Severe manifestations of chikungunya virus in critically ill patients during the 2013–2014 Caribbean outbreak. (July 2016)

• Record Type: Journal Article
• Authors: Crosby, Laura; Perreau, Caroline; Madeux, Benjamin; Cossic, Jeanne; Armand, Christophe; Herrmann-Storke, Cécile; Najioullah, Fatiha; Valentino, Ruddy; Thiéry, Guillaume
• Is Part Of: International journal of infectious diseases. Volume 48(2016:Jul.)
• Page Start: 78
• Page End: 80
• Publication Date: 2016-07
• Subjects: Chikungunya -- Arbovirus -- Encephalopathy -- Guillain–Barré syndrome -- Sepsis -- Intensive care; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2016.05.010
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: Severe manifestations of chikungunya virus infection affected a small number of patients in the total infected population. Most patients had previous underlying diseases and presented with acute exacerbations triggered by chikungunya virus infection. Encephalitis, Guillain–Barré syndrome, and severe sepsis could to be directly related to chikungunya virus. Summary: Objectives: A chikungunya epidemic occurred in 2013–2014 in the Caribbean and Americas. Although the disease is usually benign, some patients required admission to the intensive care unit (ICU). The characteristics and outcomes of patients with chikungunya virus (CHIKV) infection admitted to an ICU during this epidemic are reported. Methods: An observational study of consecutive patients with confirmed CHIKV infection admitted to ICUs in Martinique and Guadeloupe, French West Indies, between January and November 2014, was performed. In addition, patients with CHIKV-related manifestations were compared with those whose manifestations were not specifically related to CHIKV infection. Results: Sixty-five patients were admitted to the ICU with CHIKV infection. Fifty-four (83%) had a pre-existing underlying disease and 27 (41.5%) were admitted due to exacerbation of a comorbidity. Thirty-seven (57%) patients were mechanically ventilated. ICU and hospital mortality rates were 26% and 27%, respectively. CHIKV-related manifestations were observed in 28 (18%) patients and were mainly encephalitis, Guillain–Barré syndrome, and severe sepsis. These patients less frequently had chronic arterial hypertension and diabetes and more frequently had autoimmune diseases compared with patients without CHIKV-related manifestations. Conclusions: Most patients admitted to the ICU with CHIKV infection had a pre-existing comorbidity. However, severe manifestations such as Guillain–Barré syndrome, encephalitis, and severe sepsis could be specifically related to CHIKV.