Post-chikungunya rheumatic disorders in travelers after return from the Caribbean

Zeana, Cosmina; Kelly, Paul; Heredia, Wilson; Cifuentes, Angelica; Franchin, Giovanni; Purswani, Murli; Tieng, Arlene; Hagmann, Stefan

doi:10.1016/j.tmaid.2016.01.009

Cited by 22 publications

(8 citation statements)

References 18 publications

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“…[13] While, we did not find any deaths or cases with chronic comorbidities or cases that qualified as atypical, we did detect severe and chronic symptoms in this outbreak. [13, 25–30, 55] The prolonged persistence of debilitating symptoms including arthralgia and the consequent disruption of routine activities, constituted a considerable burden on the outbreak-affected community.…”

Section: Discussionmentioning

confidence: 99%

An epidemic of chikungunya in northwestern Bangladesh in 2011

et al. 2019

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BackgroundIn November 2011, a government hospital physician in Shibganj sub-district of Bangladesh reported a cluster of patients with fever and joint pain or rash. A multi-disciplinary team investigated to characterize the outbreak; confirm the cause; and recommend control and prevention measures.MethodsShibganj's residents with new onset of fever and joint pain or rash between 1 September and 15 December 2011 were defined as chikungunya fever (CHIKF) suspect cases. To estimate the attack rate, we identified 16 outpatient clinics in 16 selected wards across 16 unions in Shibganj and searched for suspect cases in the 80 households nearest to each outpatient clinic. One suspect case from the first 30 households in each ward was invited to visit the nearest outpatient clinic for clinical assessment and to provide a blood sample for laboratory testing and analyses.ResultsWe identified 1,769 CHIKF suspect cases from among 5,902 residents surveyed (30%). Their median age was 28 (IQR:15−42) years. The average attack rate in the sub-district was 30% (95% CI: 27%−33%). The lowest attack rate was found in children <5 years (15%). Anti-CHIKV IgM antibodies were detected by ELISA in 78% (264) of the 338 case samples tested. In addition to fever, predominant symptoms of serologically-confirmed cases included joint pain (97%), weakness (54%), myalgia (47%), rash (42%), itching (37%) and malaise (31%). Among the sero-positive patients, 79% (209/264) sought healthcare from outpatient clinics. CHIKV was isolated from two cases and phylogenetic analyses of full genome sequences placed these viruses within the Indian Ocean Lineage (IOL). Molecular analysis identified mutations in E2 and E1 glycoproteins and contained the E1 A226V point mutation.ConclusionThe consistently high attack rate by age groups suggested recent introduction of chikungunya in this community. Mosquito control efforts should be enhanced to reduce the risk of continued transmission and to improve global health security.

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Section: Discussionmentioning

confidence: 99%

An epidemic of chikungunya in northwestern Bangladesh in 2011

et al. 2019

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“…Although limited due to the possible bias derived from the way in which information was collected (telephone interview), the consistency of the findings related to the proportion of patients that presented CPA and articular inflammatory symptoms with the variables of age and gender, supports the reliability of the obtained data. Smaller studies (<150 patients) recently have also employed telephone interviews to collect data 10 . One such study found that one third (37%) of study participants reported ongoing complaints related to Chikungunya including joint pain (32%), muscle pain (32%), and joint swelling (26%).…”

Section: Discussionmentioning

confidence: 99%

“…One such study found that one third (37%) of study participants reported ongoing complaints related to Chikungunya including joint pain (32%), muscle pain (32%), and joint swelling (26%). A presumptive diagnosis of pCHIK chronic inflammatory arthritis (n = 4) and pCHIK musculoskeletal disorder (n = 3) was established 10 .…”

Section: Discussionmentioning

confidence: 99%

Post-chikungunya chronic inflammatory rheumatism: results from a retrospective follow-up study of 283 adult and child cases in La Virginia, Risaralda, Colombia

et al. 2016

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According to our results, at least half of the patients with CHIK developed chronic rheumatologic sequelae, and from those with pCHIK-CPA, nearly half presented clinical symptoms consistent with inflammatory forms of the disease. These results support previous estimates obtained from pooled data of studies in La Reunion (France) and India and are consistent with the results published previously from other Colombian cohorts in Venadillo (Tolima) and Since (Sucre).

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“…Unfortunately, the pain does not always pass once the acute stage of the infection, but it can last for months or even years. Depending on the research source, the symptoms continue in 32% to 70% of patients [34][35][36][37]. The time of the follow-up was between 4 months and 6 years [34].…”

Section: Long-term Sequelae Of Chikungunyamentioning

confidence: 99%

Chronic symptoms persisting after travel-related infections

Kuna

Gajewski²

2018

International Maritime Health

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The authors present the current state of knowledge about the long term sequelae of the common travel-related infections associated with immunological dysregulation. Travellers' diarrhoea, chikungunya and dengue are common in travellers and protracted manifestations such as post-infectious irritable bowel syndrome (travellers' diarrhoea), arthritis (chikungunya) or post-dengue syndrome may be more prevalent than previously thought. Attention should be paid to active prevention of the infections during travel, especially when an effective treatment against long-term sequelae has not been established. Further studies should be designed in order to determine the interactions between the host, the environment and the pathogens, as well as to identify the prognostic factors for developing long-term manifestations after infections in a large group of travellers.

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Post-chikungunya rheumatic disorders in travelers after return from the Caribbean

Cited by 22 publications

References 18 publications

An epidemic of chikungunya in northwestern Bangladesh in 2011

An epidemic of chikungunya in northwestern Bangladesh in 2011

Post-chikungunya chronic inflammatory rheumatism: results from a retrospective follow-up study of 283 adult and child cases in La Virginia, Risaralda, Colombia

Chronic symptoms persisting after travel-related infections

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