title: Chikungunya Fever in Japan Imported from the Caribbean Islands.
abstract: A 53-year-old Japanese woman who was working as a volunteer in the Commonwealth of Dominica in the Caribbean islands presented with a high-grade fever and severe incapacitating generalized arthralgia. The Asian genotype of the chikungunya virus was confirmed using reverse transcription-PCR and serology, based on the presence of a specific neutralization titer and immunoglobulin M antibodies. She was diagnosed with post-chikungunya chronic arthritis based on persistence of her polyarthritis for 3 months and the presence of rheumatoid factor, immunoglobulin G-rheumatoid factor, and matrix metalloproteinase-3. Chikungunya virus should be considered as a causative pathogen in travelers returning from Caribbean islands. Clinicians should consider chikungunya fever in the differential diagnosis of patients who complain of chronic arthritis and have a history of travel to an endemic area.
authors.affiliation: Division of Infectious Diseases and Pulmonary Medicine, National Defense Medical College.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Imai
authors.forename: Eri
authors.initials: E
authors.lastname: Nakayama
authors.forename: Takuya
authors.initials: T
authors.lastname: Maeda
authors.forename: Kei
authors.initials: K
authors.lastname: Mikita
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Aoi
authors.initials: A
authors.lastname: Mitarai
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Honma
authors.forename: Satoru
authors.initials: S
authors.lastname: Miyake
authors.forename: Koki
authors.initials: K
authors.lastname: Kaku
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Miyahira
authors.forename: Akihiko
authors.initials: A
authors.lastname: Kawana
mesh_terms: D000818:Animals; D057134:Antibodies, Neutralizing / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood; D065632:Chikungunya Fever / Q000175:diagnosis* / Q000473:pathology*; D019424:Dominica; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D007564:Japan; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012698:Serologic Tests; D014195:Travel
chemical_list: D057134:Antibodies, Neutralizing; D000914:Antibodies, Viral; D007075:Immunoglobulin M