title: Study of viremic profile in febrile specimens of chikungunya in Bandung, Indonesia.
abstract: BACKGROUND
  Data regarding the viremia profile of chikungunya virus (CHIKV) infected patients especially during the pre-febrile period is limited.
  
  
  OBJECTIVE
  To obtain virological kinetic data on CHIKV infections.
  
  
  METHODS
  A two-week community observation for dengue transmission was conducted in Bandung, Indonesia, from 2005 to 2009. Acute specimens from non-dengue febrile patients were screened by pan-alphavirus conventional RT-PCR. The positives were confirmed for CHIKV RNA by a specific RT-PCR followed by sequencing. Simultaneously these specimens were also cultured in Vero cells and tested for anti-CHIK IgM MAC-ELISA. All the available serial specimens,including the pre-febrile specimens, from confirmed CHIK cases, were tested by virus isolation, RT-PCR, qRT-PCR, and CHIK IgM ELISA.
  
  
  RESULTS
  There were five laboratory confirmed CHIK cases identified and studied. Among these, viremia was determined to extend from as early as 6 days prior to until 13 days post fever onset. Quantitative RT-PCR showed viremia peaked at or near onset of illness.
  
  
  CONCLUSIONS
  In this study, individuals were identified with viremia prior to fever onset and extending beyond the febrile phase. This extended viremic phase has the potential to impact transmission dynamics and thus the public health response to CHIK outbreaks.
authors.affiliation: Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia. Electronic address: silvita.fitri@gmail.com.
authors.forename: S F
authors.initials: SF
authors.lastname: Riswari
authors.affiliation: Eijkman Institute for Molecular Biology, Jakarta, Indonesia.
authors.forename: C N
authors.initials: CN
authors.lastname: Ma'roef
authors.affiliation: Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia.
authors.forename: H
authors.initials: H
authors.lastname: Djauhari
authors.affiliation: Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; Indonesia Research Partnership on Infectious Disease (INA-RESPOND), Jakarta, Indonesia.
authors.forename: H
authors.initials: H
authors.lastname: Kosasih
authors.affiliation: Eijkman Institute for Molecular Biology, Jakarta, Indonesia.
authors.forename: A
authors.initials: A
authors.lastname: Perkasa
authors.affiliation: Eijkman Institute for Molecular Biology, Jakarta, Indonesia.
authors.forename: F A
authors.initials: FA
authors.lastname: Yudhaputri
authors.affiliation: Eijkman Institute for Molecular Biology, Jakarta, Indonesia; Bogor Agricultural University, Bogor, Indonesia.
authors.forename: I M
authors.initials: IM
authors.lastname: Artika
authors.affiliation: Naval Medical Research Center, MD, USA.
authors.forename: M
authors.initials: M
authors.lastname: Williams
authors.affiliation: Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: van der Ven
authors.affiliation: Eijkman Institute for Molecular Biology, Jakarta, Indonesia.
authors.forename: K S
authors.initials: KS
authors.lastname: Myint
authors.affiliation: Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; Hasan Sadikin General Hospital, Bandung, Indonesia.
authors.forename: B
authors.initials: B
authors.lastname: Alisjahbana
authors.affiliation: Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, CO, USA.
authors.forename: J P
authors.initials: JP
authors.lastname: Ledermann
authors.affiliation: Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, CO, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Powers
authors.affiliation: Eijkman-Oxford Clinical Research Unit, Jakarta, Indonesia.
authors.forename: U A
authors.initials: UA
authors.lastname: Jaya
mesh_terms: D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D065632:Chikungunya Fever / Q000821:virology*; D002646:Chikungunya virus / Q000302:isolation & purification*; D002648:Child; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D007214:Indonesia; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D060888:Real-Time Polymerase Chain Reaction; D013997:Time Factors; D019562:Viral Load; D014766:Viremia / Q000175:diagnosis*
chemical_list: D000914:Antibodies, Viral; D007075:Immunoglobulin M; D012367:RNA, Viral
keywords: Chikungunya; Indonesia; Infection kinetics; Viremia profile