Kutsuna Satoshi, Kato Yasuyuki, Katanami Yuichi, Yamamoto Kei, Takeshita Nozomi, Hayakawa Kayoko, Kanagawa Shuzo, Ohmagari Norio
Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan.
Intern Med. 2018 Feb 1;57(3):325-328. doi: 10.2169/internalmedicine.8196-16. Epub 2017 Nov 1.
Objective Chikungunya fever (CHIK) is a re-emerging arboviral disease that is transmitted through the bite of infected Aedes mosquitoes. There is limited information regarding the epidemiology and clinical information of imported CHIK in Japan. The objective of this study was to review the epidemiology and clinical information of imported CHIK patients treated at the National Center for Global Health and Medicine (NCGM). Methods We evaluated all patients (n=16) who were diagnosed with imported CHIK and treated at the NCGM between October 1, 2005 and March 31, 2016. Results The primary complaint of 7 patients who presented to the NCGM after 31 days from disease onset was persistent arthritis, and the primary complaints of 9 patients who presented within 30 days after disease onset were a fever, headache, arthralgia, and rash. Eleven patients experienced a rash during the first week of illness. The median duration of the arthralgia was 75 days, and the joint pain lasted for >2 months in 8 patients and >6 months in 3 patients. Persistent arthralgia was not significantly associated with an age of >35 years (p=0.13) or patient sex (p=0.69). All 16 patients exhibited positive results for CHIK IgM, although only 4 exhibited positive real-time polymerase chain reaction results. Conclusion Physicians should consider CHIK in patients with a fever who have returned from areas where CHIK is endemic.
目的 基孔肯雅热(CHIK)是一种再度出现的虫媒病毒病,通过感染的伊蚊叮咬传播。关于日本输入性基孔肯雅热的流行病学和临床信息有限。本研究的目的是回顾在国立国际医疗研究中心(NCGM)接受治疗的输入性基孔肯雅热患者的流行病学和临床信息。方法 我们评估了2005年10月1日至2016年3月31日期间在NCGM被诊断为输入性基孔肯雅热并接受治疗的所有患者(n = 16)。结果 发病31天后到NCGM就诊的7例患者的主要主诉是持续性关节炎,发病30天内就诊的9例患者的主要主诉是发热、头痛、关节痛和皮疹。11例患者在发病第一周出现皮疹。关节痛的中位持续时间为75天,8例患者关节疼痛持续超过2个月,3例患者持续超过6个月。持续性关节痛与年龄>35岁(p = 0.13)或患者性别(p = 0.69)无显著相关性。所有16例患者的基孔肯雅热IgM检测结果均为阳性,尽管只有4例实时聚合酶链反应检测结果为阳性。结论 对于从基孔肯雅热流行地区返回且发热的患者,医生应考虑基孔肯雅热。