Epidemiology, clinical manifestations, and diagnosis of Chikungunya fever: lessons learned from the re-emerging epidemic.
Epidemiology, clinical manifestations, and diagnosis of Chikungunya fever: lessons learned from the re-emerging epidemic.
复制标题
DOI：
10.4103/0019-5154.60355
复制
发表时间：
2010-01-01
影响因子：
1.7
通讯作者：
Kumar, D Prabath
中科院分区：
文献类型：
--
作者：
Mohan, Alladi;Kiran, D H N;Kumar, D Prabath
基孔肯雅热是由基孔肯雅病毒引起的一种虫媒病毒病，由伊蚊属受感染的蚊子叮咬传播。基孔肯雅热流行病已从世界各地的几个国家的报告。这种沉寂了近32年的疾病在2005年10月印度爆发时重新出现，目前仍在继续。潜伏期为3至12天。发病通常突然，急性期的特征是突然发病，伴有高热、严重关节痛、肌痛和皮疹。肿胀的关节和关节炎通常是明显的。在慢性阶段，复发，包括发热，虚弱，关节痛，炎性多发性关节炎和僵硬的感觉可能是明显的。神经系统，眼部和皮肤粘膜的表现也有描述。大约15%的患者可能会出现慢性关节炎。病毒培养是诊断基孔肯雅热的金标准。逆转录聚合酶链反应和实时环介导等温扩增也被发现是有用的。用于检测基孔肯雅病毒的免疫球蛋白M和免疫球蛋白G抗体的血清诊断方法更常用。基孔肯雅热是一种自限性疾病;然而，严重的表现如脑膜脑炎、暴发性肝炎和出血表现有时可能危及生命。治疗是对症和支持性的。通过教育社区和公共卫生官员进行预防，病媒控制措施似乎是控制基孔肯雅热的最佳方法，因为目前印度没有可供公众使用的商用疫苗。
Chikungunya fever, caused by "Chikungunya virus," is an arbovirus disease transmitted by the bite of infected mosquitoes belonging to the genus Aedes. Chikungunya fever epidemics have been reported from several countries around the world. The disease that was silent for nearly 32 years re-emerged in the October 2005 outbreak in India that is still ongoing. The incubation period ranges from 3 to 12 days. The onset is usually abrupt and the acute stage is characterized by sudden onset with high-grade fever, severe arthralgias, myalgias, and skin rash. Swollen tender joints and crippling arthritis are usually evident. In the chronic stage, relapses that include sensation of fever, asthenia, exacerbation of arthralgias, inflammatory polyarthritis, and stiffness may be evident. Neurological, ocular, and mucocutaneous manifestations have also been described. Chronic arthritis may develop in about 15% of the patients. Viral culture is the gold standard for the diagnosis of Chikungunya fever. Reverse transcription polymerase chain reaction and real-time loop-mediated isothermal amplification have also been found to be useful. Serodiagnostic methods for the detection of immunoglobulin M and immunoglobulin G antibodies against Chikungunya virus are more frequently used. Chikungunya is a self-limiting disease; however, severe manifestations such as meningoencephalitis, fulminant hepatitis, and bleeding manifestations may sometimes be life-threatening. Treatment is symptomatic and supportive. Prevention by educating the community and public health officials, vector control measures appear to be the best approach at controlling Chikungunya fever as no commercially available vaccine is available for public use in India for this condition presently.