Emergence of Chikungunya infection in North India
Keywords:
Age, Chikungunya, Clinical features, Seasonal variation, sex correlation.Abstract
Background: Since re-emergence of chikungunya virus (CHIKV) infection in Indian subcontinent in 2005, it has become a major public health threat. Because of paucity of literature from north India, we undertook this study to determine incidence of Chikungunya infection and to assess clinical spectrum of disease.
Methods: 248 clinically suspected cases of CHIKV were enrolled. IgM ELISA for CHIKV was done on all samples. RT- PCR for CHIKV was performed on 53 selected samples.
Result: Thirty samples were positive for CHIKV IgMÂ Ab of total 248 suspected cases. Of 53 samples tested by RT-PCR, 17 were found to be positive. Majority of the confirmed cases were in age group 21-40 yrs. Male: female ratio was 1.38:1. The most common clinical features were fever with joint pain and rash. Apthous ulcers were seen in 36% and arthritis was seen in 25% of the confirmed cases. Lymph nodes were enlarged in 16% and hemorrhagic manifestations were seen in 15.9% of the positive cases. Neurological involvement was present in 7 of the CHIKV infected cases and was more common in young children. Case fatality rate amongst CHIKV infected was 4.5% (2/248, both children).
Conclusion: CHIKV IgM positivity of 12% was seen in the present study. Largest proportion of confirmed cases was in the age group 21-40 years. Neurological manifestations were present in 7 of CHIKV confirmed cases, five being children. Mortality in confirmed cases was 4.5%. The increased severity of illnesss & high case fatality rate among children demands for a more detailed understanding of the neurotropism & needs to be analysed in detail.
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References
2. Directorate of National Vector Borne Disease Control Programme (NVBDCP), Directorate General of Health Services, Government of India. Chikungunya Fever situation in the country during 2006. Available at: http://www.namp.gov.in/chikun-cases.html, accessed on October 28, 2006.
3. Government of India, Ministry of Health & Family Welfare. Update on Chikungunya. Available at: http://www.nvpdep:gov.in/doc/chikungunyaupdate.pdf, accessed on October 28, 2006.
4. Marion R. An epidemic of virus disease in Southern Povince, Tanganyika Territory in 1952, 53. Clinical features. Trans R Soc Trop Med Hyg. 1955; 49: 28-32.
5. Chatterjee SN, Chakravarti SK, Mitra AC, Sarkar JK. Virological investigation of cases with neurological complications during the outbreak of haemorrhagic fever in Calcutta. J Indian Med Assoc. 1965; 45: 314-6.
6. Shah KV, Gibbs CJ Jr, Banerjee G. Virological investigation of the epidemic of haemorrhagic fever in Calcutta: isolation of three strains of Chikungunya virus. Indian J Med Res. 1964; 52: 676-83.
7. Arankalle VA et al. Genetic divergence of Chikungunya viruses in India (1963–2006) with special reference to the 2005–2006 explosive epidemics. J Gen Virol. 2007; 88: 1967–76.
8. Yergolkar PN et al. Chikungunya outbreaks caused by African genotype, India. Emerg Infect Dis. 2006; 12: 1580–3.
9. Lahariya C, Pradhan SK. Emergence of chikungunya virus in Indian subcontinent after 32 years: A review. J Vector Borne Dis. 2006; 43: 151–60.
10. Kumar NP, Joseph R, Kamaraj T, Jambulingam P A226V mutation in virus during the 2007 chikungunya outbreak in Kerala, India. J Gen Virol. 2008; 89: 1945–8.
11. Ravi V. Re-emergence of chikungunya virus in India. Indian J Med Microbiol. 2006; 24: 83-4.
12. National Institute of Communicable Disease, New Delhi. Chikungunya fever. Commun Dis Alert. 2006; 10: 6-8.
13. NVBDCP: Epidemiological profile of chikungunya fever in the country. (prov.). 2009 [http://nvbdcp.gov.in/Doc/chikun-update07.pdf]. New Delhi: National Vector Borne Disease Control Programme.
14. NVBDCP: Status report on Dengue and Chikungunya as on 31.12.09(Dengue and chikungunya update). 2010 [http://nvbdcp.gov.in/Doc/Den_Chik_Dec09.pdf]. New Delhi: National Vector Borne Disease Control Programme.
15. Moro ML et al. Chikungunya virus in North-Eastern Italy: A Seroprevalence study. Am J Trop Med Hyg. 2010;82:508-511.
16. Mavalankar D, Shastri P, Raman P. Chikungunya epidemic in India: a major public-health disaster. Lancet Infect Dis. 2007; 7: 306-7.
17. Suryawanshi et al. Clinical profile of chikungunya fever in patients in a tertiary care centre in Maharashtra, India. Indian J Med Res. 2009; 129:438-441.
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Copyright (c) 2016 Krunal D Mehta, Shruti Malik, K P Singh, T N Dhole
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