Seroprevalence of chikungunya virus infection in five hospitals within Anyigba, Kogi State of Nigeria

ABSTRACT Febrile illnesses in developing countries are often misdiagnosed as malaria or typhoid fever. Although arboviral infections have similar clinical symptoms, they are usually not screened because of limited resources and the fact that there are several viruses in this group. Chikungunya virus (CHIKV) has been isolated in parts of Nigeria, but there is no documented evidence of the infection in Kogi State. This study determined seroprevalence of active and past CHIKV infection among febrile patients who tested negative for malaria and typhoid fever. Sera from 243 febrile patients were screened for CHIKV IgG and IgM using an immunochromatographic test kit. Clinical and socio-demographic variables were collected using a structured questionnaire. Recent CHIKV infection was observed in 5.8% of the study participants while 25.1% had IgG antibodies demonstrating previous infection. Significant associations were observed between seropositivity and age of participants (p < 0.001), sex (p = 0.044), marital status (p = 0.002), and occupation (p < 0.001). Clinical symptoms such as fever, joint pain, and headache were significantly associated with seropositivity. This study identified recent CHIKV infection in Anyigba. Therefore, there is need for routine screening of febrile patients and molecular characterization to determine the nature of circulating strains.

Chikungunya in a kidney transplant recipient: a case report / Chikungunya em um receptor de transplante renal: relato de caso

ABSTRACT In 2004, a global spread of Chikungunya fever affected most tropical and subtropical regions of the world. In 2016, an outbreak occurred in Northeast Brazil with hundreds of cases documented. Solid organ transplant recipients have a modified immune response to infection and the clinical course is usually different from immunocompetent patients. The diagnosis can be challenging in this population. Most reports describe patients residing in endemic areas, although we must emphasize the importance of differential diagnosis in kidney transplanted travelers who visit endemic regions, such as Northeast Brazil. Here, we reported a case of a kidney transplant recipient that acquired Chikungunya fever after a trip to an endemic region at Northeast Brazil during the outbreak in 2016, with a good clinical evolution. We also present warning recommendations for travelers to endemic areas as additional measures to prevent disease outbreaks.

RESUMO Em 2004, um surto global de Chikungunya afetou a maioria das regiões tropicais e subtropicais do mundo. Em 2016, um surto ocorreu no Nordeste do Brasil com centenas de casos documentados. Receptores de transplantes de órgãos sólidos têm uma resposta imune modificada à infecção, e o curso clínico é geralmente diferente daquele em pacientes imunocompetentes. O diagnóstico pode ser desafiador nessa população. A maioria dos relatos descreve pacientes residentes em áreas endêmicas, embora devamos enfatizar a importância do diagnóstico diferencial em viajantes transplantados renais que visitam regiões endêmicas, como o Nordeste do Brasil. Aqui, nós relatamos o caso de um receptor de transplante renal que adquiriu febre Chikungunya após uma viagem a uma região endêmica no Nordeste do Brasil durante o surto de 2016, com uma boa evolução clínica. Também apresentamos recomendações de alerta para viajantes em áreas endêmicas, como medidas adicionais para prevenir surtos de doenças.

Envelope specific T cell responses & cytokine profiles in chikungunya patients hospitalized with different clinical presentations.

Background & objectives: Since the 2006 massive outbreaks, chikungunya (CHIK) is a major public health concern in India. The aim of this study was to assess envelope specific immune responses in patients with chikungunya infection. Methods: This study included 46 hospitalized patients with chikungunya virus infection (encephalitis, n=22, other systemic involvement, OSI, n=12, classical, n=12) and six controls from Ahmedabad city, Gujarat, India. T cell responses and the levels of Th1, pro/ anti-inflammatory cytokines against the CHIK virus envelope antigens were assessed by lymphocyte proliferation assay and by cytometric bead array in flow cytometry, respectively. Results: Lymphoproliferative response was uniform among the patients. Comparisons of cytokines revealed significantly higher levels of interleukin (IL)-4 and IL-5 in encephalitis, OSI and classical patients versus controls. The levels of tumour necrosis factor (TNF)-α were higher in classical patients categories compared to the controls. Interferon (IFN)-γ levels were lower in encephalitis patients versus control. Interpretation & conclusions: Our findings showed recognition of T cell epitopes on the envelope region of chikungunya virus by all patient categories. Lower level of IFN-γ may be associated with the severity of disease in these patients.