Atypical Chikungunya virus infections: clinical manifestations, mortality and risk factors for severe disease during the 2005-2006 outbreak on Réunion
Autor(es): Economopoulou A, Dominguez M, Helynck B, Sissoko D, Wichmann O, Quenel P, Germonneau P, Quatresous I
Resumo: In April 2005, an outbreak of Chikungunya fever occurred on the isl- of Réunion in the Indian Ocean. During winter 2005, six patients developed meningoencephalitis - acute hepatitis due to Chikungunya virus. Our objectives were to determine the incidence - mortality of atypical Chikungunya viral infections - 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 - laboratory results were reviewed - analysed. We defined an atypical case as one in which a patient with laboratory-confirmed Chikungunya virus infection developed symptoms other than fever - 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 - forty-six cases had underlying medical conditions (of which 226 suffered from cardiovascular, 147 from neurological - 150 from respiratory disorders). Clinical features that had never been associated with Chikungunya fever were recorded, such as bullous dermatosis, pneumonia, - diabetes mellitus. Hypertension, - underlying respiratory or cardiological conditions were independent risk factors for disease severity. The overall mortality rate was 10.6% - it increased with age. This is the first time that severe cases - 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, - anticipating the course of illness.
Palavras-Chave: Chikungunya virus; Clinical manifestations; Outbreak; Réunion; Severity
Imprenta: Epidemiology & Infection, v. 137, n. 4, p. 534-541, 2009
Identificador do objeto digital: 10.1017/S0950268808001167
Descritores: Chikungunya virus - Pathogenesis ; Chikungunya virus - Viral infections ; Chikungunya Virus - Virus ; Chikungunya virus - Chikungunya fever ; Chikungunya virus - Epidemiology ; Chikungunya virus - Public health
Data de publicação: 2009
