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© Therese Couderc, Marc Lecuit
Publication : Neurology

Chikungunya virus-associated encephalitis: A cohort study on La Réunion Island, 2005-2009

Scientific Fields
Diseases
Organisms
Applications
Technique

Published in Neurology - 25 Nov 2015

Gérardin P, Couderc T, Bintner M, Tournebize P, Renouil M, Lémant J, Boisson V, Borgherini G, Staikowsky F, Schramm F, Lecuit M, Michault A,

Link to Pubmed [PMID] – 26609145

Neurology 2016 Jan;86(1):94-102

OBJECTIVE: To estimate the cumulative incidence rate (CIR) of Chikungunya virus (CHIKV)-associated CNS disease during the La Réunion outbreak, and assess the disease burden and patient outcome after 3 years.

METHODS: CHIKV-associated CNS disease was characterized retrospectively in a cohort of patients with positive CHIKV reverse transcriptase PCR or anti-CHIKV immunoglobulin M antibodies in the CSF and fulfilling International Encephalitis Consortium criteria for encephalitis or encephalopathy. Neurologic sequelae were assessed after 3 years.

RESULTS: Between September 2005 and June 2006, 57 patients were diagnosed with CHIKV-associated CNS disease, including 24 with CHIKV-associated encephalitis, the latter corresponding to a CIR of 8.6 per 100,000 persons. Patients with encephalitis were observed at both extremes of age categories. CIR per 100,000 persons were 187 and 37 in patients below 1 year and over 65 years, respectively, both far superior to those of cumulated causes of encephalitis in the United States in these age categories. The case-fatality rate of CHIKV-associated encephalitis was 16.6% and the proportion of children discharged with persistent disabilities estimated between 30% and 45%. Beyond the neonatal period, the clinical presentation and outcomes were less severe in infants than in adults.

CONCLUSIONS: In the context of a large outbreak, CHIKV is a significant cause of CNS disease. As with other etiologies, CHIKV-associated encephalitis case distribution by age follows a U-shaped parabolic curve.

https://www.ncbi.nlm.nih.gov/pubmed/26609145