title: Post-epidemic Chikungunya disease on Reunion Island: course of rheumatic manifestations and associated factors over a 15-month period.
abstract: Although the acute manifestations of Chikungunya virus (CHIKV) illness are well-documented, few data exist about the long-term rheumatic outcomes of CHIKV-infected patients. We undertook between June and September 2006 a retrospective cohort study aimed at assessing the course of late rheumatic manifestations and investigating potential risk factors associated with the persistence of these rheumatic manifestations over 15 months. 147 participants (>16 yrs) with laboratory-confirmed CHIKV disease diagnosed between March 1 and June 30, 2005, were identified through a surveillance database and interviewed by telephone. At the 15-month-period evaluation after diagnosis, 84 of 147 participants (57%) self-reported rheumatic symptoms. Of these 84 patients, 53 (63%) reported permanent trouble while 31 (37%) had recurrent symptoms. Age > or=45 years (OR = 3.9, 95% CI 1.7-9.7), severe initial joint pain (OR = 4.8, 95% CI 1.9-12.1), and presence of underlying osteoarthritis comorbidity (OR = 2.9, 95% CI 1.1-7.4) were predictors of nonrecovery. Our findings suggest that long-term CHIKV rheumatic manifestations seem to be a frequent underlying post-epidemic condition. Three independent risk factors that may aid in early recognition of patients with the highest risk of presenting prolonged CHIKV illness were identified. Such findings may be particularly useful in the development of future prevention and care strategies for this emerging virus infection.
authors.affiliation: Institut de Veille Sanitaire, Cellule Interrégionale d'Epidémiologie Réunion Mayotte, Direction Régionale des Affaires Sanitaires et Sociales, Saint Denis, La Réunion, France. Daouda.sissoko@sante.gouv.fr
authors.forename: Daouda
authors.initials: D
authors.lastname: Sissoko
authors.forename: Denis
authors.initials: D
authors.lastname: Malvy
authors.forename: Khaled
authors.initials: K
authors.lastname: Ezzedine
authors.forename: Philippe
authors.initials: P
authors.lastname: Renault
authors.forename: Frederic
authors.initials: F
authors.lastname: Moscetti
authors.forename: Martine
authors.initials: M
authors.lastname: Ledrans
authors.forename: Vincent
authors.initials: V
authors.lastname: Pierre
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018354:Alphavirus Infections / Q000150:complications / Q000453:epidemiology*; D002646:Chikungunya virus; D015331:Cohort Studies; D015897:Comorbidity; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000453:epidemiology; D012008:Recurrence; D012189:Retrospective Studies; D017508:Reunion / Q000453:epidemiology; D012213:Rheumatic Fever / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D012307:Risk Factors