O'Nyong-Nyong Fever in South-Central Uganda, 1996--1997: Clinical Features and Validation of a Clinical Case Definition for Surveillance Purposes

Abstract

O'nyong-nyong (ONN) fever, caused by infection with a mosquito-borne central African alphavirus, is an acute, nonfatal illness characterized by polyarthralgia. During 1996-1997, south-central Uganda experienced the second ONN fever epidemic ever recognized. Among 391 persons interviewed and sampled, 40 cases of confirmed and 21 of presumptive, well-characterized acute, recent, or previous ONN fever were identified through active case-finding efforts or during a household serosurvey and by the application of clinical and laboratory criteria. Among confirmed cases, the knees and ankles were the joints most commonly affected. The median duration of arthralgia was 6 days (range, 2-21 days) and of immobilization was 4 days (range, 1-14 days). In the majority, generalized skin rash was reported, and nearly half had lymphadenopathy, mainly of the cervical region. Viremia was documented in 16 cases, primarily during the first 3 days of illness, and in some of these, body temperature was normal. During this epidemic, the combination of fever, arthralgia, and lymphadenopathy had a specificity of 83% and a sensitivity of 61% in the identification of cases of ONN fever and thus could be useful for surveillance purposes.

Recent clinical experiences with Chikungunya

“…Other study also support this finding 22 but rarer neurovirulence and neuroinvasiveness 7,11 were not found in this study.…”

Arthrogenic Alphaviruses and Inflammatory Myopathies

“…Between 1959 and 1962 there was a large outbreak of ONNV in East Africa involving an estimated 2 million people in which 71% of infected patients suffered from myalgia (Posey et al, 2005;Williams et al, 1965). In 1996-1997 ONNV re-emerged in south-central Uganda (Kiwanuka et al, 1999) and is another alphavirus with the potential to cause global outbreaks of disease. Mayaro virus (MAYV) was first isolated in 1954 and is endemic to South America where it causes sporadic cases and smaller outbreaks of disease that manifest with fever, headaches, athralgia and myalgia (Anderson et al, 1957).…”

The Role of Innate versus Adaptive Immune Responses in a Mouse Model of O'Nyong-Nyong Virus Infection

“…[1][2][3][4][5][6] O'nyong-nyong virus has caused three major outbreaks of disease in Africa. [7][8][9][10] The first occurred in Uganda in the late 1950s and early 1960s and affected over 2 million people. 7 The last two outbreaks occurred in 1996 and 2003, affecting tens of thousands of people.…”

“…7 The last two outbreaks occurred in 1996 and 2003, affecting tens of thousands of people. [8][9][10][11] O'nyong-nyong virus causes a similar syndrome to CHIKV, Ross River virus (RRV), and other Old World arthritic alphaviruses, characterized by fever, rash, debilitating arthralgia, and myalgia. [7][8][9][10][11] The disease is self-limiting and lasts a few days, though some patients have more persistent arthrlagia.…”

“…[8][9][10][11] O'nyong-nyong virus causes a similar syndrome to CHIKV, Ross River virus (RRV), and other Old World arthritic alphaviruses, characterized by fever, rash, debilitating arthralgia, and myalgia. [7][8][9][10][11] The disease is self-limiting and lasts a few days, though some patients have more persistent arthrlagia. 12 In contrast to CHIKV, which has recently been shown to produce neurologic manifestations and death in some individuals, ONNV is not known to cause fatal disease.…”