Department of Rheumatology, University College London Hospitals NHS Trust, London, United Kingdom.
Hospital for Tropical Diseases, University College London Hospitals NHS Trust, London, United Kingdom.
Am J Trop Med Hyg. 2023 Mar 20;108(5):1003-1006. doi: 10.4269/ajtmh.22-0698. Print 2023 May 3.
The chikungunya virus is an arthritogenic alphavirus. Acute infection may be followed by persistent arthralgia, often causing significant functional impairment. The 2014-2015 chikungunya fever (CHIKF) epidemic resulted in a marked increase in cases presenting to rheumatology and tropical diseases services. A combined multidisciplinary rheumatology-tropical diseases service for assessment, management, and follow-up of patients with proven CHIKF and persistent (≥ 4 weeks) arthralgia was proposed and rapidly developed at The Hospital for Tropical Diseases in London. Rapid set up of a multidisciplinary clinic in response to the epidemic was achieved. Of a total of 54 patients, 21 (38.9%) patients with CHIKF developed persistent arthralgia and were reviewed by the multidisciplinary service. A combined assessment approach enabled comprehensive multidisciplinary assessment of CHIKF, assessment of joint pathology through ultrasound, and appropriate follow-up. A combined rheumatology-tropical diseases service was successfully used to identify and assess CHIKF-associated morbidity. Future outbreaks may be approached by establishing tailored multidisciplinary clinics.
基孔肯雅病毒是一种致关节炎的甲病毒。急性感染后可能会持续出现关节痛，常导致严重的功能障碍。2014-2015 年基孔肯雅热（CHIKF）流行导致风湿和热带疾病服务机构就诊的病例明显增加。伦敦热带病医院提出并迅速建立了一种多学科联合的风湿-热带疾病服务，用于评估、管理和随访确诊的基孔肯雅热和持续（≥4 周）关节痛患者。针对该流行病，迅速设立了一个多学科诊所。在总共 54 名患者中，21 名（38.9%）基孔肯雅热患者出现持续关节痛，并由多学科服务进行了检查。采用联合评估方法，可对基孔肯雅热进行全面的多学科评估、通过超声评估关节病理，并进行适当的随访。风湿-热带病服务联合成功用于识别和评估与基孔肯雅热相关的发病率。未来的爆发可能通过建立量身定制的多学科诊所来应对。
