Danis-Lozano Rogelio, Díaz-González Esteban Eduardo, Trujillo-Murillo Karina Del Carmen, Caballero-Sosa Sandra, Sepúlveda-Delgado Jesús, Malo-García Iliana Rosalía, Canseco-Ávila Luis Miguel, Salgado-Corsantes Luis Manuel, Domínguez-Arrevillaga Sergio, Torres-Zapata Raúl, Gómez-Cruz Omar, Fernández-Salas Ildefonso
Centro Regional de Investigación en Salud Pública, Instituto Nacional de Salud Pública, Tapachula, Chiapas, México.
Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Nuevo León, México.
PLoS One. 2017 Oct 24;12(10):e0186923. doi: 10.1371/journal.pone.0186923. eCollection 2017.
The emerging chikungunya virus (CHIKV), is an arbovirus causing intense outbreaks in North America. The situation in Mexico is alarming, and CHIKV threatens to spread further throughout North America. Clinical and biological features of CHIKF outbreaks in Mexico have not been well described; thus, we conducted a cross sectional study of a CHIKV outbreak in Chiapas, Southern Mexico to further characterize these features.
METHODOLOGY/PRINCIPAL FINDINGS: We collected blood samples from patients suspected of having chikungunya fever (CHIKF) who presented to Clinical Hospital ISSSTE Dr. Roberto Nettel in Tapachula, Chiapas, Mexico. In addition to the clinical examination, real-time polymerase chain reaction (PCR) standardized for the Asian Chikungunya lineage and/or enzyme-linked immunosorbent assay for immunoglobulin M (IgM) were used to confirm CHIKV diagnosis. Of a total of 850 patients who presented with probably CHIKV at Hospital "Dr. Roberto Nettel", 112 probable CHIKF cases were enrolled in this study from November 2014- June 2015, of which 95 patients (84.8%) were CHIKV positive and 17 were negative (15.2%). Of these 95 CHIKV positive patients, 62 were positive by real-time reverse transcriptase PCR (+qRT-PCR); and 33 were seropositive to +IgM with a negative qRT-PCR. The most frequent symptoms reported were fever (100%), headache (82.3%), polyarthralgia (72.1%), and exanthem (82.3%). Biological abnormalities observed during CHIKV infection were lymphopenia (41.1%), leukopenia (51.6%), elevated transaminases (30.5%-46.3%) and high LDH (46.3%) and CRP (60.0%).
Clinical and biological data obtained from this study is providing more useful information for benchmarking purposes with outbreaks from different parts of the world and would be helpful for better patient care and treatment.
新兴的基孔肯雅病毒（CHIKV）是一种虫媒病毒，在北美引发了严重疫情。墨西哥的情况令人担忧，CHIKV有进一步在北美蔓延的威胁。墨西哥基孔肯雅热（CHIKF）疫情的临床和生物学特征尚未得到充分描述；因此，我们对墨西哥南部恰帕斯州的一次CHIKV疫情进行了横断面研究，以进一步明确这些特征。
方法/主要发现：我们从墨西哥恰帕斯州塔帕丘拉市罗伯托·内特尔博士ISSSTE临床医院疑似患有基孔肯雅热（CHIKF）的患者中采集血样。除临床检查外，还采用针对亚洲基孔肯雅谱系标准化的实时聚合酶链反应（PCR）和/或免疫球蛋白M（IgM）酶联免疫吸附测定来确诊CHIKV感染。在“罗伯托·内特尔博士”医院共850例可能感染CHIKV的患者中，2014年11月至2015年6月有112例疑似CHIKF病例纳入本研究，其中95例患者（84.8%）CHIKV检测呈阳性，17例为阴性（15.2%）。在这95例CHIKV阳性患者中，62例通过实时逆转录PCR（+qRT-PCR）呈阳性；33例IgM血清学阳性但qRT-PCR阴性。报告的最常见症状为发热（100%）、头痛（82.3%）、多关节痛（72.1%）和皮疹（82.3%）。CHIKV感染期间观察到的生物学异常包括淋巴细胞减少（41.1%）、白细胞减少（51.6%）、转氨酶升高（30.5%-46.3%）以及乳酸脱氢酶（46.3%）和C反应蛋白（60.0%）升高。
本研究获得的临床和生物学数据为与世界不同地区的疫情进行基准比较提供了更有用的信息，有助于更好地护理和治疗患者。
