Arboviruses (chikungunya, dengue, and Zika) associated with ophthalmic changes: a focus on aqueous fluid and vitreous humor.

The aim of this study was to conduct a bibliographic survey and correlates the presence of arboviroses in the eyeball with the main eye changes presented by the population under study. This study is a systematic review of journals and indexed articles, carried out between January 2019 and June 2019, in which there was a query in the Pubmed/Medline and Scielo databases without temporal restriction. In addition to the aforementioned databases, the Brazilian Association of Organ Transplantation Association database, which provides epidemiological data on organ and tissue transplants in Brazil, was used as a research source. The Midwest region contributed to the increase in the number of organ transplants in Brazil. The number of corneal transplants in Brazil surpassed the number of organ transplants by four times. Several ophthalmic changes associated with Chikungunya, Dengue, and Zika virus infections have been diagnosed; however, few studies have identified the presence of the virus in the eyeball. Arboviruses are of great relevance to public health due to a number of factors, ranging from the diversity of infectious agents involved and the plurality of clinical manifestations because the absence of efficient laboratory support, leading to delayed disease confirmation due to lack of differential diagnostics available. Added to these difficulties is the lack of specific therapy, leaving only the symptomatic control of clinical manifestations as the only treatment option. However, the manifestations are directly associated with the decreased quality of vision and consequently the quality of life of patients.

How Chikungunya Virus Virology Affects Its Epidemiology and Transmission: Implications for Influencing Public Health.

Chikungunya virus has been causing a series of ongoing epidemics around the globe for the past 12 years. During that time, estimates indicate that >4 million cases occurred worldwide. Despite the magnitude of these outbreaks and the broad interest in understanding the virus and disease, significant gaps still exist in our knowledge base. An in-depth understanding of the basic virological elements that can affect the epidemiology of the agent is critical for future development of control and treatment products. This work describes how knowledge of various viral genetic and structural elements has begun to advance the development of vaccines and therapeutics and suggests that further knowledge is needed to provide additional options.

Chikungunya: a re-emerging virus.

In the past decade, chikungunya--a virus transmitted by Aedes spp mosquitoes--has re-emerged in Africa, southern and southeastern Asia, and the Indian Ocean Islands as the cause of large outbreaks of human disease. The disease is characterised by fever, headache, myalgia, rash, and both acute and persistent arthralgia. The disease can cause severe morbidity and, since 2005, fatality. The virus is endemic to tropical regions, but the spread of Aedes albopictus into Europe and the Americas coupled with high viraemia in infected travellers returning from endemic areas increases the risk that this virus could establish itself in new endemic regions. This Seminar focuses on the re-emergence of this disease, the clinical manifestations, pathogenesis of virus-induced arthralgia, diagnostic techniques, and various treatment modalities.

Dengue and Chikungunya Infections in Children : Guest Editor: Bhim S. Pandhi.

Dengue and Chikungunya are two important mosquito-borne acute febrile illnesses in children. With increased urbanization and newer strains of chikungunya virus with improved transmission with Aedes albopictus, the at-risk population for these infections has greatly increased. Dengue fever has been classified by WHO as dengue with/ without warning signs and severe dengue. Severe dengue is associated with hemorrhagic manifestations, hypovolemia and hypotension secondary to third space loss due to capillary leak or severe end organ dysfunction. NS1 antigen detection and dengue polymerase chain reaction, [polymerase chain reaction (PCR during first 5 d)] and IgM for dengue (6th day of fever onwards) are commonly utilized diagnostic tests. Appropriate fluid therapy with timely tapering of intravenous fluid rate with hematocrit, treatment of hemorrhagic manifestations and clinical monitoring are the mainstay of dengue treatment. Chikungunya has less severe course with shorter febrile phase with prominent and persistent joint symptoms. PCR and IgM against chikungunya are appropriate investigations. Treatment is supportive for chikungunya infection with appropriate joint pain relief.

An Assessment of Household and Individual-Level Mosquito Prevention Methods during the Chikungunya Virus Outbreak in the United States Virgin Islands, 2014-2015.

Recent large-scale chikungunya virus (CHIKV) and Zika virus epidemics in the Americas pose a growing public health threat. Given that mosquito bite prevention and vector control are the main prevention methods available to reduce transmission of these viruses, we assessed adherence to these methods in the United States Virgin Islands (USVI). We interviewed 334 USVI residents between December 2014 and February 2015 to measure differences in mosquito prevention practices by gender, income, presence of CHIKV symptoms, and age. Only 27% (91/334) of participants reported having an air conditioner, and of the 91 with air-conditioners, 18 (20%) reported never using it. Annual household income > $50,000 was associated with owning and using an air conditioner (41%; 95% confidence interval [CI]: 28-53% compared with annual household income ≤ $50,000: 17%; 95% CI: 12-22%). The majority of participants reported the presence of vegetation in their yard or near their home (79%; 265) and a cistern on their property (78%; 259). Only 52 (16%) participants reported wearing mosquito repellent more than once per week. Although the majority (80%; 268) of participants reported having screens on all of their windows and doors, most (82%; 273) of those interviewed still reported seeing mosquitoes in their homes. Given the uniformly low adherence to individual- and household-level mosquito bite prevention measures in the USVI, these findings emphasize the need for improved public health messaging and investment in therapeutic and vaccine research to mitigate vector-borne disease outbreaks.

Regulatory considerations in development of vaccines to prevent disease caused by Chikungunya virus.

Chikungunya virus (CHIKV) is a mosquito-transmitted alphavirus. Chikungunya disease (CHIK) in humans is characterized by sudden onset of high fever, cutaneous rash, myalgia and debilitating polyarthralgia. Until recently the virus was considered endemic to only Africa and Asia, but since 2004 CHIK has spread to previously non-endemic regions, including Europe and the Americas, thereby emerging as a global health threat. Although a variety of CHIKV vaccine candidates have been tested in animals, and a few have advanced to human clinical trials, no licensed vaccine is currently available for prevention of disease. In this article, we review recent efforts in CHIKV vaccine development and discuss regulatory considerations for CHIKV vaccine licensure under U.S. FDA regulations. Several licensure pathways are available, and the most appropriate licensure pathway for a CHIK vaccine will depend on the type of evidence that can be generated to demonstrate the vaccine's effectiveness. If "traditional approval" following demonstration of direct benefit in adequate and well-controlled clinical disease endpoint studies is not possible, the Accelerated Approval and Animal Rule pathways are potential alternatives. In terms of vaccine safety, the potential for vaccine associated arthralgia and antibody-dependent enhancement of infectivity and disease severity are important issues that should be addressed in both pre-clinical and clinical studies. CHIK vaccine developers are encouraged to communicate with the FDA during all stages of vaccine development.

[The chikungunya epidemic in the Caribbean: implications for travellers and physicians]. / De chikungunya-epidemie in de Cariben: implicaties voor reiziger en arts.

In 2013, the first autochthonous cases of the chikungunya virus (CHIKV) were reported on the Caribbean island of Saint Martin. The chikungunya virus has since become endemic in the Caribbean due to autochthonous transmission. In the presence of fever and joint symptoms in any traveller returning from the Caribbean, CHIKV should be considered. Although symptoms resemble those of dengue fever, the course of chikungunya is milder. Chikungunya much more commonly causes chronic joint pain. Laboratory tests for the chikungunya virus may give false positive results due to cross reactions with closely related viruses, so taking a full disease and travel history from the patient is necessary in order to interpret these test results correctly. There is no specific treatment for the chikungunya virus. A correct diagnosis can prevent unnecessary additional tests and unjustified treatment. The chikungunya virus can be prevented by the use of insect-repelling substances, nets and air-conditioning.

Descrição do surto de chikungunya ocorrido em Santiago, Rio Grande do Sul, maio de 2018 / Description of the chikungunya outbreak in Santiago, Rio Grande do Sul, may 2018

Trata-se de um estudo descritivo do surto de Chikungunya ocorrido em Santiago/RS em maio de 2018. (AU)

Estudio Transversal: Conocimientos, Actitudes y Prácticas sobre el Chikungunya en la Población de la Parroquia Bartolomé Ruiz del Cantón Esmeraldas ­ Ecuador, 2015 / Cross-Sectional Research: Knowledge, Attitudes and Practices on the Chikungunya in the Population of the Parish Bartolome Ruiz of the Canton Esmeraldas ­ Ecuador, 2015

INTRODUCCIÓN: En el año 2016 se reportaron 34261 casos de Chikungunya en Ecuador, La provincia de Esmeraldas ocupó el primer lugar con la mayor cantidad de casos. La enfermedad superó la capacidad de respuesta de los servicios sanitarios de esta provincia. Las condiciones socio-económicas y culturales de su población, así como su geografía están relacionadas con la aparición de esta enfermedad endémica, casos originarios y diseminación de la enfermedad. El objetivo del estudio fue determinar los conocimientos, actitudes y prácticas sobre el Chikungunya en los habitantes de la Parroquia Bartolomé Ruiz del Cantón Esmeraldas. MÉTODO: Se trató es un estudio descriptivo transversal de los conocimientos, actitudes y prácticas sobre Chikungunya en los habitantes de la Parroquia Bartolomé Ruiz Del Cantón Esmeraldas - Ecuador. Universo: 2679 habitantes. Muestra: 396 habitantes. Se aplicó un formulario de conocimientos, actitudes y prácticas. El puntaje obtenido se categorizó en: bueno, regular, malo. El análisis de la información se realizó en SPSS versión 20.0. RESULTADOS: La media de edad fue 39.46 años. El 31.3 % poseían buenos conocimientos, buenas actitudes 31.3 % y buenas practicas 8.8 %. CONCLUSIONES: Se encontró un déficit en el nivel de conocimientos, buenas actitudes y buenas prácticas como medidas de prevención frente a la fiebre del Chikungunya. La presencia de factores ambientales de riesgo, así como la poca práctica de conductas protectoras predispuso a la gran incidencia de la enfermedad. La principal recomendación para disminuir la incidencia del Chikungunya es la adopción de medidas preventivas, las cuales dependen de factores socioculturales y cognitivos.

BACKGROUND: In 2016, 34261 cases of Chikungunya were reported in Ecuador. The province of Esmeraldas occupies the first place with more cases. The disease exceeded the capacity of health services in this province. The socio-economic and cultural conditions of its population, as well as its geography, are related to the appearance ofthis endemic disease, original cases and dissemination of the disease. The aim of this study was to determine the knowledge, attitudes and practices about the Chikungunya in the inhabitants ofthe Parish Bartolome Ruiz ofthe Esmeraldas Canton. METHODS: A cross-sectional research descriptive study of the knowledge, attitudes and practices on Chikungunya in the inhabitants ofthe ParishBartolome Ruiz ofthe Canton Esmeraldas - Ecuador. Universe: 2679 inhabitants. Sample: 396 inhabitants. Knowledge, attitudes and practices form was applied. And the obtained score was categorized in: good,regular, bad. The analysis of the information was done in SPSS version 20.0. RESULTS: The mean age was 39.46 years. 31.3% had good knowledge, good attitudes 31.3 % and good practices 8.8%. CONCLUSIONS: There was a shortfall in the level of knowledge, good attitudes and good practices as prevention measures against Chikungunya fever. The presence of environmental risk factors, as well as the little practice of protective behaviors predisposed the high incidence of the disease. The main recommendation to reduce the incidence of Chikungunya is the adoption of preventivemeasures, which depend on socio-cultural and cognitive factors.