Atypical Chikungunya virus infections: clinical manifestations, mortality and risk factors for severe disease during the 2005-2006 outbreak on Reunion
Atypical Chikungunya virus infections: clinical manifestations, mortality and risk factors for severe disease during the 2005-2006 outbreak on Reunion
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DOI：
10.1017/s0950268808001167
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发表时间：
2009-04-01
影响因子：
4.2
通讯作者：
Quatresous, I.
中科院分区：
文献类型：
--
作者：
Economopoulou, A.;Dominguez, M.;Quatresous, I.
2005年4月，印度洋留尼汪岛爆发了基孔肯雅热。2005年冬季，6名患者因基孔肯雅病毒出现脑膜脑炎和急性肝炎。我们的目标是确定非典型基孔肯雅病毒感染的发病率和死亡率，并确定严重疾病的危险因素。建立了一个以医院为基础的监测系统，以收集非典型基孔肯雅病病例的数据。对病例报告、医疗记录和实验室结果进行了回顾和分析。我们将非典型病例定义为实验室确认的基孔肯雅病毒感染患者出现发烧和关节痛以外的症状。我们将严重非典型病例定义为至少需要维持一项重要功能的病例。我们记录了610例非典型基孔肯雅热病例：222例为重症病例，65例患者死亡。有基础疾病546例(其中心血管疾病2 2 6例，神经疾病14 7例，呼吸系统疾病15 0例)。记录了从未与基孔肯雅热相关的临床特征，如大疱性皮肤病、肺炎和糖尿病。高血压和潜在的呼吸系统或心脏疾病是疾病严重程度的独立危险因素。总病死率为10.6%，且随年龄增长而增加。这是首次记录到基孔肯雅热造成的严重病例和死亡。本文提供的信息可能有助于临床医生识别疾病、选择治疗策略和预测病程。
In April 2005, an outbreak of Chikungunya fever occurred on the island of Reunion in the Indian Ocean. During winter 2005, six patients developed meningoencephalitis and acute hepatitis due to Chikungunya virus. Our objectives were to determine the incidence and mortality of atypical Chikungunya viral infections and to identify risk factors for severe disease. A hospital-based surveillance system was established to collect data on atypical Chikungunya cases. Case reports, medical records and laboratory results were reviewed and analysed. We defined an atypical case as one in which a patient with laboratory-confirmed Chikungunya virus infection developed symptoms other than fever and arthralgia. We defined a severe atypical case as one which required maintenance of at least one vital function. We recorded 610 atypical cases of Chikungunya fever: 222 were severe cases, 65 affected patients died. Five hundred and forty-six cases had underlying medical conditions (of which 226 suffered from cardiovascular, 147 from neurological and 150 from respiratory disorders). Clinical features that had never been associated with Chikungunya fever were recorded, such as bullous dermatosis, pneumonia, and diabetes mellitus. Hypertension, and underlying respiratory or cardiological conditions were independent risk factors for disease severity. The overall mortality rate was 10.6% and it increased with age. This is the first time that severe cases and deaths due to Chikungunya fever have been documented. The information presented in this article may assist clinicians in identifying the disease, selecting the treatment strategy, and anticipating the course of illness.