SAT0390 Clinical spectrum of chikungunya epidemic- observational study from a tertiary referral centre in central india
Authors: A. Pandey, V. Prakash, M. Pandey
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Chikungunya virus is an alphavirus, family Togaviridae. Chikungunya fever is a mosquito born disease transmitted to humans by the bite of infected Aedes aegypti mosquitoes. An outbreak of chikungunya virus is currently ongoing in many Asian countries since January 2005. The recent outbreak and epidemic of Chikungunya fever in our state reflect the survival capability and tenacity of mosquitoes that continues to be man's biggest foes.An Observational study was conducted to evaluate epidemiological, virological and clinical features of chikungunya fever in patients presenting with acute febrile illness in our state of madhya pradesh. <h3>Objectives</h3> To observe the clinical features and laboratory parameters of patients coming with Chikungunya coming to our referral setup during the three months of epidemic presenting from 1 st July to 30th September 2017. <h3>Methods</h3> We included all patients(n=325) presenting to us from age 16 years with acute history(&lt;7 days) of fever with joints pain. They were assessed for demographic characteristics, pattern of joints involvement, systemic manifestations, lab parameters, and chikungunya virus positivity. All these parameters were observed according to age and sex and both clinical as well as laboratory markers were studied. We excluded 29 patients, twenty one had past history of inflammatory joint pain and rest had positive virology for dengue virus. <h3>Results</h3> We included 325 patients in which Males(M) were 140 and Females(F) were 185, F:M ratio of 1:0.75). The distribution of patients according to age was quite similar across all age groups. Small joints involvement in total of 287 patients (M:40.4%,F:59.6%), axial involvement in 219 patients (M:36.1% and F:67.6%), knee joint involvement in 285 patients (M:41.1% and F:58.9%), ankle pain in 285 patients(M:42.8% and F:57.2%), early morning stiffness was seen in 308 patients (M:44.8% and F:55.19%), eyes involvement in 53 patients (M:35.8% and F:64.2%), Neurological manifestations in 134 patients (M:43.3% and F:56.7%), stomatitis and oral ulcers in 85 patients (M:45.9% and F:54.1%), retrobulbar pain occurred in 73 patients (M:45.2% and F:54.8%), rashes were seen in 47 patients (M:59.6% and F:40.4%). Forty two patients(12.9%) had history of Diabetes(F:73% and M:26%) and 31 patients(9.5%) were hypothyroid with female predominant(100%). Urea and creatinine was also raised(n=18). Rheumatoid factor was positive in 19 patients (M:42.1% and F:57.9%). IgM Chikungunya was positive in 202 patients (M:46.04% and F:53.96%), and out of those 65 patients in which it was negative, we did RT-PCR in 18 patients due to unaffordability being a major factor and we found that RT-PCR came out positive in 15 patients. The mean ESR in males was 41.76±19.98, in females it was 53.66±24.66, mean CRP in males was 29.84±19.61 and in females it was 40.74±25.94. <h3>Conclusions</h3> We conclude that Chikungunya is a multisystem disease affecting both genders. In our setup, we observed it affected females more and seropositivity for chikungunya was seen in around half of the patients presenting with signs and symptoms. PCR test is more reliable for confirmation. Skin rashes with neurological symptoms, severe pain causing disability and dependence on others for personal care were main complaints. No mortality was reported in our study. <h3>Disclosure of Interest</h3> None declared