Autor(es): Ray Pratima, Ratagiri Vinod H, Kabra Sushil K, Lodha Rakesh, Sharma Sumit, Sharma B S, Kalaivani Mani, Wig Naveet

Resumo: Chikungunya (CHIKV) has recently seen a re-emergence in India with high morbidity. However, the epidemiology - disease burden remain largely undetermined. A prospective multi-centric study was conducted to evaluate clinical, epidemiological - virological features of chikugunya infection in patients with acute febrile illness from various geographical regions of India. A total of 540 patients with fever of up to 7 days duration were enrolled at Karnataka Institute of Medical Sciences (KIMS), Karnataka (South); Sawai Man Singh Medical College (SMS) Rajasthan (West), - All India Institute of Medical Sciences (AIIMS) New Delhi (North) from June 2008 to May 2009. Serum specimens were screened for chikungunya infection concurrently through RT-PCR - serology (IgM). Phylogenetic analysis was performed using Bioedit - Mega2 programs. Chikungunya infection was detected in 25.37% patients by RT-PCR -/or IgM-ELISA. Highest cases were detected in south (49.36%) followed by west (16.28%) - north (0.56%) India. A difference in proportion of positives by RT-PCR/ELISA with regard to duration of fever was observed (p<0.05). Rashes, joint pain/swelling, abdominal pain - vomiting was frequently observed among chikungunya confirmed cases (p<0.05). Adults were affected more than children. Anti-CHIK antibodies (IgM) were detected for more than 60 days of fever onset. Phylogenetic analysis based on E1 gene from KIMS patients (n = 15) revealed ?99% homology clustering with Central/East African genotype. An amino acid change from lysine to glutamine at position 132 of E1 gene was frequently observed among strains infecting children. The study documented re-emergence of chikungunya in high frequencies - severe morbidity in south - west India but rare in north. The study emphasizes the need for continuous surveillance for disease burden using multiple diagnostic tests - also warrants the need for an appropriate molecular diagnostic for early detection of chikungunya virus.

Imprenta: PloS One, v. 7, n. 2, p. e30025, 2012

Identificador do objeto digital: 10.1371/journal.pone.0030025

Descritores: Chikungunya virus - Genome ; Chikungunya virus - Pathogenesis ; Chikungunya virus - Proteins ; Chikungunya virus - RNA ; Chikungunya virus - Antibodies ; Chikungunya virus - Serology ; Chikungunya virus - Viral infections ; Chikungunya virus - Molecular methods ; Chikungunya virus - PCR detection ; Chikungunya virus - RT-PCR ; Chikungunya virus - Serology ; Chikungunya Virus - Virus ; Chikungunya virus - Molecular screening ; Chikungunya virus - Chikungunya fever ; Chikungunya virus - Epidemiology ; Chikungunya virus - Immunology ; Chikungunya virus - Public health

Data de publicação: 2012