Chikungunya fever: A re-emerging viral infection

National Institute of Communicable Diseases, 22, Sham Nath Marg, New Delhi - 110 054, India.
Indian Journal of Medical Microbiology (Impact Factor: 0.88). 01/2008; 26(1):5-12. DOI: 10.4103/0255-0857.38850
Source: PubMed


Chikungunya (CHIK) fever is a re-emerging viral disease characterized by abrupt onset of fever with severe arthralgia followed by constitutional symptoms and rash lasting for 1-7 days. The disease is almost self-limiting and rarely fatal. Chikungunya virus (CHIKV) is a RNA virus belonging to family Togaviridae, genus Alphavirus. Molecular characterization has demonstrated two distinct lineages of strains which cause epidemics in Africa and Asia. These geographical genotypes exhibit differences in the transmission cycles. In contrast to Africa where sylvatic cycle is maintained between monkeys and wild mosquitoes, in Asia the cycle continues between humans and the Aedes aegypti mosquito. CHIKV is known to cause epidemics after a period of quiescence. The first recorded epidemic occurred in Tanzania in 1952-1953. In Asia, CHIK activity was documented since its isolation in Bangkok, Thailand in 1958. Virus transmission continued till 1964. After hiatus, the virus activity re-appeared in the mid-1970s and declined by 1976. In India, well-documented outbreaks occurred in 1963 and 1964 in Kolkata and southern India, respectively. Thereafter, a small outbreak of CHIK was reported from Sholapur district, Maharashtra in 1973. CHIKV emerged in the islands of South West Indian Ocean viz. French island of La Reunion, Mayotee, Mauritius and Seychelles which are reporting the outbreak since February, 2005. After quiescence of about three decades, CHIKV re-emerged in India in the states of Andhra Pradesh, Karnataka, Maharashtra, Madhya Pradesh and Tamil Nadu since December, 2005. Cases have also been reported from Rajasthan, Gujarat and Kerala. The outbreak is still continuing. National Institute of Communicable Diseases has conducted epidemiological, entomological and laboratory investigations for confirmation of the outbreak. These have been discussed in detail along with the major challenges that the country faced during the current outbreak.

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    • "The first record of CHIK outside Africa was in Bangkok during the epidemic of dengue hemorrhagic fever in 1958.21 Since then, there have been eight sporadic outbreaks of this disease in Thailand22–25; this outbreak is the largest recorded in Thailand. Chikungunya fever presents with similar symptoms to other disease endemic in Thailand including dengue fever, leptospirosis, scrub typhus, and malaria. "
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    ABSTRACT: The Indian Ocean chikungunya epidemic re-emerged in Thailand in August 2008. Forty-five adults with laboratory-confirmed chikungunya in Songkhla province, Thailand were clinically assessed and serially bled throughout the acute and convalescent phase of the disease. Patient symptoms, antibody responses, and viral kinetics were evaluated using observational assessments, polymerase chain reaction (PCR), and serological assays. All subjects experienced joint pain with 42 (93%) involving multiple joints; the interphalangeal most commonly affected in 91% of the subjects. The mean duration of joint pain was 5.8 days, 11 (25%) experiencing discomfort through the duration of the study. Rash was observed in 37 (82%) subjects a mean 3.5 days post onset of symptoms. Patents were positive by PCR for a mean of 5.9 days with sustained peak viral load through Day 5. The IgM antibodies appeared on Day 4 and peaked at Day 7 and IgG antibodies first appeared at Day 5 and rose steadily through Day 24.
    The American journal of tropical medicine and hygiene 02/2014; 90(3). DOI:10.4269/ajtmh.12-0681 · 2.70 Impact Factor
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    • "λ1 is the inverse of the latent period of infection, which is estimated to be between 2 and 6 days [10]. γ is the rate of recovery, which is assumed to take between 1 and 7 days [11]. For chikungunya, the latent period is distinct from the pre-patent period, ω−1, which typically lasts between 4 and 7 days [12]. "
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    ABSTRACT: Chikungunya is a re-emerging arboviral disease transmitted by Aedes spp. mosquitoes. Although principally endemic to Africa and Asia, recent outbreaks have occurred in Europe following introductions by returning travellers. A particularly large outbreak occurred on Réunion Island in 2006, the published data from which forms the basis of the current study. A simple, deterministic mathematical model of the transmission of the virus between humans and mosquitoes was constructed and parameterised with the up-to-date literature on infection biology. The model is fitted to the large Réunion epidemic, resulting in an estimate of 4.1 for the type reproduction number of chikungunya. Although simplistic, the model provided a close approximation of both the peak incidence of the outbreak and the final epidemic size. Sensitivity analysis using Monte Carlo simulation demonstrated the strong influence that both the latent period of infection in humans and the pre-patent period have on these two epidemiological outcomes. We show why separating these variables, which are epidemiologically distinct in chikungunya infections, is not only necessary for accurate model fitting but also important in informing control.
    PLoS ONE 03/2013; 8(3):e57448. DOI:10.1371/journal.pone.0057448 · 3.23 Impact Factor
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    • "CHIK is a viral disease that is spread by the bite of Aedes aegypti and Aedes albopictus mosquito. The name CHIK is derived from the Makonde word which means “that which bends up” describing the stooped posture due to arthritic feature of the disease.[1] The symptoms include sudden onset of crippling arthralgia accompanied with fever, chills, headache, nausea, vomiting, low back pain, and rash lasting for a period of 1-7 days. "
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    ABSTRACT: The emergence of chikungunya (CHIK) infection was observed in Odisha, India in 2006. Thereafter many cases with symptoms suggestive of CHIK were reported from different districts of Southern-Odisha. This study was aimed to know the seroprevalence, clinical presentations and seasonal trends of CHIK infection in this region. This study was conducted in a tertiary hospital of this region. Serum samples received in the Department of Microbiology from various districts of Southern-Odisha from April 2011 to March 2012 were included in the study. The samples were tested for CHIK and dengue Immunoglobin M (IgM) antibodies by enzyme-linked immunosorbent assay and malaria parasite by immunochromatographic test (ICT) method. Out of the 678 serum samples tested, 174 were positive for CHIK, 15 for dengue and two samples were positive for both CHIK and dengue IgM antibodies. The most affected age group was 16-45 years. Females were more affected than males. The seroprevalence of CHIK among the suspected cases was 25.7%. Co-infection with CHIK and dengue was found to be 1.15%. The infection had spread to new areas during this outbreak.
    Journal of Family Medicine and Primary Care 03/2013; 2(1):33-6. DOI:10.4103/2249-4863.109939
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