Infeção por Vírus Chikungunya: Revisão para Clínicos

Autores

DOI:

https://doi.org/10.24950/Revisao/177/19/1/2020

Palavras-chave:

Febre de Chikungunya, Vírus Chikungunya

Resumo

O vírus Chikungunya é um alfavírus re-emergente que tem como vetor mosquitos do género Aedes. É endémico em África e, nos últimos anos, propagou-se para o Oceano Índico, Ásia e Américas, onde causou vários grandes surtos. Desde 2007 têm-se verificado pequenos surtos com transmissão autóctone no sul da Europa, dada a expansão do Aedes albopictus para este território. Causa doença aguda caracterizada por febre, cefaleia, exantema e artralgia. A artralgia pode progredir e tornar-se persistente. As manifestações atípicas, severas, mas raras, incluem patologia do sistema nervoso central. Está associada a morbilidade por persistência da artralgia, e a mortalidade. O diagnóstico é feito por reação em cadeia da polimerase ou por pesquisa de anticorpos IgM e IgG. Não existe terapêutica antiviral eficaz, sendo recomendado tratamento de suporte para alívio sintomático. As estratégias de controlo do vetor são o único método disponível para controlar os mosquitos do género Aedes em meio urbano.

Downloads

Não há dados estatísticos.

Referências

FRobinson MC. An epidemic of virus disease in Southern Province, Tanganyika Territory, in 1952–1953. Trans R Soc Trop Med Hyg. 1957;51:238– 40. doi:10.1016/0035-9203(57)90022-6.

Horwood PF, Buchy P. Chikungunya. Rev Sci Tech. 2015;34:479–89. doi:10.1016/B978-1-4377-1738-9.00095-5.

Panning M, Grywna K, Van Esbroeck M, Emmerich P, Drosten C. Chikungunya fever in travelers returning to Europe from the Indian Ocean Region, 2006. Emerg Infect Dis. 2008;14:416–22. doi:10.3201/eid1403.070906.

Patterson J, Sammon M, Garg M. Dengue, Zika and Chikungunya: Emerging Arboviruses in the New World. West J Emerg Med. 2016;17:671–9. doi:10.5811/westjem.2016.9.30904.

Powers AM, Brault AC, Tesh RB, Weaver SC. Re-emergence of chikungunya and o’nyong-nyong viruses: Evidence for distinct geographical lineages and distant evolutionary relationships. J Gen Virol. 2000;81:471–9. doi:10.1099/0022-1317-81-2-471.

Wahid B, Ali A, Rafique S, Idrees M. Global expansion of chikungunya virus: mapping the 64-year history. Int J Infect Dis. 2017;58:69–76. doi:10.1016/j. ijid.2017.03.006.

Weaver SC, Forrester NL. Chikungunya: Evolutionary history and recent epidemic spread. Antiviral Res. 2015;120:32–9. doi:10.1016/j.antivi- ral.2015.04.016.

Burt FJ, Rolph MS, Rulli NE, Mahalingam S, Heise MT. Chikungunya: A re-emerging virus. Lancet. 2012;379:662–71. doi:10.1016/S0140- -6736(11)60281-X.

Kraemer MUG, Sinka ME, Duda KA, Mylne AQN, Shearer FM, Barker CM, et al. The global distribution of the arbovirus vectors Aedes aegypti and Ae. albopictus. Elife. 2015;4:1–18. doi:10.7554/eLife.08347.

World Health Organization, Regional Office for South-East Asia. Guidelines for prevention and control of Chikungunya fever. Geneve: WHO; 2009.

Tsetsarkin KA, Weaver SC. Sequential Adaptive Mutations Enhance Efficient Vector Switching by Chikungunya Virus and Its Epidemic Emergence. PLoS Pathog. 2011;7:e1002412. doi:10.1371/journal.ppat.1002412.

Rougeron V, Sam IC, Caron M, Nkoghe D, Leroy E, Roques P. Chikungunya, a paradigm of neglected tropical disease that emerged to be a new health global risk. J Clin Virol. 2015;64:144–52. doi:10.1016/j.jcv.2014.08.032.

Gérardin P, Barau G, Michault A, Bintner M, Randrianaivo H, Choker G, et al. Multidisciplinary prospective study of mother -to-child chikungunya virus infections on the island of La Réunion. PLoS Med. 2008;5:0413–23. doi:10.1371/journal.pmed.0050060.

Torres JR, Falleiros-Arlant LH, Dueñas L, Pleitez-Navarrete J, Salgado DM, Castillo JB Del. Congenital and perinatal complications of chikungunya fever: a Latin American experience. Int J Infect Dis. 2016;51:85–8. doi:10.1016/j. ijid.2016.09.009.

Campos GS, Albuquerque Bandeira AC, Diniz Rocha VF, Dias JP, Carvalho RH, Sardi SI. First Detection of Chikungunya Virus in Breast Milk. Pediatr Infect Dis J. 2017;36:1015–7. doi:10.1097/INF.0000000000001658.

Sam I-C, Kümmerer BM, Chan Y-F, Roques P, Drosten C, AbuBakar S. Updates on Chikungunya Epidemiology, Clinical Disease, and Diagnostics. Vector-Borne Zoonotic Dis. 2015;15:223–30. doi:10.1089/vbz.2014.1680.

Kariuki Njenga M, Nderitu L, Ledermann JP, Ndirangu A, Logue CH, Kelly CHL, et al. Tracking epidemic Chikungunya virus into the Indian Ocean from East Africa. J Gen Virol. 2008;89:2754–60. doi:10.1099/vir.0.2008/005413-0.

Tsetsarkin KA, Vanlandingham DL, McGee CE, Higgs S. A single mutation in Chikungunya virus affects vector specificity and epidemic potential. PLoS Pathog. 2007;3:1895–906. doi:10.1371/journal.ppat.0030201.

Tsetsarkin KA, Chen R, Yun R, Rossi SL, Plante KS, Guerbois M, et al. Multi-peaked adaptive landscape for chikungunya virus evolution predicts con- tinued fitness optimization in Aedes albopictus mosquitoes. Nat Commun. 2014;5:1–14. doi:10.1038/ncomms5084.

Rezza G, Nicoletti L, Angelini R, Romi R, Finarelli A, Panning M, et al. Infection with chikungunya virus in Italy: an outbreak in a temperate region. Lancet. 2007;370:1840–6. doi:10.1016/S0140-6736(07)61779-6.

Grandadam M, Caro V, Plumet S, Thiberge JM, Souarès Y, Failloux AB, et al. Chikungunya virus, Southeastern France. Emerg Infect Dis. 2011;17:910–3. doi:10.3201/eid1705.101873.

Delisle E, Rousseau C, Broche B, Leparc-Goffart I, L’ambert G, Cochet A, et al. Chikungunya outbreak in Montpellier, France, september to october 2014. Euro Surveill. 2015;20:1–6. doi:Euro Surveill. 2015;20(17):pii=21108. 23. European Center for Disease Prevention and Control. Comunicable Disease Threaths Report - Week 44, 29 October-4 November 2017. Eur Cent Dis Prev Control. 2017:1–17.

Santé Publique France. Chikungunya, dengue et zika - Données de la surveillance renforcée en France métropolitaine en 2017. [consultado 19 de Dezembro de 2017].Disponível em: http://invs. santepubliquefrance.fr/Dossiers-thematiques/Maladies-infectieuses/Mala- dies-a-transmission-vectorielle/Chikungunya/Donnees-epidemiologiques/ France-metropolitaine/Chikungunya-dengue-et-zika-Donnees-de-la-survei- llance-renforcee-en-France-metropol.

European Center for Disease Prevention and Control. Comunicable Disease Threaths Report - Week 4, 20-26 January 2019. Eur Cent Dis Prev Control. 2019:1–11.

Leparc-Goffart I, Nougairede A, Cassadou S, Prat C, De Lamballerie X. Chikungunya in the Americas. Lancet. 2014;383:514. doi:10.1016/S0140- 6736(14)60185-9.

Feldstein LR, Ellis EM, Rowhani-Rahbar A, Elizabeth Halloran M, Ellis BR. The first reported outbreak of chikungunya in the U.S. Virgin Islands, 2014- 2015. Am J Trop Med Hyg. 2016;95:885–9. doi:10.4269/ajtmh.16-0288.

Centers for Disease Control and Prevention (CDC). Chikungunya virus in the United States 2017. [consultado 19 de Dezembro de 2017]. Disponível em: https://www.cdc.gov/chikungunya/geo/united-states.html.

Fortuna C, Remoli ME, Rizzo C, Benedetti E, Fiorentini C, Bella A, et al. Imported arboviral infections in Italy, July 2014-October 2015: a National Reference Laboratory report. BMC Infect Dis. 2017;17:216. doi:10.1186/ s12879-017-2320-1.

European Center for Disease Prevention and Control. Annual Epidemiological Report 2016 - Chikungunya fever virus disease. Eur Cent Dis Prev Con- trol. 2016. [consultado 19 de Dezembro de 2017]. Disponível em: https:// ecdc.europa.eu/en/publications-data/chikungunya-annual-epidemiologi- cal-report-2016-2014-data.

Nsoesie EO, Kraemer MU, Golding N, Pigott DM, Brady OJ, Moyes CL. Global distribution and environmental suitability for chikungunya virus, 1952 to 2015. Euro Surveill. 2016;21:1–22. doi:10.2807/1560-7917. ES.2016.21.20.30234.Global.

European Centre for Disease Prevention and Control. Annual Epidemiological Report for 2017 - Chikungunya virus disease. Solna: ECDPC; 2019.

Parreira R, Centeno-Lima S, Lopes A, Portugal-Calisto D, Constantino A, Nina J. Dengue virus serotype 4 and chikungunya virus coinfection in a traveller returning from Luanda, Angola, January 2014 Dengue virus serotype 4 and chikungunya virus coinfection in a traveller returning from Luanda. Angola Euro Surveill. 2014;19.

Paulo CO, Zé-Zé L, Jordão S, Pena ER, Neves I, Alves MJ. Dengue virus serotype 3 and Chikungunya virus co-infection in a traveller returning from India to Portugal, November 2016. IDCases. 2017;9:30–3. doi:10.1016/j. idcr.2017.03.015.

Centro de Estudos de Vetores e Doenças Infeciosas Doutor Francisco Cambournac: Departamento de Doenças Infeciosas. REVIVE 2017: Culicí- deos e Ixodídeos. 2018.

Centro de Estudos de Vetores e Doenças Infeciosas Doutor Francisco Cam- bournac: Departamento de Doenças Infeciosas. REVIVE 2018: Culicídeos e Ixodídeos. 2019.

Burt FJ, Chen W, Miner JJ, Lenschow DJ, Merits A, Schnettler E, et al.

Chikungunya virus: an update on the biology and pathogenesis of this emerging pathogen. Lancet Infect Dis. 2017;17:e107–17. doi:10.1016/ S1473-3099(16)30385-1.

Teng T-S, Kam Y-W, Lee B, Hapuarachchi HC, Wimal A, Ng L-C, et al. A Systematic Meta-analysis of Immune Signatures in Patients With Acute Chikungunya Virus Infection. J Infect Dis. 2015;211:1925–35. doi:10.1093/infdis/jiv049.

Miner JJ, Aw Yeang HX, Fox JM, Taffner S, Malkova ON, Oh ST, et al. Brief Report: Chikungunya Viral Arthritis in the United States: A Mimic of Seronegative Rheumatoid Arthritis. Arthritis Rheumatol. 2015;67:1214–20. doi:10.1002/art.39027.

Parreira R, Conceição C, Centeno-Lima S, Marques N, Saraiva J da C, Abreu C, et al. Angola’s 2013 dengue outbreak: Clinical, laboratory and molecular analyses of cases from four Portuguese institutions. J Infect Dev Ctries. 2014;8:1210–5. doi:10.3855/jidc.4910.

Suhrbier A, Jaffar-Bandjee M-C, Gasque P. Arthritogenic alphaviruses — an overview. Nat Rev Rheumatol. 2012;8:420–9. doi:10.1038/nrrheum.2012.64.

Borgherini G, Poubeau P, Staikowsky F, Lory M, Moullec NL, Becquart JP, et al. Outbreak of Chikungunya on Reunion Island: Early Clinical and La- boratory Features in 157 Adult Patients. Clin Infect Dis. 2007;44:1401–7. doi:10.1086/517537.

Madariaga M, Ticona E, Resurrecion C. Chikungunya: Bending over the Americas and the rest of the world. Brazilian J Infect Dis. 2016;20:91–8. doi:10.1016/j.bjid.2015.10.004.

Bouquillard E, Fianu A, Bangil M, Charlette N, Ribéra A, Michault A, et al. Rheumatic manifestations associated with Chikungunya virus infection: A study of 307 patients with 32-month follow-up (RHUMATOCHIK study). Jt Bone Spine. 2018;85:207–10. doi:10.1016/j.jbspin.2017.01.014.

Sissoko D, Malvy D, Ezzedine K, Renault P, Moscetti F, Ledrans M, et al. Post-epidemic Chikungunya disease on reunion island: Course of rheumatic manifestations and associated factors over a 15-month period. PLoS Negl Trop Dis. 2009;3:1–6. doi:10.1371/journal.pntd.0000389.

Rodríguez-Morales AJ, Cardona-Ospina JA, Fernanda Urbano-Garzón S, Sebastian Hurtado-Zapata J. Prevalence of Post-Chikungunya Infection Chronic Inflammatory Arthritis: A Systematic Review and Meta-Analysis. Arthritis Care Res. 2016;68:1849–58. doi:10.1002/acr.22900.

Manimunda SP, Vijayachari P, Uppoor R, Sugunan AP, Singh SS, Rai SK, et al. Clinical progression of chikungunya fever during acute and chronic arthritic stages and the changes in joint morphology as revealed by imaging. Trans R Soc Trop Med Hyg. 2010;104:392–9. doi:10.1016/j.trstmh.2010.01.011.

Economopoulou A, Dominguez M, Helynck B, Sissoko D, Wichmann O, Quenel P, et al. Atypical Chikungunya virus infections: clinical manifesta- tions, mortality and risk factors for severe disease during the 2005–2006 outbreak on Réunion. Epidemiol Infect. 2009;137:534. doi:10.1017/ S0950268808001167.

Azevedo R do S da S, Oliveira CS, Vasconcelos PF da C. Chikun- gunya risk for Brazil. Rev Saude Publica. 2015;49. doi:10.1590/S0034- 8910.2015049006219.

Soumahoro M-K, Boelle P-Y, Gaü Zere B-A, Atsou K, Pelat C, Lambert B, et al. The Chikungunya epidemic on La Ré union Island in 2005–2006: a cost-of-illness study. PLoS Negl Trop Dis. 2011;5:1–9. doi:10.1371/journal. pntd.0001197.

Villamil-Gómez WE, Ramirez-Vallejo E, Cardona-Ospina JA, Silvera LA, Ro- dríguez-Morales AJ. Electrocardiographic alterations in patients with chikungunya fever from Sucre, Colombia: A 42-case series. Travel Med Infect Dis. 2016;14:510–2. doi:10.1016/j.tmaid.2016.06.004.

de Valk H, Balleydier E, Solet J-L, Ilef D, Rachou E, Larrieu S, et al. A major epidemic of Chikungunya virus infection on Réunion Island, France, 2005–2006. Am J Trop Med Hyg. 2007;77:727–31. doi:10.4269/ ajtmh.2007.77.727.

Tandale B V., Sathe PS, Arankalle VA, Wadia RS, Kulkarni R, Shah S V., et al. Systemic involvements and fatalities during Chikungunya epidemic in India, 2006. J Clin Virol. 2009;46:145–9. doi:10.1016/j.jcv.2009.06.027.

Pereira LP, Villas-Bôas R, Scott SS de O, Nóbrega PR, Sobreira-Neto MA, de Castro JDV, et al. Encephalitis associated with the chikungunya epidemic outbreak in Brazil: Report of 2 cases with neuroimaging findings. Rev Soc Bras Med Trop. 2017;50:413–6. doi:10.1590/0037-8682-0449-2016.

Pinheiro TJ, Guimarães LF, Silva MTT, Soares CN. Manifestações neuro- lógicas das infecções pelos vírus zika e chikungunya. Arq Neuropsiquiatr. 2016;74:937–43. doi:10.1590/0004-282X20160138.

Robin S, Ramful D, Le Seach F, Jaffar-Bandjee M-C, Rigou G, Alessandri J-L. Neurologic manifestations of pediatric Chikungunya infection. J Child Neurol. 2008;23:1028–35. doi:10.1177/0883073808314151.

Doughty CT, Yawetz S, Lyons J. Emerging Causes of Arbovirus Encephalitis in North America: Powassan, Chikungunya, and Zika Viruses. Curr Neurol Neurosci Rep. 2017;17. doi:10.1007/s11910-017-0724-3.

Martínez-Pulgarín DF, Chowdhury FR, Villamil-Gomez WE, Rodriguez-Mo- rales AJ, Blohm GM, Paniz-Mondolfi AE. Ophthalmologic aspects of chi- kungunya infection. Travel Med Infect Dis. 2016;14:451–7. doi:10.1016/j. tmaid.2016.05.008.

van Aalst M, Nelen CM, Goorhuis A, Stijnis C, Grobusch MP. Long-term sequelae of chikungunya virus disease: A systematic review. Travel Med Infect Dis. 2017;15:8–22. doi:10.1016/j.tmaid.2017.01.004.

Jain J, Dubey SK, Shrinet J, Sunil S. Dengue Chikungunya co-infection: A live-in relationship?? Biochem Biophys Res Commun. 2017;492:608–16. doi:10.1016/j.bbrc.2017.02.008.

Carrillo-Hernández MY, Ruiz-Saenz J, Villamizar LJ, Gómez-Rangel SY, Martínez-Gutierrez M. Co-circulation and simultaneous co-infection of dengue, chikungunya, and zika viruses in patients with febrile syndrome at the Co- lombian-Venezuelan border. BMC Infect Dis. 2018;18:1–12. doi:10.1186/ s12879-018-2976-1.

Chopra A, Anuradha V, Lagoo-Joshi V, Kunjir V, Salvi S, Saluja M. Chikun- gunya virus aches and pains: An emerging challenge. Arthritis Rheum. 2008;58:2921–2. doi:10.1002/art.23753.

Johnson BW, Russell BJ, Goodman CH. Laboratory diagnosis of chikungunya virus infections and commercial sources for diagnostic assays. J Infect Dis. 2016;214:S471–4. doi:10.1093/infdis/jiw274.

Shukla J, Khan M, Tiwari M, Sannarangaiah S, Sharma S, Rao PVL, et al. Development and evaluation of antigen capture ELISA for early clinical diagnosis of chikungunya. Diagn Microbiol Infect Dis. 2009;65:142–9. doi:10.1016/j.diagmicrobio.2009.06.017.

Blackburn NK, Besselaar TG, Gibson G. Antigenic relationship between chikungunya virus strains and o’nyong nyong virus using monoclonal antibodies. Res Virol. 1995;146:69–73. doi:10.1016/0923-2516(96)80591-7.

Mardekian SK, Roberts AL. Diagnostic Options and Challenges for Dengue and Chikungunya Viruses. Biomed Res Int. 2015;2015. doi:10.1155/2015/834371.

Beltrán-Silva SL, Chacón-Hernández SS, Moreno-Palacios E, Pereyra-Molina JÁ. Clinical and differential diagnosis: Dengue, chikungunya and Zika. Rev Médica del Hosp Gen México. 2016:1–8. doi:10.1016/j.hgmx.2016.09.011.

United States National Center for Emerging and Zoonotic Infectious Diseases, Pan American Health Organization. Preparedness and Response for Chikungunya Virus. Washington: PAHO; 2011.

Simon F, Javelle E, Cabie A, Bouquillard E, Troisgros O, Gentile G, et al. French guidelines for the management of chikungunya (acute and persistent presentations). November 2014. Médecine Mal Infect. 2015;45:243–63. doi:10.1016/J.MEDMAL.2015.05.007.

Javelle E, Ribera A, Degasne I, Gaüzère BA, Marimoutou C, Simon F. Specific Management of Post-Chikungunya

Rheumatic Disorders: A Retrospective Study of 159 Cases in Reunion Island from 2006-2012. PLoS Negl Trop Dis. 2015;9:1–18. doi:10.1371/journal.pntd.0003603.

Ganu M, Ganu A. Post-chikungunya chronic arthritis—our experience with DMARDs over two year follow up. J Assoc Physicians India. 2011;59:83–6. 72. Assunção-Miranda I, Cruz-Oliveira C, Da Poian AT. Molecular Mechanisms Involved in the Pathogenesis of Alphavirus-Induced Arthritis. Biomed Res Int. 2013;2013:1–11. doi:10.1155/2013/973516.

World Health Organization (WHO). Chikungunya: Fact sheet No327 2017. [consultado 6 de Dezembro de 2017].Disponível em: http://www.who.int/mediacentre/factsheets/fs327/en/.

Ahmed M, Shantharam N, Visweswara Reddy YJ. Randomized Clinical Trial in Chikungunya Arthritis Cases. J Evol Med Dent Sci. 2012;1:841–7. doi:10.14260/jemds/135.

Chopra A, Saluja M, Venugopalan A. Effectiveness of Chloroquine and Inflammatory Cytokine Response in Patients With Early Persistent Musculoskeletal Pain and Arthritis Following Chikungunya Virus Infection. Arthritis Rheumatol. 2014;66:319–26. doi:10.1002/art.38221.

Padmakumar B, Jayan JB, Menon RM, Krishnankutty B, Payippallil R, Nisha R. Comparative evaluation of four therapeutic regimes in chikungunya arthritis: a prospective randomized parallel-group study. Indian J Rheumatol. 2009;4:94–101. doi:10.1016/S0973-3698(10)60189-6.

Ravindran V, Alias G. Efficacy of combination DMARD therapy vs. hydro- xychloroquine monotherapy in chronic persistent chikungunya arthritis: a 24-week randomized controlled open label study. Clin Rheumatol. 2017;36:1335–40. doi:10.1007/s10067-016-3429-0.

Martí-Carvajal A, Ramon-Pardo P, Javelle E, Simon F, Aldighieri S, Horvath H, et al. Interventions for treating patients with chikungunya virus infection-related rheumatic and musculoskeletal disorders: A systematic review. PLoS One. 2017;12:1–15. doi:10.1371/journal.pone.0179028.

Sales GMPG, Barbosa ICP, Canejo Neta LMS, Melo PL de, Leitão R de A, Melo HM de A. Treatment of chikungunya chronic arthritis: A systematic review. Rev Assoc Med Bras. 2018;64:63–70. doi:10.1590/1806- 9282.64.01.63.

Javelle E, Gautret P, Ribéra A, Gaüzère BA, Cabié A, Corail PR, et al. The challenge of chronic chikungunya. Travel Med Infect Dis. 2017;15:3–4. doi:10.1016/j.tmaid.2017.02.002.

de Brito CAA, Teixeira MG. Increased number of deaths during a chi- kungunya epidemic in Pernambuco, Brazil. Mem Inst Oswaldo Cruz. 2017;112:650–1. doi:10.1590/0074-02760170124.

Sá PK de O, Nunes M de M, Leite IR, Campelo M das GL das C, Leão CFR, de Souza JR, et al. Chikungunya virus infection with severe neuro- logic manifestations: Report of four fatal cases. Rev Soc Bras Med Trop. 2017;50:265–8. doi:10.1590/0037-8682-0375-2016.

Ritchie SA, Johnson BJ. Advances in Vector Control Science: Rear-and-Release Strategies Show Promise... but Don’t Forget the Basics. J Infect Dis. 2017;215:S103–8. doi:10.1093/infdis/jiw575.

Mcclain DJ, Pittman PR, Ramsburg HH, Nelson GO, Rossi CA, Mangiafico JA, et al. Immunologic Interference from Sequential Administration of Live Attenuated Alphavirus Vaccines. J Infect Dis. 1998;177:634–41.

Edelman R, Tacket CO, Wasserman SS, Bodison SA, Perry JG, Mangiafi- co JA. Phase II safety and immunogenicity study of live chikungunya virus vaccine TSI-GSD-218. Am J Trop Med Hyg. 2000;62:681–5. doi:10.4269/ajtmh.2000.62.681.

Ramsauer K, Tangy F. Chikungunya virus vaccines: Viral vector-based approaches. J Infect Dis. 2016;214:S500–5. doi:10.1093/infdis/jiw369.

Powers AM. Vaccine and therapeutic options to control chikungunya virus. Clin Microbiol Rev. 2018;31:1–29. doi:10.1128/CMR.00104-16.

Chang LJ, Dowd KA, Mendoza FH, Saunders JG, Sitar S, Plummer SH, et al. Safety and tolerability of chikungunya virus-like particle vaccine in healthy adults: A phase 1 dose-escalation trial. Lancet. 2014;384:2046–52. doi:10.1016/S0140-6736(14)61185-5.

Ramsauer K, Schwameis M, Firbas C, Müllner M, Putnak RJ, Thomas SJ, et al. Immunogenicity, safety, and tolerability of a recombinant measles-virus-based chikungunya vaccine: a randomised, double-blind, placebo-controlled, active. Lancet Infec Dis. 2015;15:519–27.

Rezza G. Do we need a vaccine against chikungunya? Pathog Glob Health. 2015;109:170–3. doi:10.1179/2047773215Y.0000000017.

Mutebi JP, Hawley WA, Brogdon WG. Protection against Mosquitoes, Ticks, & Other Arthropods. CDC Yellow B 2018 Heal Inf Int Travel. 2017. [consultado 20 de Dezembro de 2017].Disponível em: https://wwwnc.cdc.gov/travel/yellowbook/2018/the-pre-travel-consultation/protection-against-mosquitoes-ticks-other-arthropods.

Downloads

Publicado

08-12-2021

Como Citar

1.
Cerol M, Cezarino G, Ferrinho P, Teodósio R. Infeção por Vírus Chikungunya: Revisão para Clínicos. RPMI [Internet]. 8 de Dezembro de 2021 [citado 23 de Novembro de 2024];27(1):55-64. Disponível em: https://revista.spmi.pt/index.php/rpmi/article/view/188

Edição

Secção

Artigos de Revisão