Atypical Clinical Presentations of Acute Phase Chikungunya Virus Infection in Older Adults.

Objectives We aimed to determine whether the presentation of Chikungunya virus ( CHIKV) infection differs between older and younger adults with regard to clinical form during the acute phase defined by the World Health Organization: acute clinical, atypical, and severe acute. Design Cross-sectional, retrospective. Setting University Hospital of Martinique. Participants Individuals aged 65 and older (n = 267, mean age 80.4 ± 87.9) who attended the emergency department with a positive biological diagnosis of CHIKV (reverse transcriptase polymerase chain reaction) between January and December 2014 and a randomly selected sample of individuals younger than 65 (n = 109, mean age 46.2 ± 12.7). Results Typical presentation was present in 8.2% of older adults and 59.6% of younger individuals ( P < .001), atypical presentation in 29.6% of older adults and 5.6% of younger individuals ( P < .001), and severe presentation in 19.5% of older adults and 17.4% of younger individuals ( P = .65). One hundred fourteen (42.7%) of the older group and 19 (17.4%) of the younger group could not be classified in any category (absence of fever, absence of joint pain, or both) ( P < .001). Conclusion Only 8.2% of the older adults presenting in the acute phase of CHIKV have typical forms, suggesting that the most-frequent clinical presentation of CHIKV in older adults differs from that in younger individuals. [ABSTRACT FROM AUTHOR]