Bilsborrow Joshua B, Amaral J Kennedy, Schoen Robert
Section of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, United States.
Veterans Affairs Connecticut Healthcare System, West Haven VA Medical Center, West Haven, Connecticut, United States.
Curr Rheumatol Res. 2021;2(1):12-17. doi: 10.46439/rheumatology.2.012.
Chikungunya virus (CHIKV) has recently emerged alongside Ebolavirus, Zika virus, and SARS-CoV-2 as the causative pathogen for a global pandemic. CHIKV is a single-stranded RNA alphavirus that is transmitted by species mosquitos and has spread beyond its endemic regions in East Africa and South Asia through the Indian Ocean islands, into Southern Europe, and through the Caribbean and the wider Americas. Acute chikungunya fever (CHIKF) is characterized by high fevers, arthralgias, myalgias, headaches, gastrointestinal disturbances, and maculopapular rash. Almost all patients recover from the acute illness, but up to fifty percent develop a chronic rheumatic syndrome with disabling arthritis that can last for months to years. Treatment of acute CHIKF is mainly supportive, while immunomodulation of chronic rheumatic disease with disease modifying anti-rheumatic drugs (DMARDs) such as methotrexate appears to be beneficial. Preventive measures such as mosquito vector control and vaccination could decrease transmission and reduce the burden of chronic disabling post-viral arthritis.
基孔肯雅病毒（CHIKV）最近与埃博拉病毒、寨卡病毒和严重急性呼吸综合征冠状病毒2（SARS-CoV-2）一起出现，成为全球大流行的致病病原体。CHIKV是一种单链RNA甲病毒，由特定种类的蚊子传播，已从其在东非和南亚的流行地区，通过印度洋岛屿传播到南欧，并穿过加勒比地区和更广泛的美洲地区。急性基孔肯雅热（CHIKF）的特征是高烧、关节痛、肌痛、头痛、胃肠道不适和斑丘疹。几乎所有患者都能从急性疾病中康复，但高达50%的患者会发展为慢性风湿综合征，伴有致残性关节炎，可持续数月至数年。急性CHIKF的治疗主要是支持性的，而使用甲氨蝶呤等改善病情抗风湿药（DMARDs）对慢性风湿性疾病进行免疫调节似乎是有益的。诸如控制蚊媒和接种疫苗等预防措施可以减少传播，并减轻慢性致残性病毒后关节炎的负担。
