Epidemiology and Infection

Viral infection

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

A. CHOPRAa1 c1, V. ANURADHAa1, R. GHORPADEa1 and M. SALUJAa1

a1 Centre for Rheumatic Diseases, Pune, Maharashtra, India

SUMMARY

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.

(Accepted June 13 2011)

(Online publication July 18 2011)

Correspondence:

c1 Author for correspondence: Dr A. Chopra, Centre for Rheumatic Diseases, 11 Hermes Elegance, 1988 Convent Street, Camp, Pune – 411001, Maharashtra, India. (Email: arvindchopra60@hotmail.com)

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