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Flandes X, Hansen CA, Palani S, Abbas K, Bennett C, Caro WP, Hutubessy R, Khazhidinov K, Lambach P, Maure C, Marshall C, Rojas DP, Rosewell A, Sahastrabuddhe S, Tufet M, Wilder-Smith A, Beasley DWC, Bourne N, Barrett ADT. Vaccine value profile for Chikungunya. Vaccine 2024; 42:S9-S24. [PMID: 38407992 DOI: 10.1016/j.vaccine.2023.07.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 07/05/2023] [Accepted: 07/28/2023] [Indexed: 02/28/2024]
Abstract
Chikungunya virus (CHIKV) a mosquito-borne alphavirus is the causative agent of Chikungunya (CHIK), a disease with low mortality but high acute and chronic morbidity resulting in a high overall burden of disease. After the acute disease phase, chronic disease including persistent arthralgia is very common, and can cause fatigue and pain that is severe enough to limit normal activities. On average, around 40% of people infected with CHIKV will develop chronic arthritis, which may last for months or years. Recommendations for protection from CHIKV focus on infection control through preventing mosquito proliferation. There is currently no licensed antiviral drug or vaccine against CHIKV. Therefore, one of the most important public health impacts of vaccination would be to decrease burden of disease and economic losses in areas impacted by the virus, and prevent or reduce chronic morbidity associated with CHIK. This benefit would particularly be seen in Low and Middle Income Countries (LMIC) and socio-economically deprived areas, as they are more likely to have more infections and more severe outcomes. This 'Vaccine Value Profile' (VVP) for CHIK is intended to provide a high-level, holistic assessment of the information and data that are currently available to inform the potential public health, economic and societal value of vaccines in the development pipeline and vaccine-like products.This VVP was developed by a working group of subject matter experts from academia, non-profit organizations, public private partnerships, and multi-lateral organizations. All contributors have extensive expertise on various elements of the CHIK VVP and collectively aimed to identify current research and knowledge gaps.The VVP was developed using only existing and publicly available information.
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Affiliation(s)
- Ximena Flandes
- Department of Preventative Medicine and Population Health and University of Texas Medical Branch, Galveston, TX, United States
| | - Clairissa A Hansen
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, United States
| | - Sunil Palani
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, United States
| | - Kaja Abbas
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | | | | | | | | | | | - Clara Maure
- International Vaccine Institute, Seoul, Republic of Korea
| | | | | | | | | | - Marta Tufet
- Gavi the Vaccine Alliance, Geneva, Switzerland
| | | | - David W C Beasley
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, United States; Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston, TX, United States.
| | - Nigel Bourne
- Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston, TX, United States; Department of Pediatrics, University of Texas Medical Branch, Galveston, TX, United States.
| | - Alan D T Barrett
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, United States; Department of Pediatrics, University of Texas Medical Branch, Galveston, TX, United States.
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Ngwe Tun MM, Luvai EAC, Toizumi M, Moriuchi M, Takamatsu Y, Inoue S, Urano T, Bui MX, Thai Hung D, Thi Nguyen HA, Anh DD, Yoshida LM, Moriuchi H, Morita K. Possible vertical transmission of Chikungunya virus infection detected in the cord blood samples from a birth cohort in Vietnam. J Infect Public Health 2024; 17:1050-1056. [PMID: 38688178 DOI: 10.1016/j.jiph.2024.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 04/06/2024] [Accepted: 04/15/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Chikungunya virus (CHIKV) is an alphavirus (genus Alphavirus, family Togaviridae) that is primarily transmitted to humans by Aedes mosquitoes, and can be transmitted from mother to child. Little is known about CHIKV transmission in Vietnam, where dengue is endemic and Aedes mosquitoes are abundant. This study aimed to determine the prevalence and characteristics of vertical CHIKV infection in a birth cohort, and seroprevalence of anti-CHIKV antibodies with or without confirmation by neutralization tests among women bearing children in Vietnam. METHODS We collected umbilical cord blood plasma samples from each newly delivered baby in Nha Trang, Central Vietnam, between July 2017 and September 2018. Samples were subjected to molecular assay (quantitative real-time RT-PCR) and serological tests (anti-CHIKV IgM capture and IgG indirect enzyme-linked immunosorbent assay, and neutralization tests). RESULTS Of the 2012 tested cord blood samples from newly delivered babies, the CHIKV viral genome was detected in 6 (0.3%) samples by RT-PCR, whereas, 15 samples (0.7%) were anti-CHIKV-IgM positive. Overall, 18 (0.9%, 95% CI: 0.6-1.5) samples, including three positives for both CHIKV IgM and viral genome on RT-PCR, were regarded as vertical transmission of CHIKV infection. Of the 2012 cord blood samples, 10 (0.5%, 95% CI: 0.2-0.9) were positive for both anti-CHIKV IgM and IgG. Twenty-nine (1.4%, 95% CI: 1.0-2.1) were seropositive for anti-CHIKV IgG while 26 (1.3%, 95% CI: 0.8-1.9) of them were also positive for neutralizing antibodies, and regarded as seropositive with neutralization against CHIKV infection. CONCLUSION This is the first report of a possible CHIKV maternal-neonatal infection in a birth cohort in Vietnam. The findings indicate that follow-up and a differential diagnosis of CHIKV infection in pregnant women are needed to clarify the potential for CHIKV vertical transmission and its impact in the newborn.
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Affiliation(s)
- Mya Myat Ngwe Tun
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Department of Tropical Viral Vaccine Development, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Center for Vaccines and Therapeutic Antibodies for Emerging Infectious Diseases, Shimane University, Izumo, Japan.
| | - Elizabeth Ajema Chebichi Luvai
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Department of Biomedical Sciences and Technology, Technical University of Kenya, Nairobi, Kenya
| | - Michiko Toizumi
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Masako Moriuchi
- Department of Pediatrics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yuki Takamatsu
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Department of Tropical Viral Vaccine Development, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Shingo Inoue
- Kenya Research Station, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Takeshi Urano
- Center for Vaccines and Therapeutic Antibodies for Emerging Infectious Diseases, Shimane University, Izumo, Japan
| | - Minh Xuan Bui
- Khanh Hoa Provincial Public Health Service, Nha Trang, Viet Nam
| | - Do Thai Hung
- Pasteur Institute in Nha Trang, Nha Trang, Viet Nam
| | | | - Dang Duc Anh
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | - Lay-Myint Yoshida
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Hiroyuki Moriuchi
- Department of Pediatrics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
| | - Kouichi Morita
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Department of Tropical Viral Vaccine Development, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; DEJIMA Infectious Disease Research Alliance, Nagasaki University, Nagasaki, Japan
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3
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Warnes CM, Bustos Carrillo FA, Zambrana JV, Lopez Mercado B, Arguello S, Ampié O, Collado D, Sanchez N, Ojeda S, Kuan G, Gordon A, Balmaseda A, Harris E. Longitudinal analysis of post-acute chikungunya-associated arthralgia in children and adults: A prospective cohort study in Managua, Nicaragua (2014-2018). PLoS Negl Trop Dis 2024; 18:e0011948. [PMID: 38416797 PMCID: PMC10962812 DOI: 10.1371/journal.pntd.0011948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 03/25/2024] [Accepted: 01/27/2024] [Indexed: 03/01/2024] Open
Abstract
Chikungunya can result in debilitating arthralgia, often presenting as acute, self-limited pain, but occasionally manifesting chronically. Little is known about differences in chikungunya-associated arthralgia comparing children to adults over time. To characterize long-term chikungunya-associated arthralgia, we recruited 770 patients (105 0-4 years old [y/o], 200 5-9 y/o, 307 10-15 y/o, and 158 16+ y/o) with symptomatic chikungunya virus infections in Managua, Nicaragua, during two consecutive chikungunya epidemics (2014-2015). Participants were assessed at ~15 days and 1, 3, 6, 12, and 18 months post-fever onset. Following clinical guidelines, we defined participants by their last reported instance of arthralgia as acute (≤10 days post-fever onset), interim (>10 and <90 days), or chronic (≥90 days) cases. We observed a high prevalence of arthralgia (80-95%) across all ages over the study period. Overall, the odds of acute arthralgia increased in an age-dependent manner, with the lowest odds of arthralgia in the 0-4 y/o group (odds ratio [OR]: 0.27, 95% confidence interval [CI]: 0.14-0.51) and the highest odds of arthralgia in the 16+ y/o participants (OR: 4.91, 95% CI: 1.42-30.95) relative to 10-15 y/o participants. Females had higher odds of acute arthralgia than males (OR: 1.63, 95% CI: 1.01-2.65) across all ages. We found that 23-36% of pediatric and 53% of adult participants reported an instance of post-acute arthralgia. Children exhibited the highest prevalence of post-acute polyarthralgia in their legs, followed by the hands and torso - a pattern not seen among adult participants. Further, we observed pediatric chikungunya presenting in two distinct phases: the acute phase and the subsequent interim/chronic phases. Thus, differences in the presentation of arthralgia were observed across age, sex, and disease phase in this longitudinal chikungunya cohort. Our results elucidate the long-term burden of chikungunya-associated arthralgia among pediatric and adult populations.
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Affiliation(s)
- Colin M. Warnes
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Fausto Andres Bustos Carrillo
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
- Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | | | | | | | | | | | - Nery Sanchez
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Sergio Ojeda
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Guillermina Kuan
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro de Salud Sócrates Flores Vivas, Ministerio de Salud, Managua, Nicaragua
| | - Aubree Gordon
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, United States of America
| | - Angel Balmaseda
- Sustainable Sciences Institute, Managua, Nicaragua
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministerio de Salud, Managua, Nicaragua
| | - Eva Harris
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
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de Souza WM, Ribeiro GS, de Lima ST, de Jesus R, Moreira FR, Whittaker C, Sallum MAM, Carrington CV, Sabino EC, Kitron U, Faria NR, Weaver SC. Chikungunya: a decade of burden in the Americas. LANCET REGIONAL HEALTH. AMERICAS 2024; 30:100673. [PMID: 38283942 PMCID: PMC10820659 DOI: 10.1016/j.lana.2023.100673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/24/2023] [Accepted: 12/29/2023] [Indexed: 01/30/2024]
Abstract
In the Americas, one decade following its emergence in 2013, chikungunya virus (CHIKV) continues to spread and cause epidemics across the region. To date, 3.7 million suspected and laboratory-confirmed chikungunya cases have been reported in 50 countries or territories in the Americas. Here, we outline the current status and epidemiological aspects of chikungunya in the Americas and discuss prospects for future research and public health strategies to combat CHIKV in the region.
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Affiliation(s)
- William M. de Souza
- Department of Microbiology, Immunology and Molecular Genetics, University of Kentucky, College of Medicine, Lexington, KY, USA
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, USA
- World Reference Center for Emerging Viruses and Arboviruses, University of Texas Medical Branch, Galveston, TX, USA
- Global Virus Network, Baltimore, MD, USA
| | - Guilherme S. Ribeiro
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil
- Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Shirlene T.S. de Lima
- Laboratório Central de Saúde Pública do Ceará, Fortaleza, Ceará, Brazil
- Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas, São Paulo, Brazil
| | - Ronaldo de Jesus
- Coordenação Geral dos Laboratórios de Saúde Pública, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Brazil
- Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Filipe R.R. Moreira
- Departamento de Genética, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Charles Whittaker
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
| | - Maria Anice M. Sallum
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, Brazil
| | - Christine V.F. Carrington
- Department of Preclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Republic of Trinidad and Tobago
| | - Ester C. Sabino
- Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Uriel Kitron
- Department of Environmental Sciences, Emory University, Atlanta, GA, USA
| | - Nuno R. Faria
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
- Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Department of Biology, University of Oxford, Oxford, UK
| | - Scott C. Weaver
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, USA
- World Reference Center for Emerging Viruses and Arboviruses, University of Texas Medical Branch, Galveston, TX, USA
- Global Virus Network, Baltimore, MD, USA
- Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, TX, USA
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Meyer AD, Guerrero SM, Dean NE, Anderson KB, Stoddard ST, Perkins TA. Model-based estimates of chikungunya epidemiological parameters and outbreak risk from varied data types. Epidemics 2023; 45:100721. [PMID: 37890441 DOI: 10.1016/j.epidem.2023.100721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
Assessing the factors responsible for differences in outbreak severity for the same pathogen is a challenging task, since outbreak data are often incomplete and may vary in type across outbreaks (e.g., daily case counts, serology, cases per household). We propose that outbreaks described with varied data types can be directly compared by using those data to estimate a common set of epidemiological parameters. To demonstrate this for chikungunya virus (CHIKV), we developed a realistic model of CHIKV transmission, along with a Bayesian inference method that accommodates any type of outbreak data that can be simulated. The inference method makes use of the fact that all data types arise from the same transmission process, which is simulated by the model. We applied these tools to data from three real-world outbreaks of CHIKV in Italy, Cambodia, and Bangladesh to estimate nine model parameters. We found that these populations differed in several parameters, including pre-existing immunity and house-to-house differences in mosquito activity. These differences resulted in posterior predictions of local CHIKV transmission risk that varied nearly fourfold: 16% in Italy, 28% in Cambodia, and 62% in Bangladesh. Our inference method and model can be applied to improve understanding of the epidemiology of CHIKV and other pathogens for which outbreaks are described with varied data types.
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Affiliation(s)
- Alexander D Meyer
- Department of Biological Sciences, University of Notre Dame, Notre Dame, IN 46556, USA.
| | | | - Natalie E Dean
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Kathryn B Anderson
- Department of Microbiology and Immunology, The State University of New York (SUNY) Upstate Medical University, Syracuse, NY 13210, USA
| | - Steven T Stoddard
- Bavarian Nordic Inc., 6275 Nancy Ridge Drive Suite 110/120, San Diego, CA 92121, USA; Division of Health Promotion and Behavioral Sciences, School of Public Health, San Diego State University, San Diego, CA 92182, USA
| | - T Alex Perkins
- Department of Biological Sciences, University of Notre Dame, Notre Dame, IN 46556, USA
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Ogwuche J, Chang CA, Ige O, Sagay AS, Chaplin B, Kahansim ML, Paul M, Elujoba M, Imade G, Kweashi G, Dai YC, Hsieh SC, Wang WK, Hamel DJ, Kanki PJ. Arbovirus surveillance in pregnant women in north-central Nigeria, 2019-2022. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.08.04.23293671. [PMID: 37609234 PMCID: PMC10441490 DOI: 10.1101/2023.08.04.23293671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
The adverse impact of Zika (ZIKV), dengue (DENV), and chikungunya (CHIKV) virus infection in pregnancy has been recognized in Latin America and Asia but is not well studied in Africa. In Nigeria, we screened 1006 pregnant women for ZIKV, DENV and CHIKV IgM/IgG by rapid test (2019-2022). Women with acute infection were recruited for prospective study and infants were examined for any abnormalities from delivery through six months. A subset of rapid test-reactive samples were confirmed using virus-specific ELISAs and neutralization assays. Prevalence of acute infection (IgM+) was 3.8%, 9.9% and 11.8% for ZIKV, DENV and CHIKV, respectively; co-infections represented 24.5% of all infections. Prevalence in asymptomatic women was twice the level of symptomatic infection. We found a significant association between acute maternal ZIKV/DENV/CHIKV infection and any gross abnormal birth outcome (p=0.014). Further prospective studies will contribute to our understanding of the clinical significance of these endemic arboviruses in Africa.
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Grabenstein JD, Tomar AS. Global geotemporal distribution of chikungunya disease, 2011-2022. Travel Med Infect Dis 2023; 54:102603. [PMID: 37307983 DOI: 10.1016/j.tmaid.2023.102603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 01/06/2023] [Accepted: 06/03/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Chikungunya virus is a mosquito-borne alphavirus, transmitted by Aedes mosquitoes. Humans serve as the primary reservoir. Chikungunya infections typically appear with an abrupt onset of fever, rash, and severe joint pain. Some 40% of cases develop chronic rheumatologic complications that can persist months to years. OBJECTIVES To improve precision of risk characterization by analyzing cases of chikungunya by year and by country and depicting this geotemporal distribution in map form. METHOD Chikungunya case counts by year were compiled from national or regional health authorities from 2011 to 2022. These data were augmented by published reviews plus the Program for Monitoring Emerging Diseases (ProMED). Country-level distribution was categorized into four groups based on recency and magnitude. Data for India were mapped on a per-state basis. RESULTS The global map depicts distribution of chikungunya disease from 2011 through 2022. Most cases are reported in tropical and subtropical areas, but notable exceptions include the northern coast of the Mediterranean Sea. Countries of high recency and frequency include India, Brazil, Sudan, and Thailand. Countries with high frequency, but few cases reported in 2019-22 include many Latin American and Caribbean countries. Subnational foci are discussed in general and mapped for India. The range of Aedes mosquitoes is broader than the geography where chikungunya infection is typically diagnosed. CONCLUSIONS These maps help identify geographical regions where residents or travelers are at greatest risk of chikungunya. Once vaccines are licensed to help prevent chikungunya, maps like these can help guide future vaccine decision-making.
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Hasan A, Devi Ms S, Sharma G, Narayanan V, Sathiyarajeswaran P, Vinayak S, Sunil S. Vathasura Kudineer, an Andrographis based polyherbal formulation exhibits immunomodulation and inhibits chikungunya virus (CHIKV) under invitro conditions. JOURNAL OF ETHNOPHARMACOLOGY 2023; 302:115762. [PMID: 36181982 DOI: 10.1016/j.jep.2022.115762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/23/2022] [Accepted: 09/24/2022] [Indexed: 06/16/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Chikungunya disease (CHIKD) is caused by the alphavirus, chikungunya virus (CHIKV) and is characterized by acute fever and joint inflammation; the inflammation continues even after clearance of the virus from the system, persisting for several months to years. Currently, there are no modern medicines/vaccines available for its treatment and use of over-the-counter anti-inflammatory generic medicines to relieve symptoms is generally practiced. In India, Indian traditional medicines hold a lot of promise to treat this infection and are routinely used during outbreaks. AIM OF THE STUDY In the present study, we characterized the phytochemical and physicochemical properties of aqueous and ethanol extracts of the Vathasura Kudineer (VSK), a Andrographis based Siddha polyherbal formulation. Additionally, we evaluated its immunomodulatory and antiviral potential using an in vitro system. MATERIALS AND METHODS Aqueous and ethanolic extracts of VSK were prepared and their physico and phytochemical properties were obtained by biochemical and biophysical assays, HPTLC and FTIR. The aqueous extracts of VSK and several of its ingredients were evaluated for their cytotoxicity in Vero cells and using the maximum non-toxic concentration (MNTC), were processed further for evaluating their ability to inhibit CHIKV infection in Vero cells. We performed the co-treatment assay with ethanol extract of VSK and several of its ingredients to assess the antiviral activity against chikungunya virus on Vero cells and through pre-treatment assay (anti-adhesive effect), co-incubation assay (virucidal effect) and post-treatment assay (post-entry effect) were evaluated. Further, we tested the aqueous extract of VSK along with some of its ingredients for their immunomodulatory properties. We performed antioxidant and anti-inflammatory assays using LPS-simulated RAW 264.7 cells. For antioxidant capacity of extracts, we performed extra-cellular ABTS radical scavenging activity and intra-cellular effects on ROS generation and SOD activity. We assessed the effect on most important inflammatory mediators like Nitric oxide (NO) and Prostaglandin E2 (PGE2) and pro-inflammatory cytokines like interleukin-1 beta (IL-1β) and tumor necrosis factor alpha (TNFα). RESULTS We provided the fingerprint of the phytochemicals of both ethanol and aqueous extracts of VSK that can be used for identification. We observed that ethanol extract was able to inhibit CHIKV infection at MNTC with 48 h of treatment on Vero cells. Its ingredient VSKI-As (Anethum sowa) found to be most effective to show virucidal effect while VSKI-Cs (Clerodendrum serratum) and VSKI-Pn (Pipper nigrum) found to be effective in post-entry effect. VSK was able to show ABTS radical scavenging activity, reduce ROS generation, inhibit the inflammatory mediators (NO and PGE2) and pro-inflammatory cytokines (IL-1β and TNFα) production in LPS-stimulated RAW 264.7 cells. CONCLUSIONS We provided the evidence that VSK has both immunomodulatory as well as antiviral potential. It shows virucidal as well as post-entry effects on chikungunya virus. VSK can inhibit pro-inflammatory cytokines, IL-1β and TNFα production by suppressing the inflammatory mediators, NO and PGE2.
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Affiliation(s)
- Abdul Hasan
- Vector Borne Disease Group, International Center for Genetic Engineering and Biotechnology, New Delhi, India
| | - Shree Devi Ms
- Siddha Central Research Institute, Chennai, Tamil Nadu, India
| | - Geetika Sharma
- Vector Borne Disease Group, International Center for Genetic Engineering and Biotechnology, New Delhi, India
| | - Vimal Narayanan
- Vector Borne Disease Group, International Center for Genetic Engineering and Biotechnology, New Delhi, India
| | | | - S Vinayak
- Siddha Central Research Institute, Chennai, Tamil Nadu, India
| | - Sujatha Sunil
- Vector Borne Disease Group, International Center for Genetic Engineering and Biotechnology, New Delhi, India.
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Millsapps EM, Underwood EC, Barr KL. Development and Application of Treatment for Chikungunya Fever. Res Rep Trop Med 2022; 13:55-66. [PMID: 36561535 PMCID: PMC9767026 DOI: 10.2147/rrtm.s370046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022] Open
Abstract
The development and application of treatment for Chikungunya fever (CHIKF) remains complicated as there is no current standard treatment and many barriers to research exist. Chikungunya virus (CHIKV) causes serious global health implications due to its socioeconomic impact and high morbidity rates. In research, treatment through natural and pharmaceutical techniques is being evaluated for their efficacy and effectiveness. Natural treatment options, such as homeopathy and physiotherapy, give patients a variety of options for how to best manage acute and chronic symptoms. Some of the most used pharmaceutical therapies for CHIKV include non-steroidal anti-inflammatory drugs (NSAIDS), methotrexate (MTX), chloroquine, and ribavirin. Currently, there is no commercially available vaccine for chikungunya, but vaccine development is crucial for this virus. Potential treatments need further research until they can become a standard part of treatment. The barriers to research for this complicated virus create challenges in the efficacy and equitability of its research. The rising need for increased research to fully understand chikungunya in order to develop more effective treatment options is vital in protecting endemic populations globally.
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Affiliation(s)
- Erin M Millsapps
- Center for Global Health and Infectious Disease Research, University of South Florida, Tampa, FL, USA
| | - Emma C Underwood
- Center for Global Health and Infectious Disease Research, University of South Florida, Tampa, FL, USA
| | - Kelli L Barr
- Center for Global Health and Infectious Disease Research, University of South Florida, Tampa, FL, USA,Correspondence: Kelli L Barr, Center for Global Health and Infectious Disease Research, University of South Florida, 3720 Spectrum Blvd. Suite 304, Tampa, FL, 33612, USA, Tel +1 813 974 4480, Fax +1 813 974 4962, Email
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Fritsch H, Giovanetti M, Xavier J, Adelino TER, Fonseca V, de Jesus JG, de Jesus R, Freitas C, Peterka CRL, Campelo de Albuquerque CF, Bispo de Filippis AM, da Cunha RV, Silva EC, Alcantara LCJ, Iani FCDM. Retrospective Genomic Surveillance of Chikungunya Transmission in Minas Gerais State, Southeast Brazil. Microbiol Spectr 2022; 10:e0128522. [PMID: 36005767 PMCID: PMC9602355 DOI: 10.1128/spectrum.01285-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 07/13/2022] [Indexed: 12/30/2022] Open
Abstract
Brazil accounted for a total number of 1,276,194 reported cases of chikungunya fever between 2014 and 2022. Additionally, since 2015, the country has experienced an increasing death toll, in which the Northeast and Southeast regions appear to report the worst scenarios. Although the CHIKV transmission dynamics have been studied in many parts of the country since its introduction in 2014, little is still known about chikungunya virus (CHIKV) transmission and genetic diversity in the state of Minas Gerais, located in southeast Brazil. Moreover, no studies have been published characterizing CHIKV genomic surveillance in this state. Thus, to retrospectively explore the CHIKV epidemic in Minas Gerais, we generated 40 genomes from clinical samples using Nanopore sequencing. Phylogenetic analysis indicated that multiple introductions of CHIKV occurred, likely from the northeastern Brazilian states, with the most recent common ancestral strain dating to early March 2016, which is in agreement with local epidemiological reports. Additionally, epidemiological data reveals a decline in the number of reported cases from 2017 to 2021, indicating that population immunity or changes in vector activity may have contributed to the decreasing waves of CHIKV infection. Together, our results shed light on the dispersion dynamics of CHIKV and show that infections decreased from March 2017 to January 2021 despite multiple introductions into Minas Gerais State. In conclusion, our study highlights the importance of combining genomic and epidemiological data in order to assist public health laboratories in monitoring and understanding the patterns and diversity of mosquito-borne viral epidemics. IMPORTANCE Arbovirus infections in Brazil, including chikungunya, dengue, yellow fever, and Zika, result in considerable morbidity and mortality and are pressing public health concerns. However, our understanding of these outbreaks is hampered by the limited availability of genomic data. In this study, we combine epidemiological analysis and portable genome sequencing to retrospectively describe the CHIKV epidemic in Minas Gerais between 2017 and 2021. Our results indicate that the East/Central/South African (ECSA) CHIKV lineage was introduced into Minas Gerais by three distinct events, likely from the North and Northeast regions of Brazil. Our study provides an understanding of how CHIKV initiates transmission in the region and illustrates that genomics in the field can augment traditional approaches to infectious disease surveillance and control.
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Affiliation(s)
- Hegger Fritsch
- Laboratorio de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Laboratório Central de Saúde Pública do Estado de Minas Gerais, Fundação Ezequiel Dias, Belo Horizonte, Minas Gerais, Brazil
| | - Marta Giovanetti
- Laboratorio de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Department of Science and Technology for Humans and the Environment, Campus Bio-Medico University of Rome, Rome, Italy
| | - Joilson Xavier
- Laboratorio de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Talita Emile Ribeiro Adelino
- Laboratório Central de Saúde Pública do Estado de Minas Gerais, Fundação Ezequiel Dias, Belo Horizonte, Minas Gerais, Brazil
| | - Vagner Fonseca
- Organização Pan-Americana da Saúde, Organização Mundial da Saúde, Brasília, Distrito Federal, Brazil
| | - Jaqueline Góes de Jesus
- Laboratório de Patologia Experimental, Instituto Gonçalo Moniz, Fundacão Oswaldo Cruz, Salvador, Brazil
| | - Ronaldo de Jesus
- Coordenação Geral dos Laboratórios de Saúde Pública, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Distrito Federal, Brazil
| | - Carla Freitas
- Coordenação Geral dos Laboratórios de Saúde Pública, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Distrito Federal, Brazil
| | - Cassio Roberto Leonel Peterka
- Coordenação Geral das Arboviroses, Secretaria de Vigilância em Saúde, Ministério da Saúde (CGARB/SVS-MS), Brasília, Distrito Federal, Brazil
| | | | | | | | - Erniria Carvalhais Silva
- Coordenadoria Estadual de Vigilância das Arboviroses, Secretaria de Estado de Saúde de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Felipe Campos de Melo Iani
- Laboratório Central de Saúde Pública do Estado de Minas Gerais, Fundação Ezequiel Dias, Belo Horizonte, Minas Gerais, Brazil
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11
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Yakob L. Predictable Chikungunya Infection Dynamics in Brazil. Viruses 2022; 14:v14091889. [PMID: 36146696 PMCID: PMC9505030 DOI: 10.3390/v14091889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/22/2022] [Accepted: 08/25/2022] [Indexed: 11/21/2022] Open
Abstract
Chikungunya virus (CHIKV) was first imported into the Caribbean in 2013 and subsequently spread across the Americas. It has infected millions in the region and Brazil has become the hub of ongoing transmission. Using Seasonal Autoregressive Integrated Moving Average (SARIMA) models trained and validated on Brazilian data from the Ministry of Health’s notifiable diseases information system, we tested the hypothesis that transmission in Brazil had transitioned from sporadic and explosive to become more predictable. Consistency weighted, population standardized kernel density estimates were used to identify municipalities with the most consistent inter-annual transmission rates. Spatial clustering was assessed per calendar month for 2017−2021 inclusive using Moran’s I. SARIMA models were validated on 2020−2021 data and forecasted 106,162 (95%CI 27,303−200,917) serologically confirmed cases and 339,907 (95%CI 35,780−1035,449) total notifications for 2022−2023 inclusive, with >90% of cases in the Northeast and Southeast regions. Comparing forecasts for the first five months of 2022 to the most up-to-date ECDC report (published 2 June 2022) showed remarkable accuracy: the models predicted 92,739 (95%CI 20,685−195,191) case notifications during which the ECDC reported 92,349 case notifications. Hotspots of consistent transmission were identified in the states of Para and Tocantins (North region); Rio Grande do Norte, Paraiba and Pernambuco (Northeast region); and Rio de Janeiro and eastern Minas Gerais (Southeast region). Significant spatial clustering peaked during late summer/early autumn. This analysis highlights how CHIKV transmission in Brazil has transitioned, making it more predictable and thus enabling improved control targeting and site selection for trialing interventions.
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Affiliation(s)
- Laith Yakob
- Department of Disease Control, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
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12
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Traverse EM, Millsapps EM, Underwood EC, Hopkins HK, Young M, Barr KL. Chikungunya Immunopathology as It Presents in Different Organ Systems. Viruses 2022; 14:v14081786. [PMID: 36016408 PMCID: PMC9414582 DOI: 10.3390/v14081786] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/12/2022] [Accepted: 08/13/2022] [Indexed: 12/13/2022] Open
Abstract
Chikungunya virus (CHIKV) is currently an urgent public health problem as high morbidity from the virus leaves populations with negative physical, social, and economic impacts. CHIKV has the potential to affect every organ of an individual, leaving patients with lifelong impairments which negatively affect their quality of life. In this review, we show the importance of CHIKV in research and public health by demonstrating the immunopathology of CHIKV as it presents in different organ systems. Papers used in this review were found on PubMed, using “chikungunya and [relevant organ system]”. There is a significant inflammatory response during CHIKV infection which affects several organ systems, such as the brain, heart, lungs, kidneys, skin, and joints, and the immune response to CHIKV in each organ system is unique. Whilst there is clinical evidence to suggest that serious complications can occur, there is ultimately a lack of understanding of how CHIKV can affect different organ systems. It is important for clinicians to understand the risks to their patients.
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13
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Kanunfre KA, Rocha MC, Malta MB, Souza RMD, Castro MC, Boscardin SB, Souza HFS, Witkin SS, Cardoso MA, Okay TS. Silent circulation of Chikungunya virus among pregnant women and newborns in the Western Brazilian Amazon before the first outbreak of chikungunya fever. Rev Inst Med Trop Sao Paulo 2022; 64:e25. [PMID: 35384956 PMCID: PMC8993149 DOI: 10.1590/s1678-9946202264025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 03/03/2022] [Indexed: 11/21/2022] Open
Abstract
The prevalence of immunity to Chikungunya virus (CHIKV) in pregnant women and
newborns in the Western Brazilian Amazon was assessed at a time when previous
studies did not report chikungunya fever in the area. In 435 asymptomatic
pregnant women and 642 healthy unrelated newborns, the presence of IgM and IgG
antibodies to CHIKV were determined by a commercial ELISA. All participants were
negative to IgM anti-CHIKV. Anti-CHIKV IgG was identified in 41 (9.4%) pregnant
women and 66 (10.3%) newborns. The presence of anti-CHIKV IgG was positively
associated with the lowest socioeconomic status in pregnant women (OR 2.54, 95%
CI 1.15-5.62, p=0.021) and in the newborns’ mothers (OR 5.10, 95% CI 2.15-12.09,
p< 0.001). Anti-CHIKV IgG was also associated with maternal age in both, the
pregnant women (OR 1.06, 95% CI 1.00-1.11, p=0.037) and the newborns’mothers (OR
1.08, 95% CI 1.03-1.12, p=0.001). Pregnancy outcomes in which the mother or the
newborn was anti-CHIKV IgG positive proceeded normally. Negative CHIKV serology
was associated with being positive for DENV antibodies and having had malaria
during pregnancy. These findings showed that there was already a silent
circulation of CHIKV in this Amazon region before the first outbreak of
chikungunya fever. Furthermore, seropositivity for CHIKV was surprisingly
frequent (10%) in both, pregnant women and newborns, affecting mainly low-income
women.
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Affiliation(s)
- Kelly Aparecida Kanunfre
- Universidade de São Paulo, Faculdade de Medicina, Instituto de Medicina Tropical de São Paulo, Laboratório de Soroepidemiologia e Imunobiologia, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Faculdade de Medicina, Instituto de Medicina Tropical de São Paulo, Laboratório de Imunologia (LIM 48), São Paulo, São Paulo, Brazil
| | - Mussya Cisotto Rocha
- Universidade de São Paulo, Faculdade de Medicina, Instituto de Medicina Tropical de São Paulo, Laboratório de Soroepidemiologia e Imunobiologia, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Faculdade de Medicina, Instituto de Medicina Tropical de São Paulo, Laboratório de Imunologia (LIM 48), São Paulo, São Paulo, Brazil
| | - Maíra Barreto Malta
- Universidade de São Paulo, Faculdade de Saúde Pública, Departamento de Nutrição, São Paulo, São Paulo, Brazil.,Universidade Católica de Santos, Programa de Pós-Graduação em Saúde Pública, Santos, São Paulo, Brazil
| | | | - Marcia Caldas Castro
- Harvard T. H. Chan School of Public Health, Department of Global Health and Population, Boston, Massachusetts, USA
| | - Silvia Beatriz Boscardin
- Universidade de São Paulo, Instituto de Ciências Biomédicas, Departamento de Parasitologia, São Paulo, São Paulo, Brazil
| | - Higo Fernando Santos Souza
- Universidade de São Paulo, Instituto de Ciências Biomédicas, Departamento de Parasitologia, São Paulo, São Paulo, Brazil
| | - Steven S Witkin
- Universidade de São Paulo, Faculdade de Medicina, Instituto de Medicina Tropical de São Paulo, Laboratório de Virologia (LIM 52), São Paulo, São Paulo, Brazil.,Weill Cornell Medicine, Obstetrics and Gynecology, New York, New York, USA
| | - Marly Augusto Cardoso
- Universidade de São Paulo, Faculdade de Saúde Pública, Departamento de Nutrição, São Paulo, São Paulo, Brazil
| | - Thelma Suely Okay
- Universidade de São Paulo, Faculdade de Medicina, Instituto de Medicina Tropical de São Paulo, Laboratório de Soroepidemiologia e Imunobiologia, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Faculdade de Medicina, Departamento de Pediatria, São Paulo, São Paulo, Brazil
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14
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Bustos Carrillo FA, Mercado BL, Monterrey JC, Collado D, Saborio S, Miranda T, Barilla C, Ojeda S, Sanchez N, Plazaola M, Laguna HS, Elizondo D, Arguello S, Gajewski AM, Maier HE, Latta K, Carlson B, Coloma J, Katzelnick L, Sturrock H, Balmaseda A, Kuan G, Gordon A, Harris E. Epidemics of chikungunya, Zika, and COVID-19 reveal bias in case-based mapping. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2021.07.23.21261038. [PMID: 34341804 PMCID: PMC8328077 DOI: 10.1101/2021.07.23.21261038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Accurate tracing of epidemic spread over space enables effective control measures. We examined three metrics of infection and disease in a pediatric cohort (N≈3,000) over two chikungunya and one Zika epidemic, and in a household cohort (N=1,793) over one COVID-19 epidemic in Managua, Nicaragua. We compared spatial incidence rates (cases/total population), infection risks (infections/total population), and disease risks (cases/infected population). We used generalized additive and mixed-effects models, Kulldorf's spatial scan statistic, and intracluster correlation coefficients. Across different analyses and all epidemics, incidence rates considerably underestimated infection and disease risks, producing large and spatially non-uniform biases distinct from biases due to incomplete case ascertainment. Infection and disease risks exhibited distinct spatial patterns, and incidence clusters inconsistently identified areas of either risk. While incidence rates are commonly used to infer infection and disease risk in a population, we find that this can induce substantial biases and adversely impact policies to control epidemics.
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Affiliation(s)
| | | | | | | | | | | | | | - Sergio Ojeda
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Nery Sanchez
- Sustainable Sciences Institute, Managua, Nicaragua
| | | | | | | | | | | | | | - Krista Latta
- University of Michigan, Ann Arbor, Michigan, USA
| | | | - Josefina Coloma
- University of California, Berkeley, Berkeley, California, USA
| | - Leah Katzelnick
- University of California, Berkeley, Berkeley, California, USA
| | - Hugh Sturrock
- University of California, San Francisco, San Francisco, California, USA
- Locational, Poole, UK
| | - Angel Balmaseda
- Sustainable Sciences Institute, Managua, Nicaragua
- Ministry of Health, Managua, Nicaragua
| | - Guillermina Kuan
- Sustainable Sciences Institute, Managua, Nicaragua
- Ministry of Health, Managua, Nicaragua
| | | | - Eva Harris
- University of California, Berkeley, Berkeley, California, USA
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15
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Jourdain F, de Valk H, Noël H, Paty MC, L’Ambert G, Franke F, Mouly D, Desenclos JC, Roche B. Estimating chikungunya virus transmission parameters and vector control effectiveness highlights key factors to mitigate arboviral disease outbreaks. PLoS Negl Trop Dis 2022; 16:e0010244. [PMID: 35245304 PMCID: PMC8896662 DOI: 10.1371/journal.pntd.0010244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 02/09/2022] [Indexed: 11/29/2022] Open
Abstract
Background Viruses transmitted by Aedes mosquitoes have greatly expanded their geographic range in recent decades. They are considered emerging public health threats throughout the world, including Europe. Therefore, public health authorities must be prepared by quantifying the potential magnitude of virus transmission and the effectiveness of interventions. Methodology We developed a mathematical model with a vector-host structure for chikungunya virus transmission and estimated model parameters from epidemiological data of the two main autochthonous chikungunya virus transmission events that occurred in Southern France, in Montpellier (2014) and in Le Cannet-des-Maures (2017). We then performed simulations of the model using these estimates to forecast the magnitude of the foci of transmission as a function of the response delay and the moment of virus introduction. Conclusions The results of the different simulations underline the relative importance of each variable and can be useful to stakeholders when designing context-based intervention strategies. The findings emphasize the importance of, and advocate for early detection of imported cases and timely biological confirmation of autochthonous cases to ensure timely vector control measures, supporting the implementation and the maintenance of sustainable surveillance systems. Dengue, chikungunya and Zika viruses have expanded their geographic range during recent decades and are now considered emerging threats in temperate areas. In particular, autochthonous transmissions of chikungunya virus (CHIKV) have regularly been observed in Europe since 2010. The increase in international travel and trade appear to be major factors, encouraging both a circulation of these viruses on a global scale and the dispersion of one of their main vectors, Aedes albopictus. This trend is likely to increase significantly in the future and improved preparedness and response strategies are essential to manage these emerging risks. In this respect of decision support, we developed a mathematical model for CHIKV transmission. We first estimated key model parameters of CHIKV transmission and vector control effectiveness, using data from the two main CHIKV transmission events which have already occurred in mainland France. The model was then used to forecast the magnitude of outbreaks as a function of the delay in implementing control measures, and from the moment of virus introduction during the mosquito vector season. This work will help provide stakeholders in public health with a greater understanding of the dynamics of CHIKV transmission, and with evidence for the implementation of sustainable surveillance systems.
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Affiliation(s)
- Frédéric Jourdain
- Santé publique France (French National Public Health Agency), Saint-Maurice, France
- MIVEGEC, Université de Montpellier, IRD, CNRS, Montpellier, France
- * E-mail:
| | - Henriette de Valk
- Santé publique France (French National Public Health Agency), Saint-Maurice, France
| | - Harold Noël
- Santé publique France (French National Public Health Agency), Saint-Maurice, France
| | - Marie-Claire Paty
- Santé publique France (French National Public Health Agency), Saint-Maurice, France
| | - Grégory L’Ambert
- Entente interdépartementale pour la démoustication du littoral méditerranéen (EID Méditerranée), Montpellier, France
| | - Florian Franke
- Santé publique France (French National Public Health Agency), regional office Provence-Alpes-Côte-d’Azur-Corse, Marseille, France
| | - Damien Mouly
- Santé publique France (French National Public Health Agency), regional office Occitanie, Toulouse, France
| | | | - Benjamin Roche
- MIVEGEC, Université de Montpellier, IRD, CNRS, Montpellier, France
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16
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Nyamwaya DK, Thumbi SM, Bejon P, Warimwe GM, Mokaya J. The global burden of Chikungunya fever among children: A systematic literature review and meta-analysis. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000914. [PMID: 36962807 PMCID: PMC10022366 DOI: 10.1371/journal.pgph.0000914] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 11/17/2022] [Indexed: 12/24/2022]
Abstract
Chikungunya fever (CHIKF) is an arboviral illness that was first described in Tanzania (1952). In adults, the disease is characterised by debilitating arthralgia and arthritis that can persist for months, with severe illness including neurological complications observed in the elderly. However, the burden, distribution and clinical features of CHIKF in children are poorly described. We conducted a systematic literature review and meta-analysis to determine the epidemiology of CHIKF in children globally by describing its prevalence, geographical distribution, and clinical manifestations. We searched electronic databases for studies describing the epidemiology of CHIKF in children. We included peer-reviewed primary studies that reported laboratory confirmed CHIKF. We extracted information on study details, sampling approach, study participants, CHIKF positivity, clinical presentation and outcomes of CHIKF in children. The quality of included studies was assessed using Joanna Briggs Institute Critical Appraisal tool for case reports and National Institute of Health quality assessment tool for quantitative studies and case series. Random-effects meta-analysis was used to estimate the pooled prevalence of CHIKF among children by geographical location. We summarised clinical manifestations, laboratory findings, administered treatment and disease outcomes associated with CHIKF in children. We identified 2104 studies, of which 142 and 53 articles that met the inclusion criteria were included in the systematic literature review and meta-analysis, respectively. Most of the selected studies were from Asia (54/142 studies) and the fewest from Europe (5/142 studies). Included studies were commonly conducted during an epidemic season (41.5%) than non-epidemic season (5.1%). Thrombocytopenia was common among infected children and CHIKF severity was more prevalent in children <1 year. Children with undifferentiated fever before CHIKF was diagnosed were treated with antibiotics and/or drugs that managed specific symptoms or provided supportive care. CHIKF is a significant under-recognised and underreported health problem among children globally and development of drugs/vaccines should target young children.
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Affiliation(s)
- Doris K Nyamwaya
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
| | - Samuel M Thumbi
- Paul G Allen School for Global Health, Washington State University, Pullman, Washington, United States of America
- Institute of Immunology and Infection Research, University of Edinburgh, Edinburgh, United Kingdom
- Center for Epidemiological Modelling and Analysis, Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
| | - Philip Bejon
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
| | - George M Warimwe
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
| | - Jolynne Mokaya
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
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17
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Bettis AA, L’Azou Jackson M, Yoon IK, Breugelmans JG, Goios A, Gubler DJ, Powers AM. The global epidemiology of chikungunya from 1999 to 2020: A systematic literature review to inform the development and introduction of vaccines. PLoS Negl Trop Dis 2022; 16:e0010069. [PMID: 35020717 PMCID: PMC8789145 DOI: 10.1371/journal.pntd.0010069] [Citation(s) in RCA: 52] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 01/25/2022] [Accepted: 12/07/2021] [Indexed: 12/19/2022] Open
Abstract
Chikungunya fever is an acute febrile illness that is often associated with severe polyarthralgia in humans. The disease is caused by chikungunya virus (CHIKV), a mosquito-borne alphavirus. Since its reemergence in 2004, the virus has spread throughout the tropical world and several subtropical areas affecting millions of people to become a global public health issue. Given the significant disease burden, there is a need for medical countermeasures and several vaccine candidates are in clinical development. To characterize the global epidemiology of chikungunya and inform vaccine development, we undertook a systematic literature review in MEDLINE and additional public domain sources published up to June 13, 2020 and assessed epidemiological trends from 1999 to 2020. Observational studies addressing CHIKV epidemiology were included and studies not reporting primary data were excluded. Only descriptive analyses were conducted. Of 3,883 relevant sources identified, 371 were eligible for inclusion. 46% of the included studies were published after 2016. Ninety-seven outbreak reports from 45 countries and 50 seroprevalence studies from 31 countries were retrieved, including from Africa, Asia, Oceania, the Americas, and Europe. Several countries reported multiple outbreaks, but these were sporadic and unpredictable. Substantial gaps in epidemiological knowledge were identified, specifically granular data on disease incidence and age-specific infection rates. The retrieved studies revealed a diversity of methodologies and study designs, reflecting a lack of standardized procedures used to characterize this disease. Nevertheless, available epidemiological data emphasized the challenges to conduct vaccine efficacy trials due to disease unpredictability. A better understanding of chikungunya disease dynamics with appropriate granularity and better insights into the duration of long-term population immunity is critical to assist in the planning and success of vaccine development efforts pre and post licensure. Chikungunya disease is a mosquito-borne viral infection which causes an acute febrile illness often associated with debilitating polyarthralgia. It is estimated that over three quarters of the world’s populations live in areas at-risk of chikungunya virus transmission and to date, no efficacious medical countermeasures exist. To guide vaccine development against chikungunya, data regarding where and when outbreaks occur are needed. We conducted a systematic literature review to describe the global epidemiology of chikungunya to inform vaccine development. We used well-defined methods to search for and identify relevant research published between 1, January 1999 and 13, June 2020 in MEDLINE and other publicly available sources. We reviewed 371 references which emphasized the global expansion of chikungunya since its reemergence in 2004. Gaps in epidemiological knowledge identified included the population at risk, magnitude of outbreaks, and duration of natural immunity. This information is essential for late-stage development of chikungunya vaccines.
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Affiliation(s)
- Alison A. Bettis
- The Coalition for Epidemic Preparedness Innovations (CEPI), Oslo, Norway
| | - Maïna L’Azou Jackson
- The Coalition for Epidemic Preparedness Innovations (CEPI), London, United Kingdom
- * E-mail:
| | - In-Kyu Yoon
- The Coalition for Epidemic Preparedness Innovations (CEPI), Washington, D.C., Maryland, United States of America
| | | | - Ana Goios
- P95 Epidemiology and Pharmacovigilance, Leuven, Belgium
| | | | - Ann M. Powers
- Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado, United States of America
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18
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Chan TC, Hsu YF, Huang SC, Chen RC. Rapidly Containing the First Indigenous Outbreak of Chikungunya in Taiwan-Lessons Learned. Trop Med Infect Dis 2021; 6:tropicalmed6030165. [PMID: 34564549 PMCID: PMC8482269 DOI: 10.3390/tropicalmed6030165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/30/2021] [Accepted: 09/09/2021] [Indexed: 11/16/2022] Open
Abstract
The first indigenous outbreak of chikungunya in Taiwan occurred in New Taipei City, northern Taiwan, from August to October 2019. This study identified important containment strategies for controlling the outbreak. The outbreak investigation and ovitrap data were collected from the Department of Health, New Taipei City Government. A geographic information system (GIS) was applied for spatial analysis, and descriptive statistics were used to compute the demographic features and medical visits of confirmed cases. There were 19 residents infected during the outbreak. The source of this outbreak was a mountain trail with abundant Aedes albopictus. The atypical symptoms and lack of a rapid test led to multiple clinical visits by the patients (mean: 2.79; standard deviation: 1.65). The clinical symptoms of chikungunya are very similar to those of dengue fever. We noted that only eight patients were polymerase chain reaction (PCR)-positive in their first blood collection, and an average of 3.13 days between illness onset and PCR-positive results. The improved laboratory panel test, targeted and rapid insecticide spraying at the households and their communities, strict closure of the mountain trail, and ovitrap surveillance for evaluating intervention were important approaches to rapidly contain the outbreak.
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Affiliation(s)
- Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, 128 Academia Road, Section 2, Nankang, Taipei 115, Taiwan
- Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Taipei 112, Taiwan
- Correspondence: (T.-C.C.); (R.-C.C.); Tel.: +886-2-2789-8160 (T.-C.C.); +886-2-2257-6560 (R.-C.C.); Fax: +886-2-2785-4160 (T.-C.C.); +886-2-2258-9167 (R.-C.C.)
| | - Yu-Fen Hsu
- Department of Health, New Taipei City Government, 192-1, Yingshi Road, Banqiao District, New Taipei City 220, Taiwan; (Y.-F.H.); (S.-C.H.)
| | - Shao-Chun Huang
- Department of Health, New Taipei City Government, 192-1, Yingshi Road, Banqiao District, New Taipei City 220, Taiwan; (Y.-F.H.); (S.-C.H.)
| | - Ran-Chou Chen
- Department of Health, New Taipei City Government, 192-1, Yingshi Road, Banqiao District, New Taipei City 220, Taiwan; (Y.-F.H.); (S.-C.H.)
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Taipei 112, Taiwan
- Correspondence: (T.-C.C.); (R.-C.C.); Tel.: +886-2-2789-8160 (T.-C.C.); +886-2-2257-6560 (R.-C.C.); Fax: +886-2-2785-4160 (T.-C.C.); +886-2-2258-9167 (R.-C.C.)
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19
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de Oliveira EC, Fonseca V, Xavier J, Adelino T, Morales Claro I, Fabri A, Marques Macario E, Viniski AE, Campos Souza CL, Gomes da Costa ES, Soares de Sousa C, Guimarães Dias Duarte F, Correia de Medeiros A, Campelo de Albuquerque CF, Venancio Cunha R, Oliveira De Moura NF, Bispo de Filippis AM, de Oliveira T, Lourenço J, de Abreu AL, Alcantara LCJ, Giovanetti M. Short report: Introduction of chikungunya virus ECSA genotype into the Brazilian Midwest and its dispersion through the Americas. PLoS Negl Trop Dis 2021; 15:e0009290. [PMID: 33861753 PMCID: PMC8051810 DOI: 10.1371/journal.pntd.0009290] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 03/04/2021] [Indexed: 01/04/2023] Open
Abstract
Since introduction into Brazil in 2014, chikungunya virus (CHIKV) has presented sustained transmission, although much is unknown about its circulation in the midwestern states. Here, we analyze 24 novel partial and near complete CHIKV genomes from Cuiaba, an urban metropolis located in the Brazilian midwestern state of Mato Grosso (MT). Nanopore technology was used for sequencing CHIKV complete genomes. Phylogenetic and epidemiological approaches were used to explore the recent spatio-temporal evolution and spread of the CHIKV-ECSA genotype in Midwest Brazil as well as in the Americas. Epidemiological data revealed a reduction in the number of reported cases over 2018-2020, likely as a consequence of a gradual accumulation of herd-immunity. Phylogeographic reconstructions revealed that at least two independent introductions of the ECSA lineage occurred in MT from a dispersion event originating in the northeastern region and suggest that the midwestern Brazilian region appears to have acted as a source of virus transmission towards Paraguay, a bordering South American country. Our results show a complex dynamic of transmission between epidemic seasons and suggest a possible role of Brazil as a source for international dispersion of the CHIKV-ECSA genotype to other countries in the Americas.
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Affiliation(s)
| | - Vagner Fonseca
- Laboratório de Genética Celular e Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, University of KwaZuluNatal, Durban 4001, South Africa
- Coordenação Geral dos Laboratórios de Saúde Pública/Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Distrito Federal, Brazil
| | - Joilson Xavier
- Laboratório de Genética Celular e Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Talita Adelino
- Laboratório Central de Saúde Pública, Fundação Ezequiel Dias, Belo Horizonte, Brazil
| | - Ingra Morales Claro
- Instituto de Medicina Tropical e Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Allison Fabri
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Ana Elisa Viniski
- Laboratório Central de Saúde Pública do Estado de Mato Grosso, Cuiabá, Brazil
| | | | | | | | | | | | | | | | - Noely Fabiana Oliveira De Moura
- Coordenacao Geral das Arboviroses, Secretaria de Vigilância em Saúde/Ministério da Saúde, Brasília, Distrito Federal, Brazil
| | | | - Tulio de Oliveira
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, University of KwaZuluNatal, Durban 4001, South Africa
| | - José Lourenço
- Department of Zoology, University of Oxford, Oxford, OX1 3PS, United Kingdom
| | - André Luiz de Abreu
- Coordenação Geral dos Laboratórios de Saúde Pública/Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Distrito Federal, Brazil
| | - Luiz Carlos Junior Alcantara
- Laboratório de Genética Celular e Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Marta Giovanetti
- Laboratório de Genética Celular e Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
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20
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Nyamwaya DK, Otiende M, Omuoyo DO, Githinji G, Karanja HK, Gitonga JN, R de Laurent Z, Otieno JR, Sang R, Kamau E, Cheruiyot S, Otieno E, Agoti CN, Bejon P, Thumbi SM, Warimwe GM. Endemic chikungunya fever in Kenyan children: a prospective cohort study. BMC Infect Dis 2021; 21:186. [PMID: 33602147 PMCID: PMC7889702 DOI: 10.1186/s12879-021-05875-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/08/2021] [Indexed: 02/06/2023] Open
Abstract
Background Chikungunya fever (CHIKF) was first described in Tanzania in 1952. Several epidemics including East Africa have occurred, but there are no descriptions of longitudinal surveillance of endemic disease. Here, we estimate the incidence of CHIKF in coastal Kenya and describe the associated viral phylogeny. Methods We monitored acute febrile illnesses among 3500 children visiting two primary healthcare facilities in coastal Kenya over a 5-year period (2014–2018). Episodes were linked to a demographic surveillance system and blood samples obtained. Cross-sectional sampling in a community survey of a different group of 435 asymptomatic children in the same study location was done in 2016. Reverse-transcriptase PCR was used for chikungunya virus (CHIKV) screening, and viral genomes sequenced for phylogenetic analyses. Results We found CHIKF to be endemic in this setting, associated with 12.7% (95% CI 11.60, 13.80) of all febrile presentations to primary healthcare. The prevalence of CHIKV infections among asymptomatic children in the community survey was 0.7% (95% CI 0.22, 2.12). CHIKF incidence among children < 1 year of age was 1190 cases/100,000-person years and 63 cases/100,000-person years among children aged ≥10 years. Recurrent CHIKF episodes, associated with fever and viraemia, were observed among 19 of 170 children with multiple febrile episodes during the study period. All sequenced viral genomes mapped to the ECSA genotype albeit distinct from CHIKV strains associated with the 2004 East African epidemic. Conclusions CHIKF may be a substantial public health burden in primary healthcare on the East African coast outside epidemic years, and recurrent infections are common. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-05875-5.
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Affiliation(s)
- Doris K Nyamwaya
- KEMRI-Wellcome Trust Research Programme, P.O. Box 230-80108, Kilifi, Kenya
| | - Mark Otiende
- KEMRI-Wellcome Trust Research Programme, P.O. Box 230-80108, Kilifi, Kenya
| | | | - George Githinji
- KEMRI-Wellcome Trust Research Programme, P.O. Box 230-80108, Kilifi, Kenya
| | - Henry K Karanja
- KEMRI-Wellcome Trust Research Programme, P.O. Box 230-80108, Kilifi, Kenya
| | - John N Gitonga
- KEMRI-Wellcome Trust Research Programme, P.O. Box 230-80108, Kilifi, Kenya
| | | | - James R Otieno
- KEMRI-Wellcome Trust Research Programme, P.O. Box 230-80108, Kilifi, Kenya
| | | | - Everlyn Kamau
- KEMRI-Wellcome Trust Research Programme, P.O. Box 230-80108, Kilifi, Kenya
| | - Stanley Cheruiyot
- KEMRI-Wellcome Trust Research Programme, P.O. Box 230-80108, Kilifi, Kenya
| | - Edward Otieno
- KEMRI-Wellcome Trust Research Programme, P.O. Box 230-80108, Kilifi, Kenya
| | - Charles N Agoti
- KEMRI-Wellcome Trust Research Programme, P.O. Box 230-80108, Kilifi, Kenya
| | - Philip Bejon
- KEMRI-Wellcome Trust Research Programme, P.O. Box 230-80108, Kilifi, Kenya.,Centre for Tropical Medicine and Global Health, University of Oxford, Old Road Campus, NDM Research Building, Oxford, OX3 7FZ, UK
| | - Samuel M Thumbi
- Paul G Allen School for Global Animal Health, Washington State University, Pullman, WA, 99164-7090, USA.,Centre for Global Health Research, Kenya Medical Research Institute, P.O. Box 1578-4100, Kisumu, Kenya.,Institute of Tropical and Infectious Diseases, University of Nairobi, P.O Box 19676, Nairobi, 00202, Kenya
| | - George M Warimwe
- KEMRI-Wellcome Trust Research Programme, P.O. Box 230-80108, Kilifi, Kenya. .,Centre for Tropical Medicine and Global Health, University of Oxford, Old Road Campus, NDM Research Building, Oxford, OX3 7FZ, UK.
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21
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Population bottlenecks and founder effects: implications for mosquito-borne arboviral emergence. Nat Rev Microbiol 2021; 19:184-195. [PMID: 33432235 PMCID: PMC7798019 DOI: 10.1038/s41579-020-00482-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2020] [Indexed: 01/31/2023]
Abstract
Transmission of arthropod-borne viruses (arboviruses) involves infection and replication in both arthropod vectors and vertebrate hosts. Nearly all arboviruses are RNA viruses with high mutation frequencies, which leaves them vulnerable to genetic drift and fitness losses owing to population bottlenecks during vector infection, dissemination from the midgut to the salivary glands and transmission to the vertebrate host. However, despite these bottlenecks, they seem to avoid fitness declines that can result from Muller's ratchet. In addition, founder effects that occur during the geographic introductions of human-amplified arboviruses, including chikungunya virus and Zika virus, can affect epidemic and endemic circulation, as well as virulence. In this Review, we discuss the role of genetic drift following population bottlenecks and founder effects in arboviral evolution and spread, and the emergence of human disease.
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22
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Bae S, Lee, JY, Myoung J. Chikungunya Virus nsP2 Impairs MDA5/RIG-I-Mediated Induction of NF-κB Promoter Activation: A Potential Target for Virus-Specific Therapeutics. J Microbiol Biotechnol 2020; 30:1801-1809. [PMID: 33323678 PMCID: PMC9728393 DOI: 10.4014/jmb.2012.12005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 12/08/2020] [Accepted: 12/15/2020] [Indexed: 12/15/2022]
Abstract
Chikungunya virus (CHIKV) was first identified in 1952 as a causative agent of outbreaks. CHIKV is transmitted by two mosquito species, Aedes aegypti and A. albopictus. Symptoms after CHIKV infection in human are typically fever and joint pain, but can also include headache, muscle pain, joint swelling, polyarthralgia, and rash. CHIKV is an enveloped single-stranded, positive-sense RNA virus with a diameter of approximately 70 nm. The pathogenesis of CHIKV infection and the mechanism by which the virus evades the innate immune system remain poorly understood. Moreover, little is known about the roles of CHIKV-encoded genes in the viral evasion of host immune responses, especially type I interferon (IFN) responses. Therefore, in the present study, we screened CHIKV-encoded genes for their regulatory effect on the activation of nuclear factor kappa B (NF-κB), a critical transcription factor for the optimal activation of IFN-β. Among others, nonstructural protein 2 (nsP2) strongly inhibited melanoma differentiation-associated protein 5 (MDA5)-mediated induction of the NF-κB pathway in a dose-dependent manner. Elucidation of the detailed mechanisms of nsP2-mediated inhibition of the MDA5/RIG-I signaling pathway is anticipated to contribute to the development of virus-specific therapeutics against CHIKV infection.
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Affiliation(s)
- Sojung Bae
- Korea Zoonosis Research Institute, Department of Bioactive Material Science and Genetic Engineering Research Institute, Jeonbuk National University, Jeonju 54531, Republic of Korea
| | - Jeong Yoon Lee,
- Korea Zoonosis Research Institute, Department of Bioactive Material Science and Genetic Engineering Research Institute, Jeonbuk National University, Jeonju 54531, Republic of Korea
| | - Jinjong Myoung
- Korea Zoonosis Research Institute, Department of Bioactive Material Science and Genetic Engineering Research Institute, Jeonbuk National University, Jeonju 54531, Republic of Korea
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23
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Foeller ME, Nosrat C, Krystosik A, Noel T, Gérardin P, Cudjoe N, Mapp-Alexander V, Mitchell G, Macpherson C, Waechter R, LaBeaud AD. Chikungunya infection in pregnancy - reassuring maternal and perinatal outcomes: a retrospective observational study. BJOG 2020; 128:1077-1086. [PMID: 33040457 DOI: 10.1111/1471-0528.16562] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate pregnancy and neonatal outcomes, disease severity, and mother-to-child transmission of pregnant women with Chikungunya infection (CHIKV). DESIGN Retrospective observational study. SETTING Grenada. POPULATION Women who gave birth during a Chikungunya outbreak between January 2014 and September 2015 were eligible. METHODS This descriptive study investigated 731 mother-infant pairs who gave birth during a CHIKV outbreak. Women and infants underwent serological testing for CHIKV by ELISA. MAIN OUTCOME MEASURES Primary outcomes: composite pregnancy complication (abruption, vaginal bleeding, preterm labour/cervical incompetence, cesarean delivery for fetal distress/abruption/placental abnormality or delivery for fetal distress) and composite neonatal morbidity. RESULTS Of 416 mother-infant pairs, 150 (36%) had CHIKV during pregnancy, 135 (33%) had never had CHIKV, and 131 (31%) had CHIKV outside of pregnancy. Mean duration of joint pain was shorter among women infected during pregnancy (μ = 898 days, σ = 277 days) compared with infections outside of pregnancy (μ = 1064 days, σ = 244 days) (P < 0.0001). Rates of pregnancy complications (RR = 0.76, P = 0.599), intrapartum complications (RR = 1.50, P = 0.633), and neonatal outcomes were otherwise similar. Possible mother-to-child transmission occurred in two (1.3%) mother-infant pairs and two of eight intrapartum infections (25%). CONCLUSION CHIKV infection during pregnancy may be protective against long-term joint pain sequelae that are often associated with acute CHIKV infection. Infection during pregnancy did not appear to pose a risk for pregnancy complications or neonatal health, but maternal infection just prior to delivery might have increased risk of mother-to-child transmission of CHIKV. TWEETABLE ABSTRACT Chikungunya infection did not increase risk of pregnancy complications or adverse neonatal outcomes, unless infection was just prior to delivery.
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Affiliation(s)
- M E Foeller
- Department of Obstetrics and Gynecology, Stanford University, Stanford, CA, USA
| | - C Nosrat
- Program in Human Biology, Stanford University, Stanford, CA, USA
| | - A Krystosik
- Division of Infectious Disease, Department of Pediatrics, Stanford University, School of Medicine, Stanford, CA, USA
| | - T Noel
- Windward Islands Research and Education Foundation, True Blue, Grenada.,St. George's University, St. Georges, Grenada
| | - P Gérardin
- INSERM CIC1410, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Réunion.,Unité Mixte 134 PIMIT (INSERM 1187, CNRS 9192, IRD 249, Université de La Réunion), Sainte Clotilde, Réunion
| | - N Cudjoe
- Windward Islands Research and Education Foundation, True Blue, Grenada
| | - V Mapp-Alexander
- Windward Islands Research and Education Foundation, True Blue, Grenada.,St. George's University, St. Georges, Grenada
| | - G Mitchell
- Ministry of Health, St. Georges, Grenada
| | - C Macpherson
- Windward Islands Research and Education Foundation, True Blue, Grenada.,St. George's University, St. Georges, Grenada
| | - R Waechter
- Windward Islands Research and Education Foundation, True Blue, Grenada.,St. George's University, St. Georges, Grenada
| | - A D LaBeaud
- Division of Infectious Disease, Department of Pediatrics, Stanford University, School of Medicine, Stanford, CA, USA
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24
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Christofferson RC, Parker DM, Overgaard HJ, Hii J, Devine G, Wilcox BA, Nam VS, Abubakar S, Boyer S, Boonnak K, Whitehead SS, Huy R, Rithea L, Sochantha T, Wellems TE, Valenzuela JG, Manning JE. Current vector research challenges in the greater Mekong subregion for dengue, Malaria, and Other Vector-Borne Diseases: A report from a multisectoral workshop March 2019. PLoS Negl Trop Dis 2020; 14:e0008302. [PMID: 32730249 PMCID: PMC7392215 DOI: 10.1371/journal.pntd.0008302] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Rebecca C. Christofferson
- Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, United States of America
| | - Daniel M. Parker
- University of California, Irvine, California, United States of America
| | | | | | - Gregor Devine
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Bruce A. Wilcox
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, Thailand
| | - Vu Sinh Nam
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Sazaly Abubakar
- Tropical Infectious Diseases Research and Education Center, Kuala Lumpur, Malaysia
| | | | - Kobporn Boonnak
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Stephen S. Whitehead
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States of America
| | - Rekol Huy
- National Center for Parasitology Entomology and Malaria Control, Phnom Penh, Cambodia
| | - Leang Rithea
- National Center for Parasitology Entomology and Malaria Control, Phnom Penh, Cambodia
| | - Tho Sochantha
- National Center for Parasitology Entomology and Malaria Control, Phnom Penh, Cambodia
| | - Thomas E. Wellems
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States of America
| | - Jesus G. Valenzuela
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States of America
| | - Jessica E. Manning
- US National Institute of Allergy and Infectious Diseases, Phnom Penh, Cambodia
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25
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Pre-existing chikungunya virus neutralizing antibodies correlate with risk of symptomatic infection and subclinical seroconversion in a Philippine cohort. Int J Infect Dis 2020; 95:167-173. [PMID: 32247051 DOI: 10.1016/j.ijid.2020.03.073] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/23/2020] [Accepted: 03/24/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND A longitudinal cohort study performed in Cebu City, Philippines found that the presence of pre-existing chikungunya virus (CHIKV) neutralizing antibodies (NAb) was associated with a decreased risk of symptomatic CHIKV infection. However, the relationship between pre-existing NAb and the risk of subclinical seroconversion has not been well described. METHODS Data were analyzed from a longitudinal cohort aged 6 months to 83 years who underwent active fever surveillance in Cebu City, Philippines from 2012 to 2014. Participants with a history of fever underwent acute and 3-week convalescent visits with blood collection, and annual visits at baseline, 12 months, and 24 months. Symptomatic CHIKV infections were detected by PCR of acute illness sera. Subclinical seroconversion was defined as a ≥8-fold rise in 80% plaque reduction neutralization test (PRNT80) titer between annual visits without intervening symptomatic infection. RESULTS Among 854 participants who completed the 12-month visit (year 1) and 765 who completed the 24-month visit (year 2), 25 symptomatic CHIKV infections and 104 subclinical seroconversions occurred among 615 individuals with no detectable pre-year NAb in year 1 and 444 in year 2, while no symptomatic infections and one subclinical seroconversion occurred in those with a pre-year PRNT80 titer ≥1:10. Pre-year PRNT80 titer ≥1:10 was associated with zero relative risk of symptomatic CHIKV infection and 0.018 risk of subclinical seroconversion. CONCLUSIONS The presence of detectable pre-existing CHIKV NAb correlated with a decreased risk of both symptomatic CHIKV infection and subclinical seroconversion. These findings support the potential use of CHIKV NAb titer as a surrogate endpoint of protection from infection for vaccine development.
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26
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Effects of Chikungunya virus immunity on Mayaro virus disease and epidemic potential. Sci Rep 2019; 9:20399. [PMID: 31892710 PMCID: PMC6938517 DOI: 10.1038/s41598-019-56551-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 12/13/2019] [Indexed: 12/30/2022] Open
Abstract
Mayaro virus (MAYV) causes an acute febrile illness similar to that produced by chikungunya virus (CHIKV), an evolutionary relative in the Semliki Forest virus complex of alphaviruses. MAYV emergence is typically sporadic, but recent isolations and outbreaks indicate that the virus remains a public health concern. Given the close phylogenetic and antigenic relationship between CHIKV and MAYV, and widespread distribution of CHIKV, we hypothesized that prior CHIKV immunity may affect MAYV pathogenesis and/or influence its emergence potential. We pre-exposed immunocompetent C57BL/6 and immunocompromised A129 or IFNAR mice to wild-type CHIKV, two CHIKV vaccines, or a live-attenuated MAYV vaccine, and challenged with MAYV. We observed strong cross-protection against MAYV for mice pre-exposed to wild-type CHIKV, and moderately but significantly reduced cross-protection from CHIKV-vaccinated animals. Immunity to other alphavirus or flavivirus controls provided no protection against MAYV disease or viremia. Mechanistic studies suggested that neutralizing antibodies alone can mediate this protection, with T-cells having no significant effect on diminishing disease. Finally, human sera obtained from naturally acquired CHIKV infection cross-neutralized MAYV at high titers in vitro. Altogether, our data suggest that CHIKV infection can confer cross-protective effects against MAYV, and the resultant reduction in viremia may limit the emergence potential of MAYV.
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27
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Sharp TM, Lorenzi O, Torres-Velásquez B, Acevedo V, Pérez-Padilla J, Rivera A, Muñoz-Jordán J, Margolis HS, Waterman SH, Biggerstaff BJ, Paz-Bailey G, Barrera R. Autocidal gravid ovitraps protect humans from chikungunya virus infection by reducing Aedes aegypti mosquito populations. PLoS Negl Trop Dis 2019; 13:e0007538. [PMID: 31344040 PMCID: PMC6657827 DOI: 10.1371/journal.pntd.0007538] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 06/10/2019] [Indexed: 12/12/2022] Open
Abstract
Background Public health responses to outbreaks of dengue, chikungunya, and Zika virus have been stymied by the inability to control the primary vector, Aedes aegypti mosquitos. Consequently, the need for novel approaches to Aedes vector control is urgent. Placement of three autocidal gravid ovitraps (AGO traps) in ~85% of homes in a community was previously shown to sustainably reduce the density of female Ae. aegypti by >80%. Following the introduction of chikungunya virus (CHIKV) to Puerto Rico, we conducted a seroprevalence survey to estimate the prevalence of CHIKV infection in communities with and without AGO traps and evaluate their effect on reducing CHIKV transmission. Methods and findings Multivariate models that calculated adjusted prevalence ratios (aPR) showed that among 175 and 152 residents of communities with and without AGO traps, respectively, an estimated 26.1% and 43.8% had been infected with CHIKV (aPR = 0.50, 95% CI: 0.37–0.91). After stratification by time spent in their community, protection from CHIKV infection was strongest among residents who reported spending many or all weekly daytime hours in their community:10.3% seropositive in communities with AGO traps vs. 48.7% in communities without (PR = 0.21, 95% CI: 0.11–0.41). The age-adjusted rate of fever with arthralgia attributable to CHIKV infection was 58% (95% CI: 46–66%). The monthly number of CHIKV-infected mosquitos and symptomatic residents were diminished in communities with AGO traps compared to those without. Conclusions These findings indicate that AGO traps are an effective tool that protects humans from infection with a virus transmitted by Ae. aegypti mosquitos. Future studies should evaluate their protective effectiveness in large, urban communities. Aedes species mosquitos transmit pathogens of public health importance, including dengue, Zika, and chikungunya viruses. No tools exist to control these mosquitos that sustainably and effectively prevent human infections. Autocidal gravid ovitraps (AGO traps) have been shown to sustainably reduce Aedes populations by >80%. After chikungunya virus was introduced into Puerto Rico, we conducted serosurveys in communities with and without AGO traps. We observed a two-fold lower prevalence of chikungunya virus infection among residents of communities with AGO traps compared to communities without. Among infected residents of communities with traps, a significant proportion likely had been infected while outside their community. These findings indicate that AGO traps are an effective tool that protects humans from infection with pathogens transmitted by Aedes mosquitos.
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Affiliation(s)
- Tyler M. Sharp
- Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico, United States of America
- United States Public Health Service, Silver Springs, Maryland, United States of America
- * E-mail:
| | - Olga Lorenzi
- Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico, United States of America
| | - Brenda Torres-Velásquez
- Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico, United States of America
| | - Veronica Acevedo
- Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico, United States of America
| | - Janice Pérez-Padilla
- Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico, United States of America
| | - Aidsa Rivera
- Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico, United States of America
| | - Jorge Muñoz-Jordán
- Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico, United States of America
| | - Harold S. Margolis
- Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico, United States of America
| | - Stephen H. Waterman
- Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico, United States of America
- United States Public Health Service, Silver Springs, Maryland, United States of America
| | - Brad J. Biggerstaff
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, Fort Collins, Colorado, United States of America
| | - Gabriela Paz-Bailey
- Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico, United States of America
| | - Roberto Barrera
- Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico, United States of America
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Xavier J, Giovanetti M, Fonseca V, Thézé J, Gräf T, Fabri A, Goes de Jesus J, Lima de Mendonça MC, Damasceno dos Santos Rodrigues C, Mares-Guia MA, Cardoso dos Santos C, Fraga de Oliveira Tosta S, Candido D, Ribeiro Nogueira RM, Luiz de Abreu A, Kleber Oliveira W, Campelo de Albuquerque CF, Chieppe A, de Oliveira T, Brasil P, Calvet G, Carvalho Sequeira P, Rodrigues Faria N, Bispo de Filippis AM, Alcantara LCJ. Circulation of chikungunya virus East/Central/South African lineage in Rio de Janeiro, Brazil. PLoS One 2019; 14:e0217871. [PMID: 31185030 PMCID: PMC6559644 DOI: 10.1371/journal.pone.0217871] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 05/20/2019] [Indexed: 12/14/2022] Open
Abstract
The emergence of chikungunya virus (CHIKV) has raised serious concerns due to the virus' rapid dissemination into new geographic areas and the clinical features associated with infection. To better understand CHIKV dynamics in Rio de Janeiro, we generated 11 near-complete genomes by means of real-time portable nanopore sequencing of virus isolates obtained directly from clinical samples. To better understand CHIKV dynamics in Rio de Janeiro, we generated 11 near-complete genomes by means of real-time portable nanopore sequencing of virus isolates obtained directly from clinical samples. Our phylogenetic reconstructions indicated the circulation of the East-Central-South-African (ECSA) lineage in Rio de Janeiro. Time-measured phylogenetic analysis combined with CHIKV notified case numbers revealed the ECSA lineage was introduced in Rio de Janeiro around June 2015 (95% Bayesian credible interval: May to July 2015) indicating the virus was circulating unnoticed for 5 months before the first reports of CHIKV autochthonous transmissions in Rio de Janeiro, in November 2015. These findings reinforce that continued genomic surveillance strategies are needed to assist in the monitoring and understanding of arbovirus epidemics, which might help to attenuate public health impact of infectious diseases.
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Affiliation(s)
- Joilson Xavier
- Laboratório de Patologia Experimental, Instituto Gonçalo Moniz/Fiocruz, Salvador, Bahia, Brazil
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Marta Giovanetti
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Laboratório de Genética Celular e Molecular, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Vagner Fonseca
- Laboratório de Genética Celular e Molecular, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Julien Thézé
- Department of Zoology, University of Oxford, Oxford, United Kingdom
| | - Tiago Gräf
- Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Brazil
| | - Allison Fabri
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Brazil
| | - Jaqueline Goes de Jesus
- Laboratório de Patologia Experimental, Instituto Gonçalo Moniz/Fiocruz, Salvador, Bahia, Brazil
| | | | | | | | | | - Stephane Fraga de Oliveira Tosta
- Laboratório de Genética Celular e Molecular, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Darlan Candido
- Department of Zoology, University of Oxford, Oxford, United Kingdom
| | | | - André Luiz de Abreu
- Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Distrito Federal, Brazil
| | | | | | | | - Tulio de Oliveira
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Patrícia Brasil
- Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil
| | - Guilherme Calvet
- Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil
| | | | | | | | - Luiz Carlos Junior Alcantara
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Laboratório de Genética Celular e Molecular, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Abstract
Chikungunya virus (CHIKV) is an alphavirus that is primarily transmitted by Aedes species mosquitoes. Though reports of an illness consistent with chikungunya date back over 200 years, CHIKV only gained worldwide attention during a massive pandemic that began in East Africa in 2004. Chikungunya, the clinical illness caused by CHIKV, is characterized by a rapid onset of high fever and debilitating joint pain, though in practice, etiologic confirmation of CHIKV requires the availability and use of specific laboratory diagnostics. Similar to infections caused by other arboviruses, CHIKV infections are most commonly detected with a combination of molecular and serological methods, though cell culture and antigen detection are reported. This review provides an overview of available CHIKV diagnostics and highlights aspects of basic virology and epidemiology that pertain to viral detection. Although the number of chikungunya cases has decreased since 2014, CHIKV has become endemic in countries across the tropics and will continue to cause sporadic outbreaks in naive individuals. Consistent access to accurate diagnostics is needed to detect individual cases and initiate timely responses to new outbreaks.
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Raghavendhar S, Tripati PK, Ray P, Patel AK. Evaluation of medicinal herbs for Anti-CHIKV activity. Virology 2019; 533:45-49. [PMID: 31082733 DOI: 10.1016/j.virol.2019.04.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 04/20/2019] [Accepted: 04/22/2019] [Indexed: 01/01/2023]
Abstract
Chikungunya, a mosquito-borne viral disease is now a global public health problem. In tropical countries such as India, periodic chikungunya outbreaks can occur due the high prevalence of the mosquito vector, circulation of virus and the high population density. To curtail the virus in outbreak situation, a ready to use drug for chikungunya is necessary. Using the literature mentioned plant extracts, we used four assays to screen and identify indigenous plants with CHIKV inhibitory activity. Our results showed that the aqueous extract of five plant extracts exhibited anti-CHIKV activity by inhibiting viral attachment, four plant extracts exhibited replication inhibition through inhibition of helicase activity, two plants showed inhibition of protease activity. Two plant extracts showed both viral attachment inhibition and replication inhibition and also exhibited dose dependent response in virus replication inhibition assay. These findings warrant further investigation to standardize these plant extracts as antiviral formulation for chikungunya infection.
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Affiliation(s)
| | | | - Pratima Ray
- Dept. of Biotechnology, Jamia Hamdard University, New Delhi, 110062, India
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31
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Naveca FG, Claro I, Giovanetti M, de Jesus JG, Xavier J, Iani FCDM, do Nascimento VA, de Souza VC, Silveira PP, Lourenço J, Santillana M, Kraemer MUG, Quick J, Hill SC, Thézé J, Carvalho RDDO, Azevedo V, Salles FCDS, Nunes MRT, Lemos PDS, Candido DDS, Pereira GDC, Oliveira MAA, Meneses CAR, Maito RM, Cunha CRSB, Campos DPDS, Castilho MDC, Siqueira TCDS, Terra TM, de Albuquerque CFC, da Cruz LN, de Abreu AL, Martins DV, Simoes DSDMV, de Aguiar RS, Luz SLB, Loman N, Pybus OG, Sabino EC, Okumoto O, Alcantara LCJ, Faria NR. Genomic, epidemiological and digital surveillance of Chikungunya virus in the Brazilian Amazon. PLoS Negl Trop Dis 2019; 13:e0007065. [PMID: 30845267 PMCID: PMC6424459 DOI: 10.1371/journal.pntd.0007065] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 03/19/2019] [Accepted: 02/01/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Since its first detection in the Caribbean in late 2013, chikungunya virus (CHIKV) has affected 51 countries in the Americas. The CHIKV epidemic in the Americas was caused by the CHIKV-Asian genotype. In August 2014, local transmission of the CHIKV-Asian genotype was detected in the Brazilian Amazon region. However, a distinct lineage, the CHIKV-East-Central-South-America (ECSA)-genotype, was detected nearly simultaneously in Feira de Santana, Bahia state, northeast Brazil. The genomic diversity and the dynamics of CHIKV in the Brazilian Amazon region remains poorly understood despite its importance to better understand the epidemiological spread and public health impact of CHIKV in the country. METHODOLOGY/PRINCIPAL FINDINGS We report a large CHIKV outbreak (5,928 notified cases between August 2014 and August 2018) in Boa vista municipality, capital city of Roraima's state, located in the Brazilian Amazon region. We generated 20 novel CHIKV-ECSA genomes from the Brazilian Amazon region using MinION portable genome sequencing. Phylogenetic analyses revealed that despite an early introduction of the Asian genotype in 2015 in Roraima, the large CHIKV outbreak in 2017 in Boa Vista was caused by an ECSA-lineage most likely introduced from northeastern Brazil. Epidemiological analyses suggest a basic reproductive number of R0 of 1.66, which translates in an estimated 39 (95% CI: 36 to 45) % of Roraima's population infected with CHIKV-ECSA. Finally, we find a strong association between Google search activity and the local laboratory-confirmed CHIKV cases in Roraima. CONCLUSIONS/SIGNIFICANCE This study highlights the potential of combining traditional surveillance with portable genome sequencing technologies and digital epidemiology to inform public health surveillance in the Amazon region. Our data reveal a large CHIKV-ECSA outbreak in Boa Vista, limited potential for future CHIKV outbreaks, and indicate a replacement of the Asian genotype by the ECSA genotype in the Amazon region.
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Affiliation(s)
- Felipe Gomes Naveca
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane, FIOCRUZ, Manaus, Brazil
| | - Ingra Claro
- Instituto de Medicina Tropical e Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Marta Giovanetti
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil
- Laboratório de Genética Celular e Molecular, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Jaqueline Goes de Jesus
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil
- Laboratório de Patologia Experimental, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil
| | - Joilson Xavier
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil
- Laboratório de Patologia Experimental, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil
| | - Felipe Campos de Melo Iani
- Laboratório de Genética Celular e Molecular, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Laboratório Central de Saúde Pública, Instituto Octávio Magalhães, FUNED, Belo Horizonte, Minas Gerais, Brazil
| | - Valdinete Alves do Nascimento
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane, FIOCRUZ, Manaus, Brazil
| | - Victor Costa de Souza
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane, FIOCRUZ, Manaus, Brazil
| | - Paola Paz Silveira
- Laboratório de Virologia Molecular, Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - José Lourenço
- Department of Zoology, University of Oxford, South Parks Road, Oxford, United Kingdom
| | - Mauricio Santillana
- Harvard Medical School, Department of Pediatrics, Boston, MA, United States of America
- Computational Health Informatics Program, Boston Children’s Hospital, Boston, MA, United States of America
| | - Moritz U. G. Kraemer
- Department of Zoology, University of Oxford, South Parks Road, Oxford, United Kingdom
- Computational Epidemiology Lab, Boston Children’s Hospital, Boston, MA, United States of America
| | - Josh Quick
- Institute of Microbiology and Infection, University of Birmingham, Birmingham, United Kingdom
| | - Sarah C. Hill
- Department of Zoology, University of Oxford, South Parks Road, Oxford, United Kingdom
| | - Julien Thézé
- Department of Zoology, University of Oxford, South Parks Road, Oxford, United Kingdom
| | - Rodrigo Dias de Oliveira Carvalho
- Laboratório de Genética Celular e Molecular, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Vasco Azevedo
- Laboratório de Genética Celular e Molecular, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | | | | | | | - Glauco de Carvalho Pereira
- Laboratório de Genética Celular e Molecular, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Marluce Aparecida Assunção Oliveira
- Laboratório de Genética Celular e Molecular, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | | | | | | | - Marcia da Costa Castilho
- Departamento de Virologia, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Amazonas, Brazil
| | | | - Tiza Matos Terra
- Laboratório Central de Saúde Pública do Amazonas, Manaus, Amazonas, Brazil
| | | | | | - André Luis de Abreu
- Secretaria de Vigilância em Saúde, Ministério da Saúde (SVS/MS), Brasília-DF, Brazil
| | | | | | - Renato Santana de Aguiar
- Laboratório de Virologia Molecular, Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sérgio Luiz Bessa Luz
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane, FIOCRUZ, Manaus, Brazil
| | - Nicholas Loman
- Institute of Microbiology and Infection, University of Birmingham, Birmingham, United Kingdom
| | - Oliver G. Pybus
- Department of Zoology, University of Oxford, South Parks Road, Oxford, United Kingdom
| | - Ester C. Sabino
- Instituto de Medicina Tropical e Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Osnei Okumoto
- Secretaria de Vigilância em Saúde, Ministério da Saúde (SVS/MS), Brasília-DF, Brazil
| | - Luiz Carlos Junior Alcantara
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil
- Laboratório de Genética Celular e Molecular, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Nuno Rodrigues Faria
- Department of Zoology, University of Oxford, South Parks Road, Oxford, United Kingdom
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