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Chikungunya fever in travelers returning to Europe from the Indian Ocean region, 2006.

Panning M, Grywna K, van Esbroeck M, Emmerich P, Drosten C - Emerging Infect. Dis. (2008)

Bottom Line: Reverse transcription-PCR was positive for all samples taken up to day 4 after symptom onset.Immunofluorescence detected immunoglobulin (Ig) M on day 1 and IgG on day 2 for some patients, and in all patients from day 5 onward.Soon after onset of symptoms, patients had IgG and IgM and high viral loads (some >10(9) copies/mL plasma).

View Article: PubMed Central - PubMed

Affiliation: Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.

ABSTRACT
Chikungunya fever has spread through several Indian Ocean islands and India, including popular travel destinations. To compare usefulness of diagnostic tests and to understand reasons for the magnitude and severity of an outbreak, we used 3 diagnostic methods to test 720 samples from 680 patients returning to Europe from the Indian Ocean region in 2006. Chikungunya infection was confirmed for 24.4% patients in the first half of the year and for 9.9% in the second half. Reverse transcription-PCR was positive for all samples taken up to day 4 after symptom onset. Immunofluorescence detected immunoglobulin (Ig) M on day 1 and IgG on day 2 for some patients, and in all patients from day 5 onward. Soon after onset of symptoms, patients had IgG and IgM and high viral loads (some >10(9) copies/mL plasma). These data will help healthcare providers select diagnostic tests for returning travelers.

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Related in: MedlinePlus

Viral loads for all PCR-positive samples (left panel) and immunoglobulin (Ig)–negative/PCR-positive samples (right panel), depending on types of mutation (alanine or valine at amino acid position 226 of the envelope 1 protein, as shown on the x-axis). Boxes represent the innermost 2 quartiles of data; horizontal line shows the mean; whiskers represent the outermost 2 quartiles.
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Figure 3: Viral loads for all PCR-positive samples (left panel) and immunoglobulin (Ig)–negative/PCR-positive samples (right panel), depending on types of mutation (alanine or valine at amino acid position 226 of the envelope 1 protein, as shown on the x-axis). Boxes represent the innermost 2 quartiles of data; horizontal line shows the mean; whiskers represent the outermost 2 quartiles.

Mentions: We sequenced 40 PCR-positive samples, of which 18 (45%) showed the original E1-226A genotype and 22 (55%) had the E1-226V mutation (2 from Réunion Island, 20 from Mauritius, all sampled in the first half of 2006). Samples from India (n = 2) and from Sri Lanka (n = 2), which were collected in the second half of 2006, displayed the original E1-226A genotype. CHIKV viral loads among genotypes were compared (Figure 3). Median concentrations (1.6 × 107 copies/mL for E1-226A; 1.6 × 105 copies/mL for E1-226V) were not significantly different at the 95% confidence level. To exclude an influence of CHIKV antibodies on this result, we analyzed samples without antibodies separately. Again, the difference was not significant (226A samples (n = 12), 5 × 107 copies/mL; 226V samples (n = 12), 2.5 × 106 RNA copies/mL).


Chikungunya fever in travelers returning to Europe from the Indian Ocean region, 2006.

Panning M, Grywna K, van Esbroeck M, Emmerich P, Drosten C - Emerging Infect. Dis. (2008)

Viral loads for all PCR-positive samples (left panel) and immunoglobulin (Ig)–negative/PCR-positive samples (right panel), depending on types of mutation (alanine or valine at amino acid position 226 of the envelope 1 protein, as shown on the x-axis). Boxes represent the innermost 2 quartiles of data; horizontal line shows the mean; whiskers represent the outermost 2 quartiles.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2570846&req=5

Figure 3: Viral loads for all PCR-positive samples (left panel) and immunoglobulin (Ig)–negative/PCR-positive samples (right panel), depending on types of mutation (alanine or valine at amino acid position 226 of the envelope 1 protein, as shown on the x-axis). Boxes represent the innermost 2 quartiles of data; horizontal line shows the mean; whiskers represent the outermost 2 quartiles.
Mentions: We sequenced 40 PCR-positive samples, of which 18 (45%) showed the original E1-226A genotype and 22 (55%) had the E1-226V mutation (2 from Réunion Island, 20 from Mauritius, all sampled in the first half of 2006). Samples from India (n = 2) and from Sri Lanka (n = 2), which were collected in the second half of 2006, displayed the original E1-226A genotype. CHIKV viral loads among genotypes were compared (Figure 3). Median concentrations (1.6 × 107 copies/mL for E1-226A; 1.6 × 105 copies/mL for E1-226V) were not significantly different at the 95% confidence level. To exclude an influence of CHIKV antibodies on this result, we analyzed samples without antibodies separately. Again, the difference was not significant (226A samples (n = 12), 5 × 107 copies/mL; 226V samples (n = 12), 2.5 × 106 RNA copies/mL).

Bottom Line: Reverse transcription-PCR was positive for all samples taken up to day 4 after symptom onset.Immunofluorescence detected immunoglobulin (Ig) M on day 1 and IgG on day 2 for some patients, and in all patients from day 5 onward.Soon after onset of symptoms, patients had IgG and IgM and high viral loads (some >10(9) copies/mL plasma).

View Article: PubMed Central - PubMed

Affiliation: Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.

ABSTRACT
Chikungunya fever has spread through several Indian Ocean islands and India, including popular travel destinations. To compare usefulness of diagnostic tests and to understand reasons for the magnitude and severity of an outbreak, we used 3 diagnostic methods to test 720 samples from 680 patients returning to Europe from the Indian Ocean region in 2006. Chikungunya infection was confirmed for 24.4% patients in the first half of the year and for 9.9% in the second half. Reverse transcription-PCR was positive for all samples taken up to day 4 after symptom onset. Immunofluorescence detected immunoglobulin (Ig) M on day 1 and IgG on day 2 for some patients, and in all patients from day 5 onward. Soon after onset of symptoms, patients had IgG and IgM and high viral loads (some >10(9) copies/mL plasma). These data will help healthcare providers select diagnostic tests for returning travelers.

Show MeSH
Related in: MedlinePlus