Jeandel P, Josse R, Durand J P
Service de Santé des Armées, Hôpital d'instruction des armées Robert Picqué, Bordeaux, France.
Med Trop (Mars). 2004;64(1):81-8.
Only six of the many alphavirus known to affect humans can cause articular manifestations. They are the Ross River and Barmah Forest viruses from the South Pacific, the Chikungunya, O'Nyong Nyong and Sindbis viruses from tropical Africa, and the Mayaro virus from South America. In most cases, articular manifestations involve arthralgia or transient arthritis and are usually minor. However in some cases especially involving Ross River virus acute polyarthritis may be the most prominent clinical feature and even develop before fever. Although these joint symptoms may be severe and persist for weeks or months in a subacute mode with slightly inflammatory episodes that can be relieved using analgesics, they never cause permanent damage. Differential diagnosis of alphavirsus-related polyarthritis is simple to diagnosis especially in epidemic outbreaks as is frequently the case for Ross River virus epidemics in Australia. Imported cases should be suspected in patients presenting acute or subacute polyarthritis after a recent stay of any length of time in a tropical country and can be confirmed by ordering serology from a specialized reference laboratory.
已知可感染人类的多种甲病毒中，只有六种会引发关节症状。它们是来自南太平洋的罗斯河病毒和巴马森林病毒、来自热带非洲的基孔肯雅病毒、奥尼永尼永病毒和辛德毕斯病毒，以及来自南美洲的马亚罗病毒。在大多数情况下，关节症状表现为关节痛或短暂性关节炎，通常症状较轻。然而，在某些情况下，尤其是感染罗斯河病毒时，急性多关节炎可能是最突出的临床特征，甚至在发热之前就会出现。尽管这些关节症状可能很严重，并以亚急性模式持续数周或数月，伴有轻度炎症发作，使用镇痛药可缓解，但它们绝不会造成永久性损伤。甲病毒相关多关节炎的鉴别诊断很容易，尤其是在疫情暴发时，如澳大利亚经常出现的罗斯河病毒疫情。近期在热带国家停留过任何时长后出现急性或亚急性多关节炎的患者应怀疑为输入性病例，可通过向专业参考实验室送检血清学检查来确诊。
