Clinical Forms of Chikungunya in Gabon, 2010

Abstract

BackgroundChikungunya virus (CHIKV) has caused multiple outbreaks in tropical and temperate areas worldwide, but the clinical and biological features of this disease are poorly described, particularly in Africa. We report a prospective study of clinical and biological features during an outbreak that occurred in Franceville, Gabon in 2010.Methodology/Principal FindingsWe collected, in suspect cases (individuals presenting with at least one of the following symptoms or signs: fever, arthralgias, myalgias, headaches, rash, fatigue, nausea, vomiting, diarrhea, bleeding, or jaundice), blood samples, demographic and clinical characteristics and outcome. Hematological and biochemical tests, blood smears for malaria parasites and quantitative PCR for CHIKV then dengue virus were performed. CHIKV+ patients with concomitant malaria and/or dengue were excluded from the study. From May to July 2010, data on 270 laboratory-confirmed CHIK patients were recorded. Fever and arthralgias were reported by respectively 85% and 90% of patients, while myalgias, rash and hemorrhage were noted in 73%, 42% and 2% of patients. The patients were grouped into 4 clinical categories depending on the existence of fever and/or joint pain. On this basis, mixed forms accounted for 78.5% of cases, arthralgic forms 12.6%, febrile forms 6.7% and unusual forms (without fever and arthralgias) 2.2%. No cases of organ failure or death were reported. Elevated liver enzyme and creatinine levels, anemia and lymphocytopenia were the predominant biological abnormalities, and lymphocytopenia was more severe in patients with high viral loads (p = 0.01).Conclusions/SignificanceDuring CHIK epidemics, some patients may not have classical symptoms. The existence of unusual forms and the absence of severe forms of CHIK call for surveillance to detect any change in pathogenicity.

Chikungunya Virus Infections Among Patients with Dengue-Like Illness at a Tertiary Care Hospital in the Philippines, 2012–2013

“…This is not surprising since all the patients in our study were initially diagnosed with clinical dengue on presentation. Although other studies have found varying values for different combinations of symptoms, 41,42 we did not find any combination of symptoms that had sufficiently high sensitivity and specificity in diagnosing either dengue or chikungunya (Table 5 and 6). The combination of fever, joint pain, and skin rash showed a high sensitivity but low specificity (Table 5) in diagnosing chikungunya infection, whereas the combination of fever, joint pain, and muscle/body pain had a high sensitivity but low specificity (Table 6) in diagnosing dengue.…”

Outbreak of Chikungunya virus in the north Caribbean area of Colombia: clinical presentation and phylogenetic analysis

“…Chikungunya infection is a neglected tropical disease caused by the Chikungunya virus (CHIKV), an arthropod-borne virus belonging to the alphavirus group [1,2]. The clinical manifestations of CHIK are well defined [1].…”

“…The clinical manifestations of CHIK are well defined [1]. The infection can be diagnosed by serology to detect IgG and/or IgM.…”

Chikungunya: Molecular Aspects, Clinical Outcomes and Pathogenesis

“…In neonates, CHIKF can be accompanied by convulsions, peripheral cyanosis, podalic edema, and epithelial vesicular lesions that eventually dry and scale 35,36 . This disease is usually considered benign in children 37 .…”

“…Other less common symptoms include neuropathy, cerebral disorder, neurosensory deficiency, burning mouth syndrome, paresthesia, cubital tunnel syndrome, gastrointestinal disorders, exanthema, pruritus, bursitis, and synovitis 28,36,44,[47][48][49] .…”