Acute chikungunya virus infection and asthma: Table 1—

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To the Editors: From March 2005 to June 2006, Reunion Island, a French overseas territory in the Indian Ocean, faced an explosive chikungunya outbreak (a mosquito-borne disease caused by an alphavirus of the Togaviridae family). It was estimated that about 300,000 people were affected by the disease 1. Many patients experienced related chikungunya disease symptoms (fever, polyarthralgia, skin rashes, diarrhoea, vomiting). To date, there are no studies describing a respiratory tract involvement due to chikungunya infection. During this period, many patients complained of respiratory symptoms such as de novo dyspnoea or a worsening of various respiratory symptoms in patients with asthma. We hypothesised that acute chikungunya infection (ACI) may induce airway hyperresponsiveness (AHR) and therefore increases symptoms of asthma. The study was prospectively conducted from December 2005 to May 2006. All patients had ACI defined as symptoms (fever, polyarthralgia) that occurred in the 10 days preceding the evaluation, with a laboratory-confirmed diagnosis of acute chikungunya: positive RT-PCR, positive immunoglobulin (Ig)M serological test. All asthmatic patients had a history of significant reversibility of airflow obstruction. Pulmonary function testing (PFT) was performed with a phletysmograph (Medisoft®, Dinant, Belgium) at baseline and after inhaling 400 μg of salbutamol. Results (forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), maximum mid-expiratory flow at 25–75% of FVC) were compared with former data recorded with the same phletysmograph. Patients were asked to fill a validated asthma 15-question questionnaire to assess quality of life (mini-Asthma Quality of Life Questionnaire (AQLQ)). The questionnaire generated an overall score and a four-domain score: symptoms, five questions; activities, four questions; emotion, three questions; environmental exposure, three questions. Each ranged 1–7, with higher scores indicating better quality of life in the last 2 weeks. Treatment for asthma was carefully recorded. Nonasthmatics subjects had no history of asthma or any respiratory disease. …