Cellule Interrégionale d'Epidémiologie d'Aquitaine, Bordeaux, France.
J Clin Virol. 2010 Jan;47(1):85-8. doi: 10.1016/j.jcv.2009.11.014. Epub 2009 Dec 8.
In 2005-2006, a major epidemic of CHIKV infection occurred in the Islands of the south-western Indian Ocean, and longstanding manifestations seemed to be more frequent than described before.
To describe the frequency and related factors of late clinical manifestations of CHIKV infection among imported cases living in Aquitaine area, France.
All patients recruited through the travel clinic and tropical medicine unit of the University Hospital Centre of Bordeaux with possible CHIKV infection were prospectively recorded, and confirmed cases of CHIKV infection were interviewed 2 years after infection. Factors associated with the persistence of symptoms were determined by multivariate logistic regression.
Among the 29 cases followed, 17 still suffered from arthralgia 2 years after infection, and most of them had never recovered from the initial phase of the condition. The risk of persistent arthralgia tended to be higher among subjects with low educational level, subjects infected in the Reunion Island, and when initial phase lasted 30 days or more and was characterised by a severe pain.
Consistent with previous studies, our findings showed worsened late manifestations among patients returning from Indian Ocean area. Persistence of symptoms tended to be linked with clinical burden during the acute phase, which can be informative for early recognition and management of patients at risk for developing persistent rheumatic symptoms. Cryoglobulins failed to be identified in seronegative patients with invalidating dengue-like syndrome.
2005-2006 年，西南印度洋群岛爆发了基孔肯雅热病毒（CHIKV）的大规模疫情，长期存在的症状似乎比之前描述的更为常见。
描述法国阿基坦地区输入性 CHIKV 感染病例的迟发临床症状的频率及其相关因素。
通过波尔多大学医院中心的旅行诊所和热带医学科，前瞻性地记录所有疑似 CHIKV 感染的患者，并在感染后 2 年对确诊的 CHIKV 感染病例进行访谈。采用多变量逻辑回归确定与症状持续相关的因素。
在随访的 29 例病例中，17 例在感染后 2 年仍患有关节炎，其中大多数从未从疾病的初始阶段完全康复。文化程度较低、在留尼汪岛感染以及初始阶段持续 30 天或更长时间且伴有剧烈疼痛的患者，发生持续性关节炎的风险更高。
与先前的研究一致，我们的研究结果显示，从印度洋地区返回的患者迟发症状更为严重。症状的持续存在与急性期的临床负担有关，这有助于早期识别和管理有发生持续性风湿症状风险的患者。在血清阴性且有无效性登革热样综合征的患者中未能检测到冷球蛋白。
