Chikungunya Disease: Infection-Associated Markers from the Acute to the Chronic Phase of Arbovirus-Induced Arthralgia

At the end of 2005, an outbreak of fever associated with joint pain occurred in La Réunion. The causal agent, chikungunya virus (CHIKV), has been known for 50 years and could thus be readily identified. This arbovirus is present worldwide, particularly in India, but also in Europe, with new variants returning to Africa. In humans, it causes a disease characterized by a typical acute infection, sometimes followed by persistent arthralgia and myalgia lasting months or years. Investigations in the La Réunion cohort and studies in a macaque model of chikungunya implicated monocytes-macrophages in viral persistence. In this Review, we consider the relationship between CHIKV and the immune response and discuss predictive factors for chronic arthralgia and myalgia by providing an overview of current knowledge on chikungunya pathogenesis. Comparisons of data from animal models of the acute and chronic phases of infection, and data from clinical series, provide information about the mechanisms of CHIKV infection–associated inflammation, viral persistence in monocytes-macrophages, and their link to chronic signs

Chikungunya Virus Infection

Chikungunya virus (CHIKV) is an alphavirus transmitted by mosquitoes, mostly Aedes aegypti and Aedes albopictus. After half a century of focal outbreaks of acute febrile polyarthralgia in Africa and Asia, the disease unexpectedly spread in the past decade with large outbreaks in Africa and around the Indian Ocean and rare autochthonous transmission in temperate areas. This emergence brought new insights on its pathogenesis, notably the role of the A226V mutation that improved CHIKV fitness in Ae. albopictus and the possible CHIKV persistence in deep tissue sanctuaries for months after infection. Massive outbreaks also revealed new aspects of the acute stage: the high number of symptomatic cases, unexpected complications, mother-to-child transmission, and low lethality in debilitated patients. The follow-up of patients in epidemic areas has identified frequent, long-lasting, rheumatic disorders, including rare inflammatory joint destruction, and common chronic mood changes associated with quality-of-life impairment. Thus, the globalization of CHIKV exposes countries with Aedes mosquitoes both to brutal outbreaks of acute incapacitating episodes and endemic long-lasting disorders

Nutritional status of preschool children in Andaman and Nicobar Islands and food insecurity, food groups, and nutrient consumption among population

Background: Childhood undernutrition is a public health concern in India. But on such a serious issue, there are no data available from the Union Territory of Andaman and Nicobar (A and N) Islands. Objectives: Present study was designed to know the prevalence of food insecurity, to estimate food group and nutrient intake among the community, and undernutrition and clinical signs of micronutrient deficiency among the preschool children of A and N islands. Materials and Methods: Multistage random sampling was followed to select the households containing children aged 6-59 months. In the selected households' sociodemographic particulars, Household Food Insecurity Access Scale (HFIAS), among preschoolers the weight and height were recorded along with the documentation of clinical signs of micronutrient deficiency, morbidities suffered over previous fortnight, and measurement of hemoglobin. Diet survey was carried out in every fourth household. Results: A total of 1259 preschoolers residing in 1082 households were examined, HFIAS was measured in 710 households in Andaman group of islands and diet survey was conducted in 290 households. The prevalence of undernutrition was around 27%, stunting was 36%, and anemia was around 81%. Undernutrition and anemia prevalence were significantly low among Nicobarese children. After adjusting for all the determinants, tribal in domicile had favorable outcome [odds ratio (OR): 0.28 (0.18, 0.43)], while below poverty line family had adverse outcome on undernutrition [OR: 1.72 (1.20, 2.46)]. Conclusion: Though the prevalence of undernutrition is relatively low in the islands, but high prevalence of anemia needs to be addressed. Nicobarese children fare better in almost all indicators of nutritional well-being except for stunting