Researchers in Brazil want to share that there have been 40 confirmed deaths from Chikungunya in Fortaleza. This is a significant increase in both mortality and the severity of the disease. The Fortaleza research team are part of the REDe network, working on the Zika studies through ZIKACTION. Through this network they would like to ask their colleagues working in all the Zika study sites whether they are also seeing the increase in cases and the higher than previously seen severity of disease? We also ask other researchers across the region whether they are experiencing the same? The researchers in Fortaleza are keen to collaborate and will share their data capture forms and answer any questions. They will also be describing the situation in more detail over the next few days. Please share this link. Thank you
I would like to share information contained in the most recent epidemiological bulletin of the Health Department of the State of Ceará:
In 2016, there was a sustained transmission of Chikungunya in the State of Ceará, northeast of Brazil, characterizing an epidemic scenario, with 49,516 cases, 63.6% (31,482 / 49,516) were confirmed, distributed in 80.8% (139/172) of the municipalities.
In 2017, there is an increasing trend of reported cases up to Epidemiologic Week (EW) 18. The incidence rate of cases: Suspects of Chikungunya in Ceará is 1,051.3 cases per 100 thousand inhabitants. Up to EW 26, 94,235 cases were reported, of these, 53.1% (50,068 / 94,235) were confirmed and 9.4% (8,910 / 94,235) discarded. Of the confirmed cases, 67.0% (33,550 / 50,068) were concentrated in the age groups between 20 and 59 years old and the female sex was predominant in all age groups except for those under one year of age and those aged between five and 14 years.
In 2017, 43 deaths were confirmed by chikungunya, of which 24 (55.8%) were male and 19 (44.2%) were female, aged between 10 days and 94 years (median of 72 years and average of 68 years).
I'm a Pediatric Neurologist and Neurogeneticist from Hospital Infantil Albert SAbin, Fortaleza-Brazil. I have accompanied more than 110 cases of Congenital Zika Syndrome and also participated in several international publications. We are willing to contribute and share the knowledge we are getting about Zika and the neurological manifestations of Chikungunya.
Hi colleagues from Brazil,
this is just to remind you that I am the PI of a clinical trial aimed to investigate the efficacy and safety of hyperimmune IVIG in the prevention of Chikungunya infection in neonates perinatally exposed to viremic mothers (NCT02230163). I have been working hard to have this trial conducted in Brazil, without success so far, because of issues regrding the importation of hyper-immune IVIG from France to Brazil. A summary of the trial is available on ClinicalTrials.gov
We've been following 110 patients with Congenital Zika Syndrome at Albert Sabin Children's Hospital. All of them evolved with neuropsychomotor development, about 15% were born without microcephaly at birth, but they evolved with postnatal microcephaly, 50% had epilepsy, some cases were difficult to control, 14% had postnatal hydrocephalus, and 6 were operated on with clinical improvement. Dysphagia is also very common, which has been the main factor related to the risk of lethality due to aspiration pneumonia. 26% had intraocular abnormalities,
Including macular chorioretinal atrophy, mottled retinal pigment epithelium and optic nerve pallor; 7 patients (10%) had strabismus or nystagmus without intraocular abnormalities.
Here some publications of our team:
Since the beginning in 2017 of the chikungunya epidemic in Cérea, the lethal rate is 43/50 000 = 86/100000 cases (median age 72 years)
For comparison, during the Chikungunya epidemic in La Réunion in 2005-2006:
- The total number of cases was estimated (from a sentinel network) to 244 000 cases
- The total number of death certificates reporting a chikungunya infection was 204 (median age 79 years)
- The total number of deaths estimated from mortality statistics was 267
- The lethal rate was so therefore comprised between 83 and 109 / 100000 cases
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Dear Phillipe Quénel, do you have a report/publication with these values? This is a very important information, and it would be very valuable to share with medical doctors and health professionals in Brazil/L.A.
Back in 2014-2015 we found that two genotypes (the Asian and the East-Central-South-African lineages) were co-circulating in Brazil (ref. 1). Later, we described the introduction of the ECSA genotype and its rapid spread in Feira de Santana, Bahia (ref. 2). This lineage has previously been associated with the explosive outbreaks in southeast Asia, where the virus acquired a set of adaptive mutations that increased transmissibility in local mosquito populations. More recently we detected silent, ongoing circulation the CHIK-ECSA lineage in the northeast region of Brazil, in Maceio (ref. 3). Further, our unpunished data from 2017 (see details of the ZiBRA project, http://zibraproject.org/, described in ref. 3) further confirms that the CHIK-ECSA lineage is also spreading rapidly through the north of Brazil. Another recent paper (ref. 4) has revealed unique mutations that are possibly associated with increased fitness in mosquitoes. We are happy to share knowledge about real-time genome sequencing and epidemiological analysis on Zika, Chikungunya, and more recently, on yellow fever virus (ref. 5).
Me parece que esta iniciativa es ideal para implementarla en todos los sectores de salud sin importar el lugar, porque así conoceremos de una forma más general la epidemiologia de una de las enfermedades que se encuentra en auge actualmente, y que tantas repercusiones se han ido manifestando conforme se profundiza en su estudio.