1. First Reported Chikungunya Fever Outbreak in the Republic of Congo, 2011
- Author
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Maria Rosaria Capobianchi, Boris Pastorino, Laurence Thirion, Nanikaly Moyen, Amelia Dzia Lepfoundzou, Antoine Nougairède, Jean Vivien Mombouli, Isabelle Leparc-Goffart, Simon Djamel Thiberville, Yannick Dimi, Xavier de Lamballerie, Emergence des Pathologies Virales (EPV), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire National de Santé Publique, Centre National de Transfusion Sanguine, French National Reference Centre for Arboviruses, Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA), Laboratory of Virology, National Institute for Infectious Diseases 'Lazzaro Spallanzani', and IRBA Armed Forces Biomedical Research Institute
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Male ,Epidemiology ,lcsh:Medicine ,medicine.disease_cause ,Disease Outbreaks ,Dengue fever ,Serology ,Database and Informatics Methods ,0302 clinical medicine ,Aedes ,Seroepidemiologic Studies ,Medicine and Health Sciences ,Prospective Studies ,Chikungunya ,lcsh:Science ,MAXIMUM-LIKELIHOOD ,Phylogeny ,0303 health sciences ,Multidisciplinary ,biology ,virus diseases ,Middle Aged ,REUNION-ISLAND ,3. Good health ,Infectious Diseases ,Congo ,Cohort ,[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,Female ,Biological Cultures ,Chikungunya virus ,Research Article ,Adult ,Medical Ethics ,medicine.medical_specialty ,Adolescent ,030231 tropical medicine ,VIRUS-INFECTION ,Research and Analysis Methods ,Microbiology ,Young Adult ,03 medical and health sciences ,Diagnostic Medicine ,EPIDEMIC ,Internal medicine ,medicine ,Animals ,Humans ,Seroprevalence ,COHORT ,Molecular Biology Techniques ,Molecular Biology ,Aged ,Retrospective Studies ,030304 developmental biology ,business.industry ,lcsh:R ,Biology and Life Sciences ,Outbreak ,Retrospective cohort study ,GABON ,Tropical Diseases ,medicine.disease ,biology.organism_classification ,Virology ,Cross-Sectional Studies ,INDIAN-OCEAN ,Immunologic Techniques ,Chikungunya Fever ,lcsh:Q ,business ,PERSISTENT ARTHRALGIA - Abstract
Background: Chikungunya is an Aedes -borne disease characterised by febrile arthralgia and responsible for massive outbreaks. We present a prospective clinical cohort study and a retrospective serological study relating to a CHIK outbreak, in the Republic of Congo in 2011. Methodology and Findings: We analysed 317 suspected cases, of which 308 (97.2%) lived in the city of Brazzaville (66.6% in the South area). Amongst them, 37 (11.7%) were CHIKV+ve patients (i.e., biologically confirmed by a real-time RT-PCR assay), of whom 36 (97.3%) had fever, 22 (66.7%) myalgia and 32 (86.5%) arthralgia. All tested negative for dengue. The distribution of incident cases within Brazzaville districts was compared with CHIKV seroprevalence before the outbreak (34.4% in 517 blood donors), providing evidence for previous circulation of CHIKV. We applied a CHIK clinical score to 126 patients recruited within the two first day of illness (including 28 CHIKV+ves (22.2%)) with sensitivity (78.6%) and specificity (72.4%) values comparing with those of the referent study in Reunion Island. The negative predictive value was high (92%), but the positive predictive value (45%) indicate poor potential contribution to medical practice to identify CHIKV+ve patients in low prevalence outbreaks. However, the score allowed a slightly more accurate follow-up of the evolution of the outbreak than the criterion "fever+arthralgia". The complete sequencing of a Congolase isolate (Brazza_MRS1) demonstrated belonging to the East/Central/South African lineage and was further used for producing a robust genome-scale CHIKV phylogenetic analysis. Conclusions/Significance: We describe the first Chikungunya outbreak declared in the Republic of Congo. The seroprevalence study conducted amongst blood donors before outbreak provided evidence for previous CHIKV circulation. We suggest that a more systematic survey of the entomological situation and of arbovirus circulation is necessary in Central Africa for better understanding the environmental, microbiological and sociological determinants of emergence.
- Published
- 2014
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