Abstract
BackgroundChikungunya virus (CHIKV) is a widespread mosquito-borne virus representing a serious challenge to public health. The largest outbreak in the Middle-East was recorded in 2016–2017 in Pakistan. Sistan and Baluchistan Province of Iran shares a wide border with Pakistan; accordingly, introduction of CHIKV from Pakistan to Iran seems to be probable. The current study is aimed at investigating CHIKV infection in Sistan and Baluchistan Province.MethodsBetween April 2017 and June 2018, a total of 159 serum samples of CHIK suspected cases from 10 cities of Sistan and Baluchistan Province were tested by molecular and serological assays. Samples obtained up to 4 days after onset of illness were tested by real time PCR (n = 8). Samples collected 5–10 days after disease onset were subjected to ELISA, as well as real time PCR tests (n = 72). Samples obtained after the 10th day of disease onset were tested by only ELISA (n = 79). Phylogenetic analysis of real time PCR positive samples was carried out by sequencing of a 1014-bp region of Envelope 1 gene (E1 gene). Chi-square and independent t tests were used to evaluate the association between variables and CHIKV infection.ResultsIn total, 40 (25.1%) out of 159 samples tested positive either by real time PCR or ELISA tests.Out of 151 samples serologically analyzed, 19 (12.6%) and 28 (18.6%) cases were positive for anti-CHIKV IgM and anti-CHIKV IgG antibodies, respectively. Of 80 samples tested by real time PCR, CHIKV RNA was detected in 11 (13.7%) sera, all of them had recent travel history to Pakistan. Additionally, phylogenetic analysis of 5 samples indicated their similarity with recent isolates of Pakistan outbreak 2016–2017 belonging to Indian Ocean sub-lineage of ECSA genotype. A significant correlation between abroad travel history and CHIKV infection was observed (P < 0.001). The most common clinical symptoms included fever, arthralgia/arthritis, myalgia, headache, and chill.ConclusionsThese results present substantial evidence of CHIKV introduction to Iran from Pakistan and emphasize the need for the enhancement of surveillance system and preventive measures.
Highlights
Chikungunya virus (CHIKV) is a widespread mosquito-borne virus representing a serious challenge to public health
Similar to other arboviruses such as Dengue and Zika, CHIKV can be transmitted via the urban transmission cycle between humans and mosquito [5]
Molecular analysis of 80 serum samples showed presence of the CHIKV RNA in 11 (13.7%) sera; all of them were negative for dengue virus
Summary
Chikungunya virus (CHIKV) is a widespread mosquito-borne virus representing a serious challenge to public health. Sistan and Baluchistan Province of Iran shares a wide border with Pakistan; introduction of CHIKV from Pakistan to Iran seems to be probable. The current study is aimed at investigating CHIKV infection in Sistan and Baluchistan Province. Pouriayevali et al BMC Infectious Diseases (2019) 19:1004 up”) [3].CHIKV is transmitted to humans through infected mosquito bites of Aedes spp., in particular Ae. albopictus and Ae. aegypti. Similar to other arboviruses such as Dengue and Zika, CHIKV can be transmitted via the urban transmission cycle between humans and mosquito [5]. The main symptoms of CHIKV infection are the sudden onset of high fever (102 °F) and severe arthralgia; other symptoms include headaches, muscle aches, nausea, vomiting, arthritis, and skin rash. About 10–15% of cases develop chronic forms associated with persistent arthralgia [4, 6]
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