title: Arthritogenic alphaviruses--an overview.
abstract: Mosquito-transmitted alphaviruses causing human rheumatic disease are globally                 distributed and include chikungunya virus, Ross River virus, Barmah Forest virus,                 Sindbis virus, o'nyong-nyong virus and Mayaro virus. These viruses cause endemic                 disease and, occasionally, large epidemics; for instance, the 2004-2011                 chikungunya epidemic resulted in 1.4-6.5 million cases, with imported                 cases reported in nearly 40 countries. The disease is usually self-limiting and                 characterized by acute and chronic symmetrical peripheral                 polyarthralgia-polyarthritis, with acute disease usually including fever,                 myalgia and/or rash. Arthropathy can be debilitating, usually lasts weeks to months                 and can be protracted; although adequate attention to differential diagnoses is                 recommended. The latest chikungunya virus epidemic was also associated with some                 severe disease manifestations and mortality, primarily in elderly patients with                 comorbidities and the young. Chronic alphaviral rheumatic disease probably arises                 from inflammatory responses stimulated by the virus persisting in joint tissues,                 despite robust antiviral immune responses. Serodiagnosis by ELISA is the standard;                 although international standardization is often lacking. Treatment usually involves                 simple analgesics and/or NSAIDs, which can provide relief, but better drug                 treatments are clearly needed. However, the small market size and/or the                 unpredictable and rapid nature of epidemics present major hurdles for development                 and deployment of new alphavirus-specific interventions.
authors.affiliation: Immunovirology Laboratory, Queensland Institute of Medical Research, 300 Herston Road, Brisbane, Queensland 4006, Australia. andreasS@qimr.edu.au
authors.forename: Andreas
authors.initials: A
authors.lastname: Suhrbier
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Jaffar-Bandjee
authors.forename: Philippe
authors.initials: P
authors.lastname: Gasque
mesh_terms: D000208:Acute Disease; D000524:Alphavirus / Q000276:immunology / Q000472:pathogenicity*; D018354:Alphavirus Infections / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D000818:Animals; D001170:Arthritis, Infectious / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy / Q000821:virology*; D065632:Chikungunya Fever; D002908:Chronic Disease; D019353:Endemic Diseases; D014943:Global Health; D006801:Humans; D015994:Incidence; D007303:Insect Vectors; D009032:Mosquito Control; D012698:Serologic Tests; D014765:Viral Vaccines
chemical_list: D014765:Viral Vaccines