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

Máttar, Salim; Miranda, Jorge; Pinzón, H C Jorge; Tique, Vanesa; Bolanos, Amada; Aponte, José C.; Arrieta, Germán; González, Marco; Barrios, Katerine; Contreras, Héctor; Álvarez, Jaime; Alemán, Ader

doi:10.3855/jidc.6670

Cited by 53 publications

(48 citation statements)

References 22 publications

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“…In Trinidad and Tobago, 83.3% of confirmed patients complained of joint pain, while arthralgia was reported in 96% of patients in Colombia [19, 34]. In our study, although arthritis was not reported by any physician, there was relatively little arthralgia associated with CHIKV infection, with only 20.0% of patients reporting joint pain.…”

Section: Discussioncontrasting

confidence: 47%

Molecular Virologic and Clinical Characteristics of a Chikungunya Fever Outbreak in La Romana, Dominican Republic, 2014

et al. 2016

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Since emerging in Saint Martin in 2013, chikungunya virus (CHIKV), an alphavirus transmitted by the Aedes aegypti mosquito, has infected approximately two million individuals in the Americas, with over 500,000 reported cases in the Dominican Republic (DR). CHIKV-infected patients typically present with a febrile syndrome including polyarthritis/polyarthralgia, and a macropapular rash, similar to those infected with dengue and Zika viruses, and malaria. Nevertheless, many Dominican cases are unconfirmed due to the unavailability and high cost of laboratory testing and the absence of specific treatment for CHIKV infection. To obtain a more accurate representation of chikungunya fever (CHIKF) clinical signs and symptoms, and confirm the viral lineage responsible for the DR CHIKV outbreak, we tested 194 serum samples for CHIKV RNA and IgM antibodies from patients seen in a hospital in La Romana, DR using quantitative RT-PCR and IgM capture ELISA, and performed retrospective chart reviews. RNA and antibodies were detected in 49% and 24.7% of participants, respectively. Sequencing revealed that the CHIKV strain responsible for the La Romana outbreak belonged to the Asian/American lineage and grouped phylogenetically with recent Mexican and Trinidadian isolates. Our study shows that, while CHIKV-infected individuals were infrequently diagnosed with CHIKF, uninfected patients were never falsely diagnosed with CHIKF. Participants testing positive for CHIKV RNA were more likely to present with arthralgia, although it was reported in just 20.0% of CHIKF+ individuals. High percentages of respiratory (19.6%) signs and symptoms, especially among children, were noted, though it was not possible to determine whether individuals infected with CHIKV were co-infected with other pathogens. These results suggest that CHIKV may have been underdiagnosed during this outbreak, and that CHIKF should be included in differential diagnoses of diverse undifferentiated febrile syndromes in the Americas.

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Section: Discussioncontrasting

confidence: 47%

Molecular Virologic and Clinical Characteristics of a Chikungunya Fever Outbreak in La Romana, Dominican Republic, 2014

et al. 2016

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“…Most patients showed the same common features described in previous CHIKF outbreaks including the Colombian epidemic. 39 Of the 32 patients, 26 experienced fever (81%), 23 rash (72%), 21 arthralgia (65%), 19 myalgia (59%), and 11 headache (34%). These results were similar to others previously described in the literature.…”

Section: Resultsmentioning

confidence: 99%

Genetic Characterization of Northwestern Colombian Chikungunya Virus Strains from the 2014–2015 Epidemic

Rodas

Kautz²,

Camacho

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. Chikungunya fever, an acute and often chronic arthralgic disease caused by the mosquito-borne alphavirus, chikungunya virus (CHIKV), spread into the Americas in late 2013. Since then it has caused epidemics in nearly all New World countries, the second largest being Colombia with over 450,000 suspected cases beginning in September, 2014, and focused in Bolivar Department in the north. We examined 32 human sera from suspected cases, including diverse age groups and both genders, and sequenced the CHIKV envelope glycoprotein genes, known determinants of vector host range. As expected for Asian lineage CHIKV strains, these isolates lacked known Aedes albopictus-adaptive mutations. All the Colombian strains were closely related to those from the Virgin Islands, Saint Lucia, Mexico, Puerto Rico, and Brazil, consistent with a single, point-source introduction from the southeast Asia/Pacific region. Two substitutions in the E2 and E1 envelope glycoprotein genes were found in the Colombian strains, especially E1-K211E involving a residue shown previously to affect epistatically the penetrance of the E1-A226V A. albopictus-adaptive substitution. We also identified two amino acid substitutions unique to all American CHIKV sequences: E2-V368A and 6K-L20M. Only one codon, 6K-47, had a high nonsynonymous substitution rate suggesting positive selection.

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“…British Virgin Islands (Lanciotti and Valadere 2014), Guadeloupe, Martinique (Stapleford et al 2016) and Trinidad (Sahadeo et al 2015)] and from the American mainland [i.e. Colombia (Mattar et al 2015), Panama (Diaz et al 2015), Mexico (Diaz-Quinonez et al 2015) and Brazil (Nunes et al 2015)] also confirmed circulation of the Asian lineage. However, in Brazil, concurrent with the Asian genotype CHIKV circulation, there was an outbreak in the east-central region of Feira de Santana that was caused by a newly introduced ECSA strain (Nunes et al 2015).…”

Section: Introductionmentioning

confidence: 82%

Understanding the evolution and spread of chikungunya virus in the Americas using complete genome sequences

et al. 2017

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Local transmission of chikungunya virus (CHIKV) was first detected in the Americas in December 2013, after which it spread rapidly throughout the Caribbean islands and American mainland, causing a major chikungunya fever epidemic. Previous phylogenetic analysis of CHIKV from a limited number of countries in the Americas suggests that an Asian genotype strain was responsible, except in Brazil where both Asian and East/Central/South African (ECSA) lineage strains were detected. In this study, we sequenced thirty-three complete CHIKV genomes from viruses isolated in 2014 from fourteen Caribbean islands, the Bahamas and two mainland countries in the Americas. Phylogenetic analyses confirmed that they all belonged to the Asian genotype and clustered together with other Caribbean and mainland sequences isolated during the American outbreak, forming an ‘Asian/American’ lineage defined by two amino acid substitutions, E2 V368A and 6K L20M, and divided into two well-supported clades. This lineage is estimated to be evolving at a mean rate of 5 × 10−4 substitutions per site per year (95% higher probability density, 2.9–7.9 × 10−4) and to have arisen from an ancestor introduced to the Caribbean (most likely from Oceania) in about March 2013, 9 months prior to the first report of CHIKV in the Americas. Estimation of evolutionary rates for individual gene regions and selection analyses indicate that (in contrast to the Indian Ocean Lineage that emerged from the ECSA genotype followed by adaptive evolution and with a significantly higher substitution rate) the evolutionary dynamics of the Asian/American lineage are very similar to the rest of the Asian genotype and natural selection does not appear to have played a major role in its emergence. However, several codon sites with evidence of positive selection were identified within the non-structural regions of Asian genotype sequences outside of the Asian/American lineage.

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

Cited by 53 publications

References 22 publications

Molecular Virologic and Clinical Characteristics of a Chikungunya Fever Outbreak in La Romana, Dominican Republic, 2014

Molecular Virologic and Clinical Characteristics of a Chikungunya Fever Outbreak in La Romana, Dominican Republic, 2014

Genetic Characterization of Northwestern Colombian Chikungunya Virus Strains from the 2014–2015 Epidemic

Understanding the evolution and spread of chikungunya virus in the Americas using complete genome sequences

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