Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Dec 6;13(12):e0207406.
doi: 10.1371/journal.pone.0207406. eCollection 2018.

Atypical and severe manifestations of chikungunya virus infection in French Guiana: A hospital-based study

Timothee Bonifay  1   2   3 , Christelle Prince  1 , Clarisse Neyra  1 , Magalie Demar  1   4   5 , Dominique Rousset  6 , Hatem Kallel  7 , Mathieu Nacher  3   5 , Félix Djossou  1   5 , Loïc Epelboin  1   5 ; Char Chik Working group
Affiliations

Atypical and severe manifestations of chikungunya virus infection in French Guiana: A hospital-based study

Timothee Bonifay et al. PLoS One. .

Abstract

Background: French Guiana (FG) was the first country in South America to declare chikungunya virus infection (CHIKV). The outbreak affected about 16,000 persons between February 2014 and October 2015, with several atypical cases, but only two fatal cases. We aimed to describe the clinical presentation of patients hospitalized for CHIKV infection, to estimate and identify risk factors of unusual and severe forms in adult patients.

Materials and methods: A monocentric retrospective study was conducted in Cayenne hospital, the main city and the main hospital in FG, from March 1st 2014 to August 31st 2015. All patients admitted for at least one night with a biological diagnosis of CHIKV infection during the 2014/2015 outbreak were included, except pregnant women and children under 15 years.

Results: During the study period, 285 patients with a diagnosis of CHIKV infection were hospitalized in Cayenne hospital, among whom 96 nonpregnant adults were studied. Five were classified as severe forms (5.2%) and 23 as unusual forms (23.9%). The most frequent atypical and/or severe form was neurological (n = 20), followed by cardio-respiratory failure (acute respiratory failure n = 4, acute heart failure n = 2), digestive and hepatic disorders (acute hepatitis n = 3, acute pancreatitis n = 2), renal disorders (acute renal failure n = 5) and muscular impairment (rhabdomyolysis n = 3).

Conclusion: During the outbreak, hospitalizations were frequent, particularly for common forms, driven by algic clinical presentations and concerns due to the novelty of this infection. Despite atypical neurological and liver forms of CHIKV infection, case-fatality was low in French Guiana. No specific risk factor of atypical and/or severe forms was found in our study.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Study flow chart.
*SLM: Saint Laurent du Maroni.
Fig 2
Fig 2. Length of hospitalization estimate by Kaplan Meier by ward.
Fig 3
Fig 3. Hospitalization costs according by ward.
See this image and copyright information in PMC

References

    1. Robinson MC. An epidemic of virus disease in Southern Province, Tanganyika territory, in 1952–1953. Trans R Soc Trop Med Hyg. 1955;49: 28–32. - PubMed
    1. Staples JE, Breiman RF, Powers AM. Chikungunya Fever: An Epidemiological Review of a Re‐Emerging Infectious Disease. Clin Infect Dis. 2009;49: 942–948. 10.1086/605496 - DOI - PubMed
    1. Thiberville S-D, Moyen N, Dupuis-Maguiraga L, Nougairede A, Gould EA, Roques P, et al. Chikungunya fever: Epidemiology, clinical syndrome, pathogenesis and therapy. Antiviral Res. 2013;99: 345–370. 10.1016/j.antiviral.2013.06.009 - DOI - PMC - PubMed
    1. Thiberville S-D, Boisson V, Gaudart J, Simon F, Flahault A, de Lamballerie X. Chikungunya Fever: A Clinical and Virological Investigation of Outpatients on Reunion Island, South-West Indian Ocean. Tesh RB, editor. PLoS Negl Trop Dis. 2013;7: e2004 10.1371/journal.pntd.0002004 - DOI - PMC - PubMed
    1. Gérardin P, Guernier V, Perrau J, Fianu A, Le Roux K, Grivard P, et al. Estimating Chikungunya prevalence in La Réunion Island outbreak by serosurveys: Two methods for two critical times of the epidemic. BMC Infect Dis. 2008;8: 99 10.1186/1471-2334-8-99 - DOI - PMC - PubMed