Molecular and Clinical Characterization of Chikungunya Virus Infections in Southeast Mexico

Abstract

Chikungunya fever is an arthropod-borne infection caused by Chikungunya virus (CHIKV). Even though clinical features of Chikungunya fever in the Mexican population have been described before, there is no detailed information. The aim of this study was to perform a full description of the clinical features in confirmed Chikungunya-infected patients and describe the molecular epidemiology of CHIKV. We evaluated febrile patients who sought medical assistance in Tapachula, Chiapas, Mexico, from June through July 2015. Infection was confirmed with molecular and serological methods. Viruses were isolated and the E1 gene was sequenced. Phylogeny reconstruction was inferred using maximum-likelihood and maximum clade credibility approaches. We studied 52 patients with confirmed CHIKV infection. They were more likely to have wrist, metacarpophalangeal, and knee arthralgia. Two combinations of clinical features were obtained to differentiate between Chikungunya fever and acute undifferentiated febrile illness. We obtained 10 CHIKV E1 sequences that grouped with the Asian lineage. Seven strains diverged from the formerly reported. Patients infected with the divergent CHIKV strains showed a broader spectrum of clinical manifestations. We defined the complete clinical features of Chikungunya fever in patients from Southeastern Mexico. Our results demonstrate co-circulation of different CHIKV strains in the state of Chiapas.

Clinical and Epidemiologic Patterns of Chikungunya Virus Infection and Coincident Arboviral Disease in a School Cohort in Haiti, 2014–2015

“…As noted above, our clinical staff was convinced that the AFI peak seen in October and November 2014 ( Figure 2) reflected a "recurrence" of CHIKV; in actuality, it built on a DENV1 case cluster, with some ZIKV mixed in at the end, and a still unidentified presumptive pathogen responsible for the majority of cases. Although we recognize the difficulties inherent in making clinical arboviral diagnoses, our data reinforce the frequency with which arthralgias are seen in CHIKV cases (with knees, wrists, and ankles most commonly affected, in keeping with findings in studies in other locales [9,30]).…”

“…Moreira et al [6] have recently summarized results of studies on the epidemiology of acute febrile illness (AFI) in Latin America [6][7][8][9][10][11]. Although these studies have provided a basis for identifying the major pathogens responsible for febrile illness in the region, diagnostic criteria and approaches have differed widely, with no study having the ability to screen for previously unidentified pathogens; across all 17 studies evaluated by Moreira [6], the median number of pathogens tested per individual was 3.5.…”

Tomatidine, a natural steroidal alkaloid shows antiviral activity towards chikungunya virus in vitro

“…Important reasons for the drastic re-emergence of CHIKV is the expansion of the mosquito vector to urban areas with poor hygiene conditions, progressing climate change as well as the continuous increase in global transportation systems 7 . While other mosquito-borne arboviruses, such as dengue virus (DENV), only cause symptoms in a small fraction of infected individuals, CHIKV infection causes clinical manifestations in approximately 85% of infected individuals 8 . Acute chikungunya fever typically manifests as a rapid-onset illness characterized by fever, (poly) arthralgia, myalgia, maculopapular rashes, headaches and nausea 9 .…”

Antibodies for Venezuelan Equine Encephalitis Virus Protect Embryoid Bodies from Chikungunya Virus

“…Human exposure prevalence for these viruses can be as high as 80% in some regions [10,11]. VEEV and CHIKV have been found to circulate in the same Central and South American regions [12][13][14][15]. For example, VEEV has been thought to be endemic in southern Mexico for decades, with seroprevalence rates between 18-75%, whereas the seroprevalence of CHIKV in southern Mexico has been determined by some studies to be as high as 85% [13,14].…”

“…VEEV and CHIKV have been found to circulate in the same Central and South American regions [12][13][14][15]. For example, VEEV has been thought to be endemic in southern Mexico for decades, with seroprevalence rates between 18-75%, whereas the seroprevalence of CHIKV in southern Mexico has been determined by some studies to be as high as 85% [13,14]. Additionally, recent studies have indicated that antigenic cross-reactivity, antibody-mediated enhancement, and antibody cross-neutralization of alphaviruses can have a significant impact on the course of infection [16][17][18][19].…”