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Atypical Chikungunya virus infections: clinical manifestations, mortality and risk factors for severe disease during the 2005–2006 outbreak on Réunion

  • A. ECONOMOPOULOU (a1) (a2), M. DOMINGUEZ (a1) (a3), B. HELYNCK (a1), D. SISSOKO (a4), O. WICHMANN (a5), P. QUENEL (a6), P. GERMONNEAU (a1) and I. QUATRESOUS (a1)...
Abstract
SUMMARY

In April 2005, an outbreak of Chikungunya fever occurred on the island of Réunion in the Indian Ocean. During winter 2005, six patients developed meningoencephalitis and acute hepatitis due to Chikungunya virus. Our objectives were to determine the incidence and mortality of atypical Chikungunya viral infections and to identify risk factors for severe disease. A hospital-based surveillance system was established to collect data on atypical Chikungunya cases. Case reports, medical records and laboratory results were reviewed and analysed. We defined an atypical case as one in which a patient with laboratory-confirmed Chikungunya virus infection developed symptoms other than fever and arthralgia. We defined a severe atypical case as one which required maintenance of at least one vital function. We recorded 610 atypical cases of Chikungunya fever: 222 were severe cases, 65 affected patients died. Five hundred and forty-six cases had underlying medical conditions (of which 226 suffered from cardiovascular, 147 from neurological and 150 from respiratory disorders). Clinical features that had never been associated with Chikungunya fever were recorded, such as bullous dermatosis, pneumonia, and diabetes mellitus. Hypertension, and underlying respiratory or cardiological conditions were independent risk factors for disease severity. The overall mortality rate was 10·6% and it increased with age. This is the first time that severe cases and deaths due to Chikungunya fever have been documented. The information presented in this article may assist clinicians in identifying the disease, selecting the treatment strategy, and anticipating the course of illness.

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*Author for correspondence: Dr A. Economopoulou, Hellenic Center for Disease Control and Prevention, 9 Polytecneiou St, 10433, Athens, Greece. (Email: a_economopoulou@yahoo.gr)
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1.G Pialoux , Chikungunya, an epidemic arbovirosis. Lancet Infect Diseases 2007; 7: 319327.

2.MC Robinson . An epidemic of virus disease in Southern Province, Tanganyika Territory, in 1952–53. I. Clinical features. Transactions of the Royal Society of Tropical Medicine and Hygiene 1955; 49: 2832.

3.K Sergon , Seroprevalence of Chikungunya virus (CHIKV) infection on Lamu Island, Kenya, October 2004. American Journal of Tropical Medicine and Hygiene 2008; 78: 333337.

4.S AbuBakar , Reemergence of endemic chikungunya, Malaysia. Emerging Infectious Diseases 2007; 13: 147149.

6.G Borgherini , Outbreak of chikungunya on Reunion Island: early clinical and laboratory features in 157 adult patients. Clinical Infectious Diseases 2007; 44: 14011407.

7.RN Charrel , X de Lamballerie , D Raoult . Chikungunya outbreaks – the globalization of vectorborne disease. New England Journal of Medicine 2007; 356: 769771.

8.V Pierre , Chikungunya epidemic on Reunion Island, 2005–2006. Presse Medicale 2006; 35: 11881189.

10.H Cordel , Imported cases of chikungunya in metropolitan France, April 2005–February 2006. Eurosurveillance 2006; 11: E060420.3 (http://www.eurosurveillance.org/ew/2006/060420.asp#3).

11.W Taubitz , Chikungunya fever in travellers: Clinical presentations and course. Clinical Infectious Diseases 2007; 45: e14.

13.A Beltrame , Imported Chkungunya infection, Italy. Emerging Infectious Diseases 2007; 13: 12641266.

15.V Ravi . Re-emergence of chikungunya virus in India. Indian Journal of Medical Microbiology 2006; 24: 8384.

16.I Obeyesekere , Y Hermon . Arbovirus heart disease: myocarditis and cardiomyopathy following dengue and chikungunya fever – a follow-up study. American Heart Journal 1973; 85: 186194.

17.MM Mirabel , Acute myocarditis due to chikungunya virus assessed by contrast-enhanced MRI. International Journal of Cardiology 2007; 121: e78.

18.I Schuffenecker , Genome microevolution of chikungunya viruses causing the Indian ocean outbreak. PLoS Medicine 2006; 3: e263.

19.P Parola , Novel chikungunya virus variant in travelers returning from Indian Ocean islands. Emerging Infectious Diseases 2006; 12: 14931499.

20.L Josseran , Chikungunya disease outbreak, Reunion Island. Emerging Infectious Diseases 2006, 12: 19941995.

21.G Rezza , (CHIKV Study Group). Infection with chikungunya virus in Italy: an outbreak in a temperate region. Lancet 2007; 370: 18401846.

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Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
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