Hasan Anamul, Zamil Md Fahad, Trina Afrida Tabassum, Hossain Mohammad Sharif, Afreen Sajia, Ahmed Dilruba, Alam Mohammad Shafiul
Infectious Diseases Division, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh.
Clinical and Diagnostic Services, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh.
Am J Trop Med Hyg. 2025 Jul 1;113(3):516-519. doi: 10.4269/ajtmh.25-0064. Print 2025 Sep 3.
After a major outbreak in Bangladesh in 2017, chikungunya nearly vanished from its territory until its resurgence in late 2024. However, its symptomatic overlap with dengue virus (DENV), another major arbovirus, has hindered accurate diagnosis and reporting, resulting in limited molecular diagnostic efforts for chikungunya in this region. This diagnostic evaluation study aimed to detect and characterize arboviral infections at the molecular level, focusing on the re-emergence of chikungunya and implications for future outbreaks. Febrile individuals aged 5-65 years old presenting with fever onset within 2-5 days along with other corresponding febrile symptoms were prospectively recruited from the International Centre for Diarrhoeal Disease Research, Bangladesh diagnostic facilities in Dhaka, Bangladesh. After meeting inclusion and exclusion criteria, 569 of 1,280 screened individuals were enrolled, providing informed written consent/assent. Serum samples from 474 participants underwent real-time reverse transcription-polymerase chain reaction testing, revealing 213 positive cases for at least one arbovirus. Chikungunya cases totaled 55, including seven coinfections (six with DENV and the first documented chikungunya virus-Zika virus coinfection in Bangladesh). No infections were reported from January to August, with a peak in October and November. Most chikungunya virus infections (72.7%) had moderate to high viral loads, with symptoms of joint pain, myalgia, and headaches. This resurgence of chikungunya in late 2024 highlights the potential for a major outbreak in 2025, necessitating proactive measures to mitigate public health impact and ensure a robust response to this re-emerging threat.
2017年在孟加拉国发生一次大规模疫情后，基孔肯雅热在该国几乎消失，直至2024年末再度出现。然而，它与另一种主要虫媒病毒登革病毒（DENV）存在症状重叠，这阻碍了准确诊断和报告，导致该地区针对基孔肯雅热的分子诊断工作有限。这项诊断评估研究旨在从分子水平检测和鉴定虫媒病毒感染，重点关注基孔肯雅热的再度出现及其对未来疫情的影响。从孟加拉国达卡的国际腹泻病研究中心诊断机构前瞻性招募了年龄在5至65岁、发热起病2至5天内且伴有其他相应发热症状的发热个体。在符合纳入和排除标准后，1280名筛查个体中有569名被纳入研究，并提供了知情书面同意/赞成书。对474名参与者的血清样本进行实时逆转录聚合酶链反应检测，发现至少感染一种虫媒病毒的阳性病例有213例。基孔肯雅热病例共计55例，其中包括7例合并感染（6例与登革病毒合并感染，以及孟加拉国首例记录在案的基孔肯雅病毒 - 寨卡病毒合并感染）。1月至8月未报告感染病例，10月和11月出现感染高峰。大多数基孔肯雅热病毒感染（72.7%）具有中度至高病毒载量，伴有关节疼痛、肌痛和头痛症状。2024年末基孔肯雅热的再度出现凸显了2025年可能发生大规模疫情的可能性，因此有必要采取积极措施减轻对公共卫生的影响，并确保对这一重新出现的威胁做出有力应对。
