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Chikungunya virus–associated encephalitis

2015; Lippincott Williams & Wilkins; Volume: 86; Issue: 1 Linguagem: Inglês

10.1212/wnl.0000000000002234

1526-632X

Patrick Gérardin, Thérèse Couderc, Marc Bintner, Patrice Tournebize, Michel Renouil, Jérôme Lemant, Véronique Boisson, Gianandréa Borgherini, F. Staïkowsky, Frédéric Schramm, Marc Lecuit, Alain Michault, Nathalie Le Moullec, J Becquart, Gianandréa Borgherini, P. Poubeau, Olivier Fels, Frédéric Schramm, Alain Michault, P. Finielz, Patrice Tournebize, Cyril Charlin, Marc Bintner, Séverine Blanc, Michel Renouil, S. Piyaraly, Fabrice Paganin, F. Staïkowsky, Pierre-Jean Marianne Dit Cassou, Patrick Gérardin, B. Boumahni, Emmanuel Antok, Marie Pierre Cresta, Jérôme Lemant, Véronique Boisson, F. Staïkowsky, Frédéric Schramm, Sophie Larrieu, Daouda Sissoko, Thérèse Couderc, Marc Lecuit, Marc Lecuit, Marc Lecuit,

Virology and Viral Diseases

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.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.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.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.