Manifestations of Atypical Symptoms of Chikungunya during the Dhaka Outbreak (2017) in Bangladesh

Abstract

Chikungunya (CHIK) has emerged as a major public health concern worldwide. Recently, atypical manifestations are drawing special attention because these might be associated with various complications. Information on atypical manifestations of CHIK is still limited. Here, we analyzed a dataset of 1,326 cases from our recent Dhaka outbreak study to explore the demographics and distributions of atypical manifestations. About 80% of cases reported at least one atypical symptom. Among all atypical symptoms, the most common and unique atypical symptom was joint pain before fever (90.2%), occurred predominantly in female respondents. Other common symptoms included red eye (68.2%), oral ulcer (37.7%), and dermatological manifestations (27.1%). More than two-thirds of patients reported multiple atypical symptoms. Atypical manifestations were not significantly different across age groups, except ocular complications. This study would be an important resource for clinicians and epidemiologists to understand the diversity of Chikungunya infection and, thus, help in better patient management.

Figure 1.

Distribution of atypical symptom manifestation over age and gender in the Chikungunya Dhaka outbreak, 2017 (N = 1,098).

Figure 2.

Distribution of different atypical symptoms in the Chikungunya Dhaka outbreak, 2017 (N = 1,098). As the pain before fever manifested among 90.2% of patients suffering with atypical symptoms, this is excluded from the Venn diagram to make it readable. This figure appears in color at www.ajtmh.org.