title: Acute Chikungunya and persistent musculoskeletal pain following the 2006 Indian epidemic: a 2-year prospective rural community study.
abstract: Chikungunya virus (CHIKV) data from population studies are sparse. During the 2006 epidemic, 509 clinical cases (43% attack rate) were identified in a village survey (West India); laboratory investigations demonstrated normal blood cell counts, elevated acute-phase reactants [erythrocyte sedimentation rate, C-reactive protein and interleukin-6 (IL-6)] and excluded malaria and dengue. Acute CHIKV was characterized by high fever, severe peripheral polyarthralgias, axial myalgias and intense fatigue in over 90% of cases; skin rash (34%) and headache (19%) were uncommon. There were 49% and 62% of survey cases seropositive for IgM (rapid assay) and IgG (immunofluorescence) anti-CHIKV antibodies, respectively. Sixty-five percent of cases recovered within 4 weeks. None of the cases died. Of the population, 4·1% and 1·6% suffered from persistent rheumatic pains, predominantly non-specific, at 1 and 2 years, respectively. Chronic inflammatory arthritis was uncommon (0·3% at 1 year) although serum IL-6 often remained elevated in chronic cases. A larger population study is required to describe post-CHIKV rheumatism and its prognosis.
authors.affiliation: Centre for Rheumatic Diseases, Pune, Maharashtra, India. arvindchopra60@hotmail.com
authors.forename: A
authors.initials: A
authors.lastname: Chopra
authors.forename: V
authors.initials: V
authors.lastname: Anuradha
authors.forename: R
authors.initials: R
authors.lastname: Ghorpade
authors.forename: M
authors.initials: M
authors.lastname: Saluja
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018354:Alphavirus Infections / Q000150:complications* / Q000453:epidemiology* / Q000821:virology; D000914:Antibodies, Viral / Q000097:blood; D065632:Chikungunya Fever; D002646:Chikungunya virus / Q000472:pathogenicity*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000453:epidemiology* / Q000209:etiology*; D011446:Prospective Studies; D012424:Rural Population; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D015850:Interleukin-6