Congenital and perinatal complications of chikungunya fever: a Latin American experience

Autor: José Brea del Castillo, Jorge Pleitez-Navarrete, Lourdes Dueñas, Luiza Helena Falleiros-Arlant, Jaime R. Torres, Doris M. Salgado
Rok vydání: 2016
Předmět:
Male
Pediatrics
Complications
medicine.disease_cause
Disease Outbreaks
Congenital
0302 clinical medicine
Pregnancy
Case fatality rate
Epidemiology
Medicine
Prospective Studies
030212 general & internal medicine
Chikungunya
Pregnancy Complications
Infectious
Incidence
Incidence (epidemiology)
Pregnancy Outcome
Meningoencephalitis
General Medicine
Infectious Diseases
Female
Chikungunya virus
Adult
Microbiology (medical)
medicine.medical_specialty
Adolescent
Genotype
Pregnancy Trimester
Third
030231 tropical medicine
Lymphocytic pleocytosis
Mothers
Perinatal
lcsh:Infectious and parasitic diseases
Young Adult
03 medical and health sciences
Humans
lcsh:RC109-216
business.industry
Infant
Newborn
Infant
Outbreak
medicine.disease
Infectious Disease Transmission
Vertical
Surgery
Latin America
Chikungunya Fever
business
Zdroj: International Journal of Infectious Diseases, Vol 51, Iss C, Pp 85-88 (2016)
ISSN: 1201-9712
DOI: 10.1016/j.ijid.2016.09.009
Popis: Summary Background During the years 2014 and 2015, the Region of the Americas underwent a devastating epidemic of chikungunya virus (CHIKV) of the Asian genotype, resulting in millions of affected individuals. However, epidemiological and clinical information on this experience is scarce. Prior knowledge of congenital and neonatal illness caused by CHIKV is limited and almost exclusively based on data obtained from a single outbreak of the East/Central/South African (ECSA) genotype. The effect of chikungunya fever (CHIKF) on pregnancy outcomes and its consequences for infants born to infected mothers at the peak of the epidemic wave in Latin America are reviewed herein. Epidemiological and clinical data on maternal and neonatal infections were collected prospectively and analyzed. Methods One hundred sixty-nine symptomatic newborns with CHIKF seen at four large regional maternity hospitals in three different Central and South American countries were evaluated prospectively. The outcomes of pregnancies in symptomatic infected mothers at two of these clinical centers were also analyzed. Results The observed vertical transmission rate ranged between 27.7% and 48.29%. The incidence of congenital disease was unrelated to the use of cesarean section or natural delivery. The case fatality rate (CFR) at the only center that reported deaths was 5.3%. The most common clinical manifestations included fever, irritability, rash, hyperalgesia syndrome, diffuse limb edema, meningoencephalitis, and bullous dermatitis. Severe complications included meningoencephalitis, myocarditis, seizures, and acute respiratory failure. Leukocytosis with neutrophilia and normal or increased platelets was a common finding, and in those with signs of meningeal involvement, moderate lymphocytic pleocytosis with normal glucose and protein levels was typical. Conclusions This study presents the largest number of symptomatic neonates with CHIKF analyzed so far in any region and is the first involving infection with the Asian genotype of CHIKV. Although the clinical manifestations found were similar to those reported previously, the percentage of neurological complications was lower. The CFR was comparatively high. Chikungunya represented a substantial risk for neonates born to symptomatic parturients during the chikungunya outbreak in the Americas Region, with important clinical and public health implications.
Databáze: OpenAIRE
Externí odkaz: