Neonatal Chikungunya a€“ A Case Series

Abstract

Background: After 32years, the reemergence of Chikungunya infection was reported in India in the year 2006. During this phase, vertical transmission of the disease was also noted. Methodology: A prospective study of neonatal chikungunya was done and the presentation and biochemical parameters were studied. Results: We had a total of 8 cases of vertically transmitted disease. Majority presented with features of encephalopathy and during the course of the disease all developed perioral hyperpigmentation which later spread to other parts of the body. Conclusion: Vertical transmission of chikungunya should be among the differential diagnosis when a newborn presents with features of encephalopathy and perioral hyperpigmentation, especially in an endemic area. Perioral hyperpigmentation can be considered as the hallmark of vertically transmitted chikungunya infection.

Keywords

• neonatal chikungunya; hyperpigmentation; encephalopathy

References

1. Lenglet Y, Barau G, Robillard PY, Randrianaivo H, MichLenglet Y, Barau G, Robillard PY, Randrianaivo H, Michault A, Bouveret A, et al. Chikungunya infection in pregnancy: Evidence for intrauterine infection in pregnant women and vertical transmission in the parturient. Survey of the Reunion Island outbreak. J Gynecol Obstet Biol Reprod 2006; 35:578-83.
2. Pialoux G, Gaüzère B, Jauréguiberry S, Strobel M. Chikungunya, an epidemic arbovirus. Lancet Infect Dis. 2007; 7:319–27.
3. World Health Organization. Chikungunya, India. Wkly Epidemiol Rep. 2006; 43:409–10
4. Gérardin P, Barau G, Michault A, Bintner M, Randrianaivo H, Choker G, et al. Multidisciplinary prospective study of mother-tochild chikungunya virus infections on the island of La Réunion. PLoS Med. 2008; 5:e60.
5. Rao G, Khan YZ, Chitnis DS. Chikungunya infection in neonates. Indian Pediatr. 2008; 45:240-2.
6. Nair PM. Chikungunya in neonates. Indian Pediatr. 2008; 45:60
7. Haynes BF, Soderberg KA, Fauci AS. Introduction to the immune system. In: Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL. Harrison’s Principles of Internal Medicine. 17th edition. New York: McGraw-Hill; 2002: Pg 2036
8. Valamparampil JJ, Chirakkarot S, Letha S, Jayakumar C, Gopinathan KM. Clinical profile of Chikungunya in infants. Indian J Pediatr. 2009; 76:151-5.

9. Prashant S, Kumar AS, Mohammed Basheeruddin DD, Chowdhary TN, Madhu B. Cutaneous manifestations in patients suspected of chikungunya disease. Indian J Dermatol 2009; 54:128-31
10. Inamadar AC, Palit A, Sampagavi VV, Raghunath S, Deshmukh NS. Cutaneous manifestations of chikungunya fever: Observations made during a recent outbreak in South India. Int J Dermatol 2008; 47:154-9.
11. Couderc T,Chritiun F, Schilte C, Disson O, Brigitte M, Guivel-Benhassine F et al. A mouse model for Chikungunya: young age and inefficient type-I interferon signaling are risk factors for severe disease.Plos Pathog 2008;4:e29
12. Ramful D, Carbonnier M, Pasquet M, Bouhmani B, Ghazouani J, Noormahomed T, et al. Mother-to-child transmission of Chikungunya virus Infection. Pediatr Infect Dis J. 2007; 26:811-5.