1Department of Geriatrics, Valenciennes General Hospital, Valenciennes, France.
2Department of Geriatrics, University Hospitals of Rennes, Rennes, France.
Am J Trop Med Hyg. 2021 Jan;104(1):106-109. doi: 10.4269/ajtmh.20-0761.
The WHO defined three clinical forms for chikungunya virus infection (CHIKV, namely, acute, atypical, and severe cases) and a chronic form. These definitions seemed inappropriate for the elderly. So, we propose an adapted definition for elderly people. A cross-sectional analysis was performed including patients aged ≥ 65 years, who attended the emergency department with a positive biological diagnosis of CHIKV in 2014. A total of 267 elderly patients (80 ± 8 years) were included. When using the 2015 WHO definitions, 114 patients could not be classified (42.7%) in any of the category, of whom 43 (37.7%) reported absence of fever, 85 (74.6%) reported absence of joint pain, and 14 (12.3%) reported absence of both fever and joint pain. After adaptation of the WHO definitions, the 114 unclassifiable patients were reclassified as follows: eight as typical cases, 50 as atypical cases, 42 as severe cases, and 14 remained unclassifiable. The atypical clinical form was the most common form. The 2015 WHO definitions of the clinical forms at the acute phase of CHIKV are ill suited to the elderly. The adapted definition we propose here appears to be more appropriate and could help improved management of older patients with CHIKV.
世界卫生组织（WHO）将基孔肯雅热病毒感染（CHIKV）的临床形式定义为三种，即急性、非典型和重症病例，以及慢性形式。这些定义似乎不适合老年人。因此，我们提出了一个适用于老年人的定义。我们进行了一项横断面分析，纳入了 2014 年在急诊科就诊、经生物学诊断为基孔肯雅热病毒感染且年龄≥65 岁的患者。共纳入 267 例老年患者（80±8 岁）。当使用 2015 年 WHO 定义时，114 例患者无法归入任何类别（42.7%），其中 43 例（37.7%）报告无发热，85 例（74.6%）报告无关节痛，14 例（12.3%）报告既无发热也无关节痛。在对 WHO 定义进行调整后，114 例无法分类的患者重新分类如下：8 例为典型病例，50 例为非典型病例，42 例为重症病例，14 例仍无法分类。非典型临床形式是最常见的形式。2015 年 WHO 对 CHIKV 急性期临床形式的定义不适合老年人。我们提出的这种调整后的定义似乎更合适，可以帮助改善老年 CHIKV 患者的管理。
