Travel-associated chikungunya acquired in Myanmar in 2019

Díaz‐Menéndez, Marta; Esteban, E.; Ujiie, Mugen; Calleri, Guido; Rothe, Camilla; Malvy, Denis; Nicastri, Emanuele; Bissinger, Alfred Lennart; Grandadam, Marc; Alpern, Jonathan D.; Gobbi, Federico; Schlagenhauf, Patricia; Duvignaud, Alexandre; Javelle, Émilie; Nakamoto, Takato; Antinori, Spinello; Hamer, Davidson H.

doi:10.2807/1560-7917.es.2020.25.1.1900721

Cited by 19 publications

(15 citation statements)

References 14 publications

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“…Chikungunya virus has re-emerged in many parts of the world and is considered to be a continuous global threat [ 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 ]. The reason for this resurgence is not fully elucidated, but is believed to be multifactorial, such as increased vector susceptibility and perhaps climate change [ 6 , 61 , 62 ].…”

Section: Discussionmentioning

confidence: 99%

Chikungunya Manifestations and Viremia in Patients Who Presented to the Fever Clinic at Bangkok Hospital for Tropical Diseases during the 2019 Outbreak in Thailand

et al. 2021

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Chikungunya virus is an Alphavirus belonging to the family Togaviridae that is transmitted to humans by an infected Aedes mosquito. Patients develop fever, inflammatory arthritis, and rash during the acute stage of infection. Although the illness is self-limiting, atypical and severe cases are not uncommon, and 60% may develop chronic symptoms that persist for months or even for longer durations. Having a distinct periodical epidemiologic outbreak pattern, chikungunya virus reappeared in Thailand in December 2018. Here, we describe a cohort of acute chikungunya patients who had presented to the Bangkok Hospital for Tropical Diseases during October 2019. Infection was detected by a novel antigen kit and subsequently confirmed by real-time RT-PCR using serum collected at presentation to the Fever Clinic. Other possible acute febrile illnesses such as influenza, dengue, and malaria were excluded. We explored the sequence of clinical manifestations at presentation during the acute phase and associated the viral load with the clinical findings. Most of the patients were healthy individuals in their forties. Fever and arthralgia were the predominant clinical manifestations found in this patient cohort, with a small proportion of patients with systemic symptoms. Higher viral loads were associated with arthralgia, and arthralgia with the involvement of the large joints was more common in female patients.

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Section: Discussionmentioning

confidence: 99%

Chikungunya Manifestations and Viremia in Patients Who Presented to the Fever Clinic at Bangkok Hospital for Tropical Diseases during the 2019 Outbreak in Thailand

et al. 2021

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“…In the present study, we examined CHIKV-positive serum from Dhaka during July–December 2017 [ 11 ]. Later in 2018–2019, CHIKV transmission was observed in nearby regions simultaneously, and the number of CHIKV cases noticeably increased in travelers and locals in Myanmar and especially Thailand [ 19 , 38 , 39 , 40 ]. According to the national surveillance of Thailand, the numbers of confirmed cases were 10, 3,580, and 11,721 in 2017, 2018, and 2019, respectively [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

A Novel Sub-Lineage of Chikungunya Virus East/Central/South African Genotype Indian Ocean Lineage Caused Sequential Outbreaks in Bangladesh and Thailand

Phadungsombat

Imad

Rahman

et al. 2020

Viruses

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In recent decades, chikungunya virus (CHIKV) has become geographically widespread. In 2004, the CHIKV East/Central/South African (ECSA) genotype moved from Africa to Indian ocean islands and India followed by a large epidemic in Southeast Asia. In 2013, the CHIKV Asian genotype drove an outbreak in the Americas. Since 2016, CHIKV has re-emerged in the Indian subcontinent and Southeast Asia. In the present study, CHIKVs were obtained from Bangladesh in 2017 and Thailand in 2019, and their nearly full genomes were sequenced. Phylogenetic analysis revealed that the recent CHIKVs were of Indian Ocean Lineage (IOL) of genotype ECSA, similar to the previous outbreak. However, these CHIKVs were all clustered into a new distinct sub-lineage apart from the past IOL CHIKVs, and they lacked an alanine-to-valine substitution at position 226 of the E1 envelope glycoprotein, which enhances CHIKV replication in Aedes albopictus. Instead, all the re-emerged CHIKVs possessed mutations of lysine-to-glutamic acid at position 211 of E1 and valine-to-alanine at position 264 of E2. Molecular clock analysis suggested that the new sub-lineage CHIKV was introduced to Bangladesh around late 2015 and Thailand in early 2017. These results suggest that re-emerged CHIKVs have acquired different adaptations than the previous CHIKVs.

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“…The year 2019 in particular brought an enhanced risk for CHIKV importation due to outbreaks reaching touristic places in Brazil, Thailand, India and Malaysia as notified by the ECDC and the Geo-Sentinel surveillance network [24,25]. Likewise, the Republic of Maldives is one of the most visited countries in the world with a constant growth in numbers of tourists [26].…”

Section: Discussionmentioning

confidence: 99%

Chikungunya resurgence in the Maldives and risk for importation via tourists to Europe in 2019–2020: A GeoSentinel case series

Dudouet

Larsen

Díaz‐Menéndez

et al. 2020

Travel Medicine and Infectious Disease

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Background: Chikungunya virus (CHIKV) is an arthropod-borne virus mainly transmitted in tropical areas by Aedes spp. mosquitoes. It has been responsible for small-to-large outbreaks in temperate areas including southern Europe and North America. Past outbreaks in 2006 on the islands of Maldives, as well as on other islands in the Indian Ocean and in Southeast Asia, demonstrated for the first time the capacity of CHIKV to disseminate through travel and transcontinental commerce, and revealed the major socioeconomic impact of CHIKV epidemics. Recently, CHIKV has been circulating in highly touristic areas including the Maldives, where 1736 cases were notified by the Health Protection Agency during 2019. Case series: Among EuroTravNet/GeoSentinel patient records, eight CHIKV-confirmed cases imported the Maldives to France, Germany, Denmark, Italy and Spain were identified between February 2019 and February 2020; exceeding the total number of CHIKV infections travel-acquired in Maldives reported to this surveillance network during the previous 10 years. Conclusions: The prevention and control of CHIKV introduction into naïve areas colonised by competent vectors is crucial. CHIKV outbreaks must be detected and reported in a timely manner. This must lead to adapted health information for international travellers and to prompt management of suspected imported cases. Conversely, travellers make for excellent sentinels and increased reports of imported cases might reflect a change in the level of endemicity or even herald an outbreak. Feedback to the local health authorities and matching this with local epidemiological surveillance data may lead to health benefits for the local population.

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Travel-associated chikungunya acquired in Myanmar in 2019

Cited by 19 publications

References 14 publications

Chikungunya Manifestations and Viremia in Patients Who Presented to the Fever Clinic at Bangkok Hospital for Tropical Diseases during the 2019 Outbreak in Thailand

Chikungunya Manifestations and Viremia in Patients Who Presented to the Fever Clinic at Bangkok Hospital for Tropical Diseases during the 2019 Outbreak in Thailand

A Novel Sub-Lineage of Chikungunya Virus East/Central/South African Genotype Indian Ocean Lineage Caused Sequential Outbreaks in Bangladesh and Thailand

Chikungunya resurgence in the Maldives and risk for importation via tourists to Europe in 2019–2020: A GeoSentinel case series

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