Tuesday, June 6, 2017

MedicalConspiracies- Chikungunya: children at higher risk for vertical transmission, significant nervous system morbidity

Chikungunya: children at higher risk for vertical transmission, significant nervous system morbidity


  • As chikungunya virus (CHIKV) infections continue to spread globally (including in North America/the United States), epidemiologic/clinical surveillance is key to predicting outbreaks.
  • This is particularly important for vulnerable children aged 0-12 mo, whose clinical presentation is vastly different than for adults.

Why this matters

  • CHIKV has been linked to significant nervous symptom morbidity, including meningoencephalitis, seizures, Guillain-Barre, myelopathy, and/or myeloneuropathy, especially in small children <12 mo.
  • In very young infants (<3 mo), poorly tolerated fever is prognostic for CHIKV.
  • Clinicians should familiarize themselves with risk for vertical transmission, atypical complications found in pediatric CHIKV, and differences vs adult cases to optimize management/outcomes.

Study design

  • 235 children with CHIKV were evaluated.
  • 128 children were identified by reverse transcription-polymerase chain reaction, and 107 by epidemiologic criteria.
  • Funding: None.

Key results

  • 52% patients were aged 1-12 mo.
  • 53 patients presented with severe complications; most common were seizures, meningoencephalitis, and acute hepatitis.
  • All patients with meningoencephalitis were aged 1-12 mo; the most common clinical manifestations were fever (100%), rash (100%), irritability (100%), and hyperalgesia (93%).
  • Neurological assessment showed mild-moderate brain edema in 7 patients and elevated levels of leukocytes and protein in all 14 patients.
  • 8 patients had vertical transmission Chikungunya virus.


  • Retrospective study.


Coauthored with Chitra Ravi, MPharm

Samra JA, Hagood NL, Summer A, Medina MT, Holden KR. Clinical Features and Neurologic Complications of Children Hospitalized With Chikungunya Virus in Honduras. J Child Neurol. 2017 Jan 1 [Epub ahead of print]:883073817701879. doi: 10.1177/0883073817701879. PMID: 28459170

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