Mayaro Virus in Child with Acute Febrile Illness, Haiti, 2015

Abstract

Mayaro virus has been associated with small outbreaks in northern South America. We isolated this virus from a child with acute febrile illness in rural Haiti, confirming its role as a cause of mosquitoborne illness in the Caribbean region. The clinical presentation can mimic that of chikungunya, dengue, and Zika virus infections.

Mayaro virus: the jungle flu

“…Infrequent outbreaks have occurred in Trinidad, 25 Brazil, 28,29 Ecuador, 7 and Venezuela. 31 In addition, sporadic cases have been identified in Bolivia, 44 Haiti, 15 Mexico, 18 and Peru. 45 Finally, a few reports of import/ export events exist; these have been summarized in the Epidemiology section.…”

“…Molecular epidemiology surveillance in South and Central America suggests that recent recombination events confirmed the preference of MAYV for human hosts over non-human primates with no effect on MAYV adaptation to mosquito vectors such as Aedes aegypti and Culex quinquefasciatus, to which the virus is nonetheless well adapted. 1 In addition, the emergence of Mayaro fever cases in Mexico 18 and Haiti 15 suggests that the virus is expanding its geographical range of activity. Such geographical distribution could pose a threat to south-eastern and south-western US states (including Florida, Louisiana, Georgia, Alabama, Texas, and California), areas well within the estimated range of aedine mosquitoes.…”

“…Accurate diagnosis of Mayaro fever may be complicated by its clinical similarity to other endemic arboviruses such as eastern equine encephalitis virus, Chikungunya virus, Dengue virus, Oropuche virus, yellow fever virus, and Zika virus. 5,[11][12][13][14][15] In addition, co-infection with Dengue virus has previously been described. 15 Moreover, immune cross-reactivity with either other Semliki complex viruses in hemagglutinin inhibition and complement fixation assays 16 or other alphaviruses such as Chikungunya virus in antibody assays (i.e.…”

“…5,[11][12][13][14][15] In addition, co-infection with Dengue virus has previously been described. 15 Moreover, immune cross-reactivity with either other Semliki complex viruses in hemagglutinin inhibition and complement fixation assays 16 or other alphaviruses such as Chikungunya virus in antibody assays (i.e. enzyme-linked immunosorbent assays [ELISAs]) 17 may pose a diagnostic challenge.…”

“…5 While persistent joint pain is most common in patients with alphavirus infections, differential diagnosis should include Chikungunya, Dengue, human herpesvirus-6, parvovirus B-19, rubella virus, and Zika virus. 15,28 Clinical presumption should be followed by confirmatory laboratory diagnostic techniques including reverse-transcription polymerase chain reaction, indirect immunofluorescence, and virus neutralization assays. 15,41 In a cross-sectional study of Ecuadorian military personnel, MAYV prevalence was determined by evaluating the presence of immunoglobulin G (IgG) and IgM antibodies via ELISA.…”