Morbidity and impaired quality of life 30 months after chikungunya infection: comparative cohort of infected and uninfected French military policemen in Reunion Island.
We compared the morbidity and quality of life of military policemen ("gendarmes") infected with chikungunya virus (CHIKV+) 30 months after contamination. We categorized the subjects in 3 groups: healed patients (n = 48), non-healed patients (n = 37, 44% of CHIKV+), and uninfected subjects (CHIKV-, n = 297). Data were self-recorded in this retrospective cohort study; they included sociodemographic information, clinical symptoms, and the Medical Outcome Study 36-item short-form health survey (MOS-SF36) quality of life questionnaire. The study population was mostly men (92%), with a median age of 42.8 years, regardless of CHIKV status. The main complaints were rheumatic symptoms (pain, stiffness, and swelling), reported 5 times more often by non-healed CHIKV+ subjects and 2-3 times more often by healed CHIKV+ subjects than by CHIKV- subjects, and fatigue. The CHIKV+ patients reported more use of health care services. Thirty months after infection, all rheumatic symptoms were more frequent and intense among CHIKV+ than among CHIKV- subjects, with a gradient of severity between healed and non-healed CHIKV+ subjects. Non-healed CHIKV+ subjects reported subsequent limitation in their activities. All dimensions of MOS-SF36 as well as physical and mental component summaries were impaired in CHIKV+ compared to CHIKV- subjects, with a decreasing gradient of impairment from non-healed to healed CHIKV+ subjects, then to CHIKV- subjects. These observations confirm the long-term impact of CHIKV infection on both physical and mental health. Questions persist regarding the duration of this impairment and the possibility of a return to "before CHIKV" health status for infected patients.
From the Clinical Research Unit (CM), Department of Infectious Diseases and Tropical Medicine (EV, FS), and Department of Medical Biochemistry (MO), Laveran Military Teaching Hospital, Marseille; Center for Epidemiology and Public Health for the French Army (CM, J-PB), Marseille; and URMITE, Université de la Méditerranée (FS), Marseille, France.
Catherine
C
Marimoutou
Elodie
E
Vivier
Manuela
M
Oliver
Jean-Paul
JP
Boutin
Fabrice
F
Simon
D000328:Adult; D017677:Age Distribution; D018354:Alphavirus Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D002646:Chikungunya virus / Q000302:isolation & purification*; D015331:Cohort Studies; D004196:Disease Outbreaks; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D009017:Morbidity; D016495:Police; D011788:Quality of Life; D012016:Reference Values; D012189:Retrospective Studies; D017508:Reunion / Q000453:epidemiology; D012720:Severity of Illness Index; D017678:Sex Distribution; D018434:Sickness Impact Profile; D013997:Time Factors; D055815:Young Adult