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Varikkodan MM, Kunnathodi F, Azmi S, Wu TY. An Overview of Indian Biomedical Research on the Chikungunya Virus with Particular Reference to Its Vaccine, an Unmet Medical Need. Vaccines (Basel) 2023; 11:1102. [PMID: 37376491 DOI: 10.3390/vaccines11061102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
Chikungunya virus (CHIKV) is an infectious agent spread by mosquitos, that has engendered endemic or epidemic outbreaks of Chikungunya fever (CHIKF) in Africa, South-East Asia, America, and a few European countries. Like most tropical infections, CHIKV is frequently misdiagnosed, underreported, and underestimated; it primarily affects areas with limited resources, like developing nations. Due to its high transmission rate and lack of a preventive vaccine or effective treatments, this virus poses a serious threat to humanity. After a 32-year hiatus, CHIKV reemerged as the most significant epidemic ever reported, in India in 2006. Since then, CHIKV-related research was begun in India, and up to now, more than 800 peer-reviewed research papers have been published by Indian researchers and medical practitioners. This review gives an overview of the outbreak history and CHIKV-related research in India, to favor novel high-quality research works intending to promote effective treatment and preventive strategies, including vaccine development, against CHIKV infection.
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Affiliation(s)
- Muhammed Muhsin Varikkodan
- Department of Bioscience Technology, College of Science, Chung Yuan Christian University, Chung-Li, Taoyuan City 320314, Taiwan
| | - Faisal Kunnathodi
- Scientific Research Center, Prince Sultan Military Medical City, Riyadh 11159, Saudi Arabia
| | - Sarfuddin Azmi
- Scientific Research Center, Prince Sultan Military Medical City, Riyadh 11159, Saudi Arabia
| | - Tzong-Yuan Wu
- Department of Bioscience Technology, College of Science, Chung Yuan Christian University, Chung-Li, Taoyuan City 320314, Taiwan
- R&D Center of Membrane Technology, Chung Yuan Christian University, Chung-Li, Taoyuan City 320314, Taiwan
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2
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A Review on Chikungunya Virus Epidemiology, Pathogenesis and Current Vaccine Development. Viruses 2022; 14:v14050969. [PMID: 35632709 PMCID: PMC9147731 DOI: 10.3390/v14050969] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/28/2022] [Accepted: 05/03/2022] [Indexed: 12/20/2022] Open
Abstract
Chikungunya virus (CHIKV) is a mosquito-borne alphavirus that recently re-emerged in many parts of the world causing large-scale outbreaks. CHIKV infection presents as a febrile illness known as chikungunya fever (CHIKF). Infection is self-limited and characterized mainly by severe joint pain and myalgia that can last for weeks or months; however, severe disease presentation can also occur in a minor proportion of infections. Among the atypical CHIKV manifestations that have been described, severe arthralgia and neurological complications, such as encephalitis, meningitis, and Guillain–Barré Syndrome, are now reported in many outbreaks. Moreover, death cases were also reported, placing CHIKV as a relevant public health disease. Virus evolution, globalization, and climate change may have contributed to CHIKV spread. In addition to this, the lack of preventive vaccines and approved antiviral treatments is turning CHIKV into a major global health threat. In this review, we discuss the current knowledge about CHIKV pathogenesis, with a focus on atypical disease manifestations, such as persistent arthralgia and neurologic disease presentation. We also bring an up-to-date review of the current CHIKV vaccine development. Altogether, these topics highlight some of the most recent advances in our understanding of CHIKV pathogenesis and also provide important insights into the current development and clinical trials of CHIKV potential vaccine candidates.
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Gray M, Guerrero-Arguero I, Solis-Leal A, Robison RA, Berges BK, Pickett BE. Chikungunya virus time course infection of human macrophages reveals intracellular signaling pathways relevant to repurposed therapeutics. PeerJ 2022; 10:e13090. [PMID: 35341048 PMCID: PMC8944338 DOI: 10.7717/peerj.13090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/18/2022] [Indexed: 01/12/2023] Open
Abstract
Background Chikungunya virus (CHIKV) is a mosquito-borne pathogen, within the Alphavirus genus of the Togaviridae family, that causes ~1.1 million human infections annually. CHIKV uses Aedes albopictus and Aedes aegypti mosquitoes as insect vectors. Human infections can develop arthralgia and myalgia, which results in debilitating pain for weeks, months, and even years after acute infection. No therapeutic treatments or vaccines currently exist for many alphaviruses, including CHIKV. Targeting the phagocytosis of CHIKV by macrophages after mosquito transmission plays an important role in early productive viral infection in humans, and could reduce viral replication and/or symptoms. Methods To better characterize the transcriptional response of macrophages during early infection, we generated RNA-sequencing data from a CHIKV-infected human macrophage cell line at eight or 24 hours post-infection (hpi), together with mock-infected controls. We then calculated differential gene expression, enriched functional annotations, modulated intracellular signaling pathways, and predicted therapeutic drugs from these sequencing data. Results We observed 234 pathways were significantly affected 24 hpi, resulting in six potential pharmaceutical treatments to modulate the affected pathways. A subset of significant pathways at 24 hpi includes AGE-RAGE, Fc epsilon RI, Chronic myeloid leukemia, Fc gamma R-mediated phagocytosis, and Ras signaling. We found that the MAPK1 and MAPK3 proteins are shared among this subset of pathways and that Telmisartan and Dasatinib are strong candidates for repurposed small molecule therapeutics that target human processes. The results of our analysis can be further characterized in the wet lab to contribute to the development of host-based prophylactics and therapeutics.
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Affiliation(s)
- Madison Gray
- Microbiology and Molecular Biology, Brigham Young University, Provo, Utah, United States of America
| | - Israel Guerrero-Arguero
- Microbiology and Molecular Biology, Brigham Young University, Provo, Utah, United States of America,Population Health and Host-pathogen Interactions Programs, Texas Biomedical Research Institute, San Antonio, Texas, United States of America
| | - Antonio Solis-Leal
- Microbiology and Molecular Biology, Brigham Young University, Provo, Utah, United States of America,Population Health and Host-pathogen Interactions Programs, Texas Biomedical Research Institute, San Antonio, Texas, United States of America
| | - Richard A. Robison
- Microbiology and Molecular Biology, Brigham Young University, Provo, Utah, United States of America
| | - Bradford K. Berges
- Microbiology and Molecular Biology, Brigham Young University, Provo, Utah, United States of America
| | - Brett E. Pickett
- Microbiology and Molecular Biology, Brigham Young University, Provo, Utah, United States of America
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Rueda JC, Santos AM, Angarita JI, Saldarriaga EL, Peláez-Ballestas I, Espinosa AS, Briceño-Balcázar I, Arias-Correal S, Arias-Correal J, Villota-Erazo C, Reyes V, Bernal-Macías S, Cardiel MH, Londono J. Can presence of HLA type I and II alleles be associated with clinical spectrum of CHIKV infection? Transbound Emerg Dis 2021; 69:e895-e905. [PMID: 34752688 DOI: 10.1111/tbed.14387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 10/18/2021] [Accepted: 10/23/2021] [Indexed: 11/30/2022]
Abstract
Host immune response and virulence factors are key to disease susceptibility. However, there are no known association studies of human leukocyte antigen (HLA) class I and II alleles with chikungunya virus (CHIKV) infection in the Latin American population. Here, we aimed to identify HLA alleles present in patients with CHIKV infection versus healthy controls as well as the allelic association with the clinical spectrum of the disease. We conducted a cross-sectional analysis of a community cohort and included patients aged 18 years and older with serologically confirmed CHIKV infection. HLA typing of HLA-A, HLA-B, and HLA-DRB1 alleles was performed. Two-by-two tables were used to establish associations between allele presence and clinical characteristics. Data from 65 patients with confirmed CHIKV infection were analyzed for HLA typing. CHIKV infection was significantly associated with the presence of HLA-A*68 [p = .005; odds ratio (OR): 8.90; 95% confidence interval (CI): 1.88-42.13], HLA-B*35 (p = .03; OR: 2.01; 95% CI: 1.06-3.86), HLA-DRB*01 (p <.001; OR: 5.70; 95% CI: 1.95-16.59), HLA-DRB1*04 (p <.001; OR: 7.37; 95% CI: 3.33-16.30), and HLA-DRB1*13 (p = .004; OR: 3.75; 95% CI: 1.50-9.39) alleles in patients versus healthy subjects. A statistically significant relationship was found between the presence of a rash on the face or abdomen and the presence of HLA-DRB1*04 (p = .028; OR: 3.2; 95% CI: 1.11-9.15 and p = .007; OR: 4.33; 95% CI: 1.45-12.88, respectively). Our study demonstrated that, in our cohort, HLA type I and type II alleles are associated with CHIKV infection, and an HLA type II allele is associated with dermatological symptoms. Further research is needed to establish a path for future investigation of genes outside the HLA system to improve knowledge of the pathophysiology of CHIKV infection and its host-pathogen interaction.
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Affiliation(s)
- Juan C Rueda
- Student, Biosciences Programme, Faculty of Medicine and Engineering, Universidad de La Sabana, Chía, Colombia.,Grupo de Espondiloartropatías, Rheumatology Department, Universidad de La Sabana, Chía, Colombia
| | - Ana M Santos
- Grupo de Espondiloartropatías, Rheumatology Department, Universidad de La Sabana, Chía, Colombia
| | - Jose-Ignacio Angarita
- Grupo de Espondiloartropatías, Rheumatology Department, Universidad de La Sabana, Chía, Colombia
| | | | | | | | | | - Sofia Arias-Correal
- Grupo de Espondiloartropatías, Rheumatology Department, Universidad de La Sabana, Chía, Colombia
| | - Jose Arias-Correal
- Grupo de Espondiloartropatías, Rheumatology Department, Universidad de La Sabana, Chía, Colombia
| | - Catalina Villota-Erazo
- Grupo de Espondiloartropatías, Rheumatology Department, Universidad de La Sabana, Chía, Colombia.,Rheumatology Department, Hospital Militar Central, Bogotá, Colombia
| | - Viviana Reyes
- Grupo de Espondiloartropatías, Rheumatology Department, Universidad de La Sabana, Chía, Colombia.,Rheumatology Department, Hospital Militar Central, Bogotá, Colombia
| | - Santiago Bernal-Macías
- Grupo de Espondiloartropatías, Rheumatology Department, Universidad de La Sabana, Chía, Colombia.,Rheumatology Department, Hospital Militar Central, Bogotá, Colombia
| | - Mario H Cardiel
- Centro de Investigación Clínica de Morelia SC, Morelia, Mexico
| | - John Londono
- Grupo de Espondiloartropatías, Rheumatology Department, Universidad de La Sabana, Chía, Colombia.,Rheumatology Department, Hospital Militar Central, Bogotá, Colombia
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Abstract
El virus de chikunguña (CHIKV) es un Alfavirus perteneciente al grupo denominado del Viejo Mundo; estos son virus artritogénicos que causan una enfermedad febril caracterizada por artralgias y mialgias. Aunque la muerte por CHIKV es poco frecuente, la enfermedad puede llegar a ser incapacitante y generar un amplio espectro de manifestaciones atípicas, como complicaciones cardiovasculares, respiratorias, oculares, renales y dérmicas, entre otras. Cuando el dolor articular persiste por tres o más meses, da lugar a la forma crónica de la enfermedad denominada reumatismo inflamatorio crónico poschikunguña, el cual es la principal secuela de la enfermedad. Se considera que este virus no es neurotrópico, sin embargo, puede afectar el sistema nervioso central y generar secuelas graves y permanentes, principalmente, en niños y ancianos. En África, Asia y Europa se habían reportado anteriormente brotes epidémicos por CHIKV, pero solo hasta finales del 2013 se documentó la introducción del virus a las Américas; desde entonces, el virus se ha propagado a 45 países o territorios del continente y el número de casos acumulados ascendió a cerca de dos millones en dos años. Esta revisión describe de manera general la biología molecular del virus, sus manifestaciones clínicas, su patogénesis y las principales complicaciones posteriores a la infección. Además, reúne la información de la epidemia en Colombia y el continente americano publicada entre el 2014 y el 2020.
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Wichit S, Gumpangseth N, Hamel R, Yainoy S, Arikit S, Punsawad C, Missé D. Chikungunya and Zika Viruses: Co-Circulation and the Interplay between Viral Proteins and Host Factors. Pathogens 2021; 10:448. [PMID: 33918691 PMCID: PMC8068860 DOI: 10.3390/pathogens10040448] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 04/03/2021] [Accepted: 04/06/2021] [Indexed: 12/14/2022] Open
Abstract
Chikungunya and Zika viruses, both transmitted by mosquito vectors, have globally re-emerged over for the last 60 years and resulted in crucial social and economic concerns. Presently, there is no specific antiviral agent or vaccine against these debilitating viruses. Understanding viral-host interactions is needed to develop targeted therapeutics. However, there is presently limited information in this area. In this review, we start with the updated virology and replication cycle of each virus. Transmission by similar mosquito vectors, frequent co-circulation, and occurrence of co-infection are summarized. Finally, the targeted host proteins/factors used by the viruses are discussed. There is an urgent need to better understand the virus-host interactions that will facilitate antiviral drug development and thus reduce the global burden of infections caused by arboviruses.
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Affiliation(s)
- Sineewanlaya Wichit
- Department of Clinical Microbiology and Applied Technology, Faculty of Medical Technology, Mahidol University, Nakhon Pathom 73170, Thailand; (N.G.); (S.Y.)
- School of Medicine, Walailak University, Nakhon Si Thammarat 80160, Thailand;
| | - Nuttamonpat Gumpangseth
- Department of Clinical Microbiology and Applied Technology, Faculty of Medical Technology, Mahidol University, Nakhon Pathom 73170, Thailand; (N.G.); (S.Y.)
| | - Rodolphe Hamel
- MIVEGEC, Univ. Montpellier, CNRS, IRD, Montpellier, France; (R.H.); (D.M.)
| | - Sakda Yainoy
- Department of Clinical Microbiology and Applied Technology, Faculty of Medical Technology, Mahidol University, Nakhon Pathom 73170, Thailand; (N.G.); (S.Y.)
| | - Siwaret Arikit
- Department of Agronomy, Faculty of Agriculture at Kamphaeng Saen, Kasetsart University Kamphaeng Saen Campus, Nakhon Pathom 73140, Thailand;
| | - Chuchard Punsawad
- School of Medicine, Walailak University, Nakhon Si Thammarat 80160, Thailand;
| | - Dorothée Missé
- MIVEGEC, Univ. Montpellier, CNRS, IRD, Montpellier, France; (R.H.); (D.M.)
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Anwar S, Taslem Mourosi J, Khan MF, Ullah MO, Vanakker OM, Hosen MJ. Chikungunya outbreak in Bangladesh (2017): Clinical and hematological findings. PLoS Negl Trop Dis 2020; 14:e0007466. [PMID: 32092073 PMCID: PMC7058364 DOI: 10.1371/journal.pntd.0007466] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 03/05/2020] [Accepted: 01/09/2020] [Indexed: 01/22/2023] Open
Abstract
Introduction A massive outbreak of chikungunya virus (CHIKV) occurred in Bangladesh during the period of April-September 2017, and over two million people were at risk of getting infected by the virus. A prospective cohort of viremic patients was constituted and analyzed to define the clinical, hematological, and long-term aspects of this outbreak. Methods A 35-day long comprehensive survey was conducted in two major, neighboring cities, Dhaka and Mymensingh. One-hundred and eighty-seven laboratory-confirmed CHIKV cases were enrolled in the cross-sectional cohort study. Additionally, a smaller group of 48 chikungunya patients was monitored for post-infection effects for 12 months. Results Clinical data revealed that a combination of fever and arthralgia (oligoarthralgia and/or polyarthralgia) was the cardinal hallmark (97.9% of cases) of the infection. Hematological analysis showed that irrespective of age and sex groups, CHIKV patients had a decreased level of hemoglobin (n = 64, p < 0.01) and elevated erythrocyte sedimentation rate (n = 131, p < 0.01). Besides, a significant portion of the patients represented abnormal values for RBC (n = 38, p = 0.0005) and WBC (n = 63, p < 0.01) counts. The post-infection study revealed that children had an early recovery from the infection compared to the adults. Moreover, post-infection weakness, successive relapse of arthralgic pain, and memory problems were the most significant aftereffects, which had an impact on the daily activities of patients. Conclusions This study represents a comprehensive overview of clinical and epidemiological features of the 2017 outbreak of CHIKV in Bangladesh as well as its chronic outcomes till the 12th month. It provides insights into the natural history of this disease, which may help to improve the management of CHIKV patients. The clinical profile, epidemiology, and the economic impacts during the acute phase of chikungunya infection have been studied quite rigorously. However, studies regarding the hematological features and chronic consequences are infrequent. In this study, we analyzed the clinical and hematological features of 187 chikungunya patients in the acute phase of the infection. Also, we monitored a smaller group of 48 patients until 12 months to study its post-infection consequences. Clinical data revealed that a combination of fever and joint pain (arthralgia) was the cardinal hallmark in the acute phase of the infection. Hematological analysis showed that CHIKV infection features a significantly reduced hemoglobin and remarkably elevated erythrocyte sedimentation rate. Besides, RBC and WBC counts, especially in children and females, were beyond the reference values. The post-infection consequence study unveiled that children recovered better from the infection compared to the adults. Further, post-infection weakness, successive relapse of joint pain and memory problems were the most significant aftereffects. Overall, the infection had a moderate to severe impact on the daily activities of the respondents. This study provides insights into the clinical and hematological aspects of chikungunya infection during the acute phase as well as describes an account for its chronic outcomes, which puts forward to the knowledge for clinicians and epidemiologists regarding the infection diversity and to help improve patient management.
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Affiliation(s)
- Saeed Anwar
- Department of Genetic Engineering and Biotechnology, School of Life Sciences, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Jarin Taslem Mourosi
- Department of Genetic Engineering and Biotechnology, School of Life Sciences, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Md. Fahim Khan
- Department of Genetic Engineering and Biotechnology, School of Life Sciences, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Mohammad Ohid Ullah
- Department of Statistics, School of Physical Sciences, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | | | - Mohammad Jakir Hosen
- Department of Genetic Engineering and Biotechnology, School of Life Sciences, Shahjalal University of Science and Technology, Sylhet, Bangladesh
- * E-mail:
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Rahman MM, Been Sayed SJ, Moniruzzaman M, Kabir AKMH, Mallik MU, Hasan MR, Siddique AB, Hossain MA, Uddin N, Hassan MM, Chowdhury FR. Clinical and Laboratory Characteristics of an Acute Chikungunya Outbreak in Bangladesh in 2017. Am J Trop Med Hyg 2019; 100:405-410. [PMID: 30526743 PMCID: PMC6367608 DOI: 10.4269/ajtmh.18-0636] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
From April to September 2017, Bangladesh experienced a huge outbreak of acute Chikungunya virus infection in Dhaka. This series describes the clinical and laboratory features of a large number of cases (690; 399 confirmed and 291 probable) suffered during that period. This observational study was carried out at Dhaka Medical College Hospital, Bangladesh. The median age of the patients at presentation was 38 years (IQR 30–50) with a male (57.3%) predominance. Hypertension and diabetes were the most common comorbidities. The mean (±SD) duration of fever was 3.7 (±1.4) days. Other common manifestations were arthralgia (99.2%), maculopapular rash (50.2%), morning stiffness (49.7%), joint swelling (48.5%), and headache (37.6%). Cases were confirmed by anti-chikungunya IgG (173; 43.3%), IgM (165; 42.3%), and reverse transcription polymerase chain reaction (44; 11.0%). Important laboratory findings include high erythrocyte sedimentation rate (156; 22.6%), raised serum glutamic pyruvic transaminase (73; 10.5%), random blood sugar (54; 7.8%), leukopenia (72; 10.4%), thrombocytopenia (41; 5.9%), and others. The oligo-articular (453; 66.1%) variety of joint involvement was significantly more common compared with the poly-articular (237; 34.5%) variety. Commonly involved joints were the wrist (371; 54.1%), small joints of the hand (321; 46.8%), ankle (251; 36.6%), knee (240; 35.0%), and elbow (228; 33.2%). Eleven cases were found to be complicated with neurological involvement and two of them died. Another patient died due to myocarditis. Public health experts, clinicians, and policymakers could use the results of this study to construct the future strategy tackling chikungunya in Bangladesh and other epidemic countries.
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Affiliation(s)
| | | | | | | | - Md Uzzwal Mallik
- Director General of Health Services, Dhaka, Bangladesh.,Department of Medicine, Dhaka Medical College, Dhaka, Bangladesh
| | - Md Rockyb Hasan
- Department of Medicine, Dhaka Medical College, Dhaka, Bangladesh
| | | | - Md Arman Hossain
- Department of Medicine, Dhaka Medical College, Dhaka, Bangladesh
| | - Nazim Uddin
- Department of Medicine, Dhaka Medical College, Dhaka, Bangladesh
| | - Md Mehedi Hassan
- Department of Medicine, Dhaka Medical College, Dhaka, Bangladesh
| | - Fazle Rabbi Chowdhury
- Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.,Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand.,Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, United Kingdom
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9
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Villero-Wolf Y, Mattar S, Puerta-González A, Arrieta G, Muskus C, Hoyos R, Pinzon H, Peláez-Carvajal D. Genomic epidemiology of Chikungunya virus in Colombia reveals genetic variability of strains and multiple geographic introductions in outbreak, 2014. Sci Rep 2019; 9:9970. [PMID: 31292455 PMCID: PMC6620336 DOI: 10.1038/s41598-019-45981-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 06/17/2019] [Indexed: 01/10/2023] Open
Abstract
Chikungunya virus (CHIKV) is considered a public health problem due to its rapid spread and high morbidity. This study aimed to determine the genetic diversity and phylogenetic relationships of CHIKVs in Colombia. A descriptive and retrospective study was carried out using sera of patients infected with Chikungunya during the outbreak in Colombia. The whole genomes of CHIKV (n = 16) were sequenced with an Illumina Hi-seq 2500 and were assembled using the Iterative Virus Assembler software. A Bayesian inference phylogenetic analysis was carried out with 157 strains of worldwide origin. The Colombian CHIKV sequences were grouped in the Asian genotype; however, three independent phylogenetic subclades were observed, probably the result of three separate introductions from Panama, Nicaragua, and St. Barts. Each subclade showed several different non-synonymous mutations (nsP2-A153V; nsp2-Y543H; nsp2-G720A; nsP3-L458P; Capside R78Q), that may have functional consequences for CHIKV biology and pathogenesis. These same mutations may affect the efficacy of potential CHIKV vaccines.
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Affiliation(s)
- Yeneiris Villero-Wolf
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Montería, Córdoba, Colombia
| | - Salim Mattar
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Montería, Córdoba, Colombia. .,Clínica Salud Social, Sincelejo, Sucre, Colombia.
| | | | - German Arrieta
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Montería, Córdoba, Colombia.,Grupo de Salud Pública, Corporación Universitaria del Caribe-CECAR, Sincelejo, Sucre, Colombia
| | - Carlos Muskus
- Programa de Estudio y Control de Enfermedades Tropicales (PECET), Facultad de Medicina, Universidad de Antioquia, Medellín, Antioquia, Colombia
| | - Richard Hoyos
- Grupo de Investigación en Resistencia Bacteriana y Enfermedades Tropicales, Universidad del Sinú, Montería, Córdoba, Colombia
| | - Hernando Pinzon
- Universidad de Cartagena, Hospital Infantil Napoleon Franco, Cartagena, Colombia
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Rico-Mendoza A, Alexandra PR, Chang A, Encinales L, Lynch R. Co-circulation of dengue, chikungunya, and Zika viruses in Colombia from 2008 to 2018. Rev Panam Salud Publica 2019; 43:e49. [PMID: 31171921 PMCID: PMC6548069 DOI: 10.26633/rpsp.2019.49] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 02/22/2019] [Indexed: 12/20/2022] Open
Abstract
Objective. This study aimed to identify the co-circulation patterns of three viruses (dengue, Zika, and chikungunya) in Colombia from 2008 to 2018 by using notification reports provided to the national surveillance system. Methods. This cross-sectional study was conducted through a review of data for 2008 through 2018 from Colombia’s Public Health Surveillance System (SIVIGILA). Results. In 2015, when chikungunya was first detected, it had a higher incidence (1 359.0 cases per 100 000 persons) than did the two other diseases. In 2016, when the circulation of Zika virus was first found, the incidence was 296.4 cases per 100 000 persons; that incidence declined dramatically in the next two years. Between 2015 and 2018, there was a substantial decrease in the frequency of dengue circulation, with it going from 334.1 cases per 100 000 persons in 2015 to 90.7 cases per 100 000 in 2017 and 173.1 cases per 100 000 in 2018. Conclusions. The decrease in the number of dengue cases after co-circulation of the three viruses could indicate possible cross-protection. This finding should be further analyzed.
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Affiliation(s)
- Alejandro Rico-Mendoza
- Grupo de Medicina Comunitaria y Salud Colectiva Grupo de Medicina Comunitaria y Salud Colectiva Universidad El Bosque Bogotá Colombia Grupo de Medicina Comunitaria y Salud Colectiva, Universidad El Bosque, Bogotá, Colombia
| | - Porras-Ramírez Alexandra
- Grupo de Medicina Comunitaria y Salud Colectiva Grupo de Medicina Comunitaria y Salud Colectiva Universidad El Bosque Bogotá Colombia Grupo de Medicina Comunitaria y Salud Colectiva, Universidad El Bosque, Bogotá, Colombia
| | - Aileen Chang
- Department of Medicine, the George Washington University Department of Medicine, the George Washington University WashingtonD.C United States of America Department of Medicine, the George Washington University, Washington, D.C., United States of America
| | - Liliana Encinales
- Allied Research Society Allied Research Society BarranquillaAtlántico Colombia Allied Research Society, Barranquilla, Atlántico, Colombia
| | - Rebecca Lynch
- Department of Microbiology, Immunology, and Tropical Medicine, the George Washington University Department of Microbiology, Immunology, and Tropical Medicine, the George Washington University WashingtonD.C United States of America Department of Microbiology, Immunology, and Tropical Medicine, the George Washington University, Washington, D.C., United States of America
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Chikungunya in Infants and Children: Is Pathogenesis Increasing? Viruses 2019; 11:v11030294. [PMID: 30909568 PMCID: PMC6466311 DOI: 10.3390/v11030294] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 03/19/2019] [Accepted: 03/20/2019] [Indexed: 12/15/2022] Open
Abstract
Chikungunya virus (CHIKV) was first extensively described in children during outbreaks in India and South Asia during the mid-1960s. Prior to the 2005 emergence of CHIKV on Reunion Island, CHIKV infection was usually described as a dengue-like illness with arthralgia in Africa and febrile hemorrhagic disease in Asia. Soon after the 2005 emergence, severe CNS consequences from vertical and perinatal transmission were described and as CHIKV continued to emerge in new areas over the next 10 years, severe manifestation of infection and sequelae were increasingly reported in infants and neonates. The following review describes the global reemergence and the syndromes of Chikungunya fever (CHIKF) in infants and children. The various manifestations of CHIKF are described and connected to the viral lineage that was documented in the area at the time the disease was described. The data show that certain manifestations of CHIKF occur with specific viral lineages and genetic motifs, which suggests that severe manifestations of CHIKF in the very young may be associated with the emergence of new viral lineages.
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Aponte A, Penilla RP, Rodríguez AD, Ocampo CB. Mechanisms of pyrethroid resistance in Aedes (Stegomyia) aegypti from Colombia. Acta Trop 2019; 191:146-154. [PMID: 30552882 DOI: 10.1016/j.actatropica.2018.12.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 12/11/2018] [Accepted: 12/11/2018] [Indexed: 11/28/2022]
Abstract
In Colombia Aedes (Stegomyia) aegypti is the main vector of urban arboviruses such as dengue, chikungunya and Zika. This urban mosquito has a well-established capacity to develop insecticide resistance to different types of insecticides (pyrethroids, organochlorides, organophosphates), using multiple resistance mechanisms. An understanding of ongoing resistance mechanisms is critical to determining the activities of vector control programs. In order to identify the biochemical and molecular mechanisms associated with pyrethroid resistance in Colombia, three laboratory-selected strains resistant to DDT, Propoxur and lambdacyhalothrin, and 7 field-collected strains were evaluated. CDC bioassays were performed to measure the susceptibility status to pyrethroid type I (permethrin) and II (deltamethrin and lambdacyhalothrin), and potential cross-resistance to different types of insecticides; organochlorine (DDT), carbamates (propoxur) and organophosphates (malathion). The enzymatic activity of esterases, glutathione S-transferases (GST) and P450 monooxygenases were biochemically determined. Frequencies of kdr mutations Val1016Ile and Phe1534cys were determined through real-time PCR. The Rockefeller strain of Aedes (Stegomyia) aegypti was used as the susceptible control. The laboratory-selected strains "propoxur" and "lambdacyhalothrin" and one field population (Medellín (BF) F2 were resistant to all evaluated pyrethroids. Six of the seven field populations as well as the laboratory- selected "DDT" strain were resistant to permethrin. All the evaluated strains were resistant to DDT. Cross-resistance between lambdacyhalothrin and propoxur was observed in the laboratory-selected strains; however, all field-collected strains were susceptible to propoxur and no evidence of malathion resistance was found. The main biochemical mechanism for resistance observed in the field-collected strains was related to the enzyme GST. Further, the frequencies of kdr mutations alleles associated with insecticide resistance were high and ranged from 0.02 to 0.72 for Ile1016 and from 0.44 to 0.99 for Cys1534. Strains with high frequencies of both kdr mutations were resistant to both type I and II pyrethroids. These results suggest that Ae. aegypti from Colombia have developed multiple resistance mechanisms associated with pyrethroid resistance; therefore a resistance management strategy against these field populations of Ae. Aegypti, incorporating these findings is strongly recommended.
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Affiliation(s)
- Angélica Aponte
- Centro Internacional de Entrenamiento e Investigaciones Médicas CIDEIM, Carrera 125 N 19-225, Cali, Colombia.
| | - R Patricia Penilla
- Centro Regional de Investigación en Salud Pública- Instituto Nacional de Salud Pública de México, Avenida 4 Norte 19 calle poniente, CP 307000, Chiapas, Tapachula, Mexico.
| | - Américo D Rodríguez
- Centro Regional de Investigación en Salud Pública- Instituto Nacional de Salud Pública de México, Avenida 4 Norte 19 calle poniente, CP 307000, Chiapas, Tapachula, Mexico.
| | - Clara B Ocampo
- Centro Internacional de Entrenamiento e Investigaciones Médicas CIDEIM, Carrera 125 N 19-225, Cali, Colombia; Universidad ICESI, Calle 18 N 122-135, Cali, Colombia.
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Rueda JC, Santos AM, Angarita JI, Giraldo RB, Saldarriaga EL, Ballesteros Muñoz JG, Forero E, Valencia H, Somoza F, Martin-Arsanios D, Quintero EJ, Reyes-Martinez V, Padilla D, Cuervo FM, Peláez-Ballestas I, Cardiel MH, Pavía PX, Londono J. Demographic and clinical characteristics of chikungunya patients from six Colombian cities, 2014-2015. Emerg Microbes Infect 2019; 8:1490-1500. [PMID: 31631794 PMCID: PMC6819954 DOI: 10.1080/22221751.2019.1678366] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 10/04/2019] [Indexed: 02/07/2023]
Abstract
In 2014, the chikungunya virus reached Colombia for the first time, resulting in a nationwide epidemic. The objective of this study was to describe the demographics and clinical characteristics of suspected chikungunya cases. Chikungunya infection was confirmed by enzyme-linked immunosorbent assay and 548 patients where included in the study. Of these patients, 295 were positive for antibodies against chikungunya (53.8%), and 27.6% (151/295) were symptomatic for chikungunya infection, with a symptomatic:asymptomatic ratio of 1.04:1. Factors associated with infection included low income and low socio-economic strata (odds ratio [OR]: 1.8; 95% confidence interval [CI]: 1.0-3.2, p = 0.003 and OR: 2.1; CI: 1.3-3.4, p = 0.002, respectively). Confirmed symptomatic cases were associated with symmetric arthritis (OR: 11.7; CI: 6.0-23.0, p < 0.001) of ankles (OR: 8.5; CI: 3.5-20.9, p < 0.001), hands (OR: 8.5; CI: 3.5-20.9, p < 0.001), feet (OR: 6.5; CI: 2.8-15.3, p < 0.001), and wrists (OR: 17.3; CI: 2.3-130.5, p < 0.001). Our study showed that poverty is associated with chikungunya infection. Public health strategies to prevent and control chikungunya should focus on poorer communities that are more vulnerable to infection. The rate of asymptomatic infections among confirmed cases was 48.8%. However, those with symptoms displayed a characteristic rheumatic clinical picture, which could help differentiate chikungunya infection from other endemic viral diseases.
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Affiliation(s)
- Juan C. Rueda
- Biosciences Doctoral Programme, Faculty of Medicine and Engineering, Universidad de La Sabana, Chía, Colombia
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | - Ana M. Santos
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | - Jose-Ignacio Angarita
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | - Rodrigo B. Giraldo
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | | | | | - Elías Forero
- Department of Rheumatology and Internal Medicine, Universidad del Norte, Barranquilla, Colombia
| | - Hugo Valencia
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | - Francisco Somoza
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | - Daniel Martin-Arsanios
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | - Elias-Josué Quintero
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | - Viviana Reyes-Martinez
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | - Diana Padilla
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | - Francy M. Cuervo
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | | | | | - Paula X. Pavía
- Unidad de Investigación Científica, Hospital Militar Central, Bogotá, Colombia
| | - John Londono
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
- Department of Rheumatology, Hospital Militar Central, Bogotá, Colombia
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Mascarenhas M, Garasia S, Berthiaume P, Corrin T, Greig J, Ng V, Young I, Waddell L. A scoping review of published literature on chikungunya virus. PLoS One 2018; 13:e0207554. [PMID: 30496207 PMCID: PMC6264817 DOI: 10.1371/journal.pone.0207554] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 11/01/2018] [Indexed: 12/13/2022] Open
Abstract
Chikungunya virus (CHIKV) has caused several major epidemics globally over the last two decades and is quickly expanding into new areas. Although this mosquito-borne disease is self-limiting and is not associated with high mortality, it can lead to severe, chronic and disabling arthritis, thereby posing a heavy burden to healthcare systems. The two main vectors for CHIKV are Aedes aegypti and Aedes albopictus (Asian tiger mosquito); however, many other mosquito species have been described as competent CHIKV vectors in scientific literature. With climate change, globalization and unfettered urban planning affecting many areas, CHIKV poses a significant public health risk to many countries. A scoping review was conducted to collate and categorize all pertinent information gleaned from published scientific literature on a priori defined aspects of CHIKV and its competent vectors. After developing a sensitive and specific search algorithm for the research question, seven databases were searched and data was extracted from 1920 relevant articles. Results show that CHIKV research is reported predominantly in areas after major epidemics have occurred. There has been an upsurge in CHIKV publications since 2011, especially after first reports of CHIKV emergence in the Americas. A list of hosts and vectors that could potentially be involved in the sylvatic and urban transmission cycles of CHIKV has been compiled in this scoping review. In addition, a repository of CHIKV mutations associated with evolutionary fitness and adaptation has been created by compiling and characterizing these genetic variants as reported in scientific literature.
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Affiliation(s)
- Mariola Mascarenhas
- National Microbiology Laboratory at Guelph, Public Health Agency of Canada, Guelph, Ontario, Canada
| | - Sophiya Garasia
- National Microbiology Laboratory at Guelph, Public Health Agency of Canada, Guelph, Ontario, Canada
| | - Philippe Berthiaume
- National Microbiology Laboratory at St. Hyacinthe, Public Health Agency of Canada, St. Hyacinthe, Quebec, Canada
| | - Tricia Corrin
- National Microbiology Laboratory at Guelph, Public Health Agency of Canada, Guelph, Ontario, Canada
| | - Judy Greig
- National Microbiology Laboratory at Guelph, Public Health Agency of Canada, Guelph, Ontario, Canada
| | - Victoria Ng
- National Microbiology Laboratory at Guelph, Public Health Agency of Canada, Guelph, Ontario, Canada
| | - Ian Young
- School of Occupational and Public Health, Ryerson University, Toronto, Ontario, Canada
| | - Lisa Waddell
- National Microbiology Laboratory at Guelph, Public Health Agency of Canada, Guelph, Ontario, Canada
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15
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Oviedo-Pastrana M, Méndez N, Mattar S, Arrieta G, Gomezcaceres L. Lessons learned of emerging Chikungunya virus in two populations of social vulnerability of the Colombian tropics: epidemiological analysis. Arch Public Health 2018; 76:36. [PMID: 30062010 PMCID: PMC6055333 DOI: 10.1186/s13690-018-0284-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 06/13/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Notwithstanding the strong epidemiological impact of the Chikungunya in the Colombian Caribbean, in 2014, not the entire population were affected in the same way. This study describe the demographic, socio-economic, clinical and epidemiological aspects of the de Chikungunya in Ovejas and Corozal, two neighboring municipalities with high vulnerability in health in the Colombian Caribbean. METHODS A cross-sectional study was performed in February 2015. A convenience sampling was carried out in 971 families affected with chikungunya. Also, a socio-demographics, clinical and epidemiological questionnaire was carried out for people who met the definition of suspected Chikungunya clinical case. For the statistical analysis, data and variables, frequencies, proportions and means were compared in the two municipalities studied. A logistic regression model was constructed to explain the effect of factors studied on the risk of family infection (RFI) or likelihood of contagion within each household. Was used the software EpiInfo 7.2.2.2 and a significance level with p-value < 0.05. RESULTS In Ovejas, 516 households were affected by Chikungunya, 48% (1269/2631) of their inhabitants became sick; in Corozal, 455 families were affected and 42% (839/1999) of their members became sick. The evolution of the epidemic curves of Chikungunya outbreak was different in the two studied areas, the disease was more aggressive in Ovejas. Ten variables were pre-selected by univariate analysis to explain the RFI by Chikungunya, and were integrated into a logistic regression model. The final model was constructed with the following variables: municipality, gender, occupation, family income, use of repellent and fumigation. The logistic model was assessed as appropriate; however, the biases in the selection of the surveyed dwellings and in the selection of symptomatic patients could influence the results. CONCLUSIONS It was demonstrated the epidemiological complexity of Chikungunya and the serious problem caused in populations with high vulnerability in health. The accurate association observed in the logistic regression model suggests the role of the factors studied as determinant in the rate of infection of the Chikungunya; coverage problems and surveillance in health care, demographic aspect, socio-economic problems and lack of preventive measures could explains the risk of family infection by Chikungunya in some areas tropics of Colombia. TRIAL REGISTRATION number approval 007-2016 ethics committee-IIBT.
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Affiliation(s)
- Misael Oviedo-Pastrana
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Carrera 6 # 76-103, Montería, Cordoba, Colombia
| | - Nelson Méndez
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Carrera 6 # 76-103, Montería, Cordoba, Colombia
| | - Salim Mattar
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Carrera 6 # 76-103, Montería, Cordoba, Colombia
- Clínica Salud Social SAS, Carrera 16 # 27A-74, Sincelejo, Colombia
- Facultad de Medicina Veterinaria y Zootecnia, Universidad de Córdoba Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico (IIBT), Carrera 6 # 76-103, Montería, Cordoba, Colombia
| | - Germán Arrieta
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Carrera 6 # 76-103, Montería, Cordoba, Colombia
- Corporación Universitaria del Caribe (CECAR), Grupo de Salud Pública, Km 1, vía Corozal, Sincelejo, Colombia
- Clínica Salud Social SAS, Carrera 16 # 27A-74, Sincelejo, Colombia
| | - Luty Gomezcaceres
- Corporación Universitaria del Caribe (CECAR), Grupo de Salud Pública, Km 1, vía Corozal, Sincelejo, Colombia
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16
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Zaidi MB, Garcia-Cordero J, Rivero-Gomez R, Corzo-Gomez J, González y Almeida ME, Bonilla-Moreno R, Bustos-Arriaga J, Villegas-Sepulveda N, Flores-Romo L, Cedillo-Barron L. Competitive suppression of dengue virus replication occurs in chikungunya and dengue co-infected Mexican infants. Parasit Vectors 2018; 11:378. [PMID: 29970133 PMCID: PMC6029041 DOI: 10.1186/s13071-018-2942-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 06/07/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Co-circulation of dengue virus (DENV) and chikungunya virus (CHIKV) is increasing worldwide but information on the viral dynamics and immune response to DENV-CHIKV co-infection, particularly in young infants, is scant. METHODS Blood samples were collected from 24 patients, aged 2 months to 82 years, during a CHIKV outbreak in Mexico. DENV and CHIKV were identified by RT-PCR; ELISA was used to detect IgM and IgG antibodies. CHIKV PCR products were cloned, sequenced and subjected to BLAST analysis. To address serological findings, HMEC-1 and Vero cells were inoculated with DENV-1, DENV-2 and CHIKV alone and in combination (DENV-2-CHIKV and DENV-1-CHIKV); viral titers were measured at 24, 48 and 72 h. RESULTS Nine patients (38%) presented co-infection, of who eight were children. None of the patients presented severe illness. Sequence analysis showed that the circulating CHIKV virus belonged to the Asian lineage. Seroconversion to both viruses was only observed in the four patients five years or older, while the five infants under two years of age only seroconverted to CHIKV. Viral titers in the CHIKV mono-infected cells were greater than in the DENV-1 and DENV-2 mono-infected cells. Furthermore, we observed significantly increased CHIKV progeny and reduction of DENV progeny in the co-infected cells. CONCLUSIONS In our population, DENV-CHIKV co-infection was not associated with increased clinical severity. Our in vitro assay findings strongly suggest that the lack of DENV IgG conversion in the co-infected infants is due to suppression of DENV replication by the Asian lineage CHIKV. The presence of maternal antibody and immature immune responses in the young infants may also play a role.
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Affiliation(s)
- Mussaret B Zaidi
- Infectious Diseases Research Unit, Hospital General O’Horan, Merida, Mexico
- Department of Epidemiology and Biostatistics, Michigan State University, Lansing, USA
| | | | | | | | | | | | - José Bustos-Arriaga
- Molecular Biology and Arbovirus Immunology UBIMED FES Iztacala, Mexican National Autonomous University, Edo de Mexico, Mexico
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Galán-Huerta K, Martínez-Landeros E, Delgado-Gallegos J, Caballero-Sosa S, Malo-García I, Fernández-Salas I, Ramos-Jiménez J, Rivas-Estilla A. Molecular and Clinical Characterization of Chikungunya Virus Infections in Southeast Mexico. Viruses 2018; 10:248. [DOI: https:/doi.org/10.3390/v10050248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Molecular and Clinical Characterization of Chikungunya Virus Infections in Southeast Mexico. Viruses 2018; 10:v10050248. [PMID: 29747416 PMCID: PMC5977241 DOI: 10.3390/v10050248] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 04/29/2018] [Accepted: 04/30/2018] [Indexed: 12/28/2022] Open
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.
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19
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Huits R, De Kort J, Van Den Berg R, Chong L, Tsoumanis A, Eggermont K, Bartholomeeusen K, Ariën KK, Jacobs J, Van Esbroeck M, Bottieau E, Cnops L. Chikungunya virus infection in Aruba: Diagnosis, clinical features and predictors of post-chikungunya chronic polyarthralgia. PLoS One 2018; 13:e0196630. [PMID: 29709007 PMCID: PMC5927412 DOI: 10.1371/journal.pone.0196630] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 04/16/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Chikungunya virus (CHIKV) emerged in Aruba for the first time in 2014. We studied the clinical presentation of acute CHIKV infection and the contribution of serologic and molecular assays to its diagnosis. In a cohort of confirmed CHIKV cases, we analysed the frequency, duration and predictors of post-chikungunya chronic polyarthralgia (pCHIK-CPA), defined as joint pains lasting longer than 6 weeks or longer than 1 year. METHODOLOGY Patient sera obtained within 10 days of symptom onset were tested for CHIKV, using an indirect immunofluorescence test for the detection of CHIKV-specific Immunoglobulin M (IgM) and post-hoc, by reverse-transcription polymerase chain reaction (RT-PCR). CHIKV was isolated from selected samples and genotyped. For confirmed CHIKV cases, clinical data from chart review were complemented by a Telephone survey, conducted 18-24 months after diagnosis. When joint pain was reported, the duration, presence of inflammatory signs, type and number of joints affected, were recorded. Joint involvement was scored according to the 2010 'American College of Rheumatology/ European League Against Rheumatism' criteria for seronegative rheumatoid arthritis (ACR-score). Risk factors for pCHIK-CPA were identified by logistic regression. PRINCIPAL FINDINGS Acute CHIKV infection was diagnosed in 269 of 498 sera, by detection of IgM (n = 105), by RT-PCR (n = 59), or by both methods (n = 105). Asian genotype was confirmed in 7 samples. Clinical data were complete for 171 of 248 (69.0%) patients, aged 15 years or older (median 49.4 [35.0-59.6]). The female-to-male ratio was 2.2. The main acute symptoms were arthralgia (94%), fever (85%), myalgia (85%), headache (73%) and rash (63%). In patients with arthralgia (n = 160), pCHIK-CPA longer than 6 weeks was reported by 44% and longer than 1 year by 26% of cases. Inflammatory signs, stiffness, edema and redness were frequent (71%, 39% and 21%, respectively). Joints involved were knees (66%), ankles (50%), fingers (52%), feet (46%), shoulders (36%), elbows (34%), wrists (35%), hips (31%), toes (28.1%) and spine (28.1%). Independent predictors of pCHIK-CPA longer than 1 year were female gender (OR 5.9, 95%-CI [2.1-19.6]); high ACR-score (7.4, [2.7-23.3]), and detection of CHIKV-RNA in serum beyond 7 days of symptom onset (6.4, [1.4-34.1]. CONCLUSIONS We identified 269 CHIKV patients after the first outbreak of Asian genotype CHIKV in Aruba in 2014-2015. RT-PCR yielded 59 (28%) additional CHIKV diagnoses compared to IgM antibody detection alone. Arthralgia, fever and skin rash were the dominant acute phase symptoms. pCHIK-CPA longer than 1 year affected 26% of cases and was predicted by female gender, high ACR-score and CHIKV-RNA detection beyond 7 days of symptom onset.
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Affiliation(s)
- Ralph Huits
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Jaclyn De Kort
- Department of Internal Medicine, Horacio Oduber Hospital, Oranjestad, Aruba
| | | | - Luis Chong
- Landslaboratorium Aruba, Oranjestad, Aruba
| | - Achilleas Tsoumanis
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Kaat Eggermont
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Koen Bartholomeeusen
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Kevin K Ariën
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.,Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Jan Jacobs
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.,Department of Microbiology and Immunology, University of Leuven, Leuven, Belgium
| | - Marjan Van Esbroeck
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Lieselotte Cnops
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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20
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Elsinga J, Halabi Y, Gerstenbluth I, Tami A, Grobusch MP. Consequences of a recent past dengue infection for acute and long-term chikungunya outcome: A retrospective cohort study in Curaçao. Travel Med Infect Dis 2018; 23:34-43. [PMID: 29614385 DOI: 10.1016/j.tmaid.2018.03.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 03/12/2018] [Accepted: 03/27/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Dengue and chikungunya co-infections are an emerging threat to public health in tropical and sub-tropical areas. This study investigates acute and long-term clinical presentation patterns of chikungunya against a backdrop of preceding dengue infection and determines predicting factors for long-term chikungunya sequelae. METHODS A retrospective cohort study was performed in 2015, including 299 previously confirmed chikungunya cases, of which 162 subjects were assessed for dengue serology at disease onset. RESULTS Those with previous dengue infection (35.2% of the examined population) had a similar acute disease presentation, and suffered (not statistically significantly) more frequently from long-term musculoskeletal and neuropsychological symptoms compared to chikungunya-only patients. Patients with a preceding dengue infection (vs. those without) (OR = 4.17; p = 0.004), female sex (OR = 3.17; p = 0.034) and pre-existing joint disease (OR = 2.95; p = 0.031) had a higher risk of developing aggravated long-term chikungunya. Chronic disease (sequelae lasting >90 days) was predicted by an age between 41 and 60 (OR = 3.07; p = 0.009) and concomitant cardiovascular disease (OR = 4.08; p = 0.010), but not by a preceding dengue infection. CONCLUSIONS This study suggests several predicting factors of, and a possible link between preceding dengue and chikungunya infection and aggravated long-term sequelae, which should be interpreted in the light of the limitations of this study.
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Affiliation(s)
- Jelte Elsinga
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Yaskara Halabi
- Medical and Health Service Curaçao, Department of Epidemiology and Research, Curaçao.
| | - Izzy Gerstenbluth
- Medical and Health Service Curaçao, Department of Epidemiology and Research, Curaçao; Curaçao Biomedical & Health Research Institute, Curaçao.
| | - Adriana Tami
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Martin P Grobusch
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Center, University of Amsterdam, The Netherlands.
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Paternina-Caicedo A, De la Hoz-Restrepo F, Díaz-Quijano F, Caicedo-Torres W, Auxiliadora Badillo-Viloria M, Bula-Anichiarico D, Alvis-Guzmán N, Mattar S, Constenla D, Pinzón-Redondo H. Features of Dengue and Chikungunya Infections of Colombian Children under 24 Months of Age Admitted to the Emergency Department. J Trop Pediatr 2018; 64:31-37. [PMID: 28444295 DOI: 10.1093/tropej/fmx024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We aimed to assess clinical and laboratory differences between dengue and chikungunya in children <24 months of age in a comparative study. We collected retrospective clinical and laboratory data confirmed by NS1/IgM for dengue for 19 months (1 January 2013 to 17 August 2014). Prospective data for chikungunya confirmed by real-time polymerase chain reaction were collected for 4 months (22 September 2014-14 December 2014). Sensitivity and specificity [with 95% confidence interval (CI)] were reported for each disease diagnosis. A platelet count <150 000 cells/ml at emergency admission best characterized dengue, with a sensitivity of 67% (95% CI, 53-79) and specificity of 95% (95% CI, 82-99). The algorithm developed with classification and regression tree analysis showed a sensitivity of 93% (95% CI, 68-100) and specificity of 38% (95% CI, 9-76) to diagnose dengue. Our study provides potential differential characteristics between chikungunya and dengue in young children, especially low platelet counts.
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Affiliation(s)
- Angel Paternina-Caicedo
- Departamento de Epidemiologia, Hospital Infantil Napoleón Franco Pareja-La Casa del Niño, Cartagena, Colombia
| | | | - Fredi Díaz-Quijano
- Departamento de Epidemiologia, Faculdade de Saúde Publica, Universidade de São Paulo, São Paulo, Brazil
| | | | | | - Doris Bula-Anichiarico
- Departamento de Epidemiologia, Hospital Infantil Napoleón Franco Pareja-La Casa del Niño, Cartagena, Colombia
| | - Nelson Alvis-Guzmán
- Departamento de Epidemiologia, Hospital Infantil Napoleón Franco Pareja-La Casa del Niño, Cartagena, Colombia.,Facultad de Medicina, Universidad de Cartagena, Cartagena, Colombia
| | - Salim Mattar
- Instituto de Investigaciones Biologicas del Tropico, Universidad de Córdoba, Montería, Colombia
| | - Dagna Constenla
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Hernando Pinzón-Redondo
- Departamento de Epidemiologia, Hospital Infantil Napoleón Franco Pareja-La Casa del Niño, Cartagena, Colombia.,Facultad de Medicina, Universidad de Cartagena, Cartagena, Colombia
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22
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Carrillo-Hernández MY, Ruiz-Saenz J, Villamizar LJ, Gómez-Rangel SY, Martínez-Gutierrez M. Co-circulation and simultaneous co-infection of dengue, chikungunya, and zika viruses in patients with febrile syndrome at the Colombian-Venezuelan border. BMC Infect Dis 2018; 18:61. [PMID: 29382300 PMCID: PMC5791178 DOI: 10.1186/s12879-018-2976-1] [Citation(s) in RCA: 102] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 01/23/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND In Colombia, the dengue virus (DENV) has been endemic for decades, and with the recent entry of the chikungunya virus (CHIKV) (2014) and the Zika virus (ZIKV) (2015), health systems are overloaded because the diagnosis of these three diseases is based on clinical symptoms, and the three diseases share a symptomatology of febrile syndrome. Thus, the objective of this study was to use molecular methods to identify their co-circulation as well as the prevalence of co-infections, in a cohort of patients at the Colombian-Venezuelan border. METHODS A total of 157 serum samples from patients with febrile syndrome consistent with DENV were collected after informed consent and processed for the identification of DENV (conventional PCR and real-time PCR), CHIKV (conventional PCR), and ZIKV (real-time PCR). DENV-positive samples were serotyped, and some of those positive for DENV and CHIKV were sequenced. RESULTS Eighty-two patients were positive for one or more viruses: 33 (21.02%) for DENV, 47 (29.94%) for CHIKV, and 29 (18.47%) for ZIKV. The mean age range of the infected population was statistically higher in the patients infected with ZIKV (29.72 years) than in those infected with DENV or CHIKV (21.09 years). Both co-circulation and co-infection of these three viruses was found. The prevalence of DENV/CHIKV, DENV/ZIKV, and CHIKV/ZIKV co-infection was 7.64%, 6.37%, and 5.10%, with attack rates of 14.90, 12.42, and 9.93 cases per 100,000 inhabitants, respectively. Furthermore, three patients were found to be co-infected with all three viruses (prevalence of 1.91%), with an attack rate of 4.96 cases per 100,000 inhabitants. CONCLUSION Our results demonstrate the simultaneous co-circulation of DENV, CHIKV, ZIKV and their co-infections at the Colombian-Venezuelan border. Moreover, it is necessary to improve the differential diagnosis in patients with acute febrile syndrome and to study the possible consequences of this epidemiological overview of the clinical outcomes of these diseases in endemic regions.
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Affiliation(s)
- Marlen Yelitza Carrillo-Hernández
- Grupo de Investigación en Ciencias Animales-GRICA, Universidad Cooperativa de Colombia, Calle 30A #, 33-51, Bucaramanga, Colombia.,Universidad de Santander UDES, Facultad de Ciencias de la Salud, Programa de Bacteriología y Laboratorio clínico, Grupo de investigación en manejo clínico - CLINIUDES, Bucaramanga, Colombia.,Maestría en Investigación en Enfermedades Infecciosas, Universidad de Santander, Bucaramanga, Colombia.,Doctorado en Ciencias Básicas Biomedicas, Universidad de Antioquia, Medellin, Colombia
| | - Julian Ruiz-Saenz
- Grupo de Investigación en Ciencias Animales-GRICA, Universidad Cooperativa de Colombia, Calle 30A #, 33-51, Bucaramanga, Colombia
| | - Lucy Jaimes Villamizar
- Laboratorio Clínico, E.S.E. Jorge Cristo Sahium Hospital, Norte de Santander, Cúcuta, Colombia
| | - Sergio Yebrail Gómez-Rangel
- Universidad de Santander UDES, Facultad de Ciencias de la Salud, Programa de Bacteriología y Laboratorio clínico, Grupo de investigación en manejo clínico - CLINIUDES, Bucaramanga, Colombia
| | - Marlen Martínez-Gutierrez
- Grupo de Investigación en Ciencias Animales-GRICA, Universidad Cooperativa de Colombia, Calle 30A #, 33-51, Bucaramanga, Colombia.
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23
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Evaluation of a range of mammalian and mosquito cell lines for use in Chikungunya virus research. Sci Rep 2017; 7:14641. [PMID: 29116243 PMCID: PMC5677012 DOI: 10.1038/s41598-017-15269-w] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 10/24/2017] [Indexed: 01/29/2023] Open
Abstract
Chikungunya virus (CHIKV) is becoming an increasing global health issue which has spread across the globe and as far north as southern Europe. There is currently no vaccine or anti-viral treatment available. Although there has been a recent increase in CHIKV research, many of these in vitro studies have used a wide range of cell lines which are not physiologically relevant to CHIKV infection in vivo. In this study, we aimed to evaluate a panel of cell lines to identify a subset that would be both representative of the infectious cycle of CHIKV in vivo, and amenable to in vitro applications such as transfection, luciferase assays, immunofluorescence, western blotting and virus infection. Based on these parameters we selected four mammalian and two mosquito cell lines, and further characterised these as potential tools in CHIKV research.
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24
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Danis-Lozano R, Díaz-González EE, Trujillo-Murillo KDC, Caballero-Sosa S, Sepúlveda-Delgado J, Malo-García IR, Canseco-Ávila LM, Salgado-Corsantes LM, Domínguez-Arrevillaga S, Torres-Zapata R, Gómez-Cruz O, Fernández-Salas I. Clinical characterization of acute and convalescent illness of confirmed chikungunya cases from Chiapas, S. Mexico: A cross sectional study. PLoS One 2017; 12:e0186923. [PMID: 29065182 PMCID: PMC5655440 DOI: 10.1371/journal.pone.0186923] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Accepted: 10/10/2017] [Indexed: 01/06/2023] Open
Abstract
Background The emerging chikungunya virus (CHIKV), is an arbovirus causing intense outbreaks in North America. The situation in Mexico is alarming, and CHIKV threatens to spread further throughout North America. Clinical and biological features of CHIKF outbreaks in Mexico have not been well described; thus, we conducted a cross sectional study of a CHIKV outbreak in Chiapas, Southern Mexico to further characterize these features. Methodology/Principal findings We collected blood samples from patients suspected of having chikungunya fever (CHIKF) who presented to Clinical Hospital ISSSTE Dr. Roberto Nettel in Tapachula, Chiapas, Mexico. In addition to the clinical examination, real-time polymerase chain reaction (PCR) standardized for the Asian Chikungunya lineage and/or enzyme-linked immunosorbent assay for immunoglobulin M (IgM) were used to confirm CHIKV diagnosis. Of a total of 850 patients who presented with probably CHIKV at Hospital “Dr. Roberto Nettel”, 112 probable CHIKF cases were enrolled in this study from November 2014- June 2015, of which 95 patients (84.8%) were CHIKV positive and 17 were negative (15.2%). Of these 95 CHIKV positive patients, 62 were positive by real-time reverse transcriptase PCR (+qRT-PCR); and 33 were seropositive to +IgM with a negative qRT-PCR. The most frequent symptoms reported were fever (100%), headache (82.3%), polyarthralgia (72.1%), and exanthem (82.3%). Biological abnormalities observed during CHIKV infection were lymphopenia (41.1%), leukopenia (51.6%), elevated transaminases (30.5%-46.3%) and high LDH (46.3%) and CRP (60.0%). Conclusion Clinical and biological data obtained from this study is providing more useful information for benchmarking purposes with outbreaks from different parts of the world and would be helpful for better patient care and treatment.
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Affiliation(s)
- Rogelio Danis-Lozano
- Centro Regional de Investigación en Salud Pública, Instituto Nacional de Salud Pública, Tapachula, Chiapas, México
| | - Esteban Eduardo Díaz-González
- Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Nuevo León, México
- Centro de Investigación y Desarrollo en Ciencias de la Salud, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | - Karina del Carmen Trujillo-Murillo
- Hospital Regional de Alta Especialidad “Ciudad Salud”, Secretaría de Salud, Tapachula, Chiapas, México
- Facultad de Ciencias Químicas, Universidad Autónoma de Chiapas, Tapachula, Chiapas, México
| | - Sandra Caballero-Sosa
- Clínica Hospital “Dr. Roberto Nettel”, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Tapachula, Chiapas, México
| | - Jesús Sepúlveda-Delgado
- Hospital Regional de Alta Especialidad “Ciudad Salud”, Secretaría de Salud, Tapachula, Chiapas, México
| | - Iliana Rosalía Malo-García
- Centro Regional de Investigación en Salud Pública, Instituto Nacional de Salud Pública, Tapachula, Chiapas, México
| | - Luis Miguel Canseco-Ávila
- Hospital Regional de Alta Especialidad “Ciudad Salud”, Secretaría de Salud, Tapachula, Chiapas, México
- Facultad de Ciencias Químicas, Universidad Autónoma de Chiapas, Tapachula, Chiapas, México
| | - Luis Manuel Salgado-Corsantes
- Clínica Hospital “Dr. Roberto Nettel”, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Tapachula, Chiapas, México
| | - Sergio Domínguez-Arrevillaga
- Hospital Regional de Alta Especialidad “Ciudad Salud”, Secretaría de Salud, Tapachula, Chiapas, México
- Facultad de Ciencias Químicas, Universidad Autónoma de Chiapas, Tapachula, Chiapas, México
| | - Raúl Torres-Zapata
- Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Nuevo León, México
| | - Omar Gómez-Cruz
- Hospital Regional de Alta Especialidad “Ciudad Salud”, Secretaría de Salud, Tapachula, Chiapas, México
| | - Ildefonso Fernández-Salas
- Centro Regional de Investigación en Salud Pública, Instituto Nacional de Salud Pública, Tapachula, Chiapas, México
- Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Nuevo León, México
- Centro de Investigación y Desarrollo en Ciencias de la Salud, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
- * E-mail:
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Elsinga J, Grobusch MP, Tami A, Gerstenbluth I, Bailey A. Health-related impact on quality of life and coping strategies for chikungunya: A qualitative study in Curaçao. PLoS Negl Trop Dis 2017; 11:e0005987. [PMID: 28991920 PMCID: PMC5648258 DOI: 10.1371/journal.pntd.0005987] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 10/19/2017] [Accepted: 09/22/2017] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Chikungunya is an emerging public health problem in tropical and subtropical regions, due to ongoing transmission and its incapacitating acute disease phase, and chronic sequelae. The disease is responsible for a major impact on Health Related Quality of Life (HRQoL), which may last several years. To our knowledge, this study is the first qualitative examination of HRQoL and coping strategies of chikungunya-infected individuals. METHODS Qualitative research methods consisted of 20 in-depth interviews and seven Focus Group Discussions (FGDs), n = 50. Analysis was based on the principles of the grounded theory. RESULTS Different impacts on HRQoL were reported. The physical and emotional domains of the HRQoL were mainly affected by chikungunya, while social and individual financial consequences were limited. Individual financial impact was limited through the universal health care program of Curaçao. Long-term lingering musculoskeletal and other manifestations caused significant pain and limited mobility. Hence, participants experienced dependency, impairment of normal daily life activities, moodiness, hopelessness, a change of identity, and insecurity about their future. The unpredictable nature and consequences of chikungunya gave rise to various coping strategies. Problem-focused coping styles led to higher uptake of medical care and were linked to more negative impact of HRQoL, whereas emotional coping strategies focusing on acceptance of the situation were linked to less uptake of medical care and more positive impact on HRQoL. CONCLUSIONS This study provides an in-depth understanding of acute and long-term HRQoL impact of chikungunya. The results can better inform health promotion policies and interventions. Messages to the public should focus on promoting healthy and efficient coping strategies, in order to prevent additional stress in affected individuals.
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Affiliation(s)
- Jelte Elsinga
- University of Groningen, University Medical Center Groningen, Department of Medical Microbiology, Groningen, The Netherlands
- * E-mail:
| | - Martin P. Grobusch
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Adriana Tami
- University of Groningen, University Medical Center Groningen, Department of Medical Microbiology, Groningen, The Netherlands
| | - Izzy Gerstenbluth
- Curaçao Biomedical & Health Research Institute, Department of Epidemiology, Willemstad, Curaçao
- Epidemiology and Research Unit, Medical and Public Health Service of Curaçao, Willemstad, Curaçao
| | - Ajay Bailey
- International Development Studies, Department of Human Geography and Spatial Planning, Utrecht University, Utrecht, Netherlands
- Dr. T. M. A. Pai Endowed Chair in Qualitative Methods, Manipal University, Manipal, India
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26
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Díaz-Quiñonez JA, Garay-Morán C, Román-Pedroza JF, López-Martínez I, Rodríguez-Martínez JC, Ruiz-Matus C, Kuri-Morales P. Caracterización clínica y epidemiológica de fiebre chikungunya en México. Rev Panam Salud Publica 2017. [PMID: 28902271 PMCID: PMC6612716 DOI: 10.26633/rpsp.2017.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
El 6 de diciembre de 2013, la Organización Panamericana de la Salud (OPS) y la Organización Mundial de la Salud (OMS) notificaron la confirmación de los dos primeros casos de transmisión autóctona en la Región de las Américas de fiebre chikungunya (CHIK) en la isla de Saint Martin (Antillas Neerlandesas). Para el período 2013-2014, el total de casos confirmados fue de 25 627 distribuidos en 43 países, donde México reportó 155 casos en cinco estados. La información de los casos de CHIK en México se obtuvo de la base de datos de la Dirección General de Epidemiología, dependiente de la Secretaría de Salud de México. La distribución por sexo de los casos autóctonos confirmados de CHIK para el año 2015 indica 64% para el sexo femenino (5 583) y 36% para el sexo masculino (3 085). Los síntomas más frecuentes fueron: fiebre en 98% de los casos (8 564), seguido por cefalea con 91,6% (7 941), mialgias en 89,9% (7 792), artralgias leves en 73,5% (6 367), poliartralgias graves en 72,6% (6 295) y exantema en 58% (5 032). La presentación clínica de los casos autóctonos de CHIK en México ha mostrado algunas características clínicas diferentes de las que se han observado en los brotes de los países africanos, asiáticos y otras regiones de América, como por ejemplo un mayor porcentaje de casos con cefalea y mialgias y un menor porcentaje de casos con artralgias.
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Affiliation(s)
| | | | | | - Irma López-Martínez
- Instituto de Diagnóstico y Referencia Epidemiológicos “Dr. Manuel Martínez Báez”, México D.F., México
| | | | | | - Pablo Kuri-Morales
- Subsecretaría de Prevención y Promoción de la Salud, México D.F., México
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Sahadeo NSD, Allicock OM, De Salazar PM, Auguste AJ, Widen S, Olowokure B, Gutierrez C, Valadere AM, Polson-Edwards K, Weaver SC, Carrington CVF. Understanding the evolution and spread of chikungunya virus in the Americas using complete genome sequences. Virus Evol 2017; 3:vex010. [PMID: 28480053 PMCID: PMC5413804 DOI: 10.1093/ve/vex010] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
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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Affiliation(s)
- N S D Sahadeo
- Department of Preclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine Campus, Trinidad and Tobago
| | - O M Allicock
- Department of Preclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine Campus, Trinidad and Tobago
| | - P M De Salazar
- Caribbean Public Health Agency, Port-of-Spain, Trinidad and Tobago.,ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - A J Auguste
- Institute for Human Infections and Immunity and Department of Microbiology & Immunology, University of Texas Medical Branch, Galveston, Texas, USA
| | - S Widen
- Institute for Human Infections and Immunity and Department of Microbiology & Immunology, University of Texas Medical Branch, Galveston, Texas, USA
| | - B Olowokure
- Caribbean Public Health Agency, Port-of-Spain, Trinidad and Tobago
| | - C Gutierrez
- Caribbean Public Health Agency, Port-of-Spain, Trinidad and Tobago
| | - A M Valadere
- Caribbean Public Health Agency, Port-of-Spain, Trinidad and Tobago
| | - K Polson-Edwards
- Caribbean Public Health Agency, Port-of-Spain, Trinidad and Tobago
| | - S C Weaver
- Institute for Human Infections and Immunity and Department of Microbiology & Immunology, University of Texas Medical Branch, Galveston, Texas, USA
| | - C V F Carrington
- Department of Preclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine Campus, Trinidad and Tobago
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Wahid B, Ali A, Rafique S, Idrees M. Global expansion of chikungunya virus: mapping the 64-year history. Int J Infect Dis 2017; 58:69-76. [PMID: 28288924 DOI: 10.1016/j.ijid.2017.03.006] [Citation(s) in RCA: 168] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 03/03/2017] [Accepted: 03/07/2017] [Indexed: 10/20/2022] Open
Abstract
Chikungunya virus (CHIKV) is a mosquito-transmitted alphavirus that is emerging as a global threat because of the highly debilitating nature of the associated disease and unprecedented magnitude of its spread. Chikungunya originated in Africa and has since spread across the entire globe causing large numbers of epidemics that have infected millions of people in Asia, the Indian subcontinent, Europe, the Americas, and Pacific Islands. Phylogenetic analysis has identified four different genotypes of CHIKV: Asian, West African, East/Central/South African (ECSA), and Indian Ocean Lineage (IOL). In the absence of well-designed epidemiological studies, the aim of this review article was to summarize the global epidemiology of CHIKV and to provide baseline data for future research on the treatment, prevention, and control of this life-threatening disease.
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Affiliation(s)
- Braira Wahid
- Centre for Applied Molecular Biology, 87 West Canal Bank Road, Thokar Niaz Baig, University of the Punjab, Lahore, Pakistan.
| | - Amjad Ali
- Centre for Applied Molecular Biology, 87 West Canal Bank Road, Thokar Niaz Baig, University of the Punjab, Lahore, Pakistan.
| | - Shazia Rafique
- Centre for Applied Molecular Biology, 87 West Canal Bank Road, Thokar Niaz Baig, University of the Punjab, Lahore, Pakistan.
| | - Muhammad Idrees
- Centre for Applied Molecular Biology, 87 West Canal Bank Road, Thokar Niaz Baig, University of the Punjab, Lahore, Pakistan; Vice Chancellor Hazara University, Mansehra, Pakistan.
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Severe Chikungunya infection in Northern Mozambique: a case report. BMC Res Notes 2017; 10:88. [PMID: 28179029 PMCID: PMC5299683 DOI: 10.1186/s13104-017-2417-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 02/03/2017] [Indexed: 01/29/2023] Open
Abstract
Background Although Chikungunya virus has rapidly expanded to several countries in sub-Saharan Africa, little attention has been paid to its control and management. Until recently, Chikungunya has been regarded as a benign and self-limiting disease. In this report we describe the first case of severe Chikungunya disease in an adult patient in Pemba, Mozambique. Case presentation A previously healthy 40 year old male of Makonde ethnicity with no known past medical history and resident in Pemba for the past 11 years presented with a severe febrile illness. Despite administration of broad spectrum intravenous antibiotics the patient rapidly deteriorated and became comatose while developing anaemia, thrombocytopenia and later, melaena. Laboratory testing revealed IgM antibodies against Chikungunya virus. Malaria tests were consistently negative. Conclusions This report suggests that Chikungunya might cause unsuspected severe disease in febrile patients in Mozambique and provides insights for the improvement of national protocols for management of febrile patients in Mozambique. We recommend that clinicians should consider Chikungunya in the differential diagnosis of febrile illness in locations where Aedes aegypti mosquitos are abundant.
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Arroyo-Ávila M, Cabán A, García-Rivera EJ, Irizarry-Pérez M, Torres H, Gorbea H, Vilá LM. Clinical Manifestations Associated with Peripheral Joint Involvement in Patients with Acute Chikungunya Virus Infection. Am J Trop Med Hyg 2017; 96:916-921. [PMID: 28138049 DOI: 10.4269/ajtmh.16-0890] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
AbstractChikungunya virus (CHIKV) causes an acute febrile illness usually accompanied by severe polyarthralgia and polyarthritis. Previous studies have shown that older age, female gender, and some comorbid conditions are associated with chronic CHIKV arthritis. However, the factors associated with acute arthralgia and arthritis are not well known. Thus, we studied the clinical manifestations associated with acute peripheral joint involvement in a group of CHIKV patients from Puerto Rico. Patients with a history of fever for < 7 days evaluated at the emergency department of a university-based hospital were tested for several pathogens including CHIKV. All patients with laboratory-positive CHIKV infection were studied. Demographic features, clinical manifestations, and comorbidities were determined. Patients with and without peripheral joint involvement were compared using bivariable and multivariable analyses. In total, 172 patients with CHIKV fever were evaluated; 52.9% were women. The mean (standard deviation) age was 21.1 years (19.3). Peripheral arthralgia and/or arthritis were seen in 156 (90.7%) patients. In the multivariable analysis adjusted for age and gender, peripheral joint involvement was associated with myalgia (odds ratio [OR] = 4.65, 95% confidence interval [CI] = 1.48-14.72), back pain (OR = 16.77, 95% CI = 3.07-313.82), ocular pain (OR = 8.88, 95% CI = 1.65-165.19), headache (OR = 3.63, 95% CI = 1.06-12.53), anorexia (OR = 5.68, 95% CI = 1.87-18.97), and nausea (OR = 6.88, 95% CI = 2.05-31.49). In conclusion, in this population of patients with acute CHIKV infection, peripheral joint involvement was associated with myalgia and back pain as well as nonmusculoskeletal manifestations such as headache, ocular pain, anorexia, and nausea.
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Affiliation(s)
- Mariangelí Arroyo-Ávila
- Division of Rheumatology, Department of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Amanda Cabán
- Division of Rheumatology, Department of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Enid J García-Rivera
- Endowed Health Services Research Center, School of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Marisela Irizarry-Pérez
- Endowed Health Services Research Center, School of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Hilda Torres
- Endowed Health Services Research Center, School of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Héctor Gorbea
- Division of Infectious Diseases, Department of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Luis M Vilá
- Division of Rheumatology, Department of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
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Oviedo-Pastrana M, Méndez N, Mattar S, Arrieta G, Gomezcaceres L. Epidemic outbreak of Chikungunya in two neighboring towns in the Colombian Caribbean: a survival analysis. ACTA ACUST UNITED AC 2017; 75:1. [PMID: 28074128 PMCID: PMC5219791 DOI: 10.1186/s13690-016-0169-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 12/09/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND The first autochthonous Chikungunya virus transmission in Colombia was reported in September 2014. Three months later, every town in the Caribbean region was affected, including the bordering towns of Ovejas and Corozal, in the department of Sucre. The objective of the study was to analyze and compare the temporal dynamics of the outbreak of Chikungunya in two towns of the department of Sucre. METHODS Households with suspicious cases with clinical symptomatology for Chikungunya were enrolled. In each house an epidemiological questionnaire was applied to collect economic and social information and methods for vector control. RESULTS The study analyzed data collected between 09/01/2014 and 01/31/2015; 458 families in Corozal and 516 families in Ovejas were identified with Chikungunya cases. Estimated attack rates were 10,621 cases and 1640 cases per 100,000 inhabitants, in Ovejas and Corozal, respectively. The 75-day survival curve was 27.2% lower (0.632, CI = 0.614-0.651) in Ovejas than in Corozal (0.904, CI = 0.891-0.917). After 120 days, both curves showed a stable horizontal slope, close to a survival probability of 0.54, indicating the end of the epidemic period. The log-rank test (X2 = 94.6, 1fd, p-value = 0.000) showed the improved survival of Chikungunya in the town of Corozal. The relative risk between the two towns was 0.863 (CI = 0.809-0.921; p-value < 0.001). CONCLUSIONS The dynamics of the temporal distribution of CHIKV could be influenced by socioeconomic and preventable risk factors. Poor socioeconomic conditions such as the lack and poor efficiency of water supply and waste collection services could be determining factors in the proliferation of CHIKV. The survival analysis proved to be a suitable method for studying the presentation of CHIKV and can be applied to other prevalent vector-borne diseases such as the ZIKA and Dengue.
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Affiliation(s)
- Misael Oviedo-Pastrana
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Carrera 6 # 76-103, Montería, Córdoba Colombia
| | - Nelson Méndez
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Carrera 6 # 76-103, Montería, Córdoba Colombia
| | - Salim Mattar
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Carrera 6 # 76-103, Montería, Córdoba Colombia ; Clínica Salud Social SAS, Carrera 16 # 27A-74, Sincelejo, Colombia
| | - Germán Arrieta
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Carrera 6 # 76-103, Montería, Córdoba Colombia ; Corporación Universitaria del Caribe (CECAR), Grupo de Salud Pública, Km 1, vía Corozal, Sincelejo, Colombia ; Clínica Salud Social SAS, Carrera 16 # 27A-74, Sincelejo, Colombia
| | - Luty Gomezcaceres
- Corporación Universitaria del Caribe (CECAR), Grupo de Salud Pública, Km 1, vía Corozal, Sincelejo, Colombia
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Camacho E, Paternina-Gomez M, Blanco PJ, Osorio JE, Aliota MT. Detection of Autochthonous Zika Virus Transmission in Sincelejo, Colombia. Emerg Infect Dis 2016; 22:927-9. [PMID: 27089253 PMCID: PMC4861534 DOI: 10.3201/eid2205.160023] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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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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Chen R, Puri V, Fedorova N, Lin D, Hari KL, Jain R, Rodas JD, Das SR, Shabman RS, Weaver SC. Comprehensive Genome Scale Phylogenetic Study Provides New Insights on the Global Expansion of Chikungunya Virus. J Virol 2016; 90:10600-10611. [PMID: 27654297 PMCID: PMC5110187 DOI: 10.1128/jvi.01166-16] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 09/01/2016] [Indexed: 12/24/2022] Open
Abstract
Since the India and Indian Ocean outbreaks of 2005 and 2006, the global distribution of chikungunya virus (CHIKV) and the locations of epidemics have dramatically shifted. First, the Indian Ocean lineage (IOL) caused sustained epidemics in India and has radiated to many other countries. Second, the Asian lineage has caused frequent outbreaks in the Pacific islands and in 2013 was introduced into the Caribbean, followed by rapid spread to nearly all of the neotropics. Further, CHIKV epidemics, as well as exported cases, have been reported in central Africa after a long period of perceived silence. To understand these changes and to anticipate the future of the virus, the exact distribution, genetic diversity, transmission routes, and future epidemic potential of CHIKV require further assessment. To do so, we conducted the most comprehensive phylogenetic analysis to date, examined CHIKV evolution and transmission, and explored distinct genetic factors associated with the emergence of the East/Central/South African (ECSA) lineage, the IOL, and the Asian lineage. Our results reveal contrasting evolutionary patterns among the lineages, with growing genetic diversities observed in each, and suggest that CHIKV will continue to be a major public health threat with the potential for further emergence and spread. IMPORTANCE Chikungunya fever is a reemerging infectious disease that is transmitted by Aedes mosquitoes and causes severe health and economic burdens in affected populations. Since the unprecedented Indian Ocean and Indian subcontinent outbreaks of 2005 and 2006, CHIKV has further expanded its geographic range, including to the Americas in 2013. Its evolution and transmission during and following these epidemics, as well as the recent evolution and spread of other lineages, require optimal assessment. Using newly obtained genome sequences, we provide a comprehensive update of the global distribution of CHIKV genetic diversity and analyze factors associated with recent outbreaks. These results provide a solid foundation for future evolutionary studies of CHIKV that can elucidate emergence mechanisms and also may help to predict future epidemics.
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Affiliation(s)
- Rubing Chen
- Institute of Human Infections and Immunology and Department of Pathology, University of Texas Medical Branch, Galveston, Texas, USA
| | - Vinita Puri
- J. Craig Venter Institute, Rockville, Maryland, USA
| | | | | | | | | | | | - Suman R Das
- J. Craig Venter Institute, Rockville, Maryland, USA
| | | | - Scott C Weaver
- Institute of Human Infections and Immunology and Department of Pathology, University of Texas Medical Branch, Galveston, Texas, USA
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
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Macpherson C, Noël T, Fields P, Jungkind D, Yearwood K, Simmons M, Widjaja S, Mitchell G, Noel D, Bidaisee S, Myers TE, LaBeaud AD. Clinical and Serological Insights from the Asian Lineage Chikungunya Outbreak in Grenada, 2014: An Observational Study. Am J Trop Med Hyg 2016; 95:890-893. [PMID: 27527629 DOI: 10.4269/ajtmh.16-0122] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 07/03/2016] [Indexed: 11/07/2022] Open
Abstract
Chikungunya virus (CHIKV) spread rapidly throughout the Caribbean region in 2014, and the first serologically confirmed case was seen in Grenada in July. This study investigated the outbreak of CHIKV in Grenada to identify the distinguishing clinical manifestations and the symptoms that corresponded the closest with serological test results. Sera were tested by IgM enzyme-linked immunosorbent assay and polymerase chain reaction to distinguish between cases positive or negative for CHIKV. Of 493 cases, 426 (86%) tested positive for CHIKV. The diagnostic decision rule, "Define as CHIKV positive a patient presenting with joint pain and any combination of fever, body pain, or rash," produced the closest agreement (85%) with the serological test results (Cohen's kappa, k = 0.289, P value < 0.001). When laboratory facilities are not available for diagnostic confirmation, syndromic surveillance using these four symptoms could be useful to define cases during a CHIKV outbreak when CHIKV is the predominant circulating arbovirus.
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Affiliation(s)
- Calum Macpherson
- St. George's University School of Medicine, Saint George, Grenada. Windward Islands Research and Education Foundation, Saint George, Grenada.
| | - Trevor Noël
- St. George's University School of Medicine, Saint George, Grenada. Windward Islands Research and Education Foundation, Saint George, Grenada
| | - Paul Fields
- Windward Islands Research and Education Foundation, Saint George, Grenada
| | - Donald Jungkind
- St. George's University School of Medicine, Saint George, Grenada
| | | | | | | | | | - Dolland Noel
- St. George's University School of Medicine, Saint George, Grenada. Ministry of Health, Saint George, Grenada
| | - Satesh Bidaisee
- St. George's University School of Medicine, Saint George, Grenada. Windward Islands Research and Education Foundation, Saint George, Grenada
| | - Todd E Myers
- Naval Medical Research Center, Silver Spring, Maryland
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Rodas JD, Kautz T, Camacho E, Paternina L, Guzmán H, Díaz FJ, Blanco P, Tesh R, Weaver SC. Genetic Characterization of Northwestern Colombian Chikungunya Virus Strains from the 2014-2015 Epidemic. Am J Trop Med Hyg 2016; 95:639-46. [PMID: 27430542 DOI: 10.4269/ajtmh.16-0091] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 06/06/2016] [Indexed: 12/25/2022] Open
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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Affiliation(s)
- Juan D Rodas
- Grupo Centauro, Facultad de Ciencias Agrarias, Universidad de Antioquia, Medellín, Colombia
| | - Tiffany Kautz
- Department of Pathology, Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, Texas. Department of Microbiology and Immunology, Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, Texas
| | - Erwin Camacho
- Grupo de Investigaciónes Biomédicas, Universidad de Sucre, Sincelejo, Colombia
| | - Luis Paternina
- Grupo de Investigaciónes Biomédicas, Universidad de Sucre, Sincelejo, Colombia
| | - Hilda Guzmán
- Department of Pathology, Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, Texas
| | - Francisco J Díaz
- Grupo de Inmunovirología, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Pedro Blanco
- Grupo de Investigaciónes Biomédicas, Universidad de Sucre, Sincelejo, Colombia
| | - Robert Tesh
- Department of Pathology, Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, Texas
| | - Scott C Weaver
- Department of Pathology, Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, Texas. Department of Microbiology and Immunology, Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, Texas.
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Aliota MT, Peinado SA, Velez ID, Osorio JE. The wMel strain of Wolbachia Reduces Transmission of Zika virus by Aedes aegypti. Sci Rep 2016; 6:28792. [PMID: 27364935 PMCID: PMC4929456 DOI: 10.1038/srep28792] [Citation(s) in RCA: 198] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 06/10/2016] [Indexed: 11/09/2022] Open
Abstract
Zika virus (ZIKV) is causing an explosive outbreak of febrile disease in the Americas. There are no effective antiviral therapies or licensed vaccines for this virus, and mosquito control strategies have not been adequate to contain the virus. A promising candidate for arbovirus control and prevention relies on the introduction of the intracellular bacterium Wolbachia into Aedes aegypti mosquitoes. This primarily has been proposed as a tool to control dengue virus (DENV) transmission; however, evidence suggests Wolbachia infections confer protection for Ae. aegypti against other arboviruses. At present, it is unknown whether or not ZIKV can infect, disseminate, and be transmitted by Wolbachia-infected Ae. aegypti. Using Ae. aegypti infected with the wMel strain of Wolbachia that are being released in Medellin, Colombia, we report that these mosquitoes have reduced vector competence for ZIKV. These results support the use of Wolbachia biocontrol as a multivalent strategy against Ae. aegypti-transmitted viruses.
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Affiliation(s)
- Matthew T. Aliota
- Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Stephen A. Peinado
- Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Ivan Dario Velez
- Programa de Estudio y Control de Enfermedades Tropicales (PECET), Universidad de Antioquia, Medellin, A1226, Colombia
| | - Jorge E. Osorio
- Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, WI, USA
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Abstract
Chikungunya appeared during the second half of 2014 in Colombia. A prospective cohort study was carried to detect differences and severity between neonates and older children. Of 54 children with chikungunya, neonates had a higher viral load and greater frequency of severe laboratory and clinical findings.
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Aliota MT, Walker EC, Uribe Yepes A, Dario Velez I, Christensen BM, Osorio JE. The wMel Strain of Wolbachia Reduces Transmission of Chikungunya Virus in Aedes aegypti. PLoS Negl Trop Dis 2016; 10:e0004677. [PMID: 27124663 PMCID: PMC4849757 DOI: 10.1371/journal.pntd.0004677] [Citation(s) in RCA: 128] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 04/08/2016] [Indexed: 12/04/2022] Open
Abstract
Background New approaches to preventing chikungunya virus (CHIKV) are needed because current methods are limited to controlling mosquito populations, and they have not prevented the invasion of this virus into new locales, nor have they been sufficient to control the virus upon arrival. A promising candidate for arbovirus control and prevention relies on the introduction of the intracellular bacterium Wolbachia into Aedes aegypti mosquitoes. This primarily has been proposed as a tool to control dengue virus (DENV) transmission; however, evidence suggests Wolbachia infections confer protection for Ae. aegypti against CHIKV. Although this approach holds much promise for limiting virus transmission, at present our understanding of the ability of CHIKV to infect, disseminate, and be transmitted by wMel-infected Ae. aegypti currently being used at Wolbachia release sites is limited. Methodology/Principal Findings Using Ae. aegypti infected with the wMel strain of Wolbachia that are being released in Medellin, Colombia, we report that these mosquitoes have reduced vector competence for CHIKV, even with extremely high viral titers in the bloodmeal. In addition, we examined the dynamics of CHIKV infection over the course of four to seven days post feeding. Wolbachia-infected mosquitoes remained non-infective over the duration of seven days, i.e., no infectious virus was detected in the saliva when exposed to bloodmeals of moderate viremia, but CHIKV-exposed, wild type mosquitoes did have viral loads in the saliva consistent with what has been reported elsewhere. Finally, the presence of wMel infection had no impact on the lifespan of mosquitoes as compared to wild type mosquitoes following CHIKV infection. Conclusions/Significance These results could have an impact on vector control strategies in areas where Ae. aegypti are transmitting both DENV and CHIKV; i.e., they argue for further exploration, both in the laboratory and the field, on the feasibility of expanding this technology beyond DENV. New approaches to preventing chikungunya virus (CHIKV) infection are needed because the endemic range of this virus is expanding and because current methods are limited to controlling mosquito populations, and this approach has not effectively controlled this virus. A promising candidate for arbovirus control and prevention relies on the introduction of the intracellular bacterium Wolbachia into Aedes aegypti mosquitoes. Wolbachia biocontrol has advanced from laboratory experiments demonstrating that Wolbachia reduces virus replication to small-scale field trials demonstrating that Wolbachia are capable of spreading through wild Ae. aegypti populations. This primarily has been proposed as a tool to control dengue virus (DENV) transmission; however, Wolbachia infections confer protection for their insect hosts against a range of pathogens including CHIKV in Ae. aegypti. Medium-scale Wolbachia deployments are imminent or in certain instances have commenced. Therefore, assessing whether or not Wolbachia-infected Ae. aegypti are effective against CHIKV will help inform the viability of Wolbachia biocontrol for CHIKV control. Our study provides valuable evidence that could justify expanding this type of control program to other Ae. aegypti-transmitted arboviruses, primarily CHIKV.
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Affiliation(s)
- Matthew T. Aliota
- Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- * E-mail:
| | - Emma C. Walker
- Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Alexander Uribe Yepes
- Programa de Estudio y Control de Enfermedades Tropicales (PECET), Universidad de Antioquia, Medellin, Colombia
| | - Ivan Dario Velez
- Programa de Estudio y Control de Enfermedades Tropicales (PECET), Universidad de Antioquia, Medellin, Colombia
| | - Bruce M. Christensen
- Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Jorge E. Osorio
- Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
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Rodriguez-Morales AJ, Gil-Restrepo AF, Ramírez-Jaramillo V, Montoya-Arias CP, Acevedo-Mendoza WF, Bedoya-Arias JE, Chica-Quintero LA, Murillo-García DR, García-Robledo JE, Castrillón-Spitia JD, Londoño JJ, Bedoya-Rendón HD, Cárdenas-Pérez JDJ, Cardona-Ospina JA, Lagos-Grisales GJ. Post-chikungunya chronic inflammatory rheumatism: results from a retrospective follow-up study of 283 adult and child cases in La Virginia, Risaralda, Colombia. F1000Res 2016; 5:360. [PMID: 27081477 PMCID: PMC4813633 DOI: 10.12688/f1000research.8235.2] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/01/2016] [Indexed: 02/02/2023] Open
Abstract
Objective: There are limited studies in Latin America regarding the chronic consequences of the Chikungunya virus (CHIK), such as post-CHIK chronic inflammatory rheumatism (pCHIK-CIR). We assessed the largest cohort so far of pCHIK-CIR in Latin America, at the municipality of La Virginia, Risaralda, a new endemic area of CHIK in Colombia. Methods: We conducted a cohort retrospective study in Colombia of 283 patients diagnosed with CHIK that persisted with pCHIK-CIR after a minimum of 6 weeks and up to a maximum of 26.1 weeks. pCHIK cases were identified according to validated criteria via telephone. Results: Of the total CHIK-infected subjects, 152 (53.7%) reported persistent rheumatological symptoms (pCHIK-CIR). All of these patients reported joint pains (chronic polyarthralgia, pCHIK-CPA), 49.5% morning stiffness, 40.6% joint edema, and 16.6% joint redness. Of all patients, 19.4% required and attended for care prior to the current study assessment (1.4% consulting rheumatologists). Significant differences in the frequency were observed according to age groups and gender. Patients aged >40 years old required more medical attention (39.5%) than those ≤40 years-old (12.1%) (RR=4.748, 95%CI 2.550-8.840). Conclusions: According to our results, at least half of the patients with CHIK developed chronic rheumatologic sequelae, and from those with pCHIK-CPA, nearly half presented clinical symptoms consistent with inflammatory forms of the disease. These results support previous estimates obtained from pooled data of studies in La Reunion (France) and India and are consistent with the results published previously from other Colombian cohorts in Venadillo (Tolima) and Since (Sucre).
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Affiliation(s)
- Alfonso J Rodriguez-Morales
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia; Organización Latinoamericana para el Fomento de la Investigación en Salud (OLFIS), Bucaramanga, Colombia; Committee on Zoonoses and Haemorrhagic Fevers, Asociación Colombiana de Infectología (ACIN), Bogota, Colombia; Working Group on Zoonoses, International Society for Chemotherapy, Aberdeen, UK
| | - Andrés F Gil-Restrepo
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - Valeria Ramírez-Jaramillo
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - Cindy P Montoya-Arias
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - Wilmer F Acevedo-Mendoza
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - Juan E Bedoya-Arias
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - Laura A Chica-Quintero
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - David R Murillo-García
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - Juan E García-Robledo
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia; School of Medicine, Faculty of Health Sciences, Universidad ICESI, Cali, Colombia
| | | | - Jose J Londoño
- School of Medicine, Faculty of Health Sciences, Universidad ICESI, Cali, Colombia
| | | | | | - Jaime A Cardona-Ospina
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - Guillermo J Lagos-Grisales
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia
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Rodriguez-Morales AJ, Gil-Restrepo AF, Ramírez-Jaramillo V, Montoya-Arias CP, Acevedo-Mendoza WF, Bedoya-Arias JE, Chica-Quintero LA, Murillo-García DR, García-Robledo JE, Castrillón-Spitia JD, Londoño JJ, Bedoya-Rendón HD, Cárdenas-Pérez JDJ, Cardona-Ospina JA, Lagos-Grisales GJ. Post-chikungunya chronic inflammatory rheumatism: results from a retrospective follow-up study of 283 adult and child cases in La Virginia, Risaralda, Colombia. F1000Res 2016; 5:360. [PMID: 27081477 PMCID: PMC4813633 DOI: 10.12688/f1000research.8235.1] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/01/2016] [Indexed: 10/16/2023] Open
Abstract
OBJECTIVE There are limited studies in Latin America regarding the chronic consequences of the Chikungunya virus (CHIK), such as post-CHIK chronic inflammatory rheumatism (pCHIK-CIR). We assessed the largest cohort so far of pCHIK-CIR in Latin America, at the municipality of La Virginia, Risaralda, a new endemic area of CHIK in Colombia. METHODS We conducted a cohort retrospective study in Colombia of 283 patients diagnosed with CHIK that persisted with pCHIK-CIR after a minimum of 6 weeks and up to a maximum of 26.1 weeks. pCHIK cases were identified according to validated criteria via telephone. RESULTS Of the total CHIK-infected subjects, 152 (53.7%) reported persistent rheumatological symptoms (pCHIK-CIR). All of these patients reported joint pains (chronic polyarthralgia, pCHIK-CPA), 49.5% morning stiffness, 40.6% joint edema, and 16.6% joint redness. Of all patients, 19.4% required and attended for care prior to the current study assessment (1.4% consulting rheumatologists). Significant differences in the frequency were observed according to age groups and gender. Patients aged >40 years old required more medical attention (39.5%) than those ≤40 years-old (12.1%) (RR=4.748, 95%CI 2.550-8.840). CONCLUSIONS According to our results, at least half of the patients with CHIK developed chronic rheumatologic sequelae, and from those with pCHIK-CPA, nearly half presented clinical symptoms consistent with inflammatory forms of the disease. These results support previous estimates obtained from pooled data of studies in La Reunion (France) and India and are consistent with the results published previously from other Colombian cohorts in Venadillo (Tolima) and Since (Sucre).
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Affiliation(s)
- Alfonso J. Rodriguez-Morales
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia
- Organización Latinoamericana para el Fomento de la Investigación en Salud (OLFIS), Bucaramanga, Colombia
- Committee on Zoonoses and Haemorrhagic Fevers, Asociación Colombiana de Infectología (ACIN), Bogota, Colombia
- Working Group on Zoonoses, International Society for Chemotherapy, Aberdeen, UK
| | - Andrés F. Gil-Restrepo
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - Valeria Ramírez-Jaramillo
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - Cindy P. Montoya-Arias
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - Wilmer F. Acevedo-Mendoza
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - Juan E. Bedoya-Arias
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - Laura A. Chica-Quintero
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - David R. Murillo-García
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - Juan E. García-Robledo
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia
- School of Medicine, Faculty of Health Sciences, Universidad ICESI, Cali, Colombia
| | | | - Jose J. Londoño
- School of Medicine, Faculty of Health Sciences, Universidad ICESI, Cali, Colombia
| | | | | | - Jaime A. Cardona-Ospina
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - Guillermo J. Lagos-Grisales
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia
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Post-chikungunya rheumatic disorders in travelers after return from the Caribbean. Travel Med Infect Dis 2016; 14:21-25. [PMID: 26872414 DOI: 10.1016/j.tmaid.2016.01.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Revised: 01/20/2016] [Accepted: 01/22/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND Due to increasing concerns about post-chikungunya (pCHIK) rheumatic disorders in Latin America we aimed to evaluate its occurrence in travelers returning to NYC from the Caribbean. METHOD Patients diagnosed with chikungunya (CHIK) during 2014 at the Bronx-Lebanon Hospital Center (Bronx, NewYork) were identified by reviewing laboratory and electronic medical records. Patients and caregivers of pediatric patients were interviewed by phone ≥9 months after the CHIK diagnosis to survey for chronic symptomatology and current health care needs. Reported chronic musculoskeletal complaints were categorized according to validated criteria. RESULTS A total of 28 patients (54% females, median age [range] of 51.5 [0, 88] years) diagnosed with CHIK at our center were identified. Most (82%) had returned from the Dominican Republic. Nineteen (68%) patients were successfully contacted at a median (range) of 13 (9, 16) months since the acute diagnosis. A third (37%) reported ongoing complaints related to CHIK including joint pain (32%), muscle pain (32%), and joint swelling (26%). A presumptive diagnosis of pCHIK chronic inflammatory arthritis (n = 4) and pCHIK musculoskeletal disorder (n = 3) was established. CONCLUSIONS A third of travelers with CHIK acquired in the Caribbean may be at risk for developing persistent symptoms suggestive of pCHIK rheumatic disorder.
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