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FOLLOWING IN THE FOOTSTEPS OF THE CHIKUNGUNYA VIRUS IN BRAZIL: THE FIRST AUTOCHTHONOUS CASES IN AMAPÁ IN 2014 AND ITS EMERGENCE IN RIO DE JANEIRO DURING 2016
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Abstract
Currently, Brazil lives a triple arboviruses epidemic (DENV, ZIKV and CHIKV) making the
differential diagnosis difficult for health professionals. Here, we aimed to investigate chikungunya
cases and the possible occurrence of co-infections during the epidemic in Amapá (AP) that started in
2014 when the first autochthonous cases were reported and in Rio de Janeiro (RJ) in 2016. We further
performed molecular characterization and genotyping of representative strains. In AP, 51.4% of
the suspected cases were confirmed for CHIKV, 71.0% (76/107). Of those, 24 co-infections by
CHIKV/DENV, two by CHIKV/DENV-1, and two by CHIKV/DENV-4 were observed. In RJ,
76.9% of the suspected cases were confirmed for CHIKV and co-infections by CHIKV/DENV (n = 8)
and by CHIKV/ZIKV (n = 17) were observed. Overall, fever, arthralgia, myalgia, prostration,
edema, exanthema, conjunctival hyperemia, lower back pain, dizziness, nausea, retroorbital pain,
and anorexia were the predominating chikungunya clinical symptoms described. All strains analyzed
from AP belonged to the Asian genotype and no amino acid changes were observed. In RJ,
the East-Central-South-African genotype (ECSA) circulation was demonstrated and no E1-A226V
mutation was observed. Despite this, an E1-V156A substitution was characterized in two samples
and for the first time, the E1-K211T mutation was reported in all samples analyzed.
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