Distinguishing patients with laboratory-confirmed chikungunya from dengue and other acute febrile illnesses, Puerto Rico, 2012-2015
| العنوان: | Distinguishing patients with laboratory-confirmed chikungunya from dengue and other acute febrile illnesses, Puerto Rico, 2012-2015 |
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| المؤلفون: | Carlos Garcia-Gubern, Vanessa Rivera-Amill, Joseph Singleton, Gerson Jiménez, Aidsa Rivera, Renee L. Galloway, Cecilia Kato, Luzeida Vargas, Elizabeth Hunsperger, Kalanthe Horiuchi, Brenda Torres-Velasquez, Kay M. Tomashek, Demetrius L. Mathis, Olga D. Lorenzi, Mindy G. Elrod, Elizabeth Henderson, Juan D. Ortiz-Rivera, Tyler M. Sharp, Janice Perez-Padilla, Robert Muns-Sosa, W. Allan Nix, Jennifer H. McQuiston, Gladys E. Gonzalez-Zeno, William Santiago-Rivera, M. Steven Oberste, Doris A. Andújar-Pérez, Luisa I. Alvarado, Jorge L. Muñoz-Jordán |
| المصدر: | PLoS Neglected Tropical Diseases, Vol 13, Iss 7, p e0007562 (2019) PLoS Neglected Tropical Diseases |
| بيانات النشر: | Public Library of Science (PLoS), 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | 0301 basic medicine, myalgia, RNA viruses, Male, Viral Diseases, RC955-962, Arthritis, medicine.disease_cause, Pathology and Laboratory Medicine, Vascular Medicine, Dengue fever, Dengue, 0302 clinical medicine, Skeletal Joints, Arctic medicine. Tropical medicine, Back pain, Medicine and Health Sciences, Chikungunya, Child, Musculoskeletal System, Chikungunya Virus, virus diseases, Hematology, Middle Aged, Rash, Infectious Diseases, Medical Microbiology, Joint pain, Viral Pathogens, Child, Preschool, Viruses, Comparators, Engineering and Technology, Polyarthritis, Female, medicine.symptom, Pathogens, Anatomy, Public aspects of medicine, RA1-1270, Research Article, Neglected Tropical Diseases, Adult, medicine.medical_specialty, Adolescent, Fever, Alphaviruses, 030231 tropical medicine, Pain, Hemorrhage, Dermatology, Rashes, Real-Time Polymerase Chain Reaction, Microbiology, Togaviruses, Diagnosis, Differential, 03 medical and health sciences, Young Adult, Signs and Symptoms, Diagnostic Medicine, Predictive Value of Tests, Internal medicine, medicine, Humans, Microbial Pathogens, Biology and life sciences, business.industry, Clinical Laboratory Techniques, Puerto Rico, Public Health, Environmental and Occupational Health, Organisms, Chikungunya Infection, Myalgia, medicine.disease, Tropical Diseases, Thrombocytopenia, 030104 developmental biology, Chikungunya Fever, Electronics, business |
| الوصف: | Chikungunya, a mosquito-borne viral, acute febrile illness (AFI) is associated with polyarthralgia and polyarthritis. Differentiation from other AFI is difficult due to the non-specific presentation and limited availability of diagnostics. This 3-year study identified independent clinical predictors by day post-illness onset (DPO) at presentation and age-group that distinguish chikungunya cases from two groups: other AFI and dengue. Specimens collected from participants with fever ≤7 days were tested for chikungunya, dengue viruses 1–4, and 20 other pathogens. Of 8,996 participants, 18.2% had chikungunya, and 10.8% had dengue. Chikungunya cases were more likely than other groups to be older, report a chronic condition, and present Author summary Chikungunya is an acute febrile illness (AFI), caused by the chikungunya virus (CHIKV), that is transmitted by mosquitoes. Patients with chikungunya exhibit joint, muscle, or bone pain, and may also have skin rash, red eyes (conjunctiva), and red swollen joints (arthritis). Up to 20% of cases develop long lasting arthritis, fatigue or psychiatric conditions. We used data from our prospective study to identify signs and symptoms that predict chikungunya. We enrolled 8,996 AFI patients and tested for CHIKV, dengue viruses 1–4 (DENV 1–4), and other pathogens. A pathogen was detected in 55% of participants; 18.2% had CHIKV and 10.8% had DENV 1–4 infections. This study compared the clinical presentation of chikungunya with that of all other AFI and dengue alone. Regardless of timing of presentation, significant predictors of chikungunya were joint pain, muscle, bone or back pain, and red conjunctiva when compared to other AFI, and arthritis, joint pain, skin rash, any bleeding, and irritability, when dengue was the comparator group. Chikungunya patients were less likely than AFI and dengue patients to have low platelets, signs of poor circulation, diarrhea, headache, and cough. By enrolling febrile patients at presentation, we identified unbiased predictors of chikungunya. These findings can assist physicians to clinically diagnose chikungunya and initiate proper patient management. |
| اللغة: | English |
| تدمد: | 1935-2735 1935-2727 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::49c8d2c2a010d60cfc1e4a6abe33c496 https://doaj.org/article/11e7d0c3db5f468e8345abd9848aa9bb |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....49c8d2c2a010d60cfc1e4a6abe33c496 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19352735 19352727 |
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