Post-chikungunya rheumatic disorders in travelers after return from the Caribbean

Travel Med Infect Dis. 2016 Jan-Feb;14(1):21-25. doi: 10.1016/j.tmaid.2016.01.009. Epub 2016 Jan 30.

Abstract

Background: Due to increasing concerns about post-chikungunya (pCHIK) rheumatic disorders in Latin America we aimed to evaluate its occurrence in travelers returning to NYC from the Caribbean.

Method: Patients diagnosed with chikungunya (CHIK) during 2014 at the Bronx-Lebanon Hospital Center (Bronx, NewYork) were identified by reviewing laboratory and electronic medical records. Patients and caregivers of pediatric patients were interviewed by phone ≥9 months after the CHIK diagnosis to survey for chronic symptomatology and current health care needs. Reported chronic musculoskeletal complaints were categorized according to validated criteria.

Results: A total of 28 patients (54% females, median age [range] of 51.5 [0, 88] years) diagnosed with CHIK at our center were identified. Most (82%) had returned from the Dominican Republic. Nineteen (68%) patients were successfully contacted at a median (range) of 13 (9, 16) months since the acute diagnosis. A third (37%) reported ongoing complaints related to CHIK including joint pain (32%), muscle pain (32%), and joint swelling (26%). A presumptive diagnosis of pCHIK chronic inflammatory arthritis (n = 4) and pCHIK musculoskeletal disorder (n = 3) was established.

Conclusions: A third of travelers with CHIK acquired in the Caribbean may be at risk for developing persistent symptoms suggestive of pCHIK rheumatic disorder.

Keywords: Caribbean; Chikungunya; Rheumatic disease; Travel.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Caribbean Region / epidemiology
  • Chikungunya Fever / complications*
  • Chikungunya Fever / epidemiology*
  • Chikungunya Fever / virology
  • Child
  • Child, Preschool
  • Dominican Republic
  • Ethnicity
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Latin America / epidemiology
  • Male
  • Middle Aged
  • New York City / epidemiology
  • Prevalence
  • Rheumatic Diseases / epidemiology
  • Rheumatic Diseases / virology*
  • Seroepidemiologic Studies
  • Travel*
  • Young Adult