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Vol. 11. Issue 3.
Pages 161-164 (May - June 2015)
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Vol. 11. Issue 3.
Pages 161-164 (May - June 2015)
Review Article
DOI: 10.1016/j.reumae.2014.07.004
Chikungunya Fever. Rheumatic Manifestations of an Emerging Disease in Europe
Fiebre chikungunya. Manifestaciones reumáticas de una infección emergente en Europa
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M. Loreto Horcadaa,
Corresponding author
mlhorcada@hotmail.com

Corresponding author.
, Carlos Díaz-Calderónb, Laura Garridoa
a Servicio de Reumatología, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
b Centro Salud Tarazona, Zaragoza, Spain
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Abstract

Chikungunya fever is a viral disease caused by an alphavirus belonging to the Togaviridae family, transmitted by several species of Aedes mosquitoes: Aedes aegypti and Aedes albopictus (A. albopictus). It is endemic in Africa and Asia with recurrent outbreaks. It is an emerging disease and cases in Europe transmitted by A. albopictus have been established in Mediterranean areas. The first autochthonous cases detected on the Caribbean islands suppose a serious threat of spreading disease to America, which so far has been disease free.

Clinical symptoms begin abruptly with fever, skin rash and polyarthritis. Although mortality is low, a high percentage of patients develop a chronic phase defined by persistent arthritis for months or even years. A severe immune response is responsible for joint inflammation. The absence of specific treatment and lack of vaccine requires detailed studies about its immunopathogenesis in order to determine the most appropriate target.

Keywords:
Chikungunya fever
Chronic polyarthritis
Emergent outbreak
International alert
Resumen

La fiebre chikungunya es una enfermedad producida por un alfavirus perteneciente a la familia Togaviridae, transmitida por miembros de diferentes especies del género Aedes: Aedes aegypti y Aedes albopictus (A. albopictus). Es endémica en África y Asia, ocasionando brotes epidémicos recurrentes. En 2007, surge de forma emergente en Europa transmitida por A. albopictus, asentado en el área mediterránea. Los primeros casos autóctonos detectados recientemente en las islas caribeñas suponen una seria amenaza de propagación al continente americano, libre hasta el momento de la enfermedad.

Se manifiesta de forma aguda con fiebre, rash cutáneo y poliartritis. La mortalidad es baja, pero un porcentaje elevado de enfermos desarrollan una fase crónica definida por poliartritis persistente durante meses e incluso años.

Una severa reacción inmunitaria de defensa con incremento de citocinas proinflamatorias es la responsable de la inflamación articular. El tratamiento es sintomático. No disponemos de terapia antiviral específica ni vacuna preventiva. Por ello, debemos profundizar en el estudio de la inmunopatogénesis, con el fin encontrar dianas terapéuticas más apropiadas.

Palabras clave:
Fiebre chikungunya
Poliartritis crónica
Epidemia emergente
Alerta internacional

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