Chikungunya virus iridocyclitis in Fuchs’ heterochromic iridocyclitis.

We are reporting a case of bilateral Fuchs’ heterochromic iridocyclitis with chikungunya virus infection in the left eye. A 20-year-old female was presented with a past history of fever suggestive of chikungunya with bilateral Fuchs’ heterochromic iridocyclitis and complicated cataract. She had a tripod dendritic pattern of keratic precipitates by confocal microscopy in the left eye with a stippled pattern of keratic precipitates in both eyes. The real-time polymerase chain reaction (RT-PCR) assay in the aqueous humor detected 98 copies/ml of chikungunya virus RNA. The patient underwent clear corneal phacoemulsification with in-the-bag intraocular lens implantation in the left eye with a good visual outcome. This is the first report where the presence of chikungunya virus RNA has been associated with a case of bilateral Fuchs’ heterochromic iridocyclitis.

Entomo-epidemiological investigations on chikungunya outbreak in the Lakshadweep islands, Indian Ocean.

Background & objectives: An outbreak of chikungunya fever characterized by prolonged incapacitation in the Lakshadweep islands in Indian Ocean occurred in November 2006. We undertook the entomological and epidemiological investigations on the Chikungunya outbreak in the Lakshadweep islands, Indian Ocean. Methods: Epidemic information in the affected places was obtained from the local hospital records. Entomological observations like larval survey and the adult resting/landing collections by the hand collection methods were individually conducted in the two affected islands Andrott and Kalpeni in November and December 2006. Results: The main breeding sources of the mosquitoes were the rodent-devoured coconuts, coconut shells, areca nut soaking mud and plastic pots, discarded containers, grinding stones, metal containers and plastic containers. Aedes albopictus was pre-dominantly present in the Lakshadweep islands. Interpretation & conclusion: It is concluded that the routine campaigns need to be organized regularly within the community highlighting the potential breeding grounds of mosquitoes and the possible control methods. Source reduction strategies like destruction of coconut shells and rodent-devoured coconuts by burning or by burying them inside the ground. Ae. albopictus played major role as the vector mosquitoes responsible for the chikungunya transmission.

Clinical profile of chikungunya fever in patients in a tertiary care centre in Maharashtra, India.

Background & objectives: In India a chikungunya fever outbreak started in December 2005 when the country experienced more than 13 lakhs of chikungunya infected cases. We undertook this study to study detailed clinical profile of chikungunya fever in both indoor and outdoor patients in a tertiary care hospital in Nagpur, Maharashtra in 2006. Methods: Suspected cases of chikungunya fever (n=405) during the period of July to September 2006, having clinical triad of fever, arthralgia and/or rashes were included in the study. Clinical profile was studied in all the cases. Of the 405 samples collected, 166 were tested for serum CHIK IgM antibodies. Results: Of the 166 samples tested for CHIKV IgM antibodies, 87 (52.4%) were positive (confirmed cases). Male: female ratio was 2.3:1. Fever and arthralgia were present in all cases. Rash was present in 27(31%) confirmed and 38(12%) suspected cases. Lymphadenopathy was present in 12 (13.8 %) confirmed and 4 of suspected cases. Chronic polyarthritis was seen in 22 (25.3%) confirmed and 75 (23.6%) suspected cases. Neurological manifestations were observed in 08 (9%) confirmed and 10(3.14%) suspected cases. Mortality was 7(2.2%) in 318 suspected cases and 3 (3.4%) in 87 confirmed cases. Interpretation &conclusions: Our findings showed that about half of the serum samples for CHIKV IgM antibody tested positive from cases suspected to have chikungunya fever. Fever, joint pain and headache were major symptoms. Certain rare manifestations like lymphodenopathy, oral ulcers and encephalitis were also seen. Mortality in confirmed cases was about 3.4 per cent.