Outbreak of Neuro-Chikungunya in Northeastern Brazil

Abstract

Chikungunya virus, an alphavirus often associated with large epidemic outbreaks, has a serious social impact. The main symptoms are fever, rash and arthralgia, but recently neurologic complications have been described as an important cause of morbidity. During a large outbreak in at least five towns in poor states of the Brazilian northeast over recent months, 22 patients with chikungunya confirmed by serologic tests who presented some degree of neurologic involvement were assessed in our department. Changes in consciousness were present in almost half of the patients and epileptic seizures and persecutory delusions were present in three and four patients, respectively. As in Brazil there are insufficient serologic tests for patients with a clinical picture of neuro-chikungunya, this is probably a very underdiagnosed disease. The outcomes of the neurologic symptoms were good in all patients of the current series, in contrast with the permanent sequelae reported by other authors.

Impaired Quality of Life One Year After Neuro-Chikungunya: A Brazilian Experience

“…However, it has not been confirmed until now that CHIKV is neurotropic, with several studies showing that often patients have neurological and psychiatric symptoms in the acute and sometimes in the chronic phase of the disease, such as daily chronic headache and depressive and anxiety disorder, thereby substantially reducing their quality of life [1,5].…”

“…A recent study showed that adequate clinical management in the acute phase of the disease can prevent or even avoid more serious complications [1]. Considering all the dysfunction caused by the disease, it would be ideal for all infected patients to have monthly follow-ups with a specialized team composed of a general practitioner, rheumatologist, psychiatrist, psychologist, physiotherapist and occupational therapist to identify and adjust factors related to the impaired quality of life of patients.…”

“…Chikungunya virus (CHIKV) is a positive-strand RNA arthropodborne virus that was first described in Africa about 65 years ago, that now has spread worldwide, mostly in underdeveloped countries such as Brazil [1]. CHIKV is transmitted by the bite of an insect of the Aedes genus [2][3][4][5] that is found in poor countries with the ideal conditions to allow a widespread endemic of the disease [1,2].…”

“…CHIKV is transmitted by the bite of an insect of the Aedes genus [2][3][4][5] that is found in poor countries with the ideal conditions to allow a widespread endemic of the disease [1,2]. Among the alphaviruses, CHIKV is the most important human pathogen in terms of morbidity [1,2].…”

Psychiatric Morbidity of Chikungunya among Children in Bangladesh

“…Chikungunya occurred as a Major epidemic form in Bangladesh after a gap of 6 years in 2017. Chikungunya fever is an acute illness, mainly characterized by acute fever and severe joint pain [4] and has various complications like rheumatological, neurological, psychological, and dermatological, and even multi-organ failure.…”