Chikungunya no Rio Grande do Norte: aspectos epidemiológicos e clínicos
Originating in Africa and first isolated in 1952, the Chikungunya virus (CHIKV) belongs to the Togaviridae family, genus Alphavirus. It has a single-stranded RNA genome with positive polarity, two open reading units, surrounded by a capsid with icosahedral symmetry and a lipid envelope containing...
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| Format: | doctoralThesis |
| Langue: | pt_BR |
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Universidade Federal do Rio Grande do Norte
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| Accès en ligne: | https://repositorio.ufrn.br/handle/123456789/53341 |
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| Résumé: | Originating in Africa and first isolated in 1952, the Chikungunya virus (CHIKV) belongs
to the Togaviridae family, genus Alphavirus. It has a single-stranded RNA genome with
positive polarity, two open reading units, surrounded by a capsid with icosahedral
symmetry and a lipid envelope containing glycoprotein spikes. It is a group A arbovírus
whose and has mosquitoes of the genus Aedes as its main vectors. CHIKV infection
is an acute and self-limited febrile syndrome, in most cases, that affects people of all
age groups, causing different symptoms that can last a few days or even years. This
study aimed to describe the epidemiological, immunological and clinical aspects of
chikungunya fever from the epidemic that occurred in 2016 in the state of Rio Grande
do Norte. 284 samples of suspected cases of CHIKV infection were analyzed by using
qRT-PCR, of which 125 cases were positive (44.4%). The highest number of positive
cases occurred in the first quarter of the year, being March the most representative
month, reaching 48 positive cases. The city of Natal had the highest number of
confirmed cases. Women represented the highest (52%) frequency, of which 9.2% of
them were pregnant. Positive neonates represented 5.6%.The mean age of positive
cases was 34 years and the age group above 61 years was one of the most affected
by CHIKV. Most positive cases were detected from serum samples (41.2%). The
highest viral load occurred at the begining of the acute phase of the infection. CHIKV
was detected in ten individuals 23 days after the onset of symptoms. CHIKV negative
samples were also tested for DENV and ZIKV viruses using RT-PCR and qRT-PCR
techniques, respectively. In addition, to investigate the possibility of flavivirus infection,
a total of 120 suspected cases of CHIKV qRT-PCR negative were further tested for
anti-Flavivirus and anti-Chikugunya IgM using the ELISA method of those, 57 sera
(47.5%) were anti-Chikungunya IgM detectable. Among the anti-Chikungunya IgM
negative sera, 21 (21.7%) were positive for anti-Flavivirus IgM and 54 presented IgM
to both Chikungunya and Flavivirus simultaneously. Fever, arthralgia and conjunctivitis
were the most common symptoms of which, the fever represented 91% of the cases.
Skin blisters were a sign found in all seven newborns studied and positive for CHIKV.
However, although four adults also presented that sign, only one was positive. These
results aim to contribute and build up knowledge on the clinical and epidemiological
characteristics of CHIKV transmission and assist the clinical diagnosis of the infection. |
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