Journal Article

Atypical and severe manifestations of chikungunya virus infection in French Guiana: A hospital-based study

Bonifay, Timothee, Nacher, Mathieu, Epelboin, Loïc, Djossou, Félix, Kallel, Hatem, Demar, Magalie, Rousset, Dominique, Neyra, Clarisse, Prince, Christelle

2018

Overview

French Guiana (FG) was the first country in South America to declare chikungunya virus infection (CHIKV). The outbreak affected about 16,000 persons between February 2014 and October 2015, with several atypical cases, but only two fatal cases. We aimed to describe the clinical presentation of patients hospitalized for CHIKV infection, to estimate and identify risk factors of unusual and severe forms in adult patients. A monocentric retrospective study was conducted in Cayenne hospital, the main city and the main hospital in FG, from March 1st 2014 to August 31st 2015. All patients admitted for at least one night with a biological diagnosis of CHIKV infection during the 2014/2015 outbreak were included, except pregnant women and children under 15 years. During the study period, 285 patients with a diagnosis of CHIKV infection were hospitalized in Cayenne hospital, among whom 96 nonpregnant adults were studied. Five were classified as severe forms (5.2%) and 23 as unusual forms (23.9%). The most frequent atypical and/or severe form was neurological (n = 20), followed by cardio-respiratory failure (acute respiratory failure n = 4, acute heart failure n = 2), digestive and hepatic disorders (acute hepatitis n = 3, acute pancreatitis n = 2), renal disorders (acute renal failure n = 5) and muscular impairment (rhabdomyolysis n = 3). During the outbreak, hospitalizations were frequent, particularly for common forms, driven by algic clinical presentations and concerns due to the novelty of this infection. Despite atypical neurological and liver forms of CHIKV infection, case-fatality was low in French Guiana. No specific risk factor of atypical and/or severe forms was found in our study.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Acute kidney failure / Adolescent / Adult / Adult respiratory distress syndrome / Adults / Aged / Biology and life sciences / Chikungunya fever / Chikungunya Fever - epidemiology / Chikungunya virus / Chikungunya virus - pathogenicity / Children / Chronic illnesses / Control / Dengue fever / Diagnosis / Disease Outbreaks / Disorders / Emerging diseases / Encephalitis / Epidemics / Female / French Guiana / French Guiana - epidemiology / Guillain-Barre syndrome / Heart / Heart diseases / Heart failure / Hepatitis / Hospitals / Human health and pathology / Humans / Infections / Infectious diseases / Kidney failure / Life Sciences / Liver / Male / Medical research / Medicine and Health Sciences / Middle Aged / Outbreaks / Pancreatitis / Patients / Population / Pregnancy / Pregnant women / Renal failure / Respiratory failure / Respiratory insufficiency / Retrospective Studies / Rhabdomyolysis / Risk analysis / Risk Factors / Santé publique et épidémiologie / Signs and symptoms / South America / Systematic review / Vector-borne diseases / Viruses