Abstract
BackgroundChikungunya virus (CHIKV) infection is a long known mosquito-borne disease that is associated with severe morbidity, characterized by fever, headache, rashes, joint pain, and myalgia. It is believed that virus load has relation with severity of clinical features.ObjectivesWe performed this study to assess the relationship between virus load and clinical features in children during the acute phase of CHIKV infection, in order to draw insights for better-informed treatment.Study designBetween June 1, 2009, and May 31, 2010, 338 patients with fever and susceptive to CHIKV during first 4 days of illness were prospectively enrolled from Karnataka Institute of Medical Sciences, Hubli in our hospital based cross sectional observational study. Sybr green quantitative reverse transcription polymerase chain reaction was performed to estimate the virus load.ResultsQuantitative RT-PCR was positive for CHIKV in 54 patients. The median copy number of CHIKV was 1.3x 108 copies/ml (1.7x105-9.9x109 copies/ml). Among the observed clinical features, a statistically significant difference in log mean virus load was found between patients with and without myalgia (log mean 7.50 vs 8.34, P = 0.01).ConclusionPatients with myalgia had lower virus load and those without myalgia had a higher virus load.
Highlights
Though Chikungunya virus (CHIKV) was known since 1952, effective and timely management options are at various stages of development [1]
Quantitative RT-PCR was positive for CHIKV in 54 patients
Among the observed clinical features, a statistically significant difference in log mean virus load was found between patients with and without myalgia
Summary
Though Chikungunya virus (CHIKV) was known since 1952, effective and timely management options are at various stages of development [1]. Studies investigating the relationship between virus load and the clinical features have been limited to animals and adults [1]. Even though the mechanism of pathogenesis remains similar in both children and adults, symptoms might vary individually depending on age, immune response, virus load and cytokine levels, causing a change in the number of days of illness [6]. Chikungunya virus (CHIKV) infection is a long known mosquito-borne disease that is associated with severe morbidity, characterized by fever, headache, rashes, joint pain, and myalgia. It is believed that virus load has relation with severity of clinical features
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