Beyond Fever and Pain: Diagnostic Methods for Chikungunya Virus

Abstract

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.

Dengue, Zika and chikungunya during pregnancy: pre- and post-travel advice and clinical management

“…As CHIKV is an alphavirus, serologic diagnosis is not impacted by cross-circulation of ZIKV and DENV. Infection is confirmed by a positive RT-PCR, specific IgM detection or IgG seroconversion 5 . The sensitivity of RT-PCR is lower, starting from Days 4 to 7 5 .…”

“…Similarly, CHIKV re-emerged in 2005–2006 after more than 30 years of quiescence causing a massive epidemic in the Indian Ocean islands, 4 followed by its spread to the American continent in 2013 5 …”

“…Infections during pregnancy have long been known to potentially impair its course. Consequences include (i) increased maternal morbidity, as observed with the influenza virus, 36 (ii) preterm labour and/or preterm premature rupture of the membranes, associated with bacterial vaginosis or urinary tract infections, 37 37 (iii) stillbirths and low birth weight, as observed in low- and middle-income countries following malaria and syphilis infections, 38 , 39 (iv) in utero fetal infections that may lead to congenital manifestations as observed with the TORCH agents (Toxoplasmosis, Others [including, Syphilis, Varicella Zoster], Rubella, Cytomegalovirus (CMV) and Herpes simplex virus (HSV)) 40 or severe fetal diseases, such as the parvovirus B19-induced anaemia or congenital HIV 41 and (5) neonatal infections, such as group B streptococcal meningitis.…”

Development and Validation of a Rapid Lateral Flow E1/E2-Antigen Test and ELISA in Patients Infected with Emerging Asian Strain of Chikungunya Virus in the Americas

“…The main significance of these antigen-based CHIKV diagnostic assays is the ability to detect the virus within the first 5 days of fever onset. Although overall sensitivity is low, our analysis shows that that accuracy significantly increases when individuals have a higher viral load-which correlates to peak infectivity and progression to severe symptoms [37][38][39]. Sensitivity was likely affected by samples with low viremia, possibly because sample collection took place in the latter end of the optimal diagnostic window or some individuals had lower viremia than others.…”

Metal Nanoparticles: a Promising Treatment for Viral and Arboviral Infections

“…Complications such as eye, heart, neurological, and gastrointestinal are commonly seen in infants, adults with comorbidities, and elderly patients [ 70 – 72 ]. Occasionally, co-infections with other mosquito-borne viral infections such as dengue and Zika present an additional challenge during differential diagnosis and treatment [ 73 ]. There are no specific antivirals or vaccines available for chikungunya, except for symptomatic treatment [ 70 ].…”