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1.
Gac. méd. Méx ; 157(2): 194-200, mar.-abr. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1279101

ABSTRACT

Resumen En países americanos, simultáneas a la pandemia de enfermedad por coronavirus 2019 (COVID-19) se están dando epidemias ocasionadas por diferentes arbovirus (del dengue, chikunguña y virus del Zika). En México, varias de las estrategias para control del mosquito Aedes aegypti, transmisor de arbovirus, involucran la interacción del personal salubrista y los moradores. Debido a la pandemia de COVID-19 se han implementado medidas de distanciamiento social y resguardo domiciliario. Para respetar estas medidas y evitar riesgo de contagio por coronavirus 2 del síndrome respiratorio agudo grave (SARS-CoV-2), el Centro Nacional de Programas Preventivos y Control de Enfermedades (CENAPRECE) ha presentado la estrategia de control de vectores en el escenario de transmisión simultánea por dengue y COVID-19 en México. En este trabajo mencionamos las medidas habituales de manejo integral de mosquito y mencionamos las adaptaciones realizadas. De igual forma, discutimos la relevancia de la capacitación y la supervisión al personal médico, esto debido a la similitud entre la sintomatología entre ambas patologías.


Abstract Countries of Latin America are dealing with a simultaneous COVID-19 and vector borne disease (VBDs, Dengue, Zika and Chikungunya) outbreaks. In Mexico, certain activities to control Aedes aegypti mosquito (the main VBDs vector) comprise community participation through the interaction between householders and vector control personnel. Preventive measures against COVID-19 include social distancing and stay-at-home strategy, to obey these policies, and reduce the risk of infection, the National Center for Preventive Programs and Disease Control of Mexico (CENAPRECE) has adapted the vector control approaches in the country. In this paper we mention routine prevention and control activities to control mosquitoes and show the adapted measures. Because, a number of symptoms of the COVID-19 and dengue fever overlap with each other, we also discuss the relevance of accurate disease surveillance and medic’s training and supervision.


Subject(s)
Humans , Animals , Arbovirus Infections/epidemiology , Mosquito Control/methods , Aedes/virology , Pandemics , Epidemiological Monitoring , COVID-19/epidemiology , Arbovirus Infections/prevention & control , Dengue/epidemiology , Information Dissemination , Chikungunya Fever/epidemiology , Zika Virus Infection/epidemiology , Physical Distancing , COVID-19/prevention & control , Health Promotion
2.
Rev. Soc. Bras. Med. Trop ; 54: e0837-2020, 2021. tab, graf
Article in English | LILACS | ID: biblio-1155559

ABSTRACT

Abstract INTRODUCTION: This study evaluated the epidemiological implications of arbovirus infections and coronavirus disease (COVID-19) co-occurrences in Espírito Santo, Brazil. METHODS: This ecological study of dengue, chikungunya, zika, and COVID-19 was performed from January 1 to July 31, 2020. RESULTS: Espírito Santo registered 44,614, 8,092, 3,138, and 91,483 cases of dengue, chikungunya, zika, and COVID-19, respectively (January-July, 2020). In the 27 and four municipalities with a high incidence of dengue and chikungunya, respectively, the incidence of COVID-19 was 647.0-3,721.7 and 1,787.2-3,403.0 cases per 100,000 inhabitants, respectively. CONCLUSIONS: Espírito Santo experienced an overlap of epidemics, especially in urban areas.


Subject(s)
Humans , Coronavirus Infections , Coronavirus , Dengue/epidemiology , Epidemics , Chikungunya Fever/epidemiology , Zika Virus , Zika Virus Infection , Zika Virus Infection/complications , Brazil/epidemiology , Betacoronavirus
3.
Rev. cuba. salud pública ; 46(3): e1903, jul.-set. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1144551

ABSTRACT

Introducción: La infección aguda por chikungunya genera una alta carga de enfermedad y discapacidad dada principalmente por poliartralgias en fase aguda y artritis en fase crónica, sin embargo, presenta una sintomatología similar a otras arbovirosis, particularmente a las del dengue, lo que dificulta su diagnóstico. Objetivos: Caracterizar las manifestaciones clínicas de la infección aguda por chikungunya en los pacientes atendidos en el departamento de urgencias de la ciudad de Ibagué, Colombia, durante el brote epidémico transcurrido entre octubre de 2015 y octubre de 2016. Métodos: Estudio descriptivo, de corte transversal, en el cual se describieron las manifestaciones clínicas de la infección aguda por chikungunya, a través del instrumento desarrollado a partir de la revisión de la literartura que recogía las principales manifestaciones clínicas de la infección en fase aguda por chikungunya, como anexo a las fichas epidemiológicas de notificación obligatoria individual del Instituto Nacional de Salud que se reportan a la Secretaría Municipal de Ibagué-Tolima. Resultados: Se recolectaron 6752 fichas de pacientes atendidos en los servicios de urgencias, los que experimentaron fiebre de 38,5 ºC de 1-7 días (91,3 por ciento), mialgias (81,3 por ciento), eritema maculopapular (74,3 por ciento), artralgias severas (70,6 por ciento), poliartritis (41,1 por ciento) y adenomegalias retroauriculares (8 por ciento). Conclusiones: Los resultados obtenidos en el presente estudio aportan información importante para el diagnóstico clínico del chikungunya en sitios con características similares a las de ciudades hiperendemicas y facilita distinguir la enfermedad en fase aguda entre las diferentes arbovirosis circulantes con signos como las mialgias, adenoapatias retro-auriculares y artralgia severa(AU)


Introduction: The acute infection by Chikungunya generates a high burden of illness and disability mainly due to polyarthralgias in acute phase and artritis in chronic phase. However, it presents symptoms similar to other arboviruses, specially like dengue, which difficults its diagnosis. Objective: To characterize the clinical manifestations of the acute infection by Chikungunya in patients attended in the emergencies service of Ibagué city, Colombia, during the epidemic outbreak that occured from October, 2015 to October, 2016. Methods: Descriptive, cross-sectional study in which were described the clinical manifestations of the acute infection by chikungunya using an instrument developed from the review of the literature that comprises the main clinical manifestations of the infection by chikungunya in its acute phase, as an information attached to the epidemiologic records of individual obligatory notification of the National Institute of Health, which are reported to Ibagué-Tolima Municipal Secretary. Results: There were collected 6752 records of patients attended in emergency services, whom experienced fever of 38,5 ºC from 1 to 7 days (91,3 percent), myalgias (81,3 percent), maculopapular erythema (74,3 percent), severe arthralgias (70,6 percent), polyarthritis (41,1 percent) and retroarticular adenomegalies (8 percent). Conclusions: The results obtained in the present study provide important information for the clinical diagnosis of chikungunya in places with similar characteristics to the hyperepidemic cities and it facilitates to differentiate the disease in its acute phase among the different current arboviruses with signs of myalgia, retroarticular adenopathies and severe arthralgia(AU)


Subject(s)
Humans , Male , Female , Arbovirus Infections/transmission , Chikungunya Fever/epidemiology , Epidemiology, Descriptive , Cross-Sectional Studies , Colombia
4.
Braz. j. infect. dis ; 24(1): 1-6, Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1089330

ABSTRACT

ABSTRACT Febrile illnesses in developing countries are often misdiagnosed as malaria or typhoid fever. Although arboviral infections have similar clinical symptoms, they are usually not screened because of limited resources and the fact that there are several viruses in this group. Chikungunya virus (CHIKV) has been isolated in parts of Nigeria, but there is no documented evidence of the infection in Kogi State. This study determined seroprevalence of active and past CHIKV infection among febrile patients who tested negative for malaria and typhoid fever. Sera from 243 febrile patients were screened for CHIKV IgG and IgM using an immunochromatographic test kit. Clinical and socio-demographic variables were collected using a structured questionnaire. Recent CHIKV infection was observed in 5.8% of the study participants while 25.1% had IgG antibodies demonstrating previous infection. Significant associations were observed between seropositivity and age of participants (p < 0.001), sex (p = 0.044), marital status (p = 0.002), and occupation (p < 0.001). Clinical symptoms such as fever, joint pain, and headache were significantly associated with seropositivity. This study identified recent CHIKV infection in Anyigba. Therefore, there is need for routine screening of febrile patients and molecular characterization to determine the nature of circulating strains.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Chikungunya Fever/epidemiology , Reference Values , Socioeconomic Factors , Immunoglobulin G/immunology , Immunoglobulin G/blood , Immunoglobulin M/blood , Immunoassay , Seroepidemiologic Studies , Chikungunya virus/immunology , Prevalence , Cross-Sectional Studies , Sex Distribution , Age Distribution , Fever/epidemiology , Chikungunya Fever/immunology , Antibodies, Viral/blood , Nigeria/epidemiology
5.
Rev. Soc. Bras. Med. Trop ; 53: e20190563, 2020. graf
Article in English | LILACS | ID: biblio-1101438

ABSTRACT

Abstract INTRODUCTION The recent emergence and rapid spread of Zika and Chikungunya fevers in Brazil, occurring simultaneously to a Dengue fever epidemic, together represent major challenges to public health authorities. This study aimed to identify and compare the 2015-2016 spatial diffusion pattern of Zika, Chikungunya, and Dengue epidemics in Salvador-Bahia. METHODS We used two study designs comprising a cross-sectional-to-point pattern and an ecological analysis of lattice data. Residential addresses involving notified cases were geocoded. We used four spatial diffusion analysis techniques: (i) visual inspection of the sequential kernel and choropleth map, (ii) spatial correlogram analysis, (iii) spatial local autocorrelation (LISA) changes analysis and, (iv) nearest neighbor index (NNI) modeling. RESULTS Kernel and choropleth maps indicated that arboviruses spread to neighboring areas near the first reported cases and occupied these new areas, suggesting a diffusion expansion pattern. A greater case density occurred in central and western areas. In 2015 and 2016, the NNI best-fit model had an S-curve compatible with an expansion pattern for Zika (R2 = 0.94; 0.95), Chikungunya (R2 = 0.99; 0.98) and Dengue (R2 = 0.93; 0.99) epidemics, respectively. Spatial correlograms indicated a decline in spatial lag autocorrelations for the three diseases (expansion pattern). Significant LISA changes suggested different diffusion patterns, although a small number of changes were detected. CONCLUSIONS These findings indicate diffusion expansion, a unique spatial diffusion pattern of Zika, Chikungunya, and Dengue epidemics in Salvador-Bahia, namely. Knowing how and where arboviruses spread in Salvador-Bahia can help improve subsequent specific epidemic control interventions.


Subject(s)
Humans , Dengue/epidemiology , Epidemics , Chikungunya Fever/epidemiology , Zika Virus Infection/epidemiology , Brazil/epidemiology , Incidence , Cross-Sectional Studies , Geographic Mapping , Spatial Analysis
6.
Rev. Soc. Bras. Med. Trop ; 53: e20190433, 2020. tab
Article in English | LILACS | ID: biblio-1101442

ABSTRACT

Abstract INTRODUCTION: As highly specific molecular biology-based techniques may not be sensitive enough for the diagnosis of American tegumentary leishmaniasis (ATL), clinicians frequently rely on immunological tests before treatment initiation. Hence, the correct combination of diagnostic tests is imperative for ATL diagnosis. We aimed to evaluate the accuracy of the Montenegro (Leishmanin) skin test (MST) in polymerase chain reaction (PCR)-negative patients to accurately detect ATL. METHODS: Patients with a clinical picture compatible with ATL were divided into ATL (confirmed by lesion smear, culture indirect immunofluorescence, and/or histopathology) and no-ATL (diseases that can mimic leishmaniasis) groups. Conventional PCR for the minicircle kDNA of Leishmania was performed, and the MST was carried out for PCR-negative patients. RESULTS: Ninety-nine patients were included in this study, including 79 diagnosed with ATL (6 with mucocutaneous leishmaniasis) and 20 without ATL (no-ATL group). The MST showed a high sensitivity of 90.0% (95% confidence interval [CI] = 69.90-97.21) in PCR-negative patients that was 10% higher than the sensitivity reported in PCR-positive population (79.66%; 95% CI = 67.73-87.96). CONCLUSIONS: One of the most important reasons for PCR negativity among patients with active ATL is the presence of a strong cellular immunological response, especially in chronic and mucocutaneous leishmaniasis. This reinforces the considerable utility of the tests that detect cellular responses against Leishmania antigens such as the MST in PCR-negative patients when the performance in screening situations is questionable.


Subject(s)
Humans , Dengue/epidemiology , Chikungunya Fever/epidemiology , Zika Virus Infection/epidemiology , Brazil/epidemiology , Incidence , Cross-Sectional Studies , Epidemics , Geographic Mapping , Spatial Analysis
7.
Rev. Soc. Bras. Med. Trop ; 53: e20190583, 2020. tab, graf
Article in English | ColecionaSUS, LILACS, ColecionaSUS, SES-SP | ID: biblio-1136797

ABSTRACT

Abstract INTRODUCTION: We performed an epidemiological surveillance of the Chikungunya (CHIKV) lineages in Bahia after the 2014 East/Central/South African (ECSA) genotype outbreak. METHODS: Reverse-transcription polymerase chain reaction (RT-PCR), viral isolation, and phylogenetic analyses were conducted on serum samples from 605 patients with CHIKV-like symptoms during 2014-2018. RESULTS: Of the 605 samples, 167 were CHIKV-positive. Viral isolation was achieved for 20 samples; their phylogenetic analysis (E2 protein) revealed the presence of ECSA lineage and reinforced the phylogenetic relationship between ECSA and Indian Ocean lineages. CONCLUSIONS: The genomic surveillance of CHIKV showed that only ECSA lineage circulated in Bahia since the 2014 outbreak.


Subject(s)
Humans , Male , Female , Adult , Chikungunya virus/genetics , Genome, Viral/genetics , Chikungunya Fever/virology , Phylogeny , Brazil/epidemiology , Disease Outbreaks , Reverse Transcriptase Polymerase Chain Reaction , Epidemiological Monitoring , Chikungunya Fever/epidemiology , Genotype
8.
Mem. Inst. Oswaldo Cruz ; 115: e200278, 2020. graf
Article in English | LILACS | ID: biblio-1154866

ABSTRACT

BACKGROUND The impact of arbovirus cocirculation in Brazil is unknown. Dengue virus (DENV) reinfection may result in more intense viraemia or immunopathology, leading to more severe disease. The Zika virus (ZIKV) epidemic in the Americas provided pathogenicity evidence that had not been previously observed in flavivirus infections. In contrast to other flaviviruses, electron microscopy studies have shown that ZIKV may replicate in viroplasm-like structures. Flaviviruses produce an ensemble of structurally different virions, collectively contributing to tissue tropism and virus dissemination. OBJECTIVES AND METHODS In this work, the Aedes albopictus mosquito cell lineage (C6/36 cells) and kidney epithelial cells from African green monkeys (Vero cells) were infected with samples of the main circulating arboviruses in Brazil [DENV-1, DENV-2, DENV-3, DENV-4, ZIKV, Yellow Fever virus (YFV) and Chikungunya virus (CHIKV)], and ultrastructural studies by transmission electron microscopy were performed. FINDINGS We observed that ZIKV, the DENV serotypes, YFV and CHIKV particles are spherical. ZIKV, DENV-1, -2, -3 and -4 presented diameters of 40-50 nm, and CHIKV presented approximate diameters of 50-60 nm. Viroplasm-like structures was observed in ZIKV replication cycle. MAIN CONCLUSIONS The morphogenesis of these arboviruses is similar to what has been presented in previous studies. However, we understand that further studies are needed to investigate the relationship between viroplasm-like structures and ZIKV replication dynamics.


Subject(s)
Animals , Arboviruses , Yellow Fever , Dengue/epidemiology , Epidemics , Chikungunya Fever/epidemiology , Zika Virus , Zika Virus Infection/epidemiology , Vero Cells , Brazil/epidemiology , Chlorocebus aethiops
9.
Rev. bras. oftalmol ; 78(5): 338-341, Sept.-Oct. 2019.
Article in Portuguese | LILACS | ID: biblio-1042383

ABSTRACT

Resumo A febre Chikungunya é um problema de saúde pública mundial, com potencial para gerar epidemias de alta morbidade, visto que elevado número de pacientes pode apresentar sequelas articulares prolongadas e alterações oftalmológicas. As manifestações oftalmológicas podem estar presentes na fase aguda da doença ou ter início após várias semanas da instalação do quadro. Na literatura mundial é descrito desde alterações mais comuns e de fácil tratamento como conjuntivites até alterações mais complexas e que podem cursar com sequelas visuais graves como a retinite e neurite óptica.


Abstract Chikungunya fever is a world public health problem with the potential to generate epidemics of high morbidity, since a high number of patients may present prolonged joint sequelae and ophthalmological alterations. Ophthalmologic manifestations may be present in the acute phase of the disease or begin after several weeks of the onset of the disease. In the world literature is described from more common and easy to treat changes such as conjunctivitis to more complex changes and that can occur with severe visual sequelae such as retinitis and optic neuritis.


Subject(s)
Humans , Eye Diseases/etiology , Chikungunya Fever/complications , Antiviral Agents/therapeutic use , Serologic Tests/methods , Chikungunya virus/isolation & purification , Chikungunya virus/immunology , Chloroquine/therapeutic use , Adrenal Cortex Hormones/therapeutic use , Eye Diseases/diagnosis , Eye Diseases/drug therapy , Chikungunya Fever/diagnosis , Chikungunya Fever/drug therapy , Chikungunya Fever/blood , Chikungunya Fever/epidemiology , Anti-Inflammatory Agents/therapeutic use
10.
Rev. medica electron ; 41(2): 423-434, mar.-abr. 2019.
Article in Spanish | LILACS, CUMED | ID: biblio-1004278

ABSTRACT

RESUMEN En esta revisión se recogen las más recientes investigaciones sobre los virus de chikungunya y del zika en el continente americano y la posible emergencia de nuevos arbovirus. Se realizó una investigación de los principales artículos publicados en PubMed, Scielo y MEDLINE durante 2010-16, acerca de la presencia de arbovirus en el continente americano, su evolución y complicaciones. En el brote de chikungunya ocurrido en las Américas se han descrito la fiebre, poli artralgia, mialgia y salpullido como los síntomas más comunes en la fase aguda, mientras la artralgia crónico ha persistido en 37-90 % de cohortes pequeñas. El origen asiático de las cepas americanas de virus del chikungunya y del zika evidencian una ruta de la diseminación en común y ambos trasmitidos por el aedes aegypti. Con respecto al zika de fiebre y la asociación de malformaciones congénitas y la transmisión sexual es uno de los descubrimientos más importantes en el Nuevo Mundo. Los virus de chikungunya y zika, se transmite por el aedes aegypti, y se han convertido en un serio problema de salud principalmente por la falta de vacuna y los métodos eficaces para el control del vector.


ABSTRACT This review gathers together the most recent researches carried out on Chikungunya and Zika viruses in the American continent, and states the possible emergency of new arboviruses. The authors performed a review of the main articles published in PubMed, Scielo y MEDLINE in the period 2010-2016 on the presence of arboviruses in the American continent, their evolution and complications. The most commonly described symptoms of the chikungunya outbreak in the American continent are fever, polyarthralgia, myalgia and rash in the acute stage, while chronic arthralgia has persisted in 37-90 % of the little cohorts. The Asian origin of American Chikungunya (CHIKV) and Zika (ZIKV) viruses strains evidence a common dissemination course and common transmission by the Aedes Aegypti. Regarding Zika fever, the association of congenital malformations and sexual transmission are the most important discoveries in the New World. Chikungunya and Zika viruses are transmitted by the Aedes Aegypti and they have become a serious health problem, mainly due to the lack of vaccine and efficacious methods of the vector control.


Subject(s)
Humans , Arbovirus Infections/epidemiology , Americas/epidemiology , Disease Outbreaks , Dengue/epidemiology , Chikungunya Fever/epidemiology , Zika Virus Infection/epidemiology
11.
Mem. Inst. Oswaldo Cruz ; 114: e180597, 2019. tab, graf
Article in English | LILACS | ID: biblio-1040620

ABSTRACT

A localized Chikungunya virus (CHIKV; East/Central/South African genotype) outbreak (50 cases, 70% laboratory-confirmed; attack rate: 5.3 confirmed cases/100 people) occurred in a Salvador, Brazil neighborhood, between Apr-Jun/2017. Highly clustered cases in space and time, mostly along a single street, highlight an increased risk of CHIKV transmission among pockets of susceptible populations. This finding underscores the need for ongoing local level surveillance for arboviral outbreaks.


Subject(s)
Humans , Male , Female , Adult , Young Adult , Chikungunya virus/genetics , Chikungunya virus/immunology , Disease Outbreaks/statistics & numerical data , Chikungunya Fever/epidemiology , Phylogeny , Seasons , Brazil/epidemiology , Enzyme-Linked Immunosorbent Assay , Polymerase Chain Reaction , Chikungunya Fever/diagnosis , Chikungunya Fever/virology , Genotype , Middle Aged
12.
Rev. Soc. Bras. Med. Trop ; 52: e20190167, 2019. tab
Article in English | LILACS | ID: biblio-1041575

ABSTRACT

Abstract INTRODUCTION: The aim of this study was to characterize the clinical-epidemiological profile of Chikungunya virus infection and the factors associated with hospitalization during the peak of the most recent epidemic period in Brazil (2016-2017). METHODS Two official databases of the State Health Secretariat of Ceará were used, and a total of 182,731 notifications were analyzed. RESULTS Independent factors associated with hospital admission were chronic kidney disease (OR 4.56, 95% CI 3.36-6.17), hypertension (OR 1.90, 95% CI 1.69-2.14), leukopenia (OR 1.89, 95% CI 1.56-2.30) and diabetes mellitus (OR 1.70, 95% CI 1.44-1.99). CONCLUSIONS The pre-existing comorbidities have shown the potential to destabilize the patients' clinical status.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Epidemics , Chikungunya Fever/epidemiology , Brazil/epidemiology , Comorbidity , Cross-Sectional Studies , Risk Factors , Educational Status , Chikungunya Fever/complications , Hospitalization , Middle Aged
13.
Rev. Soc. Bras. Med. Trop ; 52: e 20180347, 2019. tab, graf
Article in English | LILACS | ID: biblio-977117

ABSTRACT

Abstract INTRODUCTION: The recent circulation of arboviruses transmitted by vectors, such as dengue, chikungunya, and Zika, is concerning due to the high morbidity rates, clinical complications, and increased demand on health services. The objective of this study was to analyze the clinical and epidemiological aspects of an epidemic caused by arboviruses in the municipality of Santa Luzia, Minas Gerais, Brazil. METHODS: Longitudinal study of patients with acute febrile disease and suspected arbovirus infection reported to Brazilian Notifiable Disease Information System (Sistema de Informação de Agravos de Notificação) from the epidemiological week 44 of 2015 to epidemiological week 52 of 2016. Patients with confirmed chikungunya were followed-up for 18 months and those with Zika for 15 months. Additionally, we analyzed and described the temporal distribution of confirmed cases of these arboviruses in this municipality. RESULTS: Overall 3,531 arboviruses cases, including 3,481 (98.7%) cases of dengue, 38 (1.0%) cases of chikungunya, and 12 (0.3%) cases of Zika were confirmed. The highest incidence of arbovirus infection occurred in the first quarter of 2016 (epidemiological week 7 to 14). The most frequent symptoms were for dengue, which included fever, headache, retro-orbital pain, and exanthema. Chikungunya infection was associated with fever, myalgia, arthralgia, and rash while Zika infection with pruritus and rash. CONCLUSIONS: Given the similarities in the initial clinical profiles of these arboviruses, it is important to perform a detailed clinical analysis, laboratory diagnosis, and patient follow-up.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Aged , Dengue/epidemiology , Chikungunya Fever/epidemiology , Zika Virus Infection/epidemiology , Brazil/epidemiology , Incidence , Longitudinal Studies , Disease Notification , Endemic Diseases , Middle Aged
14.
Rev. Hosp. Clin. Univ. Chile ; 30(2): 109-119, 2019. ilus
Article in Spanish | LILACS | ID: biblio-1052721

ABSTRACT

Chikungunya virus is an alphavirus, member of the Togaviridae family, first discovered in Africa in 1952. Since then it caused sporadic outbreaks in Africa and Asia, but since 2000, outbreaks had been more frequent, being identified in Europe, America and the Caribbean. Chikungunya virus can cause chronic and incapacitating arthralgia, with an important morbidity, being considered as a relevant re-emerging public health problem. This review intends to update our knowledge in epidemiology, transmission, pathogenesis, treatment and vaccination strategies of Chikungunya virus. (AU)


Subject(s)
Humans , Male , Female , Chikungunya virus/pathogenicity , Chikungunya Fever/prevention & control , Alphavirus , Chikungunya Fever/physiopathology , Chikungunya Fever/therapy , Chikungunya Fever/epidemiology
15.
West Indian med. j ; 67(3): 190-196, July-Sept. 2018. tab
Article in English | LILACS | ID: biblio-1045844

ABSTRACT

ABSTRACT Objective: To report demographic and self-reported clinical characteristics associated with persistent and severe arthralgia 8-12 months post-chikungunya virus (CHIKV) infection. Methods: A cross-sectional study of 306 adults who self-reported CHIKV infection was conducted. Subjects were consecutively enrolled at public primary healthcare centres in urban and rural areas in Jamaica. Adults with arthralgic conditions were compared with those who reported no arthralgia. Binary logistic regression models were used to determine demographic and self-reported clinical factors associated with severe arthralgia and persistent arthralgia. Results: Most subjects (70.3%) reported arthralgia after CHIKV outbreak (age: 47.6 ± 18.5 years). Medical consultation (36.2%) and laboratory confirmation (1.4%) were low. The prevalence of persistent and severe arthralgia in the previous month was 30.3% and 27.5%, respectively. Severe arthralgia was associated with the female gender (odds ratio (OR): 2.44; 95% confidence level (CI): 1.08, 5.52) and pre-existing arthritis (OR: 3.78; 95% CI: 1.23, 11.62). Females showed a greater likelihood of persistent arthralgia (OR: 2.18; 95% CI: 1.09, 4.39). Conclusion: Self-perceived arthralgia was an important feature 8-12 months post-CHIKV infection and has implications for the recognition and management of arthritis/rheumatic conditions.


RESUMEN Objetivo: Reportar las características clínicas demográficas y auto-reportadas asociadas con una artralgia persistente y severa de 8-12 meses tras la infección del virus de chikunguña (CHIKV). Métodos: Se llevó a cabo un estudio transversal de 306 adultos que auto-reportaron su infección de CHIKV. Los sujetos fueron alistados consecutivamente en centros públicos de atención primaria en zonas urbanas y rurales de Jamaica. Los adultos con condiciones artrálgicas fueron comparados con adultos que no reportaron artralgia alguna. Los modelos de regresión logística binaria fueron utilizados para determinar los factores clínicos demográficos y auto-reportados que se asocian con artralgia severa y artralgia persistente. Resultados: La mayoría de los sujetos (70.3%) reportaron artralgia después del brote de CHIKV (edad: 47.6 ± 18.5 años). La consulta médica (36.2%) y la confirmación del laboratorio (1.4%) fueron bajas. La prevalencia de la artralgia persistente y la severa en el mes anterior fue de 30.3%y 27.5%, respectivamente. La artralgia severa estuvo asociada al género femenino (odds-ratio (OR): 2.44; intervalo de confianza (IC): 1.08, 5.52), y artritis preexistente (OR: 3.78; 95% (IC: 1.23, 11.62). Las hembras mostraron una mayor probabilidad de artralgia persistente (OR: 2.18; 95% IC: 1.09, 4.39). Conclusión: La artralgia auto-percibida fue una característica importante de la infección post-CHIKV de 8-12 meses, y tiene implicaciones para el reconocimiento y tratamiento de la artritis y las condiciones reumáticas.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Arthralgia/virology , Chikungunya Fever/complications , Socioeconomic Factors , Severity of Illness Index , Prevalence , Disease Outbreaks , Cross-Sectional Studies , Risk Factors , Chikungunya Fever/epidemiology , Jamaica/epidemiology
17.
Rev. chil. infectol ; 35(4): 413-419, ago. 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-978052

ABSTRACT

Resumen Introducción: Chikungunya (CHIK) se introduce en América el año 2013 diseminándose rápidamente. En 2014, se diagnosticó el primer caso importado en Chile. Objetivos: Identificar pacientes con sospecha clínica de CHIK. Describir sus características clínicas y laboratorio. Pacientes y Métodos: Se enrolaron pacientes con sospecha de CHIK. Se confirmó mediante reacción de polimerasa en cadena (RPC), IgM o IgG CHIKV. Se aplicó encuesta con preguntas demográficas, características del viaje, manifestaciones clínicas y laboratorio a pacientes y médicos tratantes. Resultados: Se enrolaron 21 pacientes, confirmando CHIK en 16 que se analizaron; 12 mujeres (75%), promedio edad 39 años (27-52). Exposición más frecuente fue el Caribe y Sudamérica. El síntoma inicial fue artralgia en 63%. Los síntomas más frecuentes fueron mialgias y malestar general (100%), fiebre y poliartralgia (94%). La mediana de duración de artralgias 90 días (3-262 días) y en 53% > 3 meses. Las articulaciones más comprometidas fueron tobillos, manos y muñecas, 87% con dolor invalidante. La artritis duró más en hombres que en mujeres (p < 0,001). El 38% de pacientes presentó linfopenia y un paciente trombocitopenia leve. Hubo dos hospitalizaciones por cefalea y pielonefritis aguda. Conclusiones: Chikungunya debe sospecharse en viajeros que regresan febriles y con poliartralgias intensas. Medidas de prevención deben ser indicadas a viajeros a zonas de riesgo.


Background: Chikungunya (CHIK) was introduced in The Americas in 2013, spreading rapidly. In 2014, the first imported case was diagnosed in Chile. Aim: To identify patients with clinical suspicion of CHIK and describe their clinical and laboratory characteristics. Patients and Methods: Patients with suspected CHIK were enrolled. All were confirmed by PCR, IgM or IgG CHIK. A structured survey was applied, which included demographic questions, travel characteristics, clinical manifestations, and laboratory results. Results: 21 patients were enrolled and CHIK was confirmed in 16, who were further analyzed; 12 were female (75%), average age 39 years (27-52). The Caribbean and South Americawere the most frequent sites of exposure. In 63%, the initial symptom was arthralgia. Most frequent symptoms were myalgias, malaise (both 100%), fever, and polyarthralgia (both 94%). The median duration of arthralgias was 90 days (3-262); in 53% arthralgias lasted ≥ 3 months. Main joints involved were ankles, hands, and wrists; 87% reported invalidating pain. Arthritis lasted longer in men than in women (p < 0.001). 38% of patients presented lymphopenia and one patient mild thrombocytopenia. Two patients required hospitalization, one with severe headaches, the other with acute pyelonephritis. Conclusions: Chikungunya should be suspected in returning travelers presenting with fever and severe polyarthralgia. Travelers to endemic areas should apply prevention measures to avoid mosquito bites.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Chikungunya Fever/diagnosis , Travel , Chikungunya virus , Chile/epidemiology , Cross-Sectional Studies , Prospective Studies , Chikungunya Fever/prevention & control , Chikungunya Fever/transmission , Chikungunya Fever/epidemiology , Latin America
19.
Rev. Soc. Bras. Med. Trop ; 51(3): 347-351, Apr.-June 2018. tab, graf
Article in English | LILACS | ID: biblio-1041465

ABSTRACT

Abstract INTRODUCTION Dengue has affected Rio de Janeiro City since the 1980s. The sequential Zika and chikungunya virus introductions during 2015 aggravated the health scenario, with 97,241 cases of arboviral diseases reported in 2015-2016, some with neurological disorders. METHODS Arbovirus-related neurologic cases were descriptively analyzed, including neurological syndromes and laboratory results. RESULTS In total, 112 cases with non-congenital neurologic manifestations (Guillain-Barré syndrome, 64.3%; meningoencephalitis, 24.1%; acute demyelinating encephalomyelitis, 8%) were arbovirus-related; 43.7% were laboratory-confirmed, of which 57.1% were chikungunya-positive. CONCLUSIONS Emerging arbovirus infections brought opportunities to study atypical, severe manifestations. Surveillance responses optimized case identification and better clinical approaches.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Aged , Aged, 80 and over , Young Adult , Dengue/complications , Chikungunya Fever/complications , Zika Virus Infection/complications , Nervous System Diseases/virology , Brazil/epidemiology , Disease Notification , Communicable Diseases, Emerging/epidemiology , Communicable Diseases, Emerging/virology , Dengue/epidemiology , Chikungunya Fever/epidemiology , Zika Virus Infection/epidemiology , Middle Aged , Nervous System Diseases/epidemiology
20.
Rev. costarric. salud pública ; 27(1): 87-101, ene.-jun. 2018. graf
Article in Spanish | LILACS | ID: biblio-960278

ABSTRACT

Resumen Los mosquitos del genero Aedes, han provocado importantes epidemias de enfermedades como dengue, chikungunya, fiebre amarilla y zika en las Américas. La vigilancia epidemiológica de tales enfermedades, a través de los sistemas de información geográfica y la cartografía digital se han convertido en aliados para la Salud Pública. El objetivo de este estudio es describir el uso práctico de una herramienta geoespacial de acceso gratuito, en la vigilancia de enfermedades transmitidas por Aedes spp., en un sector endémico de Costa Rica para la presencia de este vector. Metodología: Se trata de un estudio de caso sobre la implementación de Herramientas Cartográficas digitales en un Área Rectora de Salud local del Ministerio de Salud, y su uso exitoso para la geo-localización de los casos sospechosos de dengue, zika y chikungunya notificados en esa área entre 2013 y 2016. Resultados: Se logró implementar el mapeo digital de los casos a través de marcas de posición. Con ventajas en la vigilancia epidemiológica, gracias al programa que permitió la identificación rápida de las viviendas, identificación de conglomerados, y selección de zonas prioritarias para intervenir. Además, fue un apoyo en la ejecución de los planes operativos, y en la conducción de actividades de movilización social. Discusión: Por su calidad de visualización topográfica y la interfaz intuitiva, las Herramientas Cartográficas digitales fueron útiles útil para la vigilancia epidemiológica de la transmisión de virus por el vector Aedes spp en Nandayure de Guanacaste, Costa Rica.


Abstract Aedes mosquito, because of it´s capability for spreading several virus, and it´s wide distribution at the American Continent, has generated epidemics of dengue, chikungunya, yellow fever and zika. Epidemic surveillance of these vector transmitted diseases, using free Geographic Information Systems and digital programs, has become into a great partner of Public Health departments. Objective: This study describes the practical use of free software of satellite image and free Geographic Information Systems, for the surveillance of Aedes spp transmitted diseases, in a Costa Rican Aedes endemic location. Methods: It is a case study developed at one local office, of Ministry of health in Costa Rica, geo locating the reported cases of dengue, zika, chikungunya from 2013 to 2016. Results: the achievement of position marks representing the house of all the cases reported, in a digital database of points and layers. Improvement in epidemic surveillance, thanks to the use of the selected programs that permitted to identify the conglomerates of cases at the neighborhoods, and the higher priority intervention zones. Discussion: the programs used, helped to visualize planned routes for the execution of social movement actions, and operational plans. Thanks to the image quality and the easy interactive interface, free Software selected, resulted into a useful tool for the surveillance of Aedes spp. transmitted diseases in the case of the public health department of Nandayure, from Guanacaste province of Costa Rica.


Subject(s)
Humans , Software/statistics & numerical data , Communicable Diseases , Aedes , Dengue/epidemiology , Geographic Information Systems , Disease Vectors , Epidemiological Monitoring , Geographic Mapping , Chikungunya Fever/epidemiology , Zika Virus Infection/epidemiology , Analog-Digital Conversion , Costa Rica
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