Dataset CHIKV Jaen y2023m02 [50]

The Chikungunya virus: A reemerging cause of acute febrile illness in the high jungle of northern Peru ABSTRACT Background The Chikungunya virus (CHIKV) is an emerging arthropod-borne virus (arbovirus) that causes undifferentiated acute febrile illness. Cases of CHIKV may be under reported in Peru, given the variety of difficulties for its diagnosis, such as lack of diagnostic tests in remote areas, passive characteristics of the epidemiological surveillance and co-circulation of other arthropod-borne pathogens. Therefore, we performed a study in the high jungle of northern Peru to identify the prevalence of CHIKV in febrile patients and describe their clinical characteristics Methods A cross sectional study was conducted in the province of Jaen, Cajamarca, located in the high jungle of northern Peru. Patients attending primary care health centers within Cajamarca’s Regional Health Direction were enrolled. This study was carried out as an aid for the national syndromic surveillance system for the diagnosis of arbovirosis in febrile patients, during the period between June 2020 through June 2021. Patients were included if they attended outpatient healthcare centers with a clinical diagnosis of acute febrile illness (AFI). Serum sample collection was performed on all patients and the diagnosis of CHIKV was performed using real-time RT-PCR and detection of IgM antibodies by ELISA assay. Results A total of 1047 patients with AFI were enrolled between June 2020 and June 2021. Identification of CHIKV was carried out in 130 patients/1047 (12.4%), of which 84/130 (64.6%) were diagnosed by RT-PCR, 42/130 (32.3%) by IgM ELISA detection and 4/130 (3.1%) by both assays. The majority of the patients with CHIKV infection corresponded to the 18-39 years old (46.9%), followed by the 40-59 years old (23.9%) and those with 60 years or older (12.3%). Also a greater proportion of female patients was identified (53.1%). The most common clinical symptoms in the whole study population were headache (85.6%), myalgias (71.3%) and arthralgias (64.9%). In the case of patients with CHIKV the most common symptoms were headache (84.6%), myalgias (72.3%) and arthralgias (65.0%). The majority of positive cases for CHIKV occurred during the months of May (23.1%), March (20.0%) and February (13.8%) of 2021. Conclusion In conclusion, we report a considerable frequency of CHIKV infections in patients with AFI from the high jungle in northern Peru. These findings should raise awareness that CHIKV is a pathogen with continuous transmission in different regions of Peru. Epidemiological surveillance should be strengthen with reliable diagnostic techniques, given that clinical symptoms may be nonspecific.基孔肯雅病毒：秘鲁北部高地丛林再现引发急性发热性疾病的病原体 摘要 背景：基孔肯雅病毒（Chikungunya virus, CHIKV）是一种新发虫媒病毒（arthropod-borne virus, arbovirus），可引起未分型急性发热性疾病。受限于诊断层面的多重阻碍——包括偏远地区缺乏诊断试剂、流行病学监测具有被动性以及其他虫媒病原体共同循环——秘鲁境内CHIKV感染病例或存在漏报情况。为此，本研究于秘鲁北部高地丛林地区开展，旨在明确发热患者中CHIKV的流行率，并描述其临床特征。 方法：本研究为横断面研究，实施于2020年6月至2021年6月期间，地点位于秘鲁北部高地丛林的卡哈马卡大区哈恩省。研究纳入了卡哈马卡大区区域卫生管理局所辖基层医疗中心的就诊患者，作为国家症状监测系统辅助诊断发热患者虫媒病毒感染的工作内容之一。纳入标准为因急性发热性疾病（acute febrile illness, AFI）临床诊断前往门诊医疗中心就诊的患者。研究采集所有受试者的血清样本，通过实时逆转录聚合酶链式反应（real-time RT-PCR）与酶联免疫吸附试验（ELISA）检测IgM抗体，以完成CHIKV感染诊断。 结果：本研究共纳入2020年6月至2021年6月期间的1047例急性发热性疾病患者。其中130例（12.4%，130/1047）检出CHIKV感染，具体而言，84例（64.6%，84/130）经RT-PCR确诊，42例（32.3%，42/130）经IgM ELISA检测确诊，另有4例（3.1%，4/130）两种检测方法均呈阳性。CHIKV感染患者中，18~39岁年龄段占比最高（46.9%），其次为40~59岁年龄段（23.9%），60岁及以上人群占比12.3%；女性患者占比更高，达53.1%。全研究人群中最常见的临床症状为头痛（85.6%）、肌痛（71.3%）与关节痛（64.9%）；而CHIKV感染患者中最常见症状依次为头痛（84.6%）、肌痛（72.3%）及关节痛（65.0%）。CHIKV阳性病例多数集中在2021年5月（23.1%）、3月（20.0%）及2月（13.8%）。 结论：综上，本研究报道了秘鲁北部高地丛林地区急性发热性疾病患者中CHIKV感染的较高检出率。上述结果提示，CHIKV在秘鲁不同地区存在持续传播，应引起相关重视。由于本病临床症状缺乏特异性，需采用可靠的诊断技术强化流行病学监测工作。