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Tropical arthritogenic alphaviruses
Carla-Ruth Mejía1, Rogelio López-Vélez1
1Unidad de Referencia Nacional para Enfermedades Tropicales, Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, Madrid, España.
Abstract:
Tropical alphaviruses have special tropism for bone and joint tissue. Patients can develop chronic rheumatic disorders similar to rheumatoid arthritis and ankylosing spondylitis. The prototype is Chikungunya virus, although other lesser known viruses in our environment such as Sindbis, Ross River, Mayaro, O'nyong nyong and Barmah Forest viruses have the potential to be sped through vectors and cause chronic rheumatic disease. International population movements have increased the numbers of patients diagnosed with these tropical viruses in areas in which they are not endemic. Since they can leave persistent symptoms and affect the quality of life of the patients, it is important that we be aware of them. Changes in ecosystems have favored the expansion of competent mosquitoes, making fears of local transmission in southern Europe a reality. The objective of this review is to provide a clinical approach to the different arthritogenic tropical alphaviruses, especially those in which chronic rheumatic disease is more frequent.
Insights
Tropical alphaviruses like Chikungunya can cause chronic rheumatic disorders, mimicking rheumatoid arthritis. Increased global travel and ecosystem changes raise concerns about their spread and persistent symptoms, necessitating clinical awareness.
Area of Science:
- Virology
- Rheumatology
- Epidemiology
Background:
- Tropical alphaviruses exhibit tropism for bone and joint tissues, leading to chronic rheumatic disorders.
- Diseases caused by Chikungunya, Sindbis, Ross River, and other alphaviruses can resemble rheumatoid arthritis and ankylosing spondylitis.
- International travel and ecosystem shifts facilitate the spread of these viruses into non-endemic regions.
Purpose of the Study:
- To review the clinical approach to arthritogenic tropical alphaviruses.
- To highlight viruses frequently associated with chronic rheumatic disease.
- To increase awareness of persistent symptoms and impact on quality of life.
Main Methods:
- Literature review of clinical presentations and epidemiological data.
- Analysis of viral tropism and disease mechanisms.
- Assessment of factors contributing to geographic expansion and local transmission.
Main Results:
- Alphaviruses are increasingly diagnosed in non-endemic areas due to global population movements.
- Mosquito vector expansion, influenced by ecosystem changes, poses a risk for local transmission, particularly in southern Europe.
- Persistent symptoms significantly affect patient quality of life.
Conclusions:
- Awareness of tropical alphaviruses and their rheumatic manifestations is crucial for clinicians.
- Understanding the clinical approach to these infections is essential for timely diagnosis and management.
- The potential for endemic transmission in new regions necessitates ongoing surveillance and public health preparedness.