Molecular Virologic and Clinical Characteristics of a Chikungunya Fever Outbreak in La Romana, Dominican Republic, 2014
| Autor: | Antonio E. Muruato, Tiffany F. Kautz, Albert J. Auguste, Matthew Dacso, David Yin-wei Lin, Scott C. Weaver, Kumar Hari, Nicolas Ruiz, Renessa Gerhardt, Jael Silfa, Jesse H. Erasmus, Rose M. Langsjoen, Liddy Kiaty-Figueroa, Franklin Bido, Ravi Jain, Rebecca J. Rubinstein |
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| Rok vydání: | 2016 |
| Předmět: |
Male
RNA viruses 0301 basic medicine Viral Diseases Delayed Diagnosis Critical Care and Emergency Medicine Pulmonology Fevers Antibodies Viral Pathology and Laboratory Medicine medicine.disease_cause Disease Outbreaks Dengue fever 0302 clinical medicine Aedes Medicine and Health Sciences Chikungunya Child Chikungunya Virus biology Coinfection lcsh:Public aspects of medicine virus diseases Middle Aged Arthralgia 3. Good health Infectious Diseases Medical Microbiology Child Preschool Viral Pathogens Viruses RNA Viral Female Polyarthritis Pathogens Research Article Neglected Tropical Diseases Adult lcsh:Arctic medicine. Tropical medicine Adolescent lcsh:RC955-962 Alphaviruses 030231 tropical medicine Aedes aegypti Microbiology Togaviruses Young Adult 03 medical and health sciences Signs and Symptoms Diagnostic Medicine medicine Animals Humans Pain Management Microbial Pathogens Aged Retrospective Studies Biology and life sciences business.industry Dominican Republic Infant Newborn Organisms Public Health Environmental and Occupational Health Infant Chikungunya Infection Outbreak lcsh:RA1-1270 Tropical Diseases biology.organism_classification medicine.disease Virology 030104 developmental biology Immunoglobulin M Respiratory Infections Immunology Chikungunya Fever business Malaria |
| Zdroj: | PLoS Neglected Tropical Diseases PLoS Neglected Tropical Diseases, Vol 10, Iss 12, p e0005189 (2016) |
| ISSN: | 1935-2735 |
| Popis: | Since emerging in Saint Martin in 2013, chikungunya virus (CHIKV), an alphavirus transmitted by the Aedes aegypti mosquito, has infected approximately two million individuals in the Americas, with over 500,000 reported cases in the Dominican Republic (DR). CHIKV-infected patients typically present with a febrile syndrome including polyarthritis/polyarthralgia, and a macropapular rash, similar to those infected with dengue and Zika viruses, and malaria. Nevertheless, many Dominican cases are unconfirmed due to the unavailability and high cost of laboratory testing and the absence of specific treatment for CHIKV infection. To obtain a more accurate representation of chikungunya fever (CHIKF) clinical signs and symptoms, and confirm the viral lineage responsible for the DR CHIKV outbreak, we tested 194 serum samples for CHIKV RNA and IgM antibodies from patients seen in a hospital in La Romana, DR using quantitative RT-PCR and IgM capture ELISA, and performed retrospective chart reviews. RNA and antibodies were detected in 49% and 24.7% of participants, respectively. Sequencing revealed that the CHIKV strain responsible for the La Romana outbreak belonged to the Asian/American lineage and grouped phylogenetically with recent Mexican and Trinidadian isolates. Our study shows that, while CHIKV-infected individuals were infrequently diagnosed with CHIKF, uninfected patients were never falsely diagnosed with CHIKF. Participants testing positive for CHIKV RNA were more likely to present with arthralgia, although it was reported in just 20.0% of CHIKF+ individuals. High percentages of respiratory (19.6%) signs and symptoms, especially among children, were noted, though it was not possible to determine whether individuals infected with CHIKV were co-infected with other pathogens. These results suggest that CHIKV may have been underdiagnosed during this outbreak, and that CHIKF should be included in differential diagnoses of diverse undifferentiated febrile syndromes in the Americas. Author Summary Chikungunya virus (CHIKV) is known for its ability to cause explosive outbreaks of flu-like illness followed by severe joint pain and swelling, which can persist for months to several years. We tested patient serum of both suspected and unsuspected chikungunya fever (CHIKF) cases collected at an emergency clinic in La Romana, Dominican Republic for markers of current or recent CHIKV infection, and showed through next generation sequencing that the causative CHIKV strain is closely related to other isolates from the Americas. After matching clinical outcomes with diagnostic data, we found that relatively few CHIKF patients presented with the joint symptoms typically associated with CHIKV infection in the past, which likely contributed to a notable frequency of CHIKF misdiagnosis. Other deviations from Old World CHIKF outbreaks were also discovered, including shifts in affected age groups and in the frequency of respiratory signs and symptoms. These data are particularly important for improving future surveillance endeavors, as well as the diagnosis and treatment of CHIKF in the Americas. |
| Databáze: | OpenAIRE |
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