Encephalitis Caused by Chikungunya Virus in a Traveler from the Kingdom of Tonga

ABSTRACT Febrile travelers from countries with unique endemic pathogens pose a significant diagnostic challenge. In this report, we describe the case of a Tongan man presenting with fever, rash, and altered mental status. The diagnosis of Chikungunya encephalitis was made using a laboratory-developed real-time RT-PCR and serologic testing.

[1]  S. Cassadou,et al.  Chikungunya in the Americas , 2014, The Lancet.

[2]  Frank Kunst,et al.  Genome Microevolution of Chikungunya Viruses Causing the Indian Ocean Outbreak , 2006, PLoS medicine.

[3]  S. Chusri,et al.  Case reports of neuro-Chikungunya in southern Thailand. , 2011, The American journal of tropical medicine and hygiene.

[4]  R. Tesh,et al.  The distribution and prevalence of group A arbovirus neutralizing antibodies among human populations in Southeast Asia and the Pacific islands. , 1975, The American journal of tropical medicine and hygiene.

[5]  M. Cetron,et al.  Spectrum of disease and relation to place of exposure among ill returned travelers. , 2006, The New England journal of medicine.

[6]  Malaya K. Sahoo,et al.  Multiplex Nucleic Acid Amplification Test for Diagnosis of Dengue Fever, Malaria, and Leptospirosis , 2014, Journal of Clinical Microbiology.

[7]  S. Larrieu,et al.  A major epidemic of chikungunya virus infection on Reunion Island, France, 2005-2006. , 2007, The American journal of tropical medicine and hygiene.

[8]  Suresh Mahalingam,et al.  Chikungunya: a re-emerging virus , 2012, The Lancet.

[9]  H. Bossin,et al.  Distribution of Aedes albopictus (Diptera, Culicidae) in southwestern Pacific countries, with a first report from the Kingdom of Tonga , 2012, Parasites & Vectors.

[10]  P. Quénel,et al.  Atypical Chikungunya virus infections: clinical manifestations, mortality and risk factors for severe disease during the 2005–2006 outbreak on Réunion , 2008, Epidemiology and Infection.

[11]  Alain Michault,et al.  Outbreak of chikungunya on Reunion Island: early clinical and laboratory features in 157 adult patients. , 2007, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[12]  E. Gould,et al.  Chikungunya virus adapts to tiger mosquito via evolutionary convergence: a sign of things to come? , 2008, Virology Journal.

[13]  B. Pavlin,et al.  The threat of chikungunya in Oceania. , 2013, Western Pacific surveillance and response journal : WPSAR.

[14]  A. Nisalak,et al.  Kinetics of Chikungunya Infections during an Outbreak in Southern Thailand, 2008–2009 , 2014, The American journal of tropical medicine and hygiene.