Acute Chikungunya and persistent musculoskeletal pain following the 2006 Indian epidemic: a 2-year prospective rural community study

Epidemiol Infect. 2012 May;140(5):842-50. doi: 10.1017/S0950268811001300. Epub 2011 Jul 18.

Abstract

Chikungunya virus (CHIKV) data from population studies are sparse. During the 2006 epidemic, 509 clinical cases (43% attack rate) were identified in a village survey (West India); laboratory investigations demonstrated normal blood cell counts, elevated acute-phase reactants [erythrocyte sedimentation rate, C-reactive protein and interleukin-6 (IL-6)] and excluded malaria and dengue. Acute CHIKV was characterized by high fever, severe peripheral polyarthralgias, axial myalgias and intense fatigue in over 90% of cases; skin rash (34%) and headache (19%) were uncommon. There were 49% and 62% of survey cases seropositive for IgM (rapid assay) and IgG (immunofluorescence) anti-CHIKV antibodies, respectively. Sixty-five percent of cases recovered within 4 weeks. None of the cases died. Of the population, 4·1% and 1·6% suffered from persistent rheumatic pains, predominantly non-specific, at 1 and 2 years, respectively. Chronic inflammatory arthritis was uncommon (0·3% at 1 year) although serum IL-6 often remained elevated in chronic cases. A larger population study is required to describe post-CHIKV rheumatism and its prognosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Alphavirus Infections / complications*
  • Alphavirus Infections / epidemiology*
  • Alphavirus Infections / virology
  • Antibodies, Viral / blood
  • Chikungunya Fever
  • Chikungunya virus / pathogenicity*
  • Child
  • Child, Preschool
  • Chronic Disease
  • Disease Outbreaks*
  • Female
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulin M / blood
  • India / epidemiology
  • Infant
  • Infant, Newborn
  • Interleukin-6 / blood
  • Male
  • Middle Aged
  • Musculoskeletal Pain / epidemiology*
  • Musculoskeletal Pain / etiology*
  • Prospective Studies
  • Rural Population
  • Young Adult

Substances

  • Antibodies, Viral
  • Immunoglobulin G
  • Immunoglobulin M
  • Interleukin-6