Congenital Chikungunya Virus Infection after an Outbreak in Salvador, Bahia, Brazil

Abstract

There is little information about the congenital chikungunya virus (CHIKV) transmission. We describe two cases of well-documented congenital CHIKV infection in Salvador-Brazil, where CHIKV has been identified since 2014. The outbreak in the city led to the clinical CHIKV diagnoses of both pregnant women 2 days before delivery. Urine and blood samples from the mothers and newborns were collected and tested for reverse transcription-polymerase chain reaction (PCR) analysis for Zika, dengue, and CHIKV. Both neonates and mothers had positive urine and serum PCR results for CHIKV. The newborns had significant perinatal complications and were admitted to the neonatal intensive care unit. The purpose of our case report is to show how severe congenital CHIKV infection can be and the importance to include CHIKV infection in the differential diagnosis of neonatal sepsis when mothers have clinical signs of the disease and live in an affected area.

Perinatal Vertical Transmission of Chikungunya Virus in Ruili, a Town on the Border between China and Myanmar

“…Except two women in our report, no other pregnant women were infected by CHIKV during the intrapartum period. Thus, in the three neonates born to two women with intrapartum infection, the risk of perinatal vertical transmission is 100%, which is similar to that observed in Reunion island, Brazil, Colombia and India (Lenglet et al 2006 ; Villamil-Gomez et al 2015 ; Bandeira et al 2016 ; Lyra et al 2016 ; Kumar et al 2019 ). In contrast, of 15 women delivered during acute CHIKV infection, as reported in 2015 in Colombia, 12 neonates were hospitalized to rule out vertical transmission, though no clinical findings suggestive of neonatal CHIKV infection were observed (Escobar et al 2017 ).…”

“…Thereafter, sporadic CHIKV infection through perinatal vertical transmission was observed in the Island of Curacao (van Enter et al 2018 ), Brazil (Bandeira et al . 2016 ; Lyra et al 2016 ), Colombia (Villamil-Gomez et al 2015 ) and India (Kumar et al 2019 ). In a retrospective study in Thailand and a cohort study in Colombia, however, no clinical findings suggestive of perinatal vertical transmission were observed (Laoprasopwattana et al 2016 ; Escobar et al 2017 ).…”

Zika might not be acting alone: Using an ecological study approach to investigate potential co-acting risk factors for an unusual pattern of microcephaly in Brazil

“…In addition, chikungunya virus infection may result in complications during pregnancy either to the mother or to the newborn [ 83 – 84 ]. Complications for the mother, such as chronic inflammatory rheumatism, as well as neurocognitive impairment in infants and microcephaly have been reported in congenital chikungunya transmission [ 47 , 49 , 85 – 86 ].…”

Small Molecule Inhibitors Targeting Chikungunya Virus

“…Atypical complications of CHIKV infection may occur in the elderly and in individuals with comorbidities, such as encephalitis (Lebrun et al 2009). Fetal CHIKV infections during pregnancy are rare, but perinatal infection of newborns occurs during the intrapartum period, resulting in a high mortality rate and those surviving may suffer severe, lifelong neurological outcomes (Bandeira et al 2016;Gopakumar et al 2012;Lyra et al 2016).…”