title: Chikungunya from the Caribbean: the importance of appropriate laboratory tests to confirm the diagnosis.
abstract: Chikungunya virus (CHIKV) appeared for the first time in the Western Hemisphere--the French West Indies--in December of 2013. From there, the virus has spread to other Caribbean islands. Following the diagnosis of first autochthonous CHIKV cases in the Caribbean island of Saint Martin, a large outbreak is ongoing in the Americas. As of September 12, 2014, a total of 706,093 suspected and 9803 confirmed CHIKV cases have been reported in the Americas. This case study highlights the possibility of false-negative immunochromatographic CHIKV immunoglobulin M (IgM) tests and the need of confirmatory tests for suspected cases. Moreover, a greater spread of virus together with the presence of a mosquito vector (Aedes albopictus) enhances the risk of autochthonous transmission in Europe.
authors.affiliation: 1 Department of Infectious, Parasitic and Immune-Mediate Diseases, Istituto Superiore di Sanità , Rome, Italy .
authors.forename: Fabio
authors.initials: F
authors.lastname: Magurano
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Zammarchi
authors.forename: Melissa
authors.initials: M
authors.lastname: Baggieri
authors.forename: Claudia
authors.initials: C
authors.lastname: Fortuna
authors.forename: Alberto
authors.initials: A
authors.lastname: Farese
authors.forename: Eleonora
authors.initials: E
authors.lastname: Benedetti
authors.forename: Cristiano
authors.initials: C
authors.lastname: Fiorentini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Rezza
authors.forename: Loredana
authors.initials: L
authors.lastname: Nicoletti
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bartoloni
mesh_terms: D000330:Aedes / Q000821:virology*; D000818:Animals; D000914:Antibodies, Viral / Q000276:immunology*; D017691:Caribbean Region; D065632:Chikungunya Fever / Q000175:diagnosis* / Q000821:virology; D002646:Chikungunya virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D005188:False Negative Reactions; D005260:Female; D005838:Genotype; D006801:Humans; D007075:Immunoglobulin M / Q000276:immunology; D007303:Insect Vectors / Q000821:virology*; D008875:Middle Aged
chemical_list: D000914:Antibodies, Viral; D007075:Immunoglobulin M
keywords: Chikungunya; Dominican Republic; Immunochromatographic IgM test; Italy; Rapid diagnostic test