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Updated: Mar 29, 2026
Multiplexed Isothermal Amplification Based Diagnostic Platform to Detect Zika, Chikungunya, and Dengue 1
Published on: March 13, 2018
Chikungunya virus-associated encephalitis: A cohort study on La Réunion Island, 2005-2009
Patrick Gérardin1, Thérèse Couderc2, Marc Bintner2
1From the Centre Hospitalier Universitaire (CHU) (P.G., M.B., P.T., M.R., J.L., V.B., G.B., A.M.) and Centre d'Investigation Clinique-Épidémiologie Clinique (CIC1410) de La Réunion (Inserm, CHU, Université de La Réunion, Union Régionale des Médecins Libéraux de la Réunion) (P.G.), Saint Pierre, La Réunion; UMR PIMIT (Inserm U 1187, CNRS 9192, IRD 249, Université de La Réunion) (P.G., A.M.), CYROI, Saint-Denis, La Réunion; Biology of Infection Unit (T.C., M.L.), Institut Pasteur, Paris; Inserm U1117 (T.C., M.L.), Paris; CHU Henri Mondor (F. Staikowsky), Créteil; Université de Strasbourg (F. Schramm), EA 7290, Faculté de Médecine, Strasbourg; and Université Paris Descartes (M.L.), Sorbonne Paris Cité, Division of Infectious Diseases and Tropical Medicine, Necker Enfants Malades University Hospital, Institut Imagine (M.L.), Paris, France. patrick.gerardin@chu-reunion.fr.
Objective:
To estimate the cumulative incidence rate (CIR) of Chikungunya virus (CHIKV)-associated CNS disease during the La Réunion outbreak, and assess the disease burden and patient outcome after 3 years.
Methods:
CHIKV-associated CNS disease was characterized retrospectively in a cohort of patients with positive CHIKV reverse transcriptase PCR or anti-CHIKV immunoglobulin M antibodies in the CSF and fulfilling International Encephalitis Consortium criteria for encephalitis or encephalopathy. Neurologic sequelae were assessed after 3 years.
Results:
Between September 2005 and June 2006, 57 patients were diagnosed with CHIKV-associated CNS disease, including 24 with CHIKV-associated encephalitis, the latter corresponding to a CIR of 8.6 per 100,000 persons. Patients with encephalitis were observed at both extremes of age categories. CIR per 100,000 persons were 187 and 37 in patients below 1 year and over 65 years, respectively, both far superior to those of cumulated causes of encephalitis in the United States in these age categories. The case-fatality rate of CHIKV-associated encephalitis was 16.6% and the proportion of children discharged with persistent disabilities estimated between 30% and 45%. Beyond the neonatal period, the clinical presentation and outcomes were less severe in infants than in adults.
Conclusions:
In the context of a large outbreak, CHIKV is a significant cause of CNS disease. As with other etiologies, CHIKV-associated encephalitis case distribution by age follows a U-shaped parabolic curve.
