title: Two Japanese siblings affected with Chikungunya fever with different clinical courses: Imported infections from the Cook Islands.
abstract: Two Japanese siblings visited the Cook Islands on business and stayed for 2 months. The sister developed a high fever, arthralgia, erythema and leg edema on the day after returning to Japan. The brother also developed neck and joint pain on the day following the sister's onset. Subsequently, his erythematous lesions spread over his whole body. Chikungunya virus was detected from the sister's blood and urine by specific reverse transcription polymerase chain reaction, but not in the brother's samples. Retrospectively, his history of Chikungunya fever was confirmed by the presence of the anti-Chikungunya virus immunoglobulin (Ig)M and IgG antibodies using the specific enzyme-linked immunoassay. In Japan, no autochthonous case of Chikungunya fever was reported previously. We should give attention to the imported infectious diseases for epidemic prevention. This report warns about the danger of the imported infectious diseases, and also suggests that covering the topic of infectious disease in the world is critical to doctors as well as travelers.
authors.affiliation: Department of Dermatology, Mie University Graduate School of Medicine, Mie, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Kondo
authors.affiliation: Mie Prefecture Health and Environment Research Institute, Mie, Japan.
authors.forename: Shigehiro
authors.initials: S
authors.lastname: Akachi
authors.affiliation: Department of Medical Zoology, Mie University Graduate School of Medicine, Mie, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Ando
authors.affiliation: Mie Prefectural Shima Hospital, Mie, Japan.
authors.forename: Tatsuma
authors.initials: T
authors.lastname: Nomura
authors.affiliation: Department of Dermatology, Mie University Graduate School of Medicine, Mie, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Yamanaka
authors.affiliation: Department of Dermatology, Mie University Graduate School of Medicine, Mie, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Mizutani
mesh_terms: D000328:Adult; D044466:Asian People; D065632:Chikungunya Fever / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011114:Polynesia; D014195:Travel
keywords: Chikungunya fever; Chikungunya virus; arthralgia; imported infection; tropical area