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Acute Chikungunya and persistent musculoskeletal pain following the 2006 Indian epidemic: a 2-year prospective rural community study

  • A. CHOPRA (a1), V. ANURADHA (a1), R. GHORPADE (a1) and M. SALUJA (a1)
Summary
SUMMARY

Chikungunya virus (CHIKV) data from population studies are sparse. During the 2006 epidemic, 509 clinical cases (43% attack rate) were identified in a village survey (West India); laboratory investigations demonstrated normal blood cell counts, elevated acute-phase reactants [erythrocyte sedimentation rate, C-reactive protein and interleukin-6 (IL-6)] and excluded malaria and dengue. Acute CHIKV was characterized by high fever, severe peripheral polyarthralgias, axial myalgias and intense fatigue in over 90% of cases; skin rash (34%) and headache (19%) were uncommon. There were 49% and 62% of survey cases seropositive for IgM (rapid assay) and IgG (immunofluorescence) anti-CHIKV antibodies, respectively. Sixty-five percent of cases recovered within 4 weeks. None of the cases died. Of the population, 4·1% and 1·6% suffered from persistent rheumatic pains, predominantly non-specific, at 1 and 2 years, respectively. Chronic inflammatory arthritis was uncommon (0·3% at 1 year) although serum IL-6 often remained elevated in chronic cases. A larger population study is required to describe post-CHIKV rheumatism and its prognosis.

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Corresponding author
*Author for correspondence: Dr A. Chopra, Centre for Rheumatic Diseases, 11 Hermes Elegance, 1988 Convent Street, Camp, Pune – 411001, Maharashtra, India. (Email: arvindchopra60@hotmail.com)
References
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1.Charrel RN, de Lamballerie X, Raoult D. Chikungunya outbreaks – the globalization of vector borne diseases. New England Journal of Medicine 2007; 356: 769771.
2.Powers AM, Logue CH. Changing patterns of Chikungunya virus: re-emergence of a zoonotic arbovirus. Journal of General Virology 2007; 88: 23632377.
3.Thiboutot MM, et al. Chikungunya: a potentially emerging epidemic? PLoS Neglected Tropical Diseases 2010; 4: e623.
4.Broom AK, et al. Arbovirus infections. In: Cook G, Zumla A, eds. Manson's Tropical Diseases, 21st edn. London: Saunders, 2003, pp. 737738.
5.Pialoux G, et al. Chikungunya, an epidemic arbovirosis. Lancet Infectious Diseases 2007; 7: 319327.
6.Kamath S, Das AK, Parikh SF. Chikungunya. Journal of the Association of Physicians of India 2006; 54: 725726.
7.Brighton SW, Porzesky OW, De La Harpe AL. Chikungunya virus infection. A retrospective study of 107 cases. South African Medical Journal 1983; 63: 313315.
8.Lahariya C, Pradhan SK. Emergence of Chikungunya virus in Indian subcontinent after 32 years: a review. Journal of Vector Borne Diseases 2006; 43: 151160.
9.Kalantri SP, Joshi R, Riley LW. Chikungunya epidemic: an Indian perspective. National Medical Journal of India 2006; 19: 315322.
10.Government of India. Status report on Chikungunya as of 3 January 2007. National Vector Borne Disease Control Programme, DGHS, Ministry of Health & Family Welfare (http://www.nvbdcp.gov.in/Doc/CHK.pdf).
11.Sudeep AB, Parashar D. Chikungunya: an overview. Journal of Biosciences 2008; 33: 443449.
12.Chhabra M, et al. Chikungunya fever: a re-emerging viral infection. Indian Journal of Medical Microbiology 2008; 26: 5–12.
13.Seligman SJ, et al. Dengue in travelers. New England Journal of Medicine 2005; 353: 25112513.
14.Chopra A, et al. Chikungunya virus aches and pains: an emerging challenge. Arthritis and Rheumatism 2008; 58: 29212922.
15.Klipper JH (ed.). Criteria for classification and diagnosis of rheumatic diseases. In: Primer on the Rheumatic Diseases. Atlanta: Arthritis Foundation, 2001, pp. 631648.
17.Chopra A. Community rheumatology in India – a COPCORD driven perspective. Indian Journal of Rheumatology 2009; 4: 119126.
18.Selvavinayagam TS. Chikungunya Fever Outbreak in Vellore, south India. Indian Journal of Community Medicine 2007; 32: 286287.
19.Kannan M, et al. A study on Chikungunya outbreak during 2007 in Kerala, south India. Indian Journal of Medical Research 2009; 129: 311315.
20.Sissoko D, et al. Post-epidemic Chikungunya disease on Reunion Island: course of rheumatic manifestations and associated factors over a 15 month period. PLoS Neglected Tropical Diseases 2009; 3: e389.
21.Kennedy AC, Fleming J, Solomon L. Chikungunya viral arthropathy: a clinical description. Journal of Rheumatology 1980; 7: 231236.
22.Joshi VL, Chopra A. Is there an urban rural divide? Population surveys of rheumatic musculoskeletal disorders in the Pune region of India using the COPCORD Bhigwan Model. Journal of Rheumatology 2009; 36: 614622.
23.Kam YW, et al. Immuno-biology of Chikungunya and implications for disease intervention. Microbes and Infection 2009; 11: 11861196.
24.Lakshmi V, et al. Clinical features and molecular diagnosis of Chikungunya fever from south India. Clinical Infectious Diseases 2008; 46: 14361442.
25.Lanciotti RS, et al. Chikungunya virus in US travelers returning from India, 2006. Emerging Infectious Diseases 2007; 13: 764767.
26.Mackay IR, Leskovsek NV, Rose NR. Cell damage and autoimmunity: a critical appraisal. Journal of Autoimmunity 2008; 30: 5–11.
27.Anuradha V, Chopra A. In the era of nephelometry, latex agglutination is still good enough to detect rheumatoid factor. Journal of Rheumatology 2005; 32: 23432344.
28.Ballou SP, Kushner I. Laboratory evaluation of inflammation. In: Harris ED, et al. , eds. Kelley's Textbook of Rheumatology, 7th edn, volume II. Pennsylvania: Elsevier Saunders, 2005, pp. 721727.
29.Padbidri VS, Gnaneswar TT. Epidemiological investigations of Chikungunya epidemic at Barsi, Maharashtra state, India. Journal of Hygiene, Epidemiology, Microbiology and Immunology 1979; 23: 445451.
30.Yergolkar PN, et al. Chikungunya outbreaks caused by African genotype, India. Emerging Infectious Diseases 2006; 12: 15801583.
31.Sourisseau M, et al. Characterization of reemerging Chikungunya virus. PLoS Pathogens 2007; 3: e89.
32.Couderc T, et al. A mouse model for Chikungunya: young age and inefficient type-1 interferon signaling are risk factors for severe disease. PLoS Pathogens 2008; 4: e29.
33.Borgherini G, et al. Persistent arthralgia associated with Chikungunya virus: a study of 88 adults patients in Reunion Island. Clinical Infectious Diseases 2008; 47: 469479.
34.Vassilopoulous D, Calabrese LH. Virally associated arthritis 2008: clinical, epidemiologic, and pathophysiologic considerations. Arthritis Research & Therapy 2008; 10: 215.
35.Morrison TE, et al. Characterization of Ross River virus tropism and virus-induced inflammation in a mouse model of viral arthritis and myositis. Journal of Virology 2006; 80: 737749.
36.Ozden S, et al. Human muscle satellite cells as targets of Chikungunya virus. PLoS ONE 2007; 6: e527.
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Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
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