Volume 85, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



There has been a recent increase in reports of neurologic complications as major causes of morbidity and mortality in chikungunya virus infection. As a part of 2004–2009 global outbreaks, an unprecedented large chikungunya epidemic occurred in Southern Thailand during 2008–2009 in which 49,069 cases were reported. During this period, we encountered two patients with meningoencephalitis and another patient with myeloneuropathy among 1,018 cases diagnosed as chikungunya in our hospital. The clinical pictures are presented and the key points are used to recognize and differentiate chikungunya from Japanese encephalitis virus, dengue virus, and herpesvirus infections, which are more common causes of meningoencephalitis and myelitis in this region.


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  1. Palaux G, Gaüzere BA, Jaureguiberry S, Strobel M, , 2007. Chikungunya, an epidemic arbovirosis. Lancet Infect Dis 7: 319217.[Crossref] [Google Scholar]
  2. Borgherini G, Poubeau P, Staikowsky F, Lory M, Le Moullec N, Becquart JP, Wengling C, Michault A, Paganin F, , 2007. Outbreak of chikungunya on Reunion Island: early clinical and laboratory features in 157 adult patients. Clin Infect Dis 44: 14011407.[Crossref] [Google Scholar]
  3. Sawongtho P, Thavara U, , 2009. Situation of chikungunya. Weekly Epidemiological Surveillance Report 40: 878. [Google Scholar]
  4. Tandale BV, Sathe PS, Arankalle VA, Wadia RS, Kulkarni R, Shah SV, Shah SK, Sheth JK, Sudeep AB, Tripathy AS, Mishra AC, , 2009. Systemic involvements and fatalities during chikungunya epidemic in India, 2006. J Clin Virol 46: 145149.[Crossref] [Google Scholar]
  5. Lebrun G, Chadda K, Reboux A, Gaüzère B, , 2009. Guillain-Barré syndrome after chikungunya infection. Emerg Infect Dis 15: 495496.[Crossref] [Google Scholar]
  6. Robin S, Ramful D, Le Seach' F, Jaffar-Bandjee MC, Rigou G, Alessandri JL, , 2008. Neurologic manifestations of pediatric chikungunya infection. J Child Neurol 23: 10281035.[Crossref] [Google Scholar]
  7. Nimmannitya S, Halstead SB, Cohen SN, Margiotta MR, , 1969. Dengue and chikungunya virus infection in man in Thailand, 1962–1964. Observations on hospitalized patients with hemorrhagic fever. Am J Trop Med Hyg 18: 954971. [Google Scholar]
  8. Tournebize P, Charlin C, Lagrange M, , 2009. Neurological manifestations in chikungunya: about 23 cases collected in Reunion Island. Rev Neurol (Paris) 165: 4851.[Crossref] [Google Scholar]
  9. Bhamarapravati N, Boonyaratvej S, Russell PK, , 1966. Encephalitis and pneumonitis due to chikungunya virus: report of a fatal case. J Med Assoc Thai 49: 627632. [Google Scholar]
  10. Halstead S, , 1966. Epidemiological studies of Thai haemorrhagic fever, 1962–64. Bull World Health Organ 35: 8081. [Google Scholar]
  11. Chandak NH, Kashyap RS, Kabra D, Karandikar P, Saha SS, Morey SH, Purohit HJ, Taori GM, Daginawal HF, , 2009. Neurological complications of chikungunya virus infection. Neurol India 57: 177180.[Crossref] [Google Scholar]
  12. Schuffenecker I, Iteman I, Michault A, Murri S, Frangeul L, Vaney MC, Lavenir R, Pardigon N, Reynes JM, Pettinelli F, Biscornet L, Diancourt L, Michel S, Duquerroy S, Guigon G, Frenkiel MP, Bréhin AC, Cubito N, Desprès P, Kunst F, Rey FA, Zeller H, Brisse S, , 2006. Genome microevolution of chikungunya viruses causing the Indian Ocean outbreak. PLoS Med 3: e263.[Crossref] [Google Scholar]
  13. Theamboonlers A, Rianthavorn P, Praianantathavorn K, Wuttirattanakowit N, Poovorawan Y, , 2009. Clinical and molecular characterization of chikungunya virus in south Thailand. Jpn J Infect Dis 62: 303. [Google Scholar]
  14. Simon F, Savini H, Parola P, , 2008. Chikungunya: a paradigm of emergence and globalization of vector-borne diseases. Med Clin North Am 92: 13231343.[Crossref] [Google Scholar]
  15. Renault P, Solet JL, Sissoko D, Balleydier E, Larrieu S, Filleul L, Lassalle C, Thiria J, Rachou E, de Valk H, Ilef D, Ledrans M, Quatresous I, Quenel P, Pierre V, , 2007. A major epidemic of chikungunya virus infection on Reunion Island, France, 2005–2006. Am J Trop Med Hyg 77: 727731. [Google Scholar]
  16. Rampal , Sharda M, Meena H, , 2007. Neurological complications in chikungunya fever. J Assoc Physicians India 55: 765769. [Google Scholar]
  17. Solomon T, Dung NM, Kneen R, Gainsborough M, Vaughn DW, Khanh VT, , 2000. Japanese encephalitis. J Neurol Neurosurg Psychiatry 68: 405415.[Crossref] [Google Scholar]
  18. Solomon T, Dung NM, Vaughn DW, Kneen R, Thao LT, Raengsakulrach B, Loan HT, Day NP, Farrar J, Myint KS, Warrell MJ, James WS, Nisalak A, White NJ, , 2000. Neurological manifestations of dengue infection. Lancet 25: 10531059.[Crossref] [Google Scholar]
  19. Ratsitorahina M, Harisoa J, Ratovonjato J, Biacabe S, Reynes JM, Zeller H, Raoelina Y, Talarmin A, Richard V, Louis Soares J, , 2008. Outbreak of dengue and chikungunya fevers, Toamasina, Madagascar, 2006. Emerg Infect Dis 14: 11351137.[Crossref] [Google Scholar]
  20. Hochedez P, Canestri A, Guihot A, Brichler S, Bricaire F, Caumes E, , 2008. Management of travelers with fever and exanthema, notably dengue and chikungunya infections. Am J Trop Med Hyg 78: 710713. [Google Scholar]
  21. Wadia RS, , 2007. A neurotropic virus (chikungunya) and a neuropathic amino acid (homocysteine). Ann Indian Acad Neurol 10: 198213. [Google Scholar]
  22. Ganesan K, Diwan A, Shankar SA, Desai SB, Sainani GS, Katrak SM, , 2008. Chikungunya encephalomyeloradiculitis: report of 2 cases with neuroimaging and 1 case with autopsy findings. AJNR Am J Neuroradiol 29: 16361637.[Crossref] [Google Scholar]
  23. Lim CC, Sitoh YY, Hui F, Lee KE, Ang BS, Lim E, Lim WE, Oh HM, Tambyah PA, Wong JS, Tan CB, Chee TS, , 2000. Nipah viral encephalitis or Japanese encephalitis? MR findings in a new zoonotic disease. AJNR Am J Neuroradiol 21: 455461. [Google Scholar]
  24. Kalita J, Misra UK, , 2000. Comparison of CT scan and MRI findings in the diagnosis of Japanese encephalitis. J Neurol Sci 174: 38.[Crossref] [Google Scholar]

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  • Received : 24 Dec 2010
  • Accepted : 17 May 2011
  • Published online : 01 Aug 2011

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