Autor(es): Gérardin Patrick, Barau Georges, Michault Alain, Bintner Marc, Randrianaivo Hanitra, Choker Ghassan, Lenglet Yann, Touret Yasmina, Bouveret Anne, Grivard Philippe, Le Roux Karin, Blanc Séverine, Schuffenecker Isabelle, Couderc Thérèse, Arenzana-Seisdedos Fernando, Lecuit Marc, Robillard Pierre-Yves

Resumo: An outbreak of chikungunya virus affected over one-third of the population of La Réunion Isl- between March 2005 - December 2006. In June 2005, we identified the first case of mother-to-child chikungunya virus transmission at the Groupe Hospitalier Sud-Réunion level-3 maternity department. The goal of this prospective study was to characterize the epidemiological, clinical, biological, - radiological features - outcomes of all the cases of vertically transmitted chikungunya infections recorded at our institution during this outbreak. Over 22 mo, 7,504 women delivered 7,629 viable neonates; 678 (9.0%) of these parturient women were infected (positive RT-PCR or IgM serology) during antepartum, - 61 (0.8%) in pre- or intrapartum. With the exception of three early fetal deaths, vertical transmission was exclusively observed in near-term deliveries (median duration of gestation: 38 wk, range 35-40 wk) in the context of intrapartum viremia (19 cases of vertical transmission out of 39 women with intrapartum viremia, prevalence rate 0.25%, vertical transmission rate 48.7%). Cesarean section had no protective effect on transmission. All infected neonates were asymptomatic at birth, - median onset of neonatal disease was 4 d (range 3-7 d). Pain, prostration, - fever were present in 100% of cases - thrombocytopenia in 89%. Severe illness was observed in ten cases (52.6%) - mainly consisted of encephalopathy (n = 9; 90%). These nine children had pathologic MRI findings (brain swelling, n = 9; cerebral hemorrhages, n = 2), - four evolved towards persistent disabilities. Mother-to-child chikungunya virus transmission is frequent in the context of intrapartum maternal viremia, - often leads to severe neonatal infection. Chikungunya represents a substantial risk for neonates born to viremic parturients that should be taken into account by clinicians - public health authorities in the event of a chikungunya outbreak.

Imprenta: PLoS Medicine, v. 5, n. 3, p. e60, 2008

Identificador do objeto digital: 10.1371/journal.pmed.0050060

Descritores: Chikungunya virus - Cytopathology ; Chikungunya virus - Pathogenesis ; Chikungunya virus - Infectious diseases ; Chikungunya virus - Serology ; Chikungunya virus - Viral infections ; Chikungunya virus - RT-PCR ; Chikungunya virus - Serology ; Chikungunya Virus - Virus ; Chikungunya virus - Transmission ; Chikungunya virus - Chikungunya fever ; Chikungunya virus - Epidemiology ; Chikungunya virus - Public health

Data de publicação: 2008

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