Mayaro Virus: a Neglected Arbovirus of the Americas

Abstract

Mayaro virus is a neglected tropical arbovirus that causes a mild, self-limited febrile syndrome, sometimes accompanied by a highly incapacitating arthralgia. First isolated in Trinidad and Tobago in 1954, it was reported in several countries within the tropical regions of South and Central America. Human infections are accidental spillover of the enzootic cycle. Little epidemiological data are available due to inadequate surveillance and the generic nature of clinical manifestations resulting in the misdiagnosis with other viral fevers. Despite its restricted distribution, Mayaro fever may become a public health issue due to their urbanization potential. Accurate epidemiological data are urgently needed to access the real distribution of this virus guiding public health policies better.

Mayaro fever in an HIV-infected patient suspected of having Chikungunya fever

“…Mayaro fever is a neglected disease due to two factors: inadequate surveillance in endemic areas and the generic nature of clinical manifestations that results in misdiagnosis with other viral fevers, mainly DENV (5) . Viral fevers are endemic in low socioeconomic areas and, subsequently, smaller investments are made in research, surveillance, and investigation of epidemics; many studies on arboviruses merely describe cases.…”

“…Despite outbreaks in large cities, MAYV fever is generally regarded as being limited to forests and rural areas (5) . Usually the patients are rural workers who use the forest for subsistence or live in its proximity (1) .…”

“…In this case, the virus was isolated after 10 days of the febrile illness. Since MAYV viremia is usually limited to 3-7 days (5) , this indicates an extended viremia, which may have been due to the patient's immunocompromised state. The relief of myalgia and arthralgia, without the need for corticoids or analgesics, indicates spontaneous clearance of MAYV infection, despite a prolonged viremia, suggesting that HIV did not affect the outcome of Mayaro fever.…”

“…Since the first description of autochthonous cases of Chikungunya fever in the Americas in November 2013 (3) , Brazil's Ministry of Health compiled a national contingency plan, aiming to establish appropriate strategies to prevent the import and spread of the virus and to guide clinical management of the disease (4) . The first outbreak of Mayaro fever in Brazil was reported in 1957, in Para State, affecting about 100 individuals (5) ; MAYV was isolated from six patients. Since then, there has been no standardized federal system for surveillance of this arbovirus.…”

“…Since then, there has been no standardized federal system for surveillance of this arbovirus. There are few studies on the true incidence of MAYV, detected mostly in the Amazon region and Central Highlands (5) ( Figure 1). Many countries in these areas also face serious public health problems because of the acquired immunodeficiency syndrome (AIDS) epidemic, but the possible role of immunosuppression in the outcome of arbovirus infections is unclear (6) .…”