Chikungunya virus infection of corneal grafts.
BACKGROUND
Chikungunya virus (CHIKV) is an arbovirus with a high potential to spread globally. We investigated whether CHIKV is transmittable via corneal grafts.


METHODS
Serum specimens from 69 potential corneal donors living in La Réunion during the 2005–2006 outbreak of CHIKV infection were screened for anti-CHIKV antibodies. Serum specimens and corneoscleral rims were subjected to quantitative reverse-transcription real-time polymerase chain reaction (qRT-PCR) for detection of CHIKV. CHIKV isolation and immunolabeling were performed on eye tissue specimens. Viral transmission via the ocular route was assessed in an animal model of human CHIKV infection.


RESULTS
Twelve apparently uninfected donors were viremic and/or positive for immunoglobulin M (IgM) and/or immunoglobulin G. Eye tissue specimens from 12 donors who were or were not viremic and were or were not seropositive were investigated. qRT-PCR detected CHIKV RNA in corneoscleral rims from 4 patients: 1 patient was viremic, 2 were viremic and IgM positive, and 1 was IgM positive. Infectious CHIKV was isolated from all qRT-PCR–positive samples, and antigens were detected in corneal and scleral specimens, the iris, the ciliary body, and oculomotor muscles.


CONCLUSIONS
One-third of eligible corneas (4 of 12) from donors apparently uninfected with CHIKV were infected with CHIKV during the study period. CHIKV infects the human cornea and can be transmitted via the ocular route. In the absence of systematic CHIKV screening in donors, cornea donation should be banned in areas where CHIKV circulates.
Microbes and Host Barriers Group, Paris, France.
Thérèse
T
Couderc
Nicolas
N
Gangneux
Fabrice
F
Chrétien
Valérie
V
Caro
Tan
T
Le Luong
Bernadette
B
Ducloux
Hugues
H
Tolou
Marc
M
Lecuit
Marc
M
Grandadam
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018354:Alphavirus Infections / Q000453:epidemiology / Q000635:transmission / Q000821:virology*; D000818:Animals; D000914:Antibodies, Viral / Q000097:blood; D002646:Chikungunya virus / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D003315:Cornea / Q000821:virology*; D016039:Corneal Transplantation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D007370:Interferon Type I / Q000235:genetics; D008297:Male; D051379:Mice; D008810:Mice, Inbred C57BL; D018345:Mice, Knockout; D008875:Middle Aged; D017508:Reunion / Q000453:epidemiology; D014766:Viremia; D055815:Young Adult
D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D007370:Interferon Type I