Persistent chikungunya arthritis in Roraima, Brazil

Hayd, Ramão Luciano Nogueira; Moreno, Maony Rodrigues; Naveca, Felipe Gomes; Amdur, Richard L.; Suchowiecki, Karol; Watson, Hugh; Firestein, Gary S.; Simon, Gary L.; Chang, Aileen Y.

doi:10.1007/s10067-020-05011-9

Cited by 10 publications

(15 citation statements)

References 16 publications

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“…The reason for this resurgence is not fully elucidated, but is believed to be multifactorial, such as increased vector susceptibility and perhaps climate change [6,61,62]. Though the illness is self-limiting, infection results in increased morbidity and atypical manifestation, often with increased severity and fatalities [36,37,[63][64][65][66][67][68][69][70]. Chikungunya virus causes similar clinical manifestations during the acute phase that could mimic other arboviruses, and there are no widely available point-of-care rapid diagnostics [43,71,72].…”

Section: Discussionmentioning

confidence: 99%

Chikungunya Manifestations and Viremia in Patients Who Presented to the Fever Clinic at Bangkok Hospital for Tropical Diseases during the 2019 Outbreak in Thailand

et al. 2021

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Chikungunya virus is an Alphavirus belonging to the family Togaviridae that is transmitted to humans by an infected Aedes mosquito. Patients develop fever, inflammatory arthritis, and rash during the acute stage of infection. Although the illness is self-limiting, atypical and severe cases are not uncommon, and 60% may develop chronic symptoms that persist for months or even for longer durations. Having a distinct periodical epidemiologic outbreak pattern, chikungunya virus reappeared in Thailand in December 2018. Here, we describe a cohort of acute chikungunya patients who had presented to the Bangkok Hospital for Tropical Diseases during October 2019. Infection was detected by a novel antigen kit and subsequently confirmed by real-time RT-PCR using serum collected at presentation to the Fever Clinic. Other possible acute febrile illnesses such as influenza, dengue, and malaria were excluded. We explored the sequence of clinical manifestations at presentation during the acute phase and associated the viral load with the clinical findings. Most of the patients were healthy individuals in their forties. Fever and arthralgia were the predominant clinical manifestations found in this patient cohort, with a small proportion of patients with systemic symptoms. Higher viral loads were associated with arthralgia, and arthralgia with the involvement of the large joints was more common in female patients.

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Section: Discussionmentioning

confidence: 99%

Chikungunya Manifestations and Viremia in Patients Who Presented to the Fever Clinic at Bangkok Hospital for Tropical Diseases during the 2019 Outbreak in Thailand

et al. 2021

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“…The reason for this resurgence is not fully elucidated, but is believed to be multifactorial, such as increased vector susceptibility and perhaps climate change (6,54,55). Though the illness is self-limiting, infection results in increased morbidity and atypical manifestation, often with increased severity and fatalities (36,37,(56)(57)(58)(59)(60)(61)(62)(63). Chikungunya virus causes similar clinical manifestations during the acute phase that could mimic other arboviruses, and there are no widely available point-of-care rapid diagnostics (43,64,65).…”

Section: Discussionmentioning

confidence: 99%

Chikungunya Manifestations and Viremia in Patients Who Presented to the Fever Clinic at Bangkok Hospital for Tropical Diseases During the 2019 Outbreak in Thailand

Imad¹,

Phadungsombat²,

Nakayama³

et al. 2020

Preprint

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Chikungunya virus is an Alphavirus belonging to the family Togaviridae that is transmitted to humans by an infected Aedes mosquito. Patients develop fever, inflammatory arthritis, and rash during the acute stage of infection. Although the illness is self-limiting, atypical and severe cases are not uncommon, and 60% may develop chronic symptoms that persist for months or even for longer durations. Having a distinct periodical epidemiologic outbreak pattern, chikungunya virus reappeared in Thailand in December 2018. Here, we describe a cohort of acute chikungunya patients who had presented to the Bangkok Hospital for Tropical Diseases during October 2019. Infection was confirmed by real-time RT-PCR using serum collected at presentation to the Fever Clinic. Other possible acute febrile illnesses such as influenza, dengue, and malaria were excluded. We explored the sequence of clinical manifestations at presentation during the acute phase and associated the viral load with the clinical findings. Most of the patients were healthy individuals in their forties. Fever and arthralgia were the predominant clinical manifestations found in this patient cohort, with a small proportion of patients with systemic symptoms. Higher viral loads were associated with arthralgia, and arthralgia with the involvement of the large joints was more common in female patients

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“…Conversely, studies from Brazil and La Martinique did not find a relationship with fever or myalgias at the acute phase. 13,19 In our patients with chronic CHIK arthritis, the most commonly involved joints were MCPs, shoulders, and PIPs. This finding is in agreement with other studies in which upper extremities are the most affected.…”

Section: Discussionmentioning

confidence: 87%

“…This finding is in agreement with other studies in which upper extremities are the most affected. 19,30 By contrast, Rahim et al 11 reported predominant lower limb involvement (knees and ankles) over upper limbs (elbows, wrists, and shoulders). The single consensus among all studies of patients with chronic CHIKV arthritis is the involvement of both small and large joints.…”

Section: Discussionmentioning

confidence: 97%

“…1,2,17 It is associated with significant disability and loss of productivity. [13][14][15][18][19][20] Nonsteroidal anti-inflammatory drugs (NSAIDs), low-dose corticosteroids, and synthetic and biologic disease-modifying antirheumatic drugs (DMARDs) have been used for chronic CHIKV arthritis. 4,21 However, recommendations have a low level of evidence due to a lack of randomized clinical trials.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Manifestations and Outcomes in Disease-Modifying Antirheumatic Drug-Naive Adult Patients with Chronic Chikungunya Arthritis

Medina-Cintrón

Martínez

Pérez-Ríos

et al. 2021

The American Journal of Tropical Medicine and Hygiene

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Most studies on chronic chikungunya virus (CHIKV) arthritis include patients treated with disease-modifying antirheumatic drugs (DMARDs), likely altering the expression of clinical manifestations and outcome. Therefore, we sought to evaluate the clinical features and correlates in DMARD-naive patients with chronic CHIKV arthritis. We conducted a case–control study in adult patients with serologically confirmed CHIKV infection in Puerto Rico. Demographic features, clinical manifestations, comorbidities, disease activity (per Clinical Disease Activity Index [CDAI]), functional status (per Health Assessment Questionnaire Disability Index [HAQ-DI]), and pharmacologic treatment were ascertained. Patients with and without chronic CHIKV arthritis were compared. Furthermore, a sub-analysis was performed among patients with chronic CHIKV who presented with low disease activity versus moderate-to-high disease activity at study visit. In total, 61 patients were studied; 33 patients had chronic arthritis and 28 had resolved arthritis. Patients with chronic arthritis had significantly more diabetes mellitus, chronic back pain, and fever, tiredness, and myalgias on the acute phase. The mean (SD) HAQ score was 0.95 (0.56), and 57.6% had moderate-to-high disease activity. Patients with moderate-to-high disease activity had higher scores in overall HAQ-DI and HAQ-DI categories (dressing and grooming, arising, hygiene, reaching, and activities) than in those with mild activity. In conclusion, in this group of DMARD-naive patients with chronic CHIKV arthritis, nearly 58% had moderate-to-severe disease activity and had substantial functional disability. Diabetes mellitus, chronic low back pain, and some manifestations on acute infection were associated with chronic CHIKV arthritis.

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Persistent chikungunya arthritis in Roraima, Brazil

Cited by 10 publications

References 16 publications

Chikungunya Manifestations and Viremia in Patients Who Presented to the Fever Clinic at Bangkok Hospital for Tropical Diseases during the 2019 Outbreak in Thailand

Chikungunya Manifestations and Viremia in Patients Who Presented to the Fever Clinic at Bangkok Hospital for Tropical Diseases during the 2019 Outbreak in Thailand

Chikungunya Manifestations and Viremia in Patients Who Presented to the Fever Clinic at Bangkok Hospital for Tropical Diseases During the 2019 Outbreak in Thailand

Clinical Manifestations and Outcomes in Disease-Modifying Antirheumatic Drug-Naive Adult Patients with Chronic Chikungunya Arthritis

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