Chikungunya fever in Canada: fever and polyarthritis in a returned traveller

Schwartz, Kevin L; Giga, Aliyah; Boggild, Andrea K.

doi:10.1503/cmaj.130680

Cited by 10 publications

(8 citation statements)

References 10 publications

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“…Therefore, definitive diagnosis is required. Serological assays for detection of anti-CHIKV IgM or IgG can be performed during the first few weeks or months, respectively, though false negative results can occur depending on the stage of disease [46]. Because of the high viremia associated with disease (see Blood and Clinical Chemistry Laboratory Results below), reverse-transcriptase polymerase chain reaction (RT-PCR) or virus isolation utilizing cell culture or animal inoculation can be performed during the acute stage, but is only useful at 1 to 2 weeks post-infection [10, 46].…”

Section: Joint Diseasementioning

confidence: 99%

A Review of Chikungunya Virus-induced Arthralgia: Clinical Manifestations, Therapeutics, and Pathogenesis

Goupil

2016

TORJ

108

102

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Background:Chikungunya virus (CHIKV) is a mosquito-borne alphavirus that circulates predominantly in tropical and subtropical regions, potentially affecting over 1 billion people. Recently, an outbreak began in the western hemisphere and has resulted in over 1.8 million reported suspected cases. Infection often results in severe fever, rash and debilitating polyarthralgia lasting weeks to months. Additionally, the current literature reports that CHIKV can result in a severe chronic arthralgia and/or arthritis that can last months to years following the initial infection.Objective:The purpose of this review is to evaluate the literature and summarize the current state of knowledge regarding CHIKV-associated disease, including clinical presentation, diagnosis, risk factors for development of severe disease, treatment, and pathogenesis in human patients. Additionally, recommendations are presented regarding avenues for clinical research to help further elucidate the pathogenesis of joint disease associated with CHIKV infection.Conclusion:While there is an association between initial CHIKV infection and acute disease, a causal relationship with development of chronic arthralgia has not been established at this time. Potential causes of chronic CHIKV-induced arthritis have been postulated, including viral persistence, induction of autoimmune disease, and exacerbation of pre-existing joint disease. While there are numerous reports of chronic CHIKV-associated arthralgia and/or arthritis, there is currently no evidence of a definitive link between initial infection and development of chronic disease. Additional, prospective clinical research on CHIKV-associated disease is necessary to further determine the potential role of virus and development of chronic joint disease.

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Section: Joint Diseasementioning

confidence: 99%

A Review of Chikungunya Virus-induced Arthralgia: Clinical Manifestations, Therapeutics, and Pathogenesis

Goupil

2016

TORJ

108

102

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“…Les anticorps IgM sont souvent détectés deux à six jours après l'apparition des symptômes alors que les anticorps IgG apparaissent généralement durant la phase de convalescence de la maladie et peuvent être présents pendant des années (10). L'analyse d'échantillons sériques, plasmatiques ou de liquide céphalorachidien (LCR) selon une technique de transcription inverse suivie d'une réaction en chaîne de la polymérase (RT-PCR) est la méthode d'analyse la plus sensible; elle est offerte à des fins de recherche par le Laboratoire national de microbiologie de Winnipeg, au Manitoba (11). Le cas que nous présentons met en lumière certaines des incertitudes qui caractérisent le diagnostic du chikungunya.…”

Section: Contexteunclassified

Les défis du diagnostic de l'infection à chikungunya : Présentation d'un tableau clinique atypique

Craig¹,

Klowak²,

Ak³

2015

RMTC

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Le chikungunya est devenu une préoccupation de santé publique importante, une situation attribuable en partie à l'augmentation des voyages internationaux. Les récentes éclosions observées dans les pays de la Caraïbe et le signalement d'un premier cas d'infection autochtone aux États-Unis, donnent à craindre une possible augmentation du nombre de cas au Canada. Le chikungunya ayant un grand nombre de symptômes cliniques en commun avec d'autres maladies transmises par les arthropodes, telles que la dengue, le diagnostic clinique de la maladie est compliqué. Dans cet article, nous présentons un tableau clinique atypique de chikungunya observé chez un homme au retour d'un voyage à Haïti. Le diagnostic microbiologique, le traitement, le pronostic et les implications pour la santé publique aideront à préparer les cliniciens à la prise en charge de cet agent pathogène émergent.

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“…No local transmission of chikungunya virus has yet occurred in Canada likely due to the absence of the primary mosquito vectors-Aedes aegypti and Aedes albopictus. However, Canadians make over 2.5 million visits to Caribbean countries annually (5) and also travel in significant numbers to the Asia-Pacific region where continuing outbreaks of chikungunya and other mosquito-borne agents are increasing and Canadian cases have been identified (6,7). In this article, we review the disease, describe the dramatic increase in the number of countries now reporting chikungunya virus, and report the increase in travel-related chikungunya virus cases diagnosed in Canada in 2014 compared to previous years.…”

Section: Introductionmentioning

confidence: 99%

Travel-related chikungunya cases in Canada, 2014

Drebot¹,

Holloway²,

Zheng³

et al. 2015

CCDR

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Since the spring of 2014, there has been a large increase in travel-related chikungunya cases diagnosed in Canada. As of December 9, 2014, 320 confirmed and 159 probable cases have been diagnosed in Canada, with the majority of provinces identifying at least one imported case. This surge in Canadian infections has been associated with the incursion of chikungunya virus into the Caribbean and the expansion of the virus in the Americas. Ongoing outbreaks in the Asia-Pacific region have also contributed to imported cases among Canadian travellers. Heightened awareness of chikungunya among clinicians is key to diagnosis. This highlights the need to ask for a travel history from anyone who presents with fever or recent onset of polyarthralgia, and to consider testing by provincial laboratories and the National Microbiology Laboratory for chikungunya virus and other diseases as indicated. Also essential is continued communication with travellers regarding the use of preventative measures to decrease the risk of exposure to mosquitoes when travelling to endemic areas.

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Chikungunya fever in Canada: fever and polyarthritis in a returned traveller

Cited by 10 publications

References 10 publications

A Review of Chikungunya Virus-induced Arthralgia: Clinical Manifestations, Therapeutics, and Pathogenesis

A Review of Chikungunya Virus-induced Arthralgia: Clinical Manifestations, Therapeutics, and Pathogenesis

Les défis du diagnostic de l'infection à chikungunya : Présentation d'un tableau clinique atypique

Travel-related chikungunya cases in Canada, 2014

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