Risk factors for hospitalization of patients with chikungunya virus infection at sentinel hospitals in Puerto Rico.


BACKGROUND:Hospitalization of patients during outbreaks of chikungunya virus has been reported to be uncommon (0.5-8.7%), but more frequent among infants and the elderly. CHIKV was first detected in Puerto Rico in May 2014. We enrolled patients with acute febrile illness (AFI) presenting to two hospital emergency departments in Puerto Rico and tested them for CHIKV infection to describe the frequency of detection of CHIKV-infected patients, identify risk factors for hospitalization, and describe patients with severe manifestations. METHODOLOGY/PRINCIPAL FINDINGS:Serum specimens were collected from patients with AFI and tested by rRT-PCR. During May-December 2014, a total of 3,035 patients were enrolled, and 1,469 (48.4%) had CHIKV infection. A total of 157 (10.7%) CHIKV-infected patients were hospitalized, six (0.4%) were admitted to the intensive care unit, and two died (0.1%). Common symptoms among all CHIKV-infected patients were arthralgia (82.6%), lethargy (80.6%), and myalgia (80.5%). Compared to patients aged 1-69 years (7.3%), infant (67.2%) and elderly (17.3%) patients were nine and two times more likely to be hospitalized, respectively (relative risk [RR] and 95% confidence interval [CI] = 9.16 [7.05-11.90] and 2.36 [1.54-3.62]). Multiple symptoms of AFI were associated with decreased risk of hospitalization, including arthralgia (RR = 0.31 [0.23-0.41]) and myalgia (RR = 0.29 [0.22-0.39]). Respiratory symptoms were associated with increased risk of hospitalization, including rhinorrhea (RR = 1.68 [1.24-2.27) and cough (RR = 1.77 [1.31-2.39]). Manifestations present among <5% of patients but associated with patient hospitalization included cyanosis (RR = 2.20 [1.17-4.12) and seizures (RR = 3.23 [1.80-5.81). DISCUSSION:Among this cohort of CHIKV-infected patients, hospitalization was uncommon, admission to the ICU was infrequent, and death was rare. Risk of hospitalization was higher in patients with symptoms of respiratory illness and other manifestations that may not have been the result of CHIKV infection.


PLoS Negl Trop Dis


Hsu CH,Cruz-Lopez F,Vargas Torres D,Perez-Padilla J,Lorenzi OD,Rivera A,Staples JE,Lugo E,Munoz-Jordan J,Fischer M,Garcia Gubern C,Rivera Garcia B,Alvarado L,Sharp TM




Has Abstract


2019-01-14 00:00:00














  • An Outbreak of Lymphocutaneous Sporotrichosis among Mine-Workers in South Africa.

    abstract:BACKGROUND:The largest outbreak of sporotrichosis occurred between 1938 and 1947 in the gold mines of Witwatersrand in South Africa. Here, we describe an outbreak of lymphocutaneous sporotrichosis that was investigated in a South African gold mine in 2011. METHODOLOGY:Employees working at a reopened section of the min...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Govender NP,Maphanga TG,Zulu TG,Patel J,Walaza S,Jacobs C,Ebonwu JI,Ntuli S,Naicker SD,Thomas J

    更新日期:2015-09-25 00:00:00

  • Prevention of Malaria Resurgence in Greece through the Association of Mass Drug Administration (MDA) to Immigrants from Malaria-Endemic Regions and Standard Control Measures.

    abstract::Greece was declared malaria-free in 1974 after a long antimalarial fight. In 2011-2012, an outbreak of P. vivax malaria was reported in Evrotas, an agricultural area in Southern Greece, where a large number of immigrants from endemic countries live and work. A total of 46 locally acquired and 38 imported malaria cases...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Tseroni M,Baka A,Kapizioni C,Snounou G,Tsiodras S,Charvalakou M,Georgitsou M,Panoutsakou M,Psinaki I,Tsoromokou M,Karakitsos G,Pervanidou D,Vakali A,Mouchtouri V,Georgakopoulou T,Mamuris Z,Papadopoulos N,Koliopoulos G,

    更新日期:2015-11-19 00:00:00

  • Sensitive and specific detection of Crimean-Congo Hemorrhagic Fever Virus (CCHFV)-Specific IgM and IgG antibodies in human sera using recombinant CCHFV nucleoprotein as antigen in μ-capture and IgG immune complex (IC) ELISA tests.

    abstract::As the most widespread tick-borne arbovirus causing infections in numerous countries in Asia, Africa and Europe, Crimean-Congo Hemorrhagic Fever Virus (CCHFV, family Nairoviridae) was included in the WHO priority list of emerging pathogens needing urgent Research & Development attention. To ensure preparedness for pot...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Emmerich P,Mika A,von Possel R,Rackow A,Liu Y,Schmitz H,Günther S,Sherifi K,Halili B,Jakupi X,Berisha L,Ahmeti S,Deschermeier C

    更新日期:2018-03-26 00:00:00

  • Detection and distribution of Sca autotransporter protein antigens in diverse isolates of Orientia tsutsugamushi.

    abstract::Orientia tsutsugamushi (Ots) frequently causes severe scrub typhus infections in the Asia-Pacific region. Korean investigators have demonstrated that Ots encodes five different autotransporter domain (ATD) proteins (ScaA-ScaE). ScaA functions as an adhesin and confers protective immunity in a lethal mouse model of Ots...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Koralur MC,Ramaiah A,Dasch GA

    更新日期:2018-09-20 00:00:00

  • Polyphenol-Rich Diets Exacerbate AMPK-Mediated Autophagy, Decreasing Proliferation of Mosquito Midgut Microbiota, and Extending Vector Lifespan.

    abstract:BACKGROUND:Mosquitoes feed on plant-derived fluids such as nectar and sap and are exposed to bioactive molecules found in this dietary source. However, the role of such molecules on mosquito vectorial capacity is unknown. Weather has been recognized as a major determinant of the spread of dengue, and plants under abiot...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Nunes RD,Ventura-Martins G,Moretti DM,Medeiros-Castro P,Rocha-Santos C,Daumas-Filho CR,Bittencourt-Cunha PR,Martins-Cardoso K,Cudischevitch CO,Menna-Barreto RF,Oliveira JH,Gusmão DS,Alves Lemos FJ,Alviano DS,Oliveira PL,Low

    更新日期:2016-10-12 00:00:00

  • Mycobacterium africanum is associated with patient ethnicity in Ghana.

    abstract::Mycobacterium africanum is a member of the Mycobacterium tuberculosis complex (MTBC) and an important cause of human tuberculosis in West Africa that is rarely observed elsewhere. Here we genotyped 613 MTBC clinical isolates from Ghana, and searched for associations between the different phylogenetic lineages of MTBC ...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Asante-Poku A,Yeboah-Manu D,Otchere ID,Aboagye SY,Stucki D,Hattendorf J,Borrell S,Feldmann J,Danso E,Gagneux S

    更新日期:2015-01-08 00:00:00

  • Maternal, placental and cord blood cytokines and the risk of adverse birth outcomes among pregnant women infected with Schistosoma japonicum in the Philippines.

    abstract:BACKGROUND:The objectives of this study were to 1) evaluate the influence of treatment with praziquantel on the inflammatory milieu in maternal, placental, and cord blood, 2) assess the extent to which proinflammatory signatures in placental and cord blood impacts birth outcomes, and 3) evaluate the impact of other hel...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章,随机对照试验


    authors: Abioye AI,McDonald EA,Park S,Joshi A,Kurtis JD,Wu H,Pond-Tor S,Sharma S,Ernerudh J,Baltazar P,Acosta LP,Olveda RM,Tallo V,Friedman JF

    更新日期:2019-06-12 00:00:00

  • Dextran fractional clearance studies in acute dengue infection.

    abstract:BACKGROUND:Although increased capillary permeability is the major clinical feature associated with severe dengue infections the mechanisms underlying this phenomenon remain unclear. Dextran clearance methodology has been used to investigate the molecular sieving properties of the microvasculature in clinical situations...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Nguyen-Pouplin J,Pouplin T,Van TP,The TD,Thi DN,Farrar J,Tinh HT,Wills B

    更新日期:2011-08-01 00:00:00

  • An in-depth report of quality control on Kato-Katz and data entry in four clinical trials evaluating the efficacy of albendazole against soil-transmitted helminth infections.

    abstract:BACKGROUND:Efforts to control soil-transmitted helminth (STH) infections have intensified over the past decade. Field-survey data on STH prevalence, infection intensity and drug efficacy is necessary to guide the implementation of control programs and should be of the best possible quality. METHODOLOGY:During four cli...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Vlaminck J,Cools P,Albonico M,Ame S,Ayana M,Dana D,Keiser J,Matoso LF,Montresor A,Mekonnen Z,Corrêa-Oliveira R,Pinto SA,Sayasone S,Vercruysse J,Levecke B

    更新日期:2020-09-21 00:00:00

  • Ticks as potential vectors of Mycobacterium leprae: Use of tick cell lines to culture the bacilli and generate transgenic strains.

    abstract::Leprosy is an infectious disease caused by Mycobacterium leprae and frequently resulting in irreversible deformities and disabilities. Ticks play an important role in infectious disease transmission due to their low host specificity, worldwide distribution, and the biological ability to support transovarial transmissi...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Ferreira JDS,Souza Oliveira DA,Santos JP,Ribeiro CCDU,Baêta BA,Teixeira RC,Neumann ADS,Rosa PS,Pessolani MCV,Moraes MO,Bechara GH,de Oliveira PL,Sorgine MHF,Suffys PN,Fontes ANB,Bell-Sakyi L,Fonseca AH,Lara FA

    更新日期:2018-12-19 00:00:00

  • Sero-Molecular Epidemiology of Japanese Encephalitis in Zhejiang, an Eastern Province of China.

    abstract:BACKGROUND:Sporadic Japanese encephalitis (JE) cases still have been reported in Zhejiang Province in recent years, and concerns about vaccine cross-protection and population-level immunity have been raised off and on within the public health sphere. Genotype I (GI) has replaced GIII as the dominant genotype in Asian c...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Pan JR,Yan JY,Zhou JY,Tang XW,He HQ,Xie RH,Mao HY,Zhang YJ,Xie SY

    更新日期:2016-08-25 00:00:00

  • Annexin A2 depletion exacerbates the intracerebral microhemorrhage induced by acute rickettsia and Ebola virus infections.

    abstract::Intracerebral microhemorrhages (CMHs) are small foci of hemorrhages in the cerebrum. Acute infections induced by some intracellular pathogens, including rickettsia, can result in CMHs. Annexin a2 (ANXA2) has been documented to play a functional role during intracellular bacterial adhesion. Here we report that ANXA2-kn...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Su Z,Chang Q,Drelich A,Shelite T,Judy B,Liu Y,Xiao J,Zhou C,He X,Jin Y,Saito T,Tang S,Soong L,Wakamiya M,Fang X,Bukreyev A,Ksiazek T,Russell WK,Gong B

    更新日期:2020-07-20 00:00:00

  • Feasibility of feeding Aedes aegypti mosquitoes on dengue virus-infected human volunteers for vector competence studies in Iquitos, Peru.

    abstract:BACKGROUND:Transmission of dengue virus (DENV) from humans to mosquitoes represents a critical component of dengue epidemiology. Examinations of this process have generally been hampered by a lack of methods that adequately represent natural acquisition of DENV by mosquitoes from humans. In this study, we assessed arti...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Long KC,Sulca J,Bazan I,Astete H,Jaba HL,Siles C,Kocher C,Vilcarromero S,Schwarz J,Escobedo-Vargas KS,Castro-Llanos F,Angulo L,Flores G,Ramal-Asayag C,Halsey ES,Hontz RD,Paz-Soldan VA,Scott TW,Lambrechts L,Morrison

    更新日期:2019-02-12 00:00:00

  • Vaccination with a chikungunya virus-like particle vaccine exacerbates disease in aged mice.

    abstract:INTRODUCTION:Chikungunya virus (CHIKV) is a re-emerging pathogen responsible for causing outbreaks of febrile disease accompanied with debilitating joint pain. Symptoms typically persist for two weeks, but more severe and chronic chikungunya illnesses have been reported, especially in the elderly. Currently, there are ...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Arévalo MT,Huang Y,Jones CA,Ross TM

    更新日期:2019-04-26 00:00:00

  • Isothermal microcalorimetry, a new tool to monitor drug action against Trypanosoma brucei and Plasmodium falciparum.

    abstract::Isothermal microcalorimetry is an established tool to measure heat flow of physical, chemical or biological processes. The metabolism of viable cells produces heat, and if sufficient cells are present, their heat production can be assessed by this method. In this study, we investigated the heat flow of two medically i...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Wenzler T,Steinhuber A,Wittlin S,Scheurer C,Brun R,Trampuz A

    更新日期:2012-01-01 00:00:00

  • A Four-Point Screening Method for Assessing Molecular Mechanism of Action (MMOA) Identifies Tideglusib as a Time-Dependent Inhibitor of Trypanosoma brucei GSK3β.

    abstract:BACKGROUND:New therapeutics are needed for neglected tropical diseases including Human African trypanosomiasis (HAT), a progressive and fatal disease caused by the protozoan parasites Trypanosoma brucei gambiense and T. b. rhodesiense. There is a need for simple, efficient, cost effective methods to identify new molecu...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Swinney ZT,Haubrich BA,Xia S,Ramesha C,Gomez SR,Guyett P,Mensa-Wilmot K,Swinney DC

    更新日期:2016-03-04 00:00:00

  • Caregivers' views on stigmatization and discrimination of people affected by leprosy in Ghana.

    abstract:BACKGROUND:Leprosy is a condition that has long been associated with stigma and discrimination, even when infected persons have been cured. This paper describes stigma and discrimination as viewed by caregivers who are associated with people affected by leprosy in Ghana. METHODS:A qualitative interview with semi-struc...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Asampong E,Dako-Gyeke M,Oduro R

    更新日期:2018-01-29 00:00:00

  • Geospatial distribution of intestinal parasitic infections in Rio de Janeiro (Brazil) and its association with social determinants.

    abstract:BACKGROUND:Intestinal parasitic infections remain among the most common infectious diseases worldwide. This study aimed to estimate their prevalence and provide a detailed analysis of geographical distribution of intestinal parasites in the metropolitan region of Rio de Janeiro, considering demographic, socio-economic,...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Faria CP,Zanini GM,Dias GS,da Silva S,de Freitas MB,Almendra R,Santana P,Sousa MD

    更新日期:2017-03-08 00:00:00

  • Distinct genetic diversity of Oncomelania hupensis, intermediate host of Schistosoma japonicum in mainland China as revealed by ITS sequences.

    abstract:BACKGROUND:Oncomelania hupensis is the unique intermediate host of Schistosoma japonicum, which causes schistosomiasis endemic in the Far East, and especially in mainland China. O. hupensis largely determines the parasite's geographical range. How O. hupensis's genetic diversity is distributed geographically in mainlan...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Zhao QP,Jiang MS,Littlewood DT,Nie P

    更新日期:2010-03-02 00:00:00

  • A dual drug sensitive L. major induces protection without lesion in C57BL/6 mice.

    abstract::Leishmaniasis is a major health problem in some endemic areas and yet, no vaccine is available against any form of the disease. Historically, leishmanization (LZ) which is an inoculation of individual with live Leishmania, is the most effective control measure at least against cutaneous leishmaniasis (CL). Due to vari...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Davoudi N,Khamesipour A,Mahboudi F,McMaster WR

    更新日期:2014-05-29 00:00:00

  • The formation of lipid droplets favors intracellular Mycobacterium leprae survival in SW-10, non-myelinating Schwann cells.

    abstract::Leprosy is a chronic infectious disease that is caused by the obligate intracellular pathogen Mycobacterium leprae (M.leprae), which is the leading cause of all non-traumatic peripheral neuropathies worldwide. Although both myelinating and non-myelinating Schwann cells are infected by M.leprae in patients with leproma...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Jin SH,An SK,Lee SB

    更新日期:2017-06-21 00:00:00

  • Rabies-induced behavioural changes are key to rabies persistence in dog populations: Investigation using a network-based model.

    abstract::Canine rabies was endemic pre-urbanisation, yet little is known about how it persists in small populations of dogs typically seen in rural and remote regions. By simulating rabies outbreaks in such populations (50-90 dogs) using a network-based model, our objective was to determine if rabies-induced behavioural change...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Brookes VJ,Dürr S,Ward MP

    更新日期:2019-09-23 00:00:00

  • Evaluation of conventional and four real-time PCR methods for the detection of Leishmania on field-collected samples in Ethiopia.

    abstract::In most low-resource settings, microscopy still is the standard method for diagnosis of cutaneous leishmaniasis, despite its limited sensitivity. In Ethiopia, the more sensitive molecular methods are not yet routinely used. This study compared five PCR methods with microscopy on two sample types collected from patient...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Merdekios B,Pareyn M,Tadesse D,Eligo N,Kassa M,Jacobs BKM,Leirs H,Van Geertruyden JP,van Griensven J,Caljon G,Cnops L

    更新日期:2021-01-12 00:00:00

  • A Comparison between Transcriptome Sequencing and 16S Metagenomics for Detection of Bacterial Pathogens in Wildlife.

    abstract:BACKGROUND:Rodents are major reservoirs of pathogens responsible for numerous zoonotic diseases in humans and livestock. Assessing their microbial diversity at both the individual and population level is crucial for monitoring endemic infections and revealing microbial association patterns within reservoirs. Recently, ...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Razzauti M,Galan M,Bernard M,Maman S,Klopp C,Charbonnel N,Vayssier-Taussat M,Eloit M,Cosson JF

    更新日期:2015-08-18 00:00:00

  • Cytokine response signatures in disease progression and development of severe clinical outcomes for leptospirosis.

    abstract:BACKGROUND:The role of the immune response in influencing leptospirosis clinical outcomes is not yet well understood. We hypothesized that acute-phase serum cytokine responses may play a role in disease progression, risk for death, and severe pulmonary hemorrhage syndrome (SPHS). METHODOLOGY/PRINCIPAL FINDINGS:We perf...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Reis EA,Hagan JE,Ribeiro GS,Teixeira-Carvalho A,Martins-Filho OA,Montgomery RR,Shaw AC,Ko AI,Reis MG

    更新日期:2013-09-19 00:00:00

  • Host plant forensics and olfactory-based detection in Afro-tropical mosquito disease vectors.

    abstract::The global spread of vector-borne diseases remains a worrying public health threat, raising the need for development of new combat strategies for vector control. Knowledge of vector ecology can be exploited in this regard, including plant feeding; a critical resource that mosquitoes of both sexes rely on for survival ...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Nyasembe VO,Tchouassi DP,Pirk CWW,Sole CL,Torto B

    更新日期:2018-02-20 00:00:00

  • Validation of a new test for Schistosoma haematobium based on detection of Dra1 DNA fragments in urine: evaluation through latent class analysis.

    abstract:BACKGROUND:Diagnosis of urogenital schistosomiasis in chronically infected adults is challenging but important, especially because long term infection of the bladder and urinary tract can have dire consequences. We evaluated three tests for viable infection: detection of parasite specific DNA Dra1 fragments, haematuria...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Ibironke O,Koukounari A,Asaolu S,Moustaki I,Shiff C

    更新日期:2012-01-01 00:00:00

  • Geographical distribution of soil transmitted helminths and the effects of community type in South Asia and South East Asia - A systematic review.

    abstract:BACKGROUND:Soil-transmitted helminth (STH) infections are among the most prevalent neglected tropical diseases (NTD) worldwide. Since the publication of the WHO road map to combat NTD in 2012, there has been a renewed commitment to control STH. In this study, we analysed the geographical distribution and effect of comm...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Silver ZA,Kaliappan SP,Samuel P,Venugopal S,Kang G,Sarkar R,Ajjampur SSR

    更新日期:2018-01-18 00:00:00

  • Konzo: from poverty, cassava, and cyanogen intake to toxico-nutritional neurological disease.

    abstract::Konzo is a distinct neurological entity with selective upper motor neuron damage, characterized by an abrupt onset of an irreversible, non-progressive, and symmetrical spastic para/tetraparesis. Despite its severity, konzo remains a neglected disease. The disease is associated with high dietary cyanogen consumption fr...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章,评审


    authors: Nzwalo H,Cliff J

    更新日期:2011-06-01 00:00:00

  • Screening of the Open Source Malaria Box Reveals an Early Lead Compound for the Treatment of Alveolar Echinococcosis.

    abstract::The metacestode (larval) stage of the tapeworm Echinococcus multilocularis causes alveolar echinococcosis (AE), a very severe and in many cases incurable disease. To date, benzimidazoles such as albendazole and mebendazole are the only approved chemotherapeutical treatment options. Benzimidazoles inhibit metacestode p...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章


    authors: Stadelmann B,Rufener R,Aeschbacher D,Spiliotis M,Gottstein B,Hemphill A

    更新日期:2016-03-11 00:00:00