Ross River virus disease in tropical Queensland: evolution of rheumatic manifestations in an inception cohort followed for six months.

Abstract

To describe the natural history of rheumatic manifestations of Ross River virus (RRV) disease. Prospective longitudinal clinical review. North Queensland local government areas of Cairns, Douglas, Mareeba and Atherton during January to May 1998. General practice patients diagnosed with RRV disease on the basis of symptoms and a positive RRV IgM result. Rheumatic symptoms and signs assessed as soon as possible after disease onset and on two subsequent occasions (up to 6.5 months after onset). 57 patients were recruited, 47 of whom were reviewed three times (at means of 1.1, 2.4 and 3.6 months after disease onset). Results are reported for these 47: 46 (98%) complained of joint pain at first review, with the ankles, wrists, fingers, knees and metacarpophalangeal joints (II-IV) most commonly involved. Prevalence of joint pain decreased progressively on second and third reviews, both overall (92% and 68% of patients, respectively), and in the five joints most commonly affected. The prevalence of other common rheumatic symptoms and signs, and use of non-steroidal anti-inflammatory drugs, also progressively declined over the three reviews. Earlier studies may have overestimated the prevalence and duration of symptoms in RRV disease. Progressive resolution over 3-6 months appears usual.