title: [An imported Chikungunya fever case from New Delhi, India to Ankara, Turkey: the first imported case of Turkey and review of the literature].
abstract: Chikungunya virus (CHIKV) is an arthropod-borne alphavirus that causes an acute febrile illness, chikungunya fever. CHIKV virus is geographically distributed in Africa, India, and South-East Asia. Chikungunya fever outbreaks have been reported from India since 2006. The incubation period is 3-7 days, and the disease is characterized by sudden onset of high fever and severe arthralgia. Other symptoms can be rash, headache, fatigue, nausea-vomiting, and myalgias. Here, we report the first Chikungunya case imported from India, New-Delhi to Ankara, Turkey. In December 2010, a 55-year-old female Turkish government employee living in urban area of New Delhi for the last 3 years had sudden onset fever up to 38.4°C for 2 days. Itching rash and arthralgia also developed. Symptomatic treatment was given to patient in New Delhi. She returned to Turkey and was admitted to Hacettepe University Medical Faculty, Department of Internal Medicine, Infectious Diseases Unit, since arthralgia has continued on the 26th day of her complaints. Hepatomegaly and tenosynovitis were detected in her physical examination. Serum sample sent to Refik Saydam National Public Health Agency, Virology Reference and Research Laboratory, yielded negative results for specific IgM and IgG antibodies against Hantavirus and Dengue virus types 1-4; however, the results were positive for CHIKV specific IgM and IgG antibodies by commercial immunofluorescence method (Euroimmun, Germany). CHIKV RNA which was searched by in-house real-time RT-PCR was negative. The second serum sample obtained three weeks later also found positive for CHIKV specific IgM and IgG antibodies. This was the first laboratory confirmed imported Chikungunya case in Turkey. There are predictions regarding the presence of Aedes species mosquitos that can transmit this virus in Turkey. This case report will be an alarming signal for the clinicians in our country to consider Chikungunya fever in the differential diagnosis of patients presenting with fever, arthralgia and rash.
authors.affiliation: Refik Saydam National Public Health Agency, Virology Reference and Research Laboratory, Ankara, Turkey. dilekyagci@gmail.com
authors.forename: Dilek
authors.initials: D
authors.lastname: Yağcı Çağlayık
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Uyar
authors.forename: Gülay
authors.initials: G
authors.lastname: Korukluoğlu
authors.forename: Mustafa
authors.initials: M
authors.lastname: Ertek
authors.forename: Serhat
authors.initials: S
authors.lastname: Unal
mesh_terms: D018354:Alphavirus Infections / Q000175:diagnosis*; D000914:Antibodies, Viral / Q000097:blood; D018771:Arthralgia; D065632:Chikungunya Fever; D002646:Chikungunya virus / Q000276:immunology; D003937:Diagnosis, Differential; D005076:Exanthema; D005260:Female; D005334:Fever; D006801:Humans; D007194:India; D008875:Middle Aged; D014195:Travel; D014421:Turkey
chemical_list: D000914:Antibodies, Viral