Chikungunya virus (CHIKV) is recognized but rarely considered as a cause of central nervous system infection in endemic areas. A total of 244 patients with acute meningoencephalitis in Indonesia were retrospectively tested to identify whether any CHIKV infection was associated with neurological manifestations, especially in provinces known for CHIKV endemicity. Cerebrospinal fluid and blood specimens were tested using CHIKV-specific real-time reverse transcription polymerase chain reaction and IgM ELISA, alongside a panel of neurotropic viruses. We report four cases of suspected or confirmed CHIKV-associated neurological disease, including CHIKV RNA detection in cerebrospinal fluid (CSF) of one patient and in acute serum of another, and CHIKV IgM in CSF of three patients and in serum of a fourth. In conclusion, CHIKV should be considered as a cause of neurologic disease in endemic areas and especially during outbreaks, in addition to the more common arboviral diseases such as dengue and Japanese encephalitis viruses.
Address correspondence to Khin S. A. Myint, Emerging Virus Research Unit, Eijkman Institute for Molecular Biology, Jalan Pangeran Diponegoro No. 69, DKI Jakarta, Indonesia. E-mail: email@example.com
Financial support: This work was supported by the Ministry of Research and Technology, Republic of Indonesia; Sam Ratulangi University Medical Faculty; Faculty of Medicine and Health Sciences, Universitas Jambi; and the U.S. Centers for Disease Control and Prevention. The Indonesia Brain Infection Study received support from the U.S. National Institutes of Health through the ULTIMATE project (Grant no. R01AI145781). RLH is supported by the Wellcome Trust.
Disclaimers: The funding institutions did not participate in study design, data collection or analysis, decision to publish, or preparation of the manuscript. The findings and conclusions in this report are those of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.