Chikungunya fever: CNS infection and pathologies of a re-emerging arbovirus

Das, Trina; Jaffar-Bandjee, Marie Christine; Hoarau, Jean-Jacques; Krejbich-Trotot, Pascale; Denizot, Mélanie; Lee-Pat-Yuen, Ghislaine; Sahoo, Renubala; Guiraud, Pascal; Ramful, Duksha; Robin, Stéphanie

doi:10.1016/j.pneurobio.2009.12.006

Cited by 165 publications

(154 citation statements)

References 91 publications

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“…Although a cerebrospinal fluid sample was not obtained, she may have suffered from CHIKV encephalomeningitis, a recently described manifestation of CHIKV infection. 35,36 CHIKV infection was significantly more likely to occur during cold months and dry months than during warm months and rainy months, respectively. The reason for this observation is unclear, and little work has been done to investigate the relationship between climate and CHIKV infection, especially in Africa.…”

Section: Discussionmentioning

confidence: 98%

Chikungunya and Dengue Fever among Hospitalized Febrile Patients in Northern Tanzania

Hertz

Munishi²,

Ooi³

et al. 2012

The American Society of Tropical Medicine and Hygiene

122

129

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Abstract. Consecutive febrile admissions were enrolled at two hospitals in Moshi, Tanzania. Confirmed acute Chikungunya virus (CHIKV), Dengue virus (DENV), and flavivirus infection were defined as a positive polymerase chain reaction (PCR) result. Presumptive acute DENV infection was defined as a positive anti-DENV immunoglobulin M (IgM) enzyme-linked immunsorbent assay (ELISA) result, and prior flavivirus exposure was defined as a positive anti-DENV IgG ELISA result. Among 870 participants, PCR testing was performed on 700 (80.5%). Of these, 55 (7.9%) had confirmed acute CHIKV infection, whereas no participants had confirmed acute DENV or flavivirus infection. Anti-DENV IgM serologic testing was performed for 747 (85.9%) participants, and of these 71 (9.5%) had presumptive acute DENV infection. Anti-DENV IgG serologic testing was performed for 751 (86.3%) participants, and of these 80 (10.7%) had prior flavivirus exposure. CHIKV infection was more common among infants and children than adults and adolescents (odds ratio [OR] 1.9, P = 0.026) and among HIV-infected patients with severe immunosuppression (OR 10.5, P = 0.007). CHIKV infection is an important but unrecognized cause of febrile illness in northern Tanzania. DENV or other closely related flaviviruses are likely also circulating.

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Section: Discussionmentioning

confidence: 98%

Chikungunya and Dengue Fever among Hospitalized Febrile Patients in Northern Tanzania

Hertz

Munishi²,

Ooi³

et al. 2012

The American Society of Tropical Medicine and Hygiene

122

129

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“…24 In addition to the magnitude of the epidemic, previously unreported neurological manifestations in adults and fetal encephalopathy have been reported. [25][26][27][28][29] CHIKV infection of the human central nervous system was first described in the 1960s. 30,31 However, novel neurological syndromes, such as seizures, meningoencephalopathy, myelitis, and choroiditis, have only been reported during the recent outbreaks.…”

Section: Introductionmentioning

confidence: 99%

“…30,31 However, novel neurological syndromes, such as seizures, meningoencephalopathy, myelitis, and choroiditis, have only been reported during the recent outbreaks. [25][26][27][28][29] In addition to neurological manifestations, the first observations of pre-partum neonatal transmission were associated with infection with this novel CHIKV strain; however, it remains to be determined whether these novel disease syndromes observed during the 2004-2010 outbreak reflect a change in tissue tropism or an increase in pathogenesis, or if they are simply indicative of the magnitude of the recent outbreaks and improved case reporting. [32][33][34][35] Additionally, the association of CHIKV disease in neonates with mothers infected during gestation largely has been epidemiological, without a case-controlled study and without assessment of the potential for transplacental viral passage under experimental conditions.…”

Section: Introductionmentioning

confidence: 99%

Comparative Pathogenesis of Epidemic and Enzootic Chikungunya Viruses in a Pregnant Rhesus Macaque Model

Chen¹,

Clark²,

Pesavento³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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Abstract. Since 2004, an East African genotype of Chikungunya virus (CHIKV) has emerged, causing significant epidemics of an arthralgic syndrome. In addition, this virus has been associated for the first time with neonatal transmission and neurological complications. In the current study, pregnant Rhesus macaques were inoculated with an enzootic or epidemic strain of CHIKV to compare pathogenesis and transplacental transmission potential. Viremias were similar for both strains and peaked at 2-3 days post-inoculation (dpi). Viral RNA was detected at necropsy at 21 dpi in maternal lymphoid, joint-associated, and spinal cord tissues. The absence of detectable viral RNA and the lack of germinal center development in fetuses indicated that transplacental transmission did not occur. Neutralizing antibodies were detected in all dams and fetuses. Our study establishes a non-human primate model for evaluating vaccines and antiviral therapies and indicates that Rhesus macaques could serve as a competent enzootic reservoir.

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“…During the delivery period, the rate of transmission for viremic women was close to 50%. Fifty percent of infected infants had pathological MRI findings, such as white matter lesions, swelling of the brain, and cerebral hemorrhages, sometimes progressing to permanent disabilities or death 9 . Meningoencephalitis has been reported in outbreaks in India and Réunion Island 10 .…”

Section: Clinical and Neurological Manifestationsmentioning

confidence: 99%

Neurological manifestations of Chikungunya and Zika infections

Pinheiro

Guimarães

Silva

et al. 2016

Arq. Neuro-Psiquiatr.

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The epidemics of Chikungunya virus (CHIKV) and Zika virus (ZIKV) infections have been considered the most important epidemiological occurrences in the Americas. The clinical picture of CHIKV infection is characterized by high fever, exanthema, myalgia, headaches, and arthralgia. Besides the typical clinical picture of CHIKV, atypical manifestations of neurological complications have been reported: meningo-encephalitis, meningoencephalo-myeloradiculitis, myeloradiculitis, myelitis, myeloneuropathy, Guillain-Barré syndrome and others. The diagnosis is based on clinical, epidemiological, and laboratory criteria. The most common symptoms of ZIKV infection are skin rash (mostly maculopapular), fever, arthralgia, myalgia, headache, and conjunctivitis. Some epidemics that have recently occurred in French Polynesia and Brazil, reported the most severe conditions, with involvement of the nervous system (Guillain-Barré syndrome, transverse myelitis, microcephaly and meningitis). The treatment for ZIKV and CHIKV infections are symptomatic and the management for neurological complications depends on the type of affliction. Intravenous immunoglobulin, plasmapheresis, and corticosteroid pulse therapy are options.

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Chikungunya fever: CNS infection and pathologies of a re-emerging arbovirus

Cited by 165 publications

References 91 publications

Chikungunya and Dengue Fever among Hospitalized Febrile Patients in Northern Tanzania

Chikungunya and Dengue Fever among Hospitalized Febrile Patients in Northern Tanzania

Comparative Pathogenesis of Epidemic and Enzootic Chikungunya Viruses in a Pregnant Rhesus Macaque Model

Neurological manifestations of Chikungunya and Zika infections

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