Mayaro: an emerging viral threat?

Abstract

Mayaro virus (MAYV), an enveloped RNA virus, belongs to the Togaviridae family and Alphavirus genus. This arthropod-borne virus (Arbovirus) is similar to Chikungunya (CHIKV), Dengue (DENV), and Zika virus (ZIKV). The term "ChikDenMaZika syndrome" has been coined for clinically suspected arboviruses, which have arisen as a consequence of the high viral burden, viral co-infection, and co-circulation in South America. In most cases, MAYV disease is nonspecific, mild, and self-limited. Fever, arthralgia, and maculopapular rash are among the most common symptoms described, being largely indistinguishable from those caused by other arboviruses. However, severe manifestations of the infection have been reported, such as chronic polyarthritis, neurological complications, hemorrhage, myocarditis, and even death. Currently, there are no specific commercial tools for the diagnosis of MAYV, and the use of serological methods can be affected by cross-reactivity and the window period. A diagnosis based on clinical and epidemiological data alone is still premature. Therefore, new entomological research is warranted, and new highly specific molecular diagnostic methods should be developed. This comprehensive review is intended to encourage public health authorities and scientific communities to actively work on diagnosing, preventing, and treating MAYV infection.

Fig. 1. Schematic diagram of the MAYV genome and proteins.

RNA is shown as a line and viral proteins are shown as boxes

Fig. 2. Epidemiological distribution of MAYV cases around the world.

The year corresponds to the first reported case in the country. *The year of this report corresponds to the date of the article

Fig. 3. Clinical findings in CHIKV, DENV, MAYV, and ZIKV.

Adapted from. The figure includes a color code to indicate the symptom intensity produced by each arbovirus: red corresponds to ++++, orange to +++, yellow to ++, green to +, and the absence of the arbovirus name means no symptoms

Fig. 4. Serological tests for MAYV detection.

a Hemagglutination inhibition. b Complement fixation. c Neutralization test. d IgM capture enzyme-linked immunosorbent assay. e Enzyme immunoassay using infected cells as antigens

Fig. 5. Public efforts on MAYV infection should focus not only on the vector, but on the host and its environmental surrounding.

The Mayaro virus epidemiologic triad