐term survival and clinical forms in the acute phase of Chikungunya virus infection in older Caribbeans

Contact Info

Product

Resources

About