Chikungunya Fever ; epidemiology ; prevention & control ; transmission ; Humans ; Singapore ; epidemiology

Alphavirus Infections ; diagnosis ; epidemiology ; virology ; Animals ; Chikungunya Fever ; Chikungunya virus ; genetics ; isolation & purification ; physiology ; Humans ; Viral Proteins ; genetics ; metabolism

The incidence of chikungunya infection in Singapore has been on the rise since the first reported case in 2006. Acute polyarthritis, a common manifestation among affected patients, may precede fever and present with debilitating arthritis to rheumatologists, orthopaedists, internists and primary care physicians. The diagnosis of chikungunya infection requires careful history taking and a high index of suspicion, with supporting evidence from the reverse transcription-polymerase chain reaction or the chikungunya IgM serology test. Treatment of chikungunya arthritis usually involves non-steroidal anti-inflammatory drugs. Rarely, polyarthritis in chikungunya may persist even after resolution of the acute infection, necessitating treatment with disease-modifying anti-rheumatic drugs. In this article, we present the different manifestations of chikungunya arthritis in our local setting and review the literature.
Aged ; Alphavirus Infections ; complications ; Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Arthritis ; drug therapy ; virology ; Chikungunya Fever ; Chikungunya virus ; Female ; Humans ; Male ; Middle Aged

To establish a MacELISA method for the detection of IgM antibodies against Chikungunya virus (CHIKV), we prepared virus like particle (VLP) antigens of CHIKV using the whole structural protein C-E3-E2-6K-E1 encoding gene with a baculovirus expression system in Sf9 insect cells. The VLPs were purified and used to immunize Kunming mice. Then, polyclonal antibodies were purified from the samples of ascites with a protein G HiTrap SP column and labeled with horseradish peroxidase. A MacELISA method for the detection of IgM antibodies against CHIKV was assembled with goat anti-human IgM antibody, VLP antigens and an enzyme-labeled polyclonal antibody. The results were evaluated with a serum panel containing serum samples from laboratory-confirmed CHIK, HFRS patients, healthy donors, and commercially available CHIKV IgM as a quality control. It was shown that the MacELISA had a specificity of 99% (99/100), the coefficients of variation (CoV) within a plate were <10%, and the CoV of different ELISA plates in terms of the plate variation coefficient was <15%. A comparative analysis was performed to compare the current method against a commercial CHIKV IgM antibody detection kit for IIFA-IgM. The detection limit of MacELISA was significantly lower than that of the IIFA-IgM commercial kit (P< 0.0001). Here, we demonstrate that the VLP-based MacELISA is a promising tool for the early diagnosis and epidemiological investigation of CHIKV infection, with a high level of sensitivity and specificity for the detection of IgM antibodies against CHIKV.
Animals ; Antibodies, Viral ; blood ; Chikungunya Fever ; blood ; diagnosis ; virology ; Chikungunya virus ; immunology ; isolation & purification ; Enzyme-Linked Immunosorbent Assay ; methods ; Humans ; Immunoglobulin M ; blood ; Mice

BACKGROUND: Chikungunya virus (CHIKV) is a mosquito- borne  alphavirus  of  the  family  Togaviridae  transmitted  to humans by the Aedes spp. mosquitoes, causing Chikungunya   Fever  (CHIKF).
OBJECTIVE: This study aims to describe the course and outcome of musculoskeletal (MSK) manifestations in patients  with  CHIKF  seen  over  a   three-month     period.
DESIGN: This is a prospective descriptive  study.  Seventy  patients  with  fever,  rash,  and  arthritis  seen   at the University of the Philippines-Philippine General Hospital  and  private  arthritis  clinics  were  collected from August - December 2012.  Demographics  and course   of   arthritis   were  described.
RESULTS:  Seventy   patients,   53   (68.6%)   female,   with  a mean age  of  39.2  ±13.50  were  diagnosed  with CHIKF. All cases were from the Metropolitan  Manila area. Of these, 15 (21.4%) had  family  members  affected. Twenty-four patients (34.3%) were either employed or students. The most common presenting symptoms were fever (94.3%), arthritis or athralgia  (98.6%), and rash (87.1%).  The  most  common  joint  areas involved were the ankles  (60.0%),  the  wrists (40.0%) and the small joints of the hand (51.4%). Twenty-seven (47.3%) had symmetric  arthritis.  Thirty- seven   cases   (52.9%)   had   arthralgia   or   arthritis    for at least  six  weeks.  By  the  end  of  the  follow-up  period, only four (5.7%) had persistent musculoskeletal symptoms. Age and  sex  were not  found to  be  factors in  determining  chronicity  of  arthritic  symptoms  (p   =   0.104   and   p=0.58  respectively). Of the seventy patients, 31 (44. 3%) were confirmed  cases  of  CHIKF--  29 had  (+)   CHIKV  IgM   by ELISA,  and  two   had   (+)   CHIKV   PCR.   Twenty-  one (67.7%) had  persistent  arthritis  of  at least  six  weeks. Treatment  consisted  of continuous  NSAIDs  for  at  least  two   weeks   and   some   received   steroids.  In this subgroup, age and sex were not shown to  correlate with chronic arthritis (p=0.47 and p=0.05 respectively).
CONCLUSION: This report on a recent outbreak of CHIKF showed the classic triad of fever, rash,  and  arthritis.  There  was  no  correlation  between  age  and  chronicity of  arthritic  symptoms.  Sex,  likewise,  did  not  appear   to influence chronicity. The disease occurred in family clusters. Patients required continuous treatment with NSAIDs and  some  had  to  be given  steroids.  Most cases   resolved   by   12 weeks.

Human ; Male ; Female ; Middle Aged ; Adult ; Chikungunya Fever ; Chikungunya Virus ; Togaviridae ; Anti-inflammatory Agents, Non-steroidal ; Arthralgia ; Arthritis ; Exanthema ; Enzyme-linked Immunosorbent Assay

The recent epidemic of Zika virus in South America caused people around the world to exhibit an increased interest in the impact of arboviral illnesses. In Korea, malaria and Japanese encephalitis are the most important mosquito-borne diseases that occur indigenously. However, with the continuously increasing number of international travelers, the incidence of imported arboviral illnesses is also increasing. Currently, dengue fever is the most common mosquito-borne disease among Korean international travelers. The number of patients with Japanese encephalitis, chikungunya fever, and Zika virus infection is also on the rise. Many countries that have disease-transmitting mosquitoes have already experienced autochthonous arboviral infections due to the introduction of viruses by travelers. Moreover, with global warming and urbanization of the areas in which mosquito-borne diseases occur, the environment is becoming more favorable for mosquito-borne diseases. This concise review describes the current status and outlook of mosquito-borne diseases in Korea.
Chikungunya Fever ; Culicidae ; Dengue ; Encephalitis, Japanese ; Global Warming ; Humans ; Incidence ; Korea* ; Malaria ; South America ; Urbanization ; Zika Virus ; Zika Virus Infection

INTRODUCTION: Typhoon Haiyan, or Typhoon "Yolanda" in the Philippines, caused catastrophic damage last November 8, 2013 in the islands of Leyte. As of April 17, 201, NDRRMC confirmed 6,300 fatalities across the country and around 5,877 were from Eastern Visayas. The actual death toll remained unclear although it is being claimed to be about 10,000 in Tacloban City alone.

OBJECTIVE: This study aimed to determine the transmission of notifiable diseases under PIDSR as to increase in morbidity, deaths and case fatality rates among patients consulted and/or admitted at EVRMC before and after ST Yolanda.

MATERIALS AND METHODS: This is a descriptive study which included all patients who sought consultation and/or admission in EVRMC with clinical diagnosis of any notifiable disease under the PIDSR reference list.

RESULTS: A cumulative total of 8,299 patients with notifiable diseases sought and/or admission between November 2012 - October 2013 and November 2013 - October 2014. Of which, 3,873 or 46.67% were cases before Super Typhoon Yolanda while 4,426 or 53.33% were cases a year after. Patients below 14 years old were mostly affected after the disaster. There were few patients, 70 years old and above who sought consultation and/or admission. As to occurrence between sexes, there were more females affected than males after the disaster which comprised of 51.4% of the total. As to geographic distribution, there were more cases coming from the 1st district of Leyte including Tacloban City comprising 61.58% compared to its occurrence prior to the disaster.  As to the number of cases under Category I, an increased cases of measles from 2 cases to 356 or an increase of 99.44% after the disaster. Notifiable diseases under Category II comprised 91.53% of the total post disaster with an increase of 12.5% from the total cases the previous year. Acute watery diarrhea had the highest number of patients affected then, was followed by Dengue fever,  27.43% and Acute bloody diarrhea, 2.35%. Chikungunya increased from 10 cases the previous year to 33. As to deaths, there was no increase under Category I but, under Category II, an increase of 26.1% after the typhoon was observed. Among these, were Acute watery diarrhea, Dengue fever, Influenza like illness and Measles after disaster.

CONCLUSION: During calamities, everything is affected, from infrastructure, agriculture and most of all the people. Transmission of different infectious diseases occur because of displacement of the population, lack of safe water supply and sanitation facilities and, lack of available health care services.

Human ; Male ; Female ; Cyclonic Storms ; Sanitation ; Philippines ; Influenza, Human ; Disasters ; Chikungunya Fever ; Cities ; Measles ; Dengue ; Water Supply ; Diarrhea ; Agriculture ; Islands

Chikungunya infection is caused by an arbovirus transmitted by the Aedes mosquito. A 19-year-old man who had traveled to the Republic of Surinam to perform volunteer work complained of a fever, arthralgia, articular stiffness, and a skin rash on both the arm and trunk. Chikungunya fever was diagnosed using a Chikungunya virus specific IgM antibody in an enzyme-linked immunosorbent assay (ELISA) using blood samples obtained during follow-up visits. In this report, we describe a case of imported Chikungunya fever that presented with arthralgia and a skin rash, with islands of normal skin, that occurred following travel to Surinam, South America.
Aedes ; Arboviruses ; Arm ; Arthralgia ; Chikungunya virus* ; Culicidae ; Enzyme-Linked Immunosorbent Assay ; Exanthema ; Fever ; Follow-Up Studies ; Humans ; Immunoglobulin M ; Islands ; Skin ; South America* ; Suriname* ; Volunteers ; Young Adult

This report describes the chikungunya cases and local transmission detected in Brunei Darussalam for the first time, despite the country being situated in a region that has experienced a multitude of outbreaks over the years. A combined strategy of active case detection, patient isolation and vector control measures was deployed in an attempt to avert further transmission. The findings have important public health implications for international surveillance and control strategies for this re-emerging disease.
Adult ; Alphavirus Infections ; diagnosis ; epidemiology ; transmission ; Brunei ; epidemiology ; Chikungunya Fever ; Disease Outbreaks ; prevention & control ; Female ; Humans ; Male ; Middle Aged ; Population Surveillance

Chikungunya is caused by an arbovirus transmitted by Aedes mosquito vector. With the increase of habitat of mosquito by global warming and frequent international travel and interchange, chikungunya reemerged and showed global distribution recently. Until now there has not been reported any case infected with chikungunya virus in Korea. A 23-year-old man has been the Republic of the Philippines for 1 week, and visited our emergency center due to fever and back pain. Chikungunya viral infection was diagnosed by specific IgM for chickungunya virus by enzyme-linked immunosorbent assayin Korea Centers for Disease Control and Prevention. His clinical course was self limited. We introduce the first imported case infected with chikungunya virus in Korea.
Aedes ; Arboviruses ; Back Pain ; Centers for Disease Control and Prevention (U.S.) ; Chikungunya virus* ; Culicidae ; Ecosystem ; Emergencies ; Fever ; Global Warming ; Humans ; Immunoglobulin M ; Korea ; Philippines ; Young Adult