Caglioti Claudia, Lalle Eleonora, Castilletti Concetta, Carletti Fabrizio, Capobianchi Maria Rosaria, Bordi Licia
Laboratory of Virology, "L. Spallanzani" National Institute for Infectious Diseases, Rome, Italy.
New Microbiol. 2013 Jul;36(3):211-27. Epub 2013 Jun 30.
Chikungunya virus (CHIKV) is a mosquito-transmitted alphavirus belonging to the Togaviridae family, first isolated in Tanzania in 1952. The main vectors are mosquitoes from the Aedes species. Recently, the establishment of an envelope mutation increased infectivity for A. albopictus. CHIKV has recently re-emerged causing millions of infections in countries around the Indian Ocean characterized by climate conditions favourable to high vector density. Importation of human cases to European regions with high density of suitable arthropod vectors (such as A. albopictus) may trigger autochthonous outbreaks. The clinical signs of CHIKV infection include non-specific flu-like symptoms, and a characteristic rash accompanied by joint pain that may last for a long time after the resolution of the infection. The death rate is not particularly high, but excess mortality has been observed in concomitance with large CHIKV outbreaks. Deregulation of innate defense mechanisms, such as cytokine inflammatory response, may participate in the main clinical signs of CHIKV infection, and the establishment of persistent (chronic) disease. There is no specific therapy, and prevention is the main countermeasure. Prevention is based on insect control and in avoiding mosquito bites in endemic countries. Diagnosis is based on the detection of virus by molecular methods or by virus culture on the first days of infection, and by detection of an immune response in later stages. CHIKV infection must be suspected in patients with compatible clinical symptoms returning from epidemic/endemic areas. Differential diagnosis should take into account the cross-reactivity with other viruses from the same antigenic complex (i.e. O'nyong-nyong virus).
基孔肯雅病毒（CHIKV）是一种由蚊子传播的甲病毒，属于披膜病毒科，1952年首次在坦桑尼亚分离出来。主要传播媒介是伊蚊属的蚊子。最近，一种包膜突变的出现增加了对白纹伊蚊的感染力。基孔肯雅病毒最近再度出现，在印度洋周边国家引发了数百万起感染病例，这些国家的气候条件有利于高媒介密度。将人类病例输入到有高密度适宜节肢动物媒介（如白纹伊蚊）的欧洲地区，可能引发本地疫情。基孔肯雅病毒感染的临床症状包括非特异性的流感样症状，以及一种特征性皮疹，并伴有关节疼痛，这种疼痛在感染消退后可能会持续很长时间。死亡率并非特别高，但在基孔肯雅病毒大规模暴发期间观察到了额外的死亡情况。先天防御机制的失调，如细胞因子炎症反应，可能参与了基孔肯雅病毒感染的主要临床症状以及持续性（慢性）疾病的形成。目前没有特效疗法，预防是主要对策。预防措施基于控制昆虫以及在流行国家避免被蚊子叮咬。诊断基于在感染初期通过分子方法或病毒培养检测病毒，以及在后期检测免疫反应。对于有符合临床症状且从流行/疫区返回的患者，必须怀疑感染了基孔肯雅病毒。鉴别诊断应考虑与来自同一抗原复合物的其他病毒（即奥尼昂-尼昂病毒）的交叉反应性。
