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- a harmful or corrupting agency; "bigotry is a virus that must not be allowed to spread"; "the virus of jealousy is latent in everyone"
- (virology) ultramicroscopic infectious agent that replicates itself only within cells of living hosts; many are pathogenic; a piece of nucleic acid (DNA or RNA) wrapped in a thin coat of protein
- a software program capable of reproducing itself and usually capable of causing great harm to files or other programs on the same computer; "a true virus cannot spread to another computer without human assistance" (同)computer virus
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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/09/26 20:48:25」(JST)
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| Chikungunya | |
|---|---|
| Classification and external resources | |
| ICD-10 | A92.0 |
| ICD-9 | 065.4, 066.3 |
| DiseasesDB | 32213 |
| MeSH | D018354 |
| Chikungunya virus | |
|---|---|
| Virus classification | |
| Group: | Group IV ((+)ssRNA) |
| Family: | Togaviridae |
| Genus: | Alphavirus |
| Species: | Chikungunya virus |
Chikungunya (in the Makonde language "that which bends up") virus (CHIKV) is an insect-borne virus, of the genus Alphavirus, that is transmitted to humans by virus-carrying Aedes mosquitoes.[1] There have been recent breakouts of CHIKV associated with severe illness.
CHIKV infection causes an illness with symptoms similar to dengue fever, with an acute febrile phase of the illness lasting only two to five days, followed by a prolonged arthralgic disease that affects the joints of the extremities. The pain associated with CHIKV infection of the joints persists for weeks or months, or in some cases years.[2][3]
Contents
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Signs and symptoms
The incubation period of chikungunya disease ranges from one to twelve days, usually two to three. Its symptoms include a fever up to 40 °C (104 °F), a petechial or maculopapular rash of the trunk and occasionally the limbs, and arthralgia or arthritis affecting multiple joints.[4] Other nonspecific symptoms can include headache, conjunctivitis, slight photophobia and partial loss of taste.[5]
Typically, the fever lasts for two days and then ends abruptly. However, other symptoms—namely joint pain, intense headache, insomnia and an extreme degree of prostration—last for a variable period; usually for about five to seven days.[4] Patients have complained of joint pains for much longer time periods; some as long as two years, depending on their age.[6][7]
Diagnosis
Common laboratory tests for chikungunya include RT-PCR, virus isolation, and serological tests.
- Virus isolation provides the most definitive diagnosis, but takes one to two weeks for completion and must be carried out in biosafety level 3 laboratories.[8] The technique involves exposing specific cell lines to samples from whole blood and identifying chikungunya virus-specific responses.
- RT-PCR using nested primer pairs is used to amplify several chikungunya-specific genes from whole blood. Results can be determined in one to two days.[8]
- Serological diagnosis requires a larger amount of blood than the other methods, and uses an ELISA assay to measure chikungunya-specific IgM levels. Results require two to three days, and false positives can occur with infection via other related viruses, such as o'nyong'nyong virus and Semliki Forest virus.[8]
Causes
| This section requires expansion. (July 2008) |
Chikungunya virus is indigenous to tropical Africa and Asia, where it is transmitted to humans by the bite of infected mosquitoes, usually of the genus Aedes. Chikungunya virus belongs to alphavirus genus of the Togaviridae family. It is an "Arbovirus" (Ar-arthropod, bo-borne).
CHIK fever epidemics are sustained by human-mosquito-human transmission. The main virus reservoirs are monkeys, but other species can also be affected, including humans.[9]
Pathophysiology
| This section requires expansion. (March 2008) |
Human epithelial and endothelial cells, primarily fibroblasts and monocyte-derived macrophages, are susceptible to infection. Lymphoid and monocytoid cells, primary lymphocytes and monocytes and monocyte-derived dendritic cells are not susceptible to infection. Viral entry occurs through pH-dependent endocytosis. Infection is cytopathic and associated with the induction of apoptosis in the infected cell.
Infection is highly sensitive to the antiviral activity of type I and II interferon.
Prevention
The Aedes aegypti mosquito biting a person.
The most effective means of prevention are protection against contact with the disease-carrying mosquitoes and mosquito control. These include using insect repellents with substances such as DEET (N,N-diethyl-meta-toluamide; also known as N,N'-diethyl-3-methylbenzamide or NNDB), icaridin (also known as picaridin and KBR3023), PMD (p-menthane-3,8-diol, a substance derived from the lemon eucalyptus tree), or IR3535. Wearing bite-proof long sleeves and trousers (pants) also offers protection.
In addition, garments can be treated with pyrethroids, a class of insecticides that often has repellent properties. Vaporized pyrethroids (for example in mosquito coils) are also insect repellents. Securing screens on windows and doors will help to keep mosquitoes out of the house. In the case of the day-active Aedes aegypti and Aedes albopictus, however, this will have only a limited effect, since many contacts between the vector and the host occur outside.
Treatment
There are no specific treatments for chikungunya, and no vaccine is currently available. A Phase II vaccine trial, sponsored by the US Government and published in the American Journal of Tropical Medicine and Hygiene in 2000, used a live, attenuated virus, developing viral resistance in 98% of those tested after 28 days and 85% still showed resistance after one year.[10]
A serological test for chikungunya is available from the University of Malaya in Kuala Lumpur, icul.
Chloroquine is gaining ground as a possible treatment for the symptoms associated with chikungunya, and as an anti-inflammatory agent to combat the arthritis associated with the virus. A University of Malaya study found that for arthritis-like symptoms not relieved by aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs), chloroquine phosphate (250 mg/day) has given promising results.[11] Unpublished studies in cell culture and monkeys show no effect of chloroquine treatment on reduction of chikungunya disease. The fact sheet[9] on chikungunya advises against using aspirin, ibuprofen, naproxen and other NSAIDs that are recommended for arthritic pain and fever.
Vaccine development
A virus-like particle-based vaccine has protected monkeys from chikungunya virus infection, and passive immunization from these monkeys protected immunodeficient mice against exposure to a dose of virus that would otherwise be lethal, demonstrating the humoral response was highly protective.[12]
A DNA vaccine candidate is also being tested. The vaccine cassette was designed based on CHIKV capsid and envelope specific consensus sequences with several modifications, including codon optimization, RNA optimization, the addition of a Kozak sequence, and a substituted immunoglobulin E leader sequence. These constructs induced humoral and cellular immune responses in mice.[13]
Passive immunity
Antibodies isolated from patients recovering from chikungunya fever have been shown to protect mice from infection.[14]
Prognosis
| This section requires expansion. (March 2008) |
Recovery from the disease varies by age. Younger patients recover within 5 to 15 days; middle-aged patients recover in 1 to 2.5 months. Recovery is longer for the elderly. The severity of the disease as well as its duration is less in younger patients and pregnant women. In pregnant women, no untoward effects are noticed after the infection.
Ocular inflammation from Chikungunya may present as iridocyclitis, and have retinal lesions as well.[15]
Pedal oedema (swelling of legs) is observed in many patients, the cause of which remains obscure as it is not related to any cardiovascular, renal or hepatic abnormalities.
Epidemiology
Cases of chikungunya fever (between 1952-2006) have been reported in the countries depicted in red on this map.
Chikungunya virus is an alphavirus closely related to the o'nyong'nyong virus,[16] the Ross River virus in Australia, and the viruses that cause eastern equine encephalitis and western equine encephalitis.[17]
Three genotypes of this virus have been described: West African, East/Central/South African and Asian genotypes.[18]
Chikungunya is generally spread through bites from Aedes aegypti mosquitoes, but recent research by the Pasteur Institute in Paris has suggested chikungunya virus strains in the 2005-2006 Reunion Island outbreak incurred a mutation that facilitated transmission by Asian tiger mosquito (Aedes albopictus).[19]
Concurrent studies by arbovirologists at the University of Texas Medical Branch in Galveston, Texas, confirmed definitively that enhanced chikungunya virus infection of A. albopictus was caused by a point mutation in one of the viral envelope genes (E1).[20][21] Enhanced transmission of chikungunya virus by A. albopictus could mean an increased risk for chikungunya outbreaks in other areas where the Asian tiger mosquito is present. A recent epidemic in Italy was likely perpetuated by A. albopictus.[22]
In Africa, chikungunya is spread via a sylvatic cycle in which the virus largely resides in other primates in between human outbreaks.[17]
On 28 May 2009 in Changwat Trang of Thailand where the virus is endemic, the provincial hospital decided to deliver by Caesarean section a male baby from his chikungunya-infected mother, Khwanruethai Sutmueang, 28, a Trang native, to prevent mother-fetus virus transmission. However, after delivering the baby, the physicians discovered the baby was already infected with the virus, and put him into intensive care because the infection had left the baby unable to breathe by himself or to drink milk. The physicians presumed the virus might be able to be transmitted from a mother to her fetus, but without laboratory confirmation.[23]
Viral evolution
This virus was first identified in Tanzania in the 1953 appears to have evolved from an alphavirus ~1713 AD (95% credible interval: 1573 - 1843) in Africa.[18][24] The East/Central/South African (ECSA) and Asian strains diverged within the last 150 years (95% HPD: 1879 to 1927). The extant ECSA strains - which include the first isolate of this virus - evolved between 1924 and 1943.
The Asian group split into two clades: an Indian lineage which has probably become extinct and a Southeast Asian lineage. The Southeast Asian lineage spread from Thailand to Indonesia; and then to the Philippines and more recently Malaysia. The recent Indian Ocean basin outbreak that began in 2004 appears to have originated from the ECSA group back in 2002 (95% credible interval: December 2001 to December 2003).
The estimated overall mutation rate is 4.33 × 10−4 nucleotide substitutions per site per year - a rate similar to those forun in other viruses with RNA genomes.[24]
History
Main article: Chikungunya outbreaks
The word chikungunya is thought to derive from a description in the local Makonde dialect, meaning "that which bends up", of the contorted posture of patients afflicted with the severe joint pain and arthritic symptoms associated with this disease.[25] The disease was first described by Marion Robinson[26] and W.H.R. Lumsden[27] in 1955, following an outbreak in 1952 on the Makonde Plateau, along the border between Mozambique and Tanganyika (the mainland part of modern day Tanzania).
According to the initial 1955 report about the epidemiology of the disease, the term chikungunya is derived from the Makonde root verb kungunyala, meaning to dry up or become contorted. In concurrent research, Robinson glossed the Makonde term more specifically as "that which bends up". Subsequent authors apparently overlooked the references to the Makonde language and assumed the term derived from Swahili, the lingua franca of the region. The erroneous attribution of the term as a Swahili word has been repeated in numerous print sources. Many other erroneous spellings and forms of the term are in common use including "chicken guinea", "chicken gunaya," and "chickengunya".[citation needed]
Since its discovery in Tanganyika, Africa, in 1952, chikungunya virus outbreaks have occurred occasionally in Africa, South Asia, and Southeast Asia, but recent outbreaks have spread the disease over a wider range.
The first recorded outbreak of this disease may have been in 1779.[28] This is in agreement with the molecular genetics evidence that suggests it evolved around the year 1700.[29]
Use as a biological weapon
Chikungunya was one of more than a dozen agents the United States researched as potential biological weapons before the nation suspended its biological weapons program.[30]
See also
- Chikungunya outbreaks: outbreaks of the disease, 2004 to present
- DEET
- O'nyong'nyong virus: a similar virus
- Vector (epidemiology)
References
- ^ Lahariya C, Pradhan SK (December 2006). "Emergence of chikungunya virus in Indian subcontinent after 32 years: a review" (PDF). J Vect Borne Dis 43 (4): 151–60. http://www.mrcindia.org/journal/issues/434151.PDF.
- ^ Powers AM, Logue CH (September 2007). "Changing patterns of chikungunya virus: re-emergence of a zoonotic arbovirus". J. Gen. Virol. 88 (Pt 9): 2363–77. doi:10.1099/vir.0.82858-0. PMID 17698645.
- ^ Sourisseau M, Schilte C, Casartelli N, Trouillet C, Guivel-Benhassine F, Rudnicka D, Sol-Foulon N, Le Roux K, Prevost MC, Fsihi H, Frenkiel MP, Blanchet F, Afonso PV, Ceccaldi PE, Ozden S, Gessain A, Schuffenecker I, Verhasselt B, Zamborlini A, Saïb A, Rey FA, Arenzana-Seisdedos F, Desprès P, Michault A, Albert ML, Schwartz O (June 2007). "Characterization of reemerging chikungunya virus". PLoS Pathog. 3 (6): e89. doi:10.1371/journal.ppat.0030089. PMC 1904475. PMID 17604450. //www.ncbi.nlm.nih.gov/pmc/articles/PMC1904475/.
- ^ a b Chhabra M, Mittal V, Bhattacharya D, Rana U, Lal S (2008). "Chikungunya fever: a re-emerging viral infection". Indian J Med Microbiol 26 (1): 5–12. PMID 18227590. http://www.ijmm.org/article.asp?issn=0255-0857;year=2008;volume=26;issue=1;spage=5;epage=12;aulast=Chhabra.
- ^ Vatsal Anand (2011-03-18). "After effects of Chikungunya Fever". http://www.onlymyhealth.com/after-effects-chikungunya-fever-1300445384. Retrieved 2012-06-29.
- ^ Simon F, Parola P, Grandadam M, Fourcade S, Oliver M, Brouqui P, Hance P, Kraemer P, Ali Mohamed A, de Lamballerie X, Charrel R, Tolou H (May 2007). "Chikungunya infection: an emerging rheumatism among travelers returned from Indian Ocean islands. Report of 47 cases". Medicine (Baltimore) 86 (3): 123–37. doi:10.1097/MD/0b013e31806010a5. PMID 17505252.
- ^ Taubitz W, Cramer JP, Kapaun A, Pfeffer M, Drosten C, Dobler G, Burchard GD, Löscher T (July 2007). "Chikungunya fever in travelers: clinical presentation and course". Clin. Infect. Dis. 45 (1): e1–4. doi:10.1086/518701. PMID 17554689.
- ^ a b c "WHO — Laboratory Diagnosis of Chikungunya Fevers". http://www.searo.who.int/EN/Section10/Section2246_12902.htm. Retrieved 2008-07-11.
- ^ a b "Chikungunya—Fact sheet". European Centre for Disease Prevention and Control. 2008-01-23. http://ecdc.europa.eu/en/Health_Topics/Chikungunya_Fever/facts.aspx. Retrieved 2008-03-25. [dead link]
- ^ Edelman R, Tacket CO, Wasserman SS, Bodison SA, Perry JG, Mangiafico JA (June 2000). "Phase II safety and immunogenicity study of live chikungunya virus vaccine TSI-GSD-218". Am. J. Trop. Med. Hyg. 62 (6): 681–5. PMID 11304054. http://www.ajtmh.org/cgi/reprint/62/6/681.
- ^ Alphaviruses
- ^ Akahata W, Yang ZY, Andersen H, et al. (March 2010). "A virus-like particle vaccine for epidemic Chikungunya virus protects nonhuman primates against infection". Nat. Med. 16 (3): 334–8. doi:10.1038/nm.2105. PMC 2834826. PMID 20111039. //www.ncbi.nlm.nih.gov/pmc/articles/PMC2834826/.
- ^ Muthumani K, Lankaraman KM, Laddy DJ, et al. (September 2008). "Immunogenicity of novel consensus-based DNA vaccines against Chikungunya virus". Vaccine 26 (40): 5128–34. doi:10.1016/j.vaccine.2008.03.060. PMC 2582145. PMID 18471943. http://linkinghub.elsevier.com/retrieve/pii/S0264-410X(08)00341-1.
- ^ Couderc T, Khandoudi N, Grandadam M, et al. (2009). "Prophylaxis and therapy for Chikungunya virus infection". J Infect Dis 200 (4): 516–523. doi:10.1086/600381. PMID 19572805. http://www.journals.uchicago.edu/doi/full/10.1086/600381.
- ^ Mahendradas P, Ranganna SK, Shetty R, et al. (February 2008). "Ocular manifestations associated with chikungunya". Ophthalmology 115 (2): 287–91. doi:10.1016/j.ophtha.2007.03.085. PMID 17631967. http://linkinghub.elsevier.com/retrieve/pii/S0161-6420(07)00488-5.
- ^ Vanlandingham DL, Hong C, Klingler K, Tsetsarkin K, McElroy KL, Powers AM, Lehane MJ, Higgs S (2005). "Differential infectivities of o'nyong-nyong and chikungunya virus isolates in Anopheles gambiae and Aedes aegypti mosquitoes". Am J Trop Med Hyg 72 (5): 616–21. PMID 15891138.
- ^ a b Martin Enserink (2007). "Chikungunya: No Longer a Third World Disease". Science 318 (5858): 1860–1. doi:10.1126/science.318.5858.1860. PMID 18096785.
- ^ a b Powers AM, Brault AC, Tesh RB, Weaver SC (2000) Re-emergence of Chikungunya and O'nyong-nyong viruses: evidence for distinct geographical lineages and distant evolutionary relationships. J Gen Virol 81(2):471-479
- ^ Martin E (2007). "EPIDEMIOLOGY: Tropical Disease Follows Mosquitoes to Europe". Science 317 (5844): 1485. doi:10.1126/science.317.5844.1485a. PMID 17872417.
- ^ Tsetsarkin KA, Vanlandingham DL, McGee CE, Higgs S (2007). "A Single Mutation in Chikungunya Virus Affects Vector Specificity and Epidemic Potential". PLoS Pathog 3 (12): e201. doi:10.1371/journal.ppat.0030201. PMC 2134949. PMID 18069894. //www.ncbi.nlm.nih.gov/pmc/articles/PMC2134949/.
- ^ ProMED-mail (2007) Chikungunya virus: genetic change. Archive Number 20071209.3973
- ^ European Centers for Disease Control Report Chikungunya in Italy.
- ^ T Rath (2009). Trang hospital found Chikungunya transmitted from a mother to her foetus, 28 May 2009. (Accessed: 29 May 2009).
- ^ a b Volk SM, Chen R, Tsetsarkin KA, Adams AP, Garcia TI, Sall AA, Nasar F, Schuh AJ, Holmes EC, Higgs S, Maharaj PD, Brault AC, Weaver SC (2010) Genome-scale phylogenetic analyses of chikungunya virus reveal independent emergences of recent epidemics and various evolutionary rates. J Virol 84(13):6497-6504
- ^ Centers for Disease Control and Prevention (CDC) (September 29, 2006). "Chikungunya fever diagnosed among international travelers—United States, 2005–2006". MMWR Morb. Mortal. Wkly. Rep. 55 (38): 1040–2. PMID 17008866. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5538a2.htm.
- ^ Robinson MC (1955). "An epidemic of virus disease in Southern Province, Tanganyika Territory, in 1952-53. I. Clinical features". Trans. R. Soc. Trop. Med. Hyg. 49 (1): 28–32. doi:10.1016/0035-9203(55)90080-8. PMID 14373834.
- ^ Lumsden WH (1955). "An epidemic of virus disease in Southern Province, Tanganyika Territory, in 1952–53. II. General description and epidemiology". Trans. R. Soc. Trop. Med. Hyg. 49 (1): 33–57. doi:10.1016/0035-9203(55)90081-X. PMID 14373835.
- ^ Carey DE (July 1971). "Chikungunya and dengue: a case of mistaken identity?". J Hist Med Allied Sci 26 (3): 243–62. PMID 4938938. http://jhmas.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=4938938.
- ^ Cherian SS, Walimbe AM, Jadhav SM, Gandhe SS, Hundekar SL, Mishra AC, Arankalle VA (2009) Evolutionary rates and timescale comparison of chikungunya viruses inferred from the whole genome/E1 gene with special reference to the 2005-07 outbreak in the Indian subcontinent. Infect Genet Evol 9(1):16-23
- ^ "Chemical and Biological Weapons: Possession and Programs Past and Present", James Martin Center for Nonproliferation Studies, Middlebury College, April 9, 2002, accessed November 14, 2008.
Further reading
- Powers AM, Logue CH (2007). "Changing patterns of chikungunya virus: re-emergence of a zoonotic arbovirus". J Gen Virol 88 (9): 2363–77. doi:10.1099/vir.0.82858-0. PMID 17698645.
- "Chikungunya — Fact sheet". European Centre for Disease Prevention and Control. 2008-01-23. http://www.ecdc.europa.eu/en/Health_topics/Chikungunya_Fever/. Retrieved 2008-03-19. [dead link]
External links
- WHO site on disease outbreak news
- Schuffenecker I, Iteman I, Michault A, et al. (July 2006). "Genome microevolution of chikungunya viruses causing the Indian Ocean outbreak". PLoS Med. 3 (7): e263. doi:10.1371/journal.pmed.0030263. PMC 1463904. PMID 16700631. http://dx.plos.org/10.1371/journal.pmed.0030263.
- Mosquito-borne African virus a new threat to West Update on increasing threat, from Reuters
- Virus Pathogen Database and Analysis Resource (ViPR): Togaviridae
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English Journal
- Prime-Boost Immunization Strategies against Chikungunya Virus.
- Hallengärd D1, Lum FM2, Kümmerer BM3, Lulla A4, Lulla V4, García-Arriaza J5, Fazakerley JK6, Roques P7, Le Grand R8, Merits A4, Ng LF2, Esteban M5, Liljeström P1.
- Journal of virology.J Virol.2014 Nov 15;88(22):13333-43. doi: 10.1128/JVI.01926-14. Epub 2014 Sep 10.
- Chikungunya virus (CHIKV) is a reemerging mosquito-borne alphavirus that causes debilitating arthralgia in humans. Here we describe the development and testing of novel DNA replicon and protein CHIKV vaccine candidates and evaluate their abilities to induce antigen-specific immune responses against
- PMID 25210177
- Critical role for bone marrow stromal antigen 2 in acute Chikungunya virus infection.
- Mahauad-Fernandez WD1, Jones PH2, Okeoma CM3.
- The Journal of general virology.J Gen Virol.2014 Nov;95(Pt 11):2450-61. doi: 10.1099/vir.0.068643-0. Epub 2014 Jul 22.
- Bone marrow stromal antigen 2 (BST-2; also known as tetherin or CD317) is an IFN-inducible gene that functions to block the release of a range of nascent enveloped virions from infected host cells. However, the role of BST-2 in viral pathogenesis remains poorly understood. BST-2 plays a multifaceted
- PMID 25053563
- Residue 82 of the chikungunya virus e2 attachment protein modulates viral dissemination and arthritis in mice.
- Ashbrook AW1, Burrack KS2, Silva LA3, Montgomery SA4, Heise MT5, Morrison TE2, Dermody TS6.
- Journal of virology.J Virol.2014 Nov 1;88(21):12180-92. doi: 10.1128/JVI.01672-14. Epub 2014 Aug 20.
- Chikungunya virus (CHIKV) is a mosquito-borne alphavirus that has reemerged to cause profound epidemics of fever, rash, and arthralgia throughout sub-Saharan Africa, Southeast Asia, and the Caribbean. Like other arthritogenic alphaviruses, mechanisms of CHIKV pathogenesis are not well defined. Using
- PMID 25142598
Japanese Journal
- Transmission potential of Zika virus infection in the South Pacific
- International journal of infectious diseases 45, 95-97, 2016-04
- NAID 120005766750
- Characterization of RyDEN (C19orf66) as an Interferon-Stimulated Cellular Inhibitor against Dengue Virus Replication
- PLOS Pathogens 12(1), 2016-01-06
- NAID 120005763386
- Chikungunya Fever in Japan Imported from the Caribbean Islands
- Japanese Journal of Infectious Diseases 69(2), 151-153, 2016
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