Molecular characterisation of Chikungunya virus infections in trinidad and comparison of clinical and laboratory features with dengue and other acute febrile cases
Autor(es): Sahadeo Nikita, Mohammed Hamish, Allicock Orchid M, Auguste Albert J, Widen Steven G, Badal Kimberly, Pulchan Krishna, Foster Jerome E, Weaver Scott C, Carrington Christine V F
Resumo: Local transmission of Chikungunya virus (CHIKV) was first documented in Trinidad - Tobago (T&T) in July 2014 preceding a large epidemic. At initial presentation, it is difficult to distinguish chikungunya fever (CHIKF) from other acute undifferentiated febrile illnesses (AUFIs), including life-threatening dengue disease. We characterised - compared dengue virus (DENV) - CHIKV infections in 158 patients presenting with suspected dengue fever (DF) - CHIKF at a major hospital in T&T, - performed phylogenetic analyses on CHIKV genomic sequences recovered from 8 individuals. The characteristics of patients with - without PCR-confirmed CHIKV were compared using Pearson's ?2 - student's t-tests, - adjusted odds ratios (aORs) - 95% confidence intervals (CIs) were determined using logistic regression. We then compared signs - symptoms of people with RT-qPCR-confirmed CHIKV - DENV infections using the Mann-Whitney U, Pearson's ?2 - Fisher's exact tests. Among the 158 persons there were 8 (6%) RT-qPCR-confirmed DENV - 30 (22%) RT-qPCR-confirmed CHIKV infections. Phylogenetic analyses showed that the CHIKV strains belonged to the Asian genotype - were most closely related to a British Virgin Isl-s strain isolated at the beginning of the 2013/14 outbreak in the Americas. Compared to persons who were RT-qPCR-negative for CHIKV, RT-qPCR-positive individuals were significantly more likely to have joint pain (aOR: 4.52 [95% CI: 1.28-16.00]), less likely to be interviewed at a later stage of illness (days post onset of fever--aOR: 0.56 [0.40-0.78]) - had a lower white blood cell count (aOR: 0.83 [0.71-0.96]). Among the 38 patients with RT-qPCR-confirmed CHIKV or DENV, there were no significant differences in symptomatic presentation. However when individuals with serological evidence of recent DENV or CHIKV infection were included in the analyses, there were key differences in clinical presentation between CHIKF - other AUFIs including DF, which can be used to triage patients for appropriate care in the clinical setting.
Imprenta: PLoS Neglected Tropical Diseases, v. 9, n. 11, p. e0004199, 2015
Identificador do objeto digital: 10.1371/journal.pntd.0004199
Descritores: Chikungunya virus - Biochemistry ; Chikungunya virus - Cell ; Chikungunya virus - RT-PCR ; Chikungunya Virus - Virus ; Chikungunya virus - Transmission ; Chikungunya virus - Chikungunya fever ; Chikungunya virus - Dengue ; Chikungunya virus - Epidemic ; Chikungunya virus - Immunology ; Chikungunya virus - Public health
Data de publicação: 2015
