Chikungunya virus outbreak in Sint Maarten: Long-term arthralgia after a 15-month period

Background & objectives: The first chikungunya (CHIK) epidemic in the Americas was reported in December 2013. Chikungunya virus (CHIKV) causes an acute febrile illness and is transmitted to humans by Aedes mosquitoes. Although earlier studies have described long-term clinical manifestations of C...

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Bibliographic Details
Published in:	Journal of vector borne diseases Vol. 55; no. 2; pp. 137 - 143
Main Authors:	Peters, C.M.M, Pijnacker, R, Fanoy, E, Bouwman, L.J.T, de Langen, L, van den Kerkhof, J.H.T.C, Reimerink, J, Pilot, E, Henry, M, Oostburg, V, Braks, M.A.H
Format:	Journal Article
Language:	English
Published:	India Wolters Kluwer - Medknow Publications 01-04-2018 Medknow Publications and Media Pvt. Ltd Medknow Publications & Media Pvt. Ltd Wolters Kluwer Medknow Publications
Subjects:	Adolescent Adult Aged Aged, 80 and over Arthralgia Arthralgia - epidemiology Arthralgia - etiology Arthralgia; Caribbean; chikungunya; Sint Maarten; vector-borne diseases Care and treatment Chikungunya fever Chikungunya Fever - complications Chikungunya Fever - virology Chikungunya virus Chikungunya virus - genetics Chikungunya virus - isolation & purification Chikungunya virus - physiology Child Child, Preschool Complications and side effects Development and progression Disease prevention Epidemics Female Forecasts and trends Health aspects Humans Interviews Male Middle Aged Mosquitoes Pain Patients Public health Public health administration Quality of life Retrospective Studies Sint Maarten Young Adult Sint Maarten Sint Maarten Caribbean Arthralgia vector-borne diseases chikungunya
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Summary:	Background & objectives: The first chikungunya (CHIK) epidemic in the Americas was reported in December 2013. Chikungunya virus (CHIKV) causes an acute febrile illness and is transmitted to humans by Aedes mosquitoes. Although earlier studies have described long-term clinical manifestations of CHIK patients infected with the East/Central/South African (ECSA) genotype, little is known about persistent manifestations in the Caribbean region, for which the Asian genotype is responsible. The objective of this study was to describe the presence of persisting clinical manifestations, specifically arthralgia, in CHIKV-infected patients on the Caribbean Island, Sint Maarten, 15 months after onset of the disease. Methods: This retrospective cohort study included confirmed CHIK patients that were recorded by the participating general practitioners (GPs) during the chikungunya outbreak in 2014 in Sint Maarten. Between March and July 2015, 15 months after the onset of disease, patients were interviewed via telephone about the presence, duration and impact of clinical CHIKV manifestations. Results: In total, 56 patients were interviewed (median age 47 yr), of which 30 (54%) were females. Out of the total interviewed patients, 52 (93%) reported arthralgia for the first three months after the disease onset, of which 23 (44%) patients reported to have persistent arthralgia, 15 months after the disease onset. Pain intensity of persistent arthralgia was perceived as mild in the majority of patients (n = 14; 60%), moderate in 7 (30%) patients and severe in 2 (9%) patients. During the acute phase of disease, most patients had to miss school or work (n = 39; 72%) due to clinical CHIKV manifestations and reported a negative impact on daily activities (n = 36; 57%). Interpretation & conclusion: Results suggested that persisting arthralgia is a frequent complication in CHIK patients included in the study. Future research on strain-specific clinical long-term manifestations and on their impact on daily life of patients, in the form of a comparative study between patients and controls, is recommended.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0972-9062
DOI:	10.4103/0972-9062.242561