Browsing by Author "Akoroda, Ufuoma"

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Open Access
Chikungunya as a cause of acute febrile illness in southern Sri Lanka.
(PLoS One, 2013) Reller, Megan E; Akoroda, Ufuoma; Nagahawatte, Ajith; Devasiri, Vasantha; Kodikaarachchi, Wasantha; Strouse, John J; Chua, Robert; Hou, Yan'an; Chow, Angelia; Sessions, October M; Østbye, Truls; Gubler, Duane J; Woods, Christopher W; Bodinayake, Champica
BACKGROUND: Chikungunya virus (CHIKV) re-emerged in Sri Lanka in late 2006 after a 40-year hiatus. We sought to identify and characterize acute chikungunya infection (CHIK) in patients presenting with acute undifferentiated febrile illness in unstudied rural and semi-urban southern Sri Lanka in 2007. METHODOLOGY/PRINCIPAL FINDINGS: We enrolled febrile patients ≥ 2 years of age, collected uniform epidemiologic and clinical data, and obtained serum samples for serology, virus isolation, and real-time reverse-transcriptase PCR (RT-PCR). Serology on paired acute and convalescent samples identified acute chikungunya infection in 3.5% (28/797) patients without acute dengue virus (DENV) infection, 64.3% (18/28) of which were confirmed by viral isolation and/or real-time RT-PCR. No CHIKV/DENV co-infections were detected among 54 patients with confirmed acute DENV. Sequencing of the E1 coding region of six temporally distinct CHIKV isolates (April through October 2007) showed that all isolates posessed the E1-226A residue and were most closely related to Sri Lankan and Indian isolates from the same time period. Except for more frequent and persistent musculoskeletal symptoms, acute chikungunya infections mimicked DENV and other acute febrile illnesses. Only 12/797 (1.5%) patients had serological evidence of past chikungunya infection. CONCLUSIONS/SIGNIFICANCE: Our findings suggest CHIKV is a prominent cause of non-specific acute febrile illness in southern Sri Lanka.
Open Access
Chikungunya as an Emerging Cause of Acute Febrile Illness in Southern Sri Lanka
(2012) Akoroda, Ufuoma
Abstract
Objective: The aim of this study was to determine the epidemiology of Chikungunya as an etiology of acute febrile illness in southern Sri Lanka.
MethodAs part of the Duke-Ruhuna post-Tsunami response, a joint research team established a prospective study of acute febrile illness. Between February and November 2007, the investigators enrolled 1079 patients > 2 years of age who presented with fever (>38°C tympanic) to the acute care clinics and emergency department of Teaching Hospital Karapitiya, Sri Lanka. We obtained paired sera from participants for Chikungunya diagnosis including IgG Indirect immunofluorescent assay (IFA), PCR, virus isolation, and sequencing.
Results: Of the 797 patients with available paired sera, 109 (13.7%) screened positive for Chikungunya IgG using IFA. Using a 4-fold rise in acute and convalescent sera, we identified 28(3.5%) acute infections. Additionally, we identified 12 past infections based on the presence of antibodies in both acute and convalescent sera. Among the 28 seroconversions, 10 were isolated by culture and 18 by PCR. Those with acute infections were older (40 years compared to 30 years, p=0.07), more likely males (82% compared to 60%, p=0.02) and were more often admitted to the hospital (93% vs 71%, p=0.001) compared to those without acute Chikungunya infection. Participants with acute Chikungunya infection were more likely to have joint pain (RR: 3.12, CI: 1.39, 7.00, p=0.004), muscle pain (RR: 4.86, CI: 1.87, 12.67, p=<0.001), rash (RR: 5.49, CI: 1.83, 16.45, p=0.001) and conjunctival injection (RR: 3.36, CI: 1.59, 7.10, p=0.001) than those without acute Chikungunya infection. Furthermore, viral Sequencing data confirmed the presence of epidemic African strain throughout the study.
Conclusion:Chikungunya virus was present in southern Sri Lanka and should be considered in the differential diagnosis of acute febrile illnesses. Our limited data suggest infection with the recently identified epidemic strain.