Ward Caleb E, Chapman Jennifer I
Pediatric Emergency Medicine Fellow (Ward), and.
Assistant Professor of Pediatrics (Chapman), Division of Pediatric Emergency Medicine, Department of Pediatrics, Children's National Health System, George Washington University School of Medicine and Health Sciences, Washington DC.
Pediatr Emerg Care. 2018 Jul;34(7):510-515. doi: 10.1097/PEC.0000000000001529.
Chikungunya (CHIKV) is an emerging arboviral infection with recent spikes in transmission in the Americas. Chikungunya is most commonly transmitted by mosquitos, specifically Aedes aegypti and Aedes albopictus. These mosquitoes are found throughout many parts of the United States. The classic tetrad of symptoms for CHIKV is fever, symmetric polyarthralgia, maculopapular rash, and nonpurulent conjunctivitis. Although the majority (3 of 4) of infected people will be symptomatic, the viral illness generally runs a benign course. Nevertheless, when compared with infected adults, children more commonly have neurological and dermatological symptoms and are less likely to have arthralgia. The key differential diagnosis to consider is dengue, which has greater immediate morbidity and which can cause coinfection. Local health departments facilitate diagnostic testing, using either RNA polymerase chain reaction or antibody screening based on the timing of presentation. Management is supportive. The purpose of this review article is to provide readers basic knowledge regarding the microbiology, epidemiology, risk factors for transmission, and typical clinical presentation of CHIKV. A practical approach to diagnosis and management of infected children is provided.
基孔肯雅热（CHIKV）是一种新出现的虫媒病毒感染，近期在美洲地区传播激增。基孔肯雅热最常见的传播途径是蚊子，特别是埃及伊蚊和白纹伊蚊。在美国的许多地区都能发现这些蚊子。基孔肯雅病毒感染的典型四联症状是发热、对称性多关节痛、斑丘疹和非脓性结膜炎。虽然大多数（4人中的3人）感染者会出现症状，但这种病毒性疾病通常病程良性。然而，与感染的成年人相比，儿童更常出现神经和皮肤症状，且关节痛的可能性较小。需要考虑的主要鉴别诊断是登革热，登革热的即时发病率更高，且可导致合并感染。当地卫生部门根据就诊时间，通过RNA聚合酶链反应或抗体筛查来协助进行诊断检测。治疗以支持治疗为主。这篇综述文章的目的是为读者提供关于基孔肯雅病毒的微生物学、流行病学、传播风险因素和典型临床表现的基本知识。本文还提供了一种针对感染儿童的实用诊断和管理方法。
