Publication: Clinical features of acute chikungunya virus infection in children and adults during an outbreak in the Maldives
Issued Date
2021-10-01
Resource Type
ISSN
14761645
00029637
00029637
Other identifier(s)
2-s2.0-85117057765
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Mahidol University
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SCOPUS
Bibliographic Citation
American Journal of Tropical Medicine and Hygiene. Vol.105, No.4 (2021), 946-954
Suggested Citation
Hisham Ahmed Imad, Juthamas Phadungsombat, Emi E. Nakayama, Keita Suzuki, Ahmed Mifthah Ibrahim, Aminath Afaa, Aminath Azeema, Aminath Nazfa, Aminath Yazfa, Anoosha Ahmed, Athifa Saeed, Azna Waheed, Fathimath Shareef, Mohamed Moinul Islam, Shausha Mohamed Anees, Sana Saleem, Aminath Aroosha, Ibrahim Afzal, Pornsawan Leaungwutiwong, Watcharapong Piyaphanee, Weerapong Phumratanaprapin, Tatsuo Shioda Clinical features of acute chikungunya virus infection in children and adults during an outbreak in the Maldives. American Journal of Tropical Medicine and Hygiene. Vol.105, No.4 (2021), 946-954. doi:10.4269/ajtmh.21-0189 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/77215
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Title
Clinical features of acute chikungunya virus infection in children and adults during an outbreak in the Maldives
Author(s)
Hisham Ahmed Imad
Juthamas Phadungsombat
Emi E. Nakayama
Keita Suzuki
Ahmed Mifthah Ibrahim
Aminath Afaa
Aminath Azeema
Aminath Nazfa
Aminath Yazfa
Anoosha Ahmed
Athifa Saeed
Azna Waheed
Fathimath Shareef
Mohamed Moinul Islam
Shausha Mohamed Anees
Sana Saleem
Aminath Aroosha
Ibrahim Afzal
Pornsawan Leaungwutiwong
Watcharapong Piyaphanee
Weerapong Phumratanaprapin
Tatsuo Shioda
Juthamas Phadungsombat
Emi E. Nakayama
Keita Suzuki
Ahmed Mifthah Ibrahim
Aminath Afaa
Aminath Azeema
Aminath Nazfa
Aminath Yazfa
Anoosha Ahmed
Athifa Saeed
Azna Waheed
Fathimath Shareef
Mohamed Moinul Islam
Shausha Mohamed Anees
Sana Saleem
Aminath Aroosha
Ibrahim Afzal
Pornsawan Leaungwutiwong
Watcharapong Piyaphanee
Weerapong Phumratanaprapin
Tatsuo Shioda
Abstract
The chikungunya virus is an arthritogenic arbovirus that has re-emerged in many tropical and subtropical regions, causing explosive outbreaks. This re-emergence is due to a genomic polymorphism that has increased the vector susceptibility of the virus. The majority of those infected with chikungunya virus exhibit symptoms of fever, rash, and debilitating polyarthralgia or arthritis. Symptoms can persist for weeks, and patients can relapse months later. Fatalities are rare, but individuals of extreme age can develop severe infection. Here, we describe the 2019 outbreak, the second-largest since the virus re-emerged in the Maldives after the 2004 Indian Ocean epidemic, in which a total of 1,470 cases were reported to the Health Ministry. Sixty-seven patients presenting at the main referral tertiary care hospital in the Maldives capital with acute undifferentiated illness were recruited following a negative dengue serology. A novel point-of-care antigen kit was used to screen suspected cases, 50 of which were subsequently confirmed using real-time reverse transcription-polymerase chain reaction. We describe the genotype and polymorphism of Maldives chikungunya virus using phylogenetic analysis. All isolates were consistent with the East Central South African genotype of the Indian Ocean lineage, with a specific E1-K211E mutation. In addition, we explored the clinical and laboratory manifestations of acute chikungunya in children and adults, of which severe infection was found in some children, whereas arthritis primarily occurred in adults. Arthritides in adults occurred irrespective of underlying comorbidities and were associated with the degree of viremia.