title: Post-chikungunya rheumatic disorders in travelers after return from the Caribbean.
abstract: BACKGROUND
  Due to increasing concerns about post-chikungunya (pCHIK) rheumatic disorders in Latin America we aimed to evaluate its occurrence in travelers returning to NYC from the Caribbean.
  
  
  METHODS
  Patients diagnosed with chikungunya (CHIK) during 2014 at the Bronx-Lebanon Hospital Center (Bronx, NewYork) were identified by reviewing laboratory and electronic medical records. Patients and caregivers of pediatric patients were interviewed by phone ≥9 months after the CHIK diagnosis to survey for chronic symptomatology and current health care needs. Reported chronic musculoskeletal complaints were categorized according to validated criteria.
  
  
  RESULTS
  A total of 28 patients (54% females, median age [range] of 51.5 [0, 88] years) diagnosed with CHIK at our center were identified. Most (82%) had returned from the Dominican Republic. Nineteen (68%) patients were successfully contacted at a median (range) of 13 (9, 16) months since the acute diagnosis. A third (37%) reported ongoing complaints related to CHIK including joint pain (32%), muscle pain (32%), and joint swelling (26%). A presumptive diagnosis of pCHIK chronic inflammatory arthritis (n = 4) and pCHIK musculoskeletal disorder (n = 3) was established.
  
  
  CONCLUSIONS
  A third of travelers with CHIK acquired in the Caribbean may be at risk for developing persistent symptoms suggestive of pCHIK rheumatic disorder.
authors.affiliation: Division of Infectious Diseases, Bronx-Lebanon Hospital Center, Bronx, NY, USA; Department of Medicine, Bronx-Lebanon Hospital Center, Bronx, NY, USA.
authors.forename: Cosmina
authors.initials: C
authors.lastname: Zeana
authors.affiliation: Division of Infectious Diseases, Bronx-Lebanon Hospital Center, Bronx, NY, USA; Department of Medicine, Bronx-Lebanon Hospital Center, Bronx, NY, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Kelly
authors.affiliation: Department of Pediatrics, Bronx-Lebanon Hospital Center, Bronx, NY, USA.
authors.forename: Wilson
authors.initials: W
authors.lastname: Heredia
authors.affiliation: Department of Medicine, Bronx-Lebanon Hospital Center, Bronx, NY, USA.
authors.forename: Angelica
authors.initials: A
authors.lastname: Cifuentes
authors.affiliation: Department of Medicine, Bronx-Lebanon Hospital Center, Bronx, NY, USA; Division of Rheumatology, Bronx-Lebanon Hospital Center, Bronx, NY, USA.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Franchin
authors.affiliation: Department of Pediatrics, Bronx-Lebanon Hospital Center, Bronx, NY, USA; Division of Pediatric Infectious Diseases, Bronx-Lebanon Hospital Center, Bronx, NY, USA.
authors.forename: Murli
authors.initials: M
authors.lastname: Purswani
authors.affiliation: Department of Medicine, Bronx-Lebanon Hospital Center, Bronx, NY, USA; Division of Rheumatology, Bronx-Lebanon Hospital Center, Bronx, NY, USA.
authors.forename: Arlene
authors.initials: A
authors.lastname: Tieng
authors.affiliation: Department of Pediatrics, Bronx-Lebanon Hospital Center, Bronx, NY, USA; Division of Pediatric Infectious Diseases, Bronx-Lebanon Hospital Center, Bronx, NY, USA. Electronic address: shagmann@bronxleb.org.
authors.forename: Stefan H F
authors.initials: SHF
authors.lastname: Hagmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017691:Caribbean Region / Q000453:epidemiology; D065632:Chikungunya Fever / Q000150:complications* / Q000453:epidemiology* / Q000821:virology; D002648:Child; D002675:Child, Preschool; D004293:Dominican Republic; D005006:Ethnicity; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007843:Latin America / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D015995:Prevalence; D012216:Rheumatic Diseases / Q000453:epidemiology / Q000821:virology*; D016036:Seroepidemiologic Studies; D014195:Travel; D055815:Young Adult
keywords: Caribbean; Chikungunya; Rheumatic disease; Travel