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Montera MW, Marcondes-Braga FG, Simões MV, Moura LAZ, Fernandes F, Mangine S, Oliveira Júnior ACD, Souza ALADAGD, Ianni BM, Rochitte CE, Mesquita CT, de Azevedo Filho CF, Freitas DCDA, Melo DTPD, Bocchi EA, Horowitz ESK, Mesquita ET, Oliveira GH, Villacorta H, Rossi Neto JM, Barbosa JMB, Figueiredo Neto JAD, Luiz LF, Hajjar LA, Beck-da-Silva L, Campos LADA, Danzmann LC, Bittencourt MI, Garcia MI, Avila MS, Clausell NO, Oliveira NAD, Silvestre OM, Souza OFD, Mourilhe-Rocha R, Kalil Filho R, Al-Kindi SG, Rassi S, Alves SMM, Ferreira SMA, Rizk SI, Mattos TAC, Barzilai V, Martins WDA, Schultheiss HP. Brazilian Society of Cardiology Guideline on Myocarditis - 2022. Arq Bras Cardiol 2022; 119:143-211. [PMID: 35830116 PMCID: PMC9352123 DOI: 10.36660/abc.20220412] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
| | - Fabiana G Marcondes-Braga
- Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | - Marcus Vinícius Simões
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, São Paulo, SP - Brasil
| | | | - Fabio Fernandes
- Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | - Sandrigo Mangine
- Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | | | | | - Bárbara Maria Ianni
- Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | - Carlos Eduardo Rochitte
- Instituto do Coração (InCor) - Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.,Hospital do Coração (HCOR), São Paulo, SP - Brasil
| | - Claudio Tinoco Mesquita
- Hospital Pró-Cardíaco, Rio de Janeiro, RJ - Brasil.,Universidade Federal Fluminense,Rio de Janeiro, RJ - Brasil.,Hospital Vitória, Rio de Janeiro, RJ - Brasil
| | | | | | | | - Edimar Alcides Bocchi
- Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | | | - Evandro Tinoco Mesquita
- Universidade Federal Fluminense,Rio de Janeiro, RJ - Brasil.,Centro de Ensino e Treinamento Edson de Godoy Bueno / UHG, Rio de Janeiro, RJ - Brasil
| | | | | | | | | | | | | | - Ludhmila Abrahão Hajjar
- Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil.,Instituto do Câncer do Estado de São Paulo da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil
| | - Luis Beck-da-Silva
- Hospital de Clínicas de Porto Alegre, Porto Alegre, RS - Brasil.,Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS - Brasil
| | | | | | - Marcelo Imbroise Bittencourt
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ - Brasil.,Hospital Universitário Pedro Ernesto, Rio de Janeiro, RJ - Brasil
| | - Marcelo Iorio Garcia
- Hospital Universitário Clementino Fraga Filho (HUCFF) da Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ - Brasil
| | - Monica Samuel Avila
- Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | | | | | | | | | | | | | - Sadeer G Al-Kindi
- Harrington Heart and Vascular Institute, University Hospitals and Case Western Reserve University,Cleveland, Ohio - EUA
| | | | - Silvia Marinho Martins Alves
- Pronto Socorro Cardiológico de Pernambuco (PROCAPE), Recife, PE - Brasil.,Universidade de Pernambuco (UPE), Recife, PE - Brasil
| | - Silvia Moreira Ayub Ferreira
- Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | - Stéphanie Itala Rizk
- Instituto do Câncer do Estado de São Paulo da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.,Hospital Sírio Libanês, São Paulo, SP - Brasil
| | | | - Vitor Barzilai
- Instituto de Cardiologia do Distrito Federal, Brasília, DF - Brasil
| | - Wolney de Andrade Martins
- Universidade Federal Fluminense,Rio de Janeiro, RJ - Brasil.,DASA Complexo Hospitalar de Niterói, Niterói, RJ - Brasil
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Cotella JI, Sauce AL, Saldarriaga CI, Perez GE, Farina JM, Wyss F, Sosa Liprandi A, Mendoza I, Múnera AG, Alexander B, Baranchuk A. Chikungunya and the Heart. Cardiology 2021; 146:324-334. [PMID: 33789296 DOI: 10.1159/000514206] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 12/29/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Neglected tropical diseases are a group of communicable diseases that occur in tropical and subtropical conditions and are closely related to poverty and inadequate sanitation conditions. Among these entities, chikungunya remains one of the most widely spread diseases. Although the main symptoms are related to a febrile syndrome, cardiovascular (CV) involvement has been reported, with short- and long-term implications. As part of the "Neglected Tropical Diseases and other Infectious Diseases involving the Heart" (NET-Heart) Project, the aim of this review is to compile all the information available regarding CV involvement of this disease, to help healthcare providers gain knowledge in this field, and contribute to improving early diagnosis, treatment, and prevention strategies. METHODS We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement in conducting and reporting this systematic review. The search was conducted using MEDLINE/PubMed, SciELO, and LILACS databases to identify any relevant studies or reviews detailing an association between chikungunya and cardiac involvement published from January 1972 to May 31, 2020. RESULTS Despite its mechanism not being fully understood, CV involvement has been described as the most frequent atypical presentation of chikungunya (54.2%). Myocarditis is the most prevalent CV complication. Different rhythm disturbances have been reported in 52% of cases, whereas heart failure was reported in 15% of cases, pericarditis in 5%, and acute myocardial infarction in 2%. Overall estimated CV mortality is 10%, although in patients with other comorbidities, it may increase up to 20%. In the proper clinical setting, the presence of fever, polyarthralgia, and new-onset arrhythmia suggests chikungunya virus-related myocarditis. CONCLUSION Although most cases are rarely fatal, CV involvement in chikungunya infection remains the most frequent atypical presentation of this disease and may have severe manifestations. Timely diagnosis and appropriate management are necessary to improve patient outcomes.
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Affiliation(s)
- Juan I Cotella
- Division of Cardiology, Centro Privado de Cardiología San Miguel de Tucumán, Tucumán, Argentina
| | - Ana L Sauce
- Division of Cardiology, Centro Médico Nacional Siglo XXI, Mexico, Mexico
| | - Clara I Saldarriaga
- Department of Cardiology and Heart Failure Clinic, Clínica Cardiovascular, University of Antioquia, Medellin, Colombia
| | - Gonzalo E Perez
- Division of Cardiology, Clínica Olivos, Buenos Aires, Argentina
| | - Juan M Farina
- Division of Cardiology, Clínica Olivos, Buenos Aires, Argentina
| | - Fernando Wyss
- Servicios y Tecnología Cardiovascular de Guatemala - Cardiosolutions, Guatemala, Guatemala
| | | | - Ivan Mendoza
- Division of Cardiology, Tropical Medicine Institute, Central University of Venezuela, Caracas, Venezuela
| | - Ana G Múnera
- Division of Cardiology, Hospital General de Medellín, Medellín, Colombia
| | - Bryce Alexander
- Division of Cardiology, Kingston Health Science Center, Queen's University, Kingston, Ontario, Canada
| | - Adrian Baranchuk
- Division of Cardiology, Kingston Health Science Center, Queen's University, Kingston, Ontario, Canada
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Athayde CCD, Nishijuka FA, Queiroz MCDC, Luna MM, Figueiredo JL, Albuquerque NMD, Castilho SCRD, Castro RRT. Acute Decompensated Heart Failure due to Chikungunya Fever. Arq Bras Cardiol 2020; 114:19-22. [PMID: 32428107 PMCID: PMC8149109 DOI: 10.36660/abc.20180316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 03/10/2019] [Indexed: 01/09/2023] Open
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Alvarez MF, Bolívar-Mejía A, Rodriguez-Morales AJ, Ramirez-Vallejo E. Cardiovascular involvement and manifestations of systemic Chikungunya virus infection: A systematic review. F1000Res 2017; 6:390. [PMID: 28503297 DOI: 10.12688/f1000research.11078.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/24/2017] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND In the last three years, chikungunya virus disease has been spreading, affecting particularly the Americas, producing more than two million cases. In this setting, not only new disease-related epidemiological patterns have been found, but also new clinical findings have been reported by different research groups. These include findings on the cardiovascular system, including clinical, electrocardiographic and echocardiographic alterations. No previous systemic reviews have been found in major databases about it. METHODS We performed a systematic review looking for reports about cardiovascular compromise during chikungunya disease. Cardiac compromise is not so common in isolated episodes; but countries where chikungunya virus is an epidemic should be well informed about this condition. We used 6 bibliographical databases as resources: Medline/Pubmed, Embase, ScienceDirect, ClinicalKey, Ovid and SciELO. Dengue reports on cardiovascular compromise were included as well, to compare both arbovirus' organic compromises. Articles that delved mainly into the rheumatic articular and cutaneous complications were not considered, as they were not in line with the purpose of this study. The type of articles included were reviews, meta-analyses, case-controls, cohort studies, case reports and case series. This systematic review does not reach or performed a meta-analysis. RESULTS Originally based on 737 articles, our reviewed selected 40 articles with 54.2% at least mentioning CHIKV cardiovascular compromise within the systemic compromise. Cardiovascular manifestations can be considered common and have been reported in France, India, Sri Lanka, Malaysia, Colombia, Venezuela and USA, including mainly, but no limited to: hypotension, shock and circulatory collapse, Raynaud phenomenon, arrhythmias, murmurs, myocarditis, dilated cardiomyopathy, congestive insufficiency, heart failure and altered function profile (Troponins, CPK). CONCLUSIONS Physicians should be encouraged to keep divulgating reports on the cardiovascular involvement of chikungunya virus disease, to raise awareness and ultimately encourage suitable diagnosis and intervention worldwide. More research about cardiovascular involvement and manifestations of systemic Chikungunya virus infection is urgently needed.
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Affiliation(s)
| | - Adrián Bolívar-Mejía
- Department of Internal Medicine, Universidad Industrial de Santander, Santander, Colombia
| | - Alfonso J Rodriguez-Morales
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia.,Colombian Collaborative Network on Zika and other Arboviruses (RECOLZIKA), Pereira, Risaralda, Colombia
| | - Eduardo Ramirez-Vallejo
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia.,Colombian Collaborative Network on Zika and other Arboviruses (RECOLZIKA), Pereira, Risaralda, Colombia
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5
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Alvarez MF, Bolívar-Mejía A, Rodriguez-Morales AJ, Ramirez-Vallejo E. Cardiovascular involvement and manifestations of systemic Chikungunya virus infection: A systematic review. F1000Res 2017; 6:390. [PMID: 28503297 PMCID: PMC5405794 DOI: 10.12688/f1000research.11078.2] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/27/2017] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND In the last three years, chikungunya virus disease has been spreading, affecting particularly the Americas, producing more than two million cases. In this setting, not only new disease-related epidemiological patterns have been found, but also new clinical findings have been reported by different research groups. These include findings on the cardiovascular system, including clinical, electrocardiographic and echocardiographic alterations. No previous systemic reviews have been found in major databases about it. METHODS We performed a systematic review looking for reports about cardiovascular compromise during chikungunya disease. Cardiac compromise is not so common in isolated episodes; but countries where chikungunya virus is an epidemic should be well informed about this condition. We used 6 bibliographical databases as resources: Medline/Pubmed, Embase, ScienceDirect, ClinicalKey, Ovid and SciELO. Dengue reports on cardiovascular compromise were included as well, to compare both arbovirus' organic compromises. Articles that delved mainly into the rheumatic articular and cutaneous complications were not considered, as they were not in line with the purpose of this study. The type of articles included were reviews, meta-analyses, case-controls, cohort studies, case reports and case series. This systematic review does not reach or performed a meta-analysis. RESULTS Originally based on 737 articles, our reviewed selected 40 articles with 54.2% at least mentioning CHIKV cardiovascular compromise within the systemic compromise. Cardiovascular manifestations can be considered common and have been reported in France, India, Sri Lanka, Malaysia, Colombia, Venezuela and USA, including mainly, but no limited to: hypotension, shock and circulatory collapse, Raynaud phenomenon, arrhythmias, murmurs, myocarditis, dilated cardiomyopathy, congestive insufficiency, heart failure and altered function profile (Troponins, CPK). CONCLUSIONS Physicians should be encouraged to keep divulgating reports on the cardiovascular involvement of chikungunya virus disease, to raise awareness and ultimately encourage suitable diagnosis and intervention worldwide. More research about cardiovascular involvement and manifestations of systemic Chikungunya virus infection is urgently needed.
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Affiliation(s)
| | - Adrián Bolívar-Mejía
- Department of Internal Medicine, Universidad Industrial de Santander, Santander, Colombia
| | - Alfonso J Rodriguez-Morales
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia.,Colombian Collaborative Network on Zika and other Arboviruses (RECOLZIKA), Pereira, Risaralda, Colombia
| | - Eduardo Ramirez-Vallejo
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia.,Colombian Collaborative Network on Zika and other Arboviruses (RECOLZIKA), Pereira, Risaralda, Colombia
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Langsjoen RM, Rubinstein RJ, Kautz TF, Auguste AJ, Erasmus JH, Kiaty-Figueroa L, Gerhardt R, Lin D, Hari KL, Jain R, Ruiz N, Muruato AE, Silfa J, Bido F, Dacso M, Weaver SC. Molecular Virologic and Clinical Characteristics of a Chikungunya Fever Outbreak in La Romana, Dominican Republic, 2014. PLoS Negl Trop Dis 2016; 10:e0005189. [PMID: 28030537 PMCID: PMC5193339 DOI: 10.1371/journal.pntd.0005189] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 11/16/2016] [Indexed: 11/18/2022] Open
Abstract
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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Affiliation(s)
- Rose M. Langsjoen
- Institute for Human Infections and Immunity and Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX, United States of America
- Institute for Translational Sciences, University of Texas Medical Branch, Galveston, TX, United States of America
| | - Rebecca J. Rubinstein
- Institute for Human Infections and Immunity and Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX, United States of America
- Center for Global Health Education, University of Texas Medical Branch, Galveston, TX, United States of America
| | - Tiffany F. Kautz
- Institute for Human Infections and Immunity and Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX, United States of America
- Department of Microbiology & Immunology, University of Texas, Galveston, TX, United States of America
| | - Albert J. Auguste
- Institute for Human Infections and Immunity and Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX, United States of America
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, United States of America
| | - Jesse H. Erasmus
- Institute for Human Infections and Immunity and Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX, United States of America
- Institute for Translational Sciences, University of Texas Medical Branch, Galveston, TX, United States of America
| | - Liddy Kiaty-Figueroa
- Center for Global Health Education, University of Texas Medical Branch, Galveston, TX, United States of America
| | - Renessa Gerhardt
- Center for Global Health Education, University of Texas Medical Branch, Galveston, TX, United States of America
| | - David Lin
- cBio Inc., Fremont, CA, United States of America
| | | | - Ravi Jain
- cBio Inc., Fremont, CA, United States of America
| | - Nicolas Ruiz
- Center for Global Health Education, University of Texas Medical Branch, Galveston, TX, United States of America
| | - Antonio E. Muruato
- Institute for Human Infections and Immunity and Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX, United States of America
- Department of Microbiology & Immunology, University of Texas, Galveston, TX, United States of America
| | - Jael Silfa
- Hospital Dr. Francisco Gonzalvo, La Romana, Dominican Republic
| | - Franklin Bido
- Hospital el Buen Samaritano, La Romana, Dominican Republic
| | - Matthew Dacso
- Institute for Human Infections and Immunity and Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX, United States of America
- Center for Global Health Education, University of Texas Medical Branch, Galveston, TX, United States of America
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, United States of America
| | - Scott C. Weaver
- Institute for Human Infections and Immunity and Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX, United States of America
- Department of Microbiology & Immunology, University of Texas, Galveston, TX, United States of America
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, United States of America
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McGraw IT, Dhanani N, Ray LA, Bentley RM, Bush RL, Vanderpool DM. Rapidly Evolving Outbreak of a Febrile Illness in Rural Haiti: The Importance of a Field Diagnosis of Chikungunya Virus in Remote Locations. Vector Borne Zoonotic Dis 2016; 15:678-82. [PMID: 26565773 DOI: 10.1089/vbz.2014.1763] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Although rarely fatal, chikungunya virus (CHIKV) infection can lead to chronic debilitating sequelae. We describe the outbreak of suspected CHIKV in 93 subjects who presented voluntarily over 2 months to a remote rural Haitian general medical clinic staffed by international health care providers. Diagnosis was made on clinical signs and symptoms because no serum analysis was available in this remote rural site. The subjects were 18.0 ± 16.2 (median ± standard deviation) years of age and were of similar gender distribution. The presenting vital signs included a temperature of 102.3°F ± 0.6°F with fever lasting for 3.0 ± 0.7 days. Symptoms mainly consisted of symmetrical polyarthralgias in 82.8%, headache in 28.0%, abdominal pain in 17.2%, cough in 8.6%, maculopapular rash in 30.0%, and extremity bullae in 12.9%. In 84.9% of subjects, symptoms persisted for 7.1 ± 8.3 days with 16.1% having ongoing disability due to persistent pain (≥ 14 days duration). There were no deaths. In Haiti, especially in remote, rural regions, the risk for CHIKV spread is high given the shortage of detection methods and treatment in this tropical climate and the lack of preventative efforts underway. Implications for global public health are likely, with outbreak expansion and spread to neighboring countries, including the United States.
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Affiliation(s)
- Ian T McGraw
- Texas A & M Health Science Center College of Medicine , Bryan, Texas
| | - Naila Dhanani
- Texas A & M Health Science Center College of Medicine , Bryan, Texas
| | - Lee Ann Ray
- Texas A & M Health Science Center College of Medicine , Bryan, Texas
| | - Regina M Bentley
- Texas A & M Health Science Center College of Medicine , Bryan, Texas
| | - Ruth L Bush
- Texas A & M Health Science Center College of Medicine , Bryan, Texas
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Thiberville SD, Moyen N, Dupuis-Maguiraga L, Nougairede A, Gould EA, Roques P, de Lamballerie X. Chikungunya fever: epidemiology, clinical syndrome, pathogenesis and therapy. Antiviral Res 2013; 99:345-70. [PMID: 23811281 PMCID: PMC7114207 DOI: 10.1016/j.antiviral.2013.06.009] [Citation(s) in RCA: 304] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Revised: 05/21/2013] [Accepted: 06/18/2013] [Indexed: 12/11/2022]
Abstract
Chikungunya fever is caused by a mosquito-borne alphavirus originating in East Africa. During the past 7 years, the disease has spread to islands of the Indian Ocean, Asia and Europe. Its spread has been facilitated by a mutation favouring replication in the mosquito Ae. albopictus. No vaccines or antiviral drugs are available to prevent or treat chikungunya fever. This paper provides an extensive review of the virus and disease, including Supplementary Tables.
Chikungunya virus (CHIKV) is the aetiological agent of the mosquito-borne disease chikungunya fever, a debilitating arthritic disease that, during the past 7 years, has caused immeasurable morbidity and some mortality in humans, including newborn babies, following its emergence and dispersal out of Africa to the Indian Ocean islands and Asia. Since the first reports of its existence in Africa in the 1950s, more than 1500 scientific publications on the different aspects of the disease and its causative agent have been produced. Analysis of these publications shows that, following a number of studies in the 1960s and 1970s, and in the absence of autochthonous cases in developed countries, the interest of the scientific community remained low. However, in 2005 chikungunya fever unexpectedly re-emerged in the form of devastating epidemics in and around the Indian Ocean. These outbreaks were associated with mutations in the viral genome that facilitated the replication of the virus in Aedes albopictus mosquitoes. Since then, nearly 1000 publications on chikungunya fever have been referenced in the PubMed database. This article provides a comprehensive review of chikungunya fever and CHIKV, including clinical data, epidemiological reports, therapeutic aspects and data relating to animal models for in vivo laboratory studies. It includes Supplementary Tables of all WHO outbreak bulletins, ProMED Mail alerts, viral sequences available on GenBank, and PubMed reports of clinical cases and seroprevalence studies.
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Affiliation(s)
- Simon-Djamel Thiberville
- UMR_D 190 "Emergence des Pathologies Virales" (Aix-Marseille Univ. IRD French Institute of Research for Development EHESP French School of Public Health), Marseille, France; University Hospital Institute for Infectious Disease and Tropical Medicine, Marseille, France.
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Teo TH, Lum FM, Claser C, Lulla V, Lulla A, Merits A, Rénia L, Ng LFP. A Pathogenic Role for CD4+T Cells during Chikungunya Virus Infection in Mice. THE JOURNAL OF IMMUNOLOGY 2012; 190:259-69. [DOI: 10.4049/jimmunol.1202177] [Citation(s) in RCA: 157] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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10
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Mouse models for Chikungunya virus: deciphering immune mechanisms responsible for disease and pathology. Immunol Res 2012; 53:136-47. [PMID: 22418724 DOI: 10.1007/s12026-012-8266-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Chikungunya virus (CHIKV), an alphavirus, has been responsible for large epidemic outbreaks with serious economic and social impact during the last 6 years. Transmitted by Aedes mosquitoes, it causes Chikungunya fever, an acute illness in patients with a stooped posture often associated with chronic and incapacitating arthralgia. The unprecedented re-emergence has stimulated renewed interest in CHIKV. This review discusses the advantages and disadvantages of different animal models for CHIKV infections and their importance to study the role of the immune system in different pathologies caused by CHIKV. We also reveal how such studies still present a difficult challenge, but are indispensible for mechanistic studies to further understand the pathophysiology of CHIKV infections.
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Gaüzère BA, Bohrer M, Drouet D, Gasque P, Jaffar-Bandjee MC, Filleul L, Vandroux D. Infection à virus Chikungunya à La Réunion en 2005–2006 : formes graves émergentes de l’adulte en réanimation. MEDECINE INTENSIVE REANIMATION 2011. [DOI: 10.1007/s13546-011-0261-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Simon F, Savini H, Parola P. Chikungunya: a paradigm of emergence and globalization of vector-borne diseases. Med Clin North Am 2008; 92:1323-43, ix. [PMID: 19061754 DOI: 10.1016/j.mcna.2008.07.008] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Chikungunya (CHIK) fever is a tropical arboviral disease responsible for acute polyarthritis which can last for weeks to months. In 2007, the chikungunya virus (CHIKV) reached Europe. Since the beginning of this outbreak, several million cases of chikungunya virus disease have occurred in autochthonous populations and in travelers who were diagnosed after they returned home from epidemic areas. CHIKV, usually transmitted by Aedes aegypti mosquitoes, has now been repeatedly associated with a new vector, Aedes albopictus (the "Asian tiger mosquito"), which has spread into tropical areas previously occupied predominantly by A aegypti, and has dispersed worldwide. Because CHIKV could spread throughout the world, all physicians should be prepared to encounter this arboviral infection, which represents a paradigm for emerging arboviral infections. In this article, the authors review different aspects of this reemerging and fascinating disease, focusing on clinical aspects and lessons from the recent large-scale outbreaks.
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Affiliation(s)
- Fabrice Simon
- Service de Pathologies Infectieuses et Tropicales, Hôspital d'Instruction des Armées Laveran, BP 50, 13998 Marseille Armées, France.
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Atypical Chikungunya virus infections: clinical manifestations, mortality and risk factors for severe disease during the 2005-2006 outbreak on Réunion. Epidemiol Infect 2008; 137:534-41. [PMID: 18694529 DOI: 10.1017/s0950268808001167] [Citation(s) in RCA: 343] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
In April 2005, an outbreak of Chikungunya fever occurred on the island of Réunion in the Indian Ocean. During winter 2005, six patients developed meningoencephalitis and acute hepatitis due to Chikungunya virus. Our objectives were to determine the incidence and mortality of atypical Chikungunya viral infections and to identify risk factors for severe disease. A hospital-based surveillance system was established to collect data on atypical Chikungunya cases. Case reports, medical records and laboratory results were reviewed and analysed. We defined an atypical case as one in which a patient with laboratory-confirmed Chikungunya virus infection developed symptoms other than fever and arthralgia. We defined a severe atypical case as one which required maintenance of at least one vital function. We recorded 610 atypical cases of Chikungunya fever: 222 were severe cases, 65 affected patients died. Five hundred and forty-six cases had underlying medical conditions (of which 226 suffered from cardiovascular, 147 from neurological and 150 from respiratory disorders). Clinical features that had never been associated with Chikungunya fever were recorded, such as bullous dermatosis, pneumonia, and diabetes mellitus. Hypertension, and underlying respiratory or cardiological conditions were independent risk factors for disease severity. The overall mortality rate was 10.6% and it increased with age. This is the first time that severe cases and deaths due to Chikungunya fever have been documented. The information presented in this article may assist clinicians in identifying the disease, selecting the treatment strategy, and anticipating the course of illness.
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