Distinguishing patients with laboratory-confirmed chikungunya from dengue and other acute febrile illnesses, Puerto Rico, 2012–2015

Chikungunya, a mosquito-borne viral, acute febrile illness (AFI) is associated with polyarthralgia and polyarthritis. Differentiation from other AFI is difficult due to the non-specific presentation and limited availability of diagnostics. This 3-year study identified independent clinical predictors by day post-illness onset (DPO) at presentation and age-group that distinguish chikungunya cases from two groups: other AFI and dengue. Specimens collected from participants with fever ≤7 days were tested for chikungunya, dengue viruses 1–4, and 20 other pathogens. Of 8,996 participants, 18.2% had chikungunya, and 10.8% had dengue. Chikungunya cases were more likely than other groups to be older, report a chronic condition, and present基孔肯雅热（Chikungunya）是一种经蚊虫传播的病毒性急性发热性疾病（acute febrile illness, AFI），常伴多发性关节痛与多发性关节炎。由于临床表现缺乏特异性且诊断资源有限，其与其他急性发热性疾病的鉴别诊断颇具挑战。本项为期3年的研究，通过受试者就诊时的发病后天数（day post-illness onset, DPO）与年龄分组，筛选出可将基孔肯雅热病例与两类对照人群（其他急性发热性疾病患者及登革热患者）区分开的独立临床预测因子。研究人员对发热时长≤7天的受试者样本开展检测，检测靶点涵盖基孔肯雅热病毒、登革热病毒1-4型以及其余20种病原体。在总计8996名受试者中，18.2%确诊为基孔肯雅热，10.8%确诊为登革热。相较于其他两组人群，基孔肯雅热病例更易出现年龄偏大、伴有慢性疾病以及