Brito Carlos, Falcão Melissa Barreto, de Albuquerque Maria de Fatima Pessoa Militão, Cerqueira-Silva Thiago, Teixeira Maria Glória, Franca Rafael Freitas de Oliveira
Programa de Pós-Graduação em Medicina Tropical, Centro de Ciências Médicas, Universidade Federal de Pernambuco (UFPE), Recife 50740-465, Brazil.
Departamento de Imunologia, Instituto Autoimune de Pesquisa, Recife 52011-040, Brazil.
Viruses. 2025 Jan 3;17(1):62. doi: 10.3390/v17010062.
Chikungunya virus infection often manifests as an acute, self-limiting febrile illness, with arthralgia and musculoskeletal symptoms being the most commonly reported. Arthralgia can persist for months or even years, and approximately 50% of cases progress to chronic conditions. However, recent outbreaks have revealed a rising number of severe cases and fatalities. This review examines evidence from the past decade that suggests a higher incidence of severe chikungunya virus (CHIKV) infections and increased mortality rates, challenging official reports and guidelines from many countries. The literature review includes case reports, series, and studies with comparison groups to assess whether CHIKV-related mortality is underreported. Evaluating excess mortality involves analyzing consistent findings across different regions, biological plausibility, and systemic manifestations that contribute to severe outcomes. These findings aim to expand disease classifications in international guidelines and raise awareness among healthcare professionals to better identify severe CHIKV cases and related deaths. Studies were identified through PubMed using the search terms "chikungunya", "death", "severe", "pathogenesis", and "pathophysiology".
基孔肯雅病毒感染通常表现为一种急性、自限性发热疾病，关节痛和肌肉骨骼症状是最常报告的症状。关节痛可持续数月甚至数年，约50%的病例会发展为慢性病。然而，最近的疫情显示严重病例和死亡人数不断增加。本综述审视了过去十年的证据，这些证据表明基孔肯雅病毒（CHIKV）严重感染的发病率更高，死亡率上升，这对许多国家的官方报告和指南提出了挑战。文献综述包括病例报告、系列研究以及有对照组的研究，以评估CHIKV相关死亡率是否报告不足。评估超额死亡率涉及分析不同地区的一致发现、生物学合理性以及导致严重后果的系统表现。这些发现旨在扩大国际指南中的疾病分类，并提高医疗专业人员的认识，以便更好地识别严重CHIKV病例及相关死亡。通过在PubMed上使用搜索词“基孔肯雅”“死亡”“严重”“发病机制”和“病理生理学”来识别相关研究。
