Chikungunya

epidemiology

• outreaks
  • 2004-06 Indian Ocean countries
  • 2014-16 Caribbean region and USA
• 1.3 bil. people living in endemic area

virology

• mutation A226V enhanced replication ability in Ae. albopictus

clinical

• incubation 3-7 days
• polyarthralgia 2-5 days after onset
• severe complication >65 y/o
  • meningoencephalitis, hepatitis, renal failure, myocarditis

• persistent symptoms
  • polyarthralgia, polyarthritis, tenosynovitis, Ranaud's phenomena