Recommendations of the Brazilian Society of Rheumatology for diagnosis and treatment of Chikungunya fever. Part 1 - Diagnosis and special situations

Recommendations of the Brazilian Society of Rheumatology for diagnosis and treatment of Chikungunya fever. Part 1 - Diagnosis and special situations

Abstract Chikungunya fever has become a relevant public health problem in countries where epidemics occur. Until 2013, only imported cases occurred in the Americas, but in October of that year, the first cases were reported in Saint Marin island in the Caribbean. The first autochthonous cases were confirmed in Brazil in September 2014; until epidemiological week 37 of 2016, 236,287 probable cases of infection with Chikungunya virus had been registered, 116,523 of which had serological confirmation. Environmental changes caused by humans, disorderly urban growth and an ever-increasing number of international travelers were described as the factors responsible for the emergence of large-scale epidemics. Clinically characterized by fever and joint pain in the acute stage, approximately half of patients progress to the chronic stage (beyond 3 months), which is accompanied by persistent and disabling pain. The aim of the present study was to formulate recommendations for the diagnosis and treatment of Chikungunya fever in Brazil. A literature review was performed in the MEDLINE, SciELO and PubMed databases to ground the decisions for recommendations. The degree of concordance among experts was established through the Delphi method, involving 2 in-person meetings and several online voting rounds. In total, 25 recommendations were formulated and divided into 3 thematic groups: (1) clinical, laboratory and imaging diagnosis; (2) special situations; and (3) treatment. The first 2 themes are presented in part 1, and treatment is presented in part 2.

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Main Authors: Marques,Claudia Diniz Lopes, Duarte,Angela Luzia Branco Pinto, Ranzolin,Aline, Dantas,Andrea Tavares, Cavalcanti,Nara Gualberto, Gonçalves,Rafaela Silva Guimarães, Rocha Junior,Laurindo Ferreira da, Valadares,Lilian David de Azevedo, Melo,Ana Karla Guedes de, Freire,Eutilia Andrade Medeiros, Teixeira,Roberto, Bezerra Neto,Francisco Alves, Medeiros,Marta Maria das Chagas, Carvalho,Jozélio Freire de, Santos,Mario Sergio F., Océa,Regina Adalva de L. Couto, Levy,Roger A., Andrade,Carlos Augusto Ferreira de, Pinheiro,Geraldo da Rocha Castelar, Abreu,Mirhelen Mendes, Verztman,José Fernando, Merenlender,Selma, Ribeiro,Sandra Lucia Euzebio, Costa,Izaias Pereira da, Pileggi,Gecilmara, Trevisani,Virginia Fernandes Moça, Lopes,Max Igor Banks, Brito,Carlos, Figueiredo,Eduardo, Queiroga,Fabio, Feitosa,Tiago, Tenório,Angélica da Silva, Siqueira,Gisela Rocha de, Paiva,Renata, Vasconcelos,José Tupinambá Sousa, Christopoulos,Georges
Format: Digital revista
Language:English
Published: Sociedade Brasileira de Reumatologia 2017
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0482-50042017000800003
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Summary:Abstract Chikungunya fever has become a relevant public health problem in countries where epidemics occur. Until 2013, only imported cases occurred in the Americas, but in October of that year, the first cases were reported in Saint Marin island in the Caribbean. The first autochthonous cases were confirmed in Brazil in September 2014; until epidemiological week 37 of 2016, 236,287 probable cases of infection with Chikungunya virus had been registered, 116,523 of which had serological confirmation. Environmental changes caused by humans, disorderly urban growth and an ever-increasing number of international travelers were described as the factors responsible for the emergence of large-scale epidemics. Clinically characterized by fever and joint pain in the acute stage, approximately half of patients progress to the chronic stage (beyond 3 months), which is accompanied by persistent and disabling pain. The aim of the present study was to formulate recommendations for the diagnosis and treatment of Chikungunya fever in Brazil. A literature review was performed in the MEDLINE, SciELO and PubMed databases to ground the decisions for recommendations. The degree of concordance among experts was established through the Delphi method, involving 2 in-person meetings and several online voting rounds. In total, 25 recommendations were formulated and divided into 3 thematic groups: (1) clinical, laboratory and imaging diagnosis; (2) special situations; and (3) treatment. The first 2 themes are presented in part 1, and treatment is presented in part 2.

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