Chikungunya virus infection, a threat to public health

Many countries in the world have reported human infections by chikungunya virus (CHIKV) a mosquito-borne togavirus belonging to the genus alpha virus. After half a century of focal out breaks of acute febrile poly arthralgia, the disease had spread unexpectedly in the past decade with large outbreaks in Africa around the Indian Ocean and in Bangladesh. In Asia, CHIKV is thought to be transmitted by the same mosquito as dengue, Aedes aegypti and Aedes albopictus. Due to similarities in clinical presentation with dengue, limited awareness and a lack of laboratory diagnostic facilities, CHIKV is probably often under diagnosed or misdiagnosed as dengue. Treatment is supportive. The prognosis is generally good although some patients experience chronic arthritis. There is no vaccine or antiviral therapy against CHIKV. Early identification of disease and control of vector will prevent the spread of disease.     

Re-emergence of Chikungunya virus in Malaysia

An outbreak of Chikugunya (CHIK) fever occurred among the fishing community in Bagan Pancor, Perak. The outbreak was laboratory confirmed within 48 hours after the receipt of the specimens. Fifty-three patients' serum samples were submitted for laboratory investigation and 47 (88.7%) were confirmed to be positive for CHIK infection by RT-PCR, and/or virus isolation, and/or in-house immunoflourescent test. RT-PCR and virus isolation were the tests of choice for patients with illness of four days or less and detection of CHIK specific IgM for those with more than four days of fever. The nucleic acid sequence based on the 354- and 294-bp of the nsP1 and E1 genes of the CHIK virus detected from pools of adults Aedes aegypti mosquitoes were identical to those CHIKV virus isolated from humans in the same locality. Phylogenetic analysis of the CHIK virus based on the 257 nts partial E1 gene indicates that Bagan Panchor's strain was closely related to the first CHIK virus isolated during the outbreak in Klang in 1998.     

Chikungunya virus of Central/East African genotype detected in Malaysia

Since its isolation in Tanzania in 1953, chikungunya virus has caused periodic outbreaks in both tropical Africa and Asia. In the last decade, the virus has shown not only increased activity but has expanded its geographical locations, thus classical delineation of various genotypes of chikungunya virus to specific geographic locales no longer holds true. Rapid mass movement of people and the constant presence of the right vectors in this region could have contributed to the change in virus ecology. This paper documents the first detection of chikungunya virus of Central/East genotype in Malaysia from a patient who was most likely infected with the virus during her visit to India. Without good Aedes vector measures, only time will tell whether this genotype rather than the existing endemic genotype will subsequently cause the next chikungunya outbreak in Malaysia.     

深圳市新分离两株基孔肯雅热病毒的分子遗传学分析

目的 对2010～2012年深圳市报告的两起输入性基孔肯雅热病原体进行分子遗传学分析.方法 利用C6/36细胞从病人血清中分离基孔肯雅病毒(Chikungunya virus,CHIKV),对分离得到的CHIKV进行全基因组测序和构建系统发生树,结合流行病学资料对其分子遗传特征进行分析.结果 成功分离得到两株CHIKV,分别命名为SZ_20101028和SZ 20120702,SZ_20101028全基因组长为12377bp,SZ_20120823全基因组长为11893bp;构建系统发生树分析,结果表明,SZ_20101028是印度洋亚型,ECSA型的后裔.SZ_20120702为Asian亚型.结论 SZ_20101028与最近10年来在印度洋岛屿爆发流行新亚型且与2010年由输入性引发起东莞疫情爆发的毒株亲源性最高,为99％;而SZ_20120702为Asian亚型,不是近年来爆发流行株.     

基孔肯雅病毒,不容小觑——肆虐美洲的“登革病毒”

2014年,一种类似于登革热的传染病——基孔肯雅热席卷了中南美洲,其病原体为基孔肯雅病毒,隶属于披膜病毒科甲病毒属的单股正链RNA病毒,传播媒介主要是伊蚊属,尤其是白纹伊蚊和埃及伊蚊。基孔肯雅热的临床症状与登革热十分相似,临床上需要鉴别诊断。2010年该疾病在我国广东曾小规模流行,其对人民健康造成的危害以及所带来的经济负担不亚于登革热,应高度重视,遏制其蔓延。     

Rhabdomyolysis following dengue virus infection

We describe a 27-year-old man who developed prolonged myalgia and dark red-coloured urine following dengue virus infection. The patient was found to have raised serum creatine kinase levels, consistent with rhabdomyolysis. He was treated with intravenous hydration and recovered uneventfully. Despite dengue fever being endemic in Singapore and South-east Asia, this is the first case report of such complication in this region.     

丙型肝炎病毒感染的管理

黄病毒属RNA病毒丙型肝炎病毒（HCV）慢性感染是肝脏疾病的一个主要原因。英国卫生部估计,该国HCV慢性感染者约2百万人——其中50％并不知道自身感染了这种病毒。流行情况在不同人群中有所差别：献血者为0．04％,泌尿生殖门诊患者为1％,静脉吸毒者可达到50％。一名全科医师平均处置1800名患者就有8～20名丙型肝炎。如果这些患者得以诊治,一半以上可获病毒清除。我们概括了肝脏病学的这一领域,着重强调HCV感染的危险因素、筛查人群以及慢性感染患者的专业治疗。     

Chikungunya epidemic: an Indian perspective

Chikungunya, caused by the chikungunya virus, recently emerged as an important public health problem in the Indian Ocean Islands and India. In 2006, an estimated 1.38 million people across southern and central India developed symptomatic disease. The incidence of the disease may have been higher but may have been underreported due to lack of accurate reporting. First isolated in Tanzania in 1953, the chikungunya virus belongs to the family Togaviridae (single-stranded RNA alphaviruses) and has 3 distinct genotypes: East African, West African and Asian. Previous outbreaks in India (1963 and 1973) were caused by the Asian genotypes, but the 2005 epidemic in the Indian Ocean islands and the 2006 epidemic in India have been attributed to the East African genotype. The virus is transmitted to humans by the bites of mosquitoes of the species Aedes aegypti and A. albopictus. Researchers speculate that mutation of the virus, absence of herd immunity, lack of vector control, and globalization of trade and travel might have contributed to the resurgence of the infection. Chikungunya is characterized by high fever, severe arthralgia and rash. Although viral diagnostics (culture, serological tests and polymerase chain reaction tests) can be used to confirm the infection, these tests are not accessible during outbreaks to the majority of the population. The disease is a self-limiting febrile illness and treatment is symptomatic. As no effective vaccine or antiviral drugs are available, mosquito control by evidence-based interventions is the most appropriate strategy to contain the epidemic and pre-empt future outbreaks.     

细胞培养与PCR法检测生殖器疱疹病毒的对比研究

目的:比较不同方法检测生殖器疱疹病毒感染的效率。方法:采用病毒培养和PCR法检测疑为生殖器疱疹病毒感染者标本60例,并用PCR作病毒分型。结果:根据病史及临床表现确诊的生殖器疱疹患者标本60例中,病毒培养法阳性36例,阳性率60%(36/60);PCR检测单纯疱疹病毒(HSV)阳性45例,阳性率75%(45/60),和病毒培养相比,差异非常显著(χ2=26.76,P<0.01);PCR分型结果显示阳性标本均为单纯疱疹病毒Ⅱ型(HSV-2)。水疱和脓疱标本的病毒培养和PCR检测阳性率均较高(80.0%~93.3%),糜烂、结痂、斑丘疹标本检测中PCR阳性率(20.0%~66.7%)高于病毒培养(0~33.3%)。结论:对疑为生殖器疱疹患者作病原学诊断,采集水疱、脓疱标本进行病毒分离或PCR检测较佳。