598. Chikungunya Fever in a Pediatric Population in the Dominican Republic
Session: Poster Abstract Session: Oh One World: Infections from Near and Far
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • Chikungunya.pediatric.pdf (259.9 kB)
  • Background: Chikungunya Fever (CHIK) is an arboviral disease transmitted by the Aedes mosquito. The disease is characterized by fever, rash, arthritis and myalgias. In 2014, there was a large outbreak of CHIK in the Dominican Republic (DR) with 539,000 cases reported to the Dominican Ministry of Health. Infants and young children are more susceptible to symptomatic arboviral diseases and typically have a more severe clinical course. The objective of this study was to evaluate the epidemiological characteristics and establish a clinical profile of pediatric patients admitted with CHIK during a large epidemic.

    Methods: This was a cross-sectional retrospective review of pediatric patients with a clinical diagnosis of CHIK evaluated in 2014 at the Robert Reid Cabral Hospital (RRCH) in the DR. We used the World Health Organization criteria to classify probable cases. We extracted demographic and clinical data from surveillance forms and patient records. We generated descriptive statistics and performed bivariate analysis.

    Results: A total of 86 patients were diagnosed with CHIK at the RRCH during March-September 2014. Median age of the cohort was 3 years (IQR 1 month – 9.5 years). More than half were male (55.8%), residing in an urban area, and a significant proportion (55%) were hospitalized. The most frequent clinical manifestations were fever (100%), arthritis/arthralgias (100%), rash and other skin manifestations (55%), and headache (45.4%). Fever (71.8%) was the most common presenting symptom followed by arthritis/arthralgia (12.7%), skin manifestations (7.0%), and headache (4.2%). Among hospitalized patients for whom there is clinical and laboratory data (n=13), the median number of febrile days was 2 (IQR 1-3) and median hospital stay was 6 days (IQR 6-7). Arthritis of the hands (p 0.02) and feet (p 0.007) was more common in toddlers/pre-teens compared to newborns and infants (< 1 year age).

    Conclusion: Children with CHIK were more frequently urban males. Fever, arthralgia/arthritis and rash were the most common first presenting signs in this group of children. Infants < 1 year of age were most frequently hospitalized. Toddlers and pre-teens experienced more arthritis than infants.

    Virgen Gomez, MD1, Rachel Bernard, MD2, Ann Tran, MD2, Daniel Crespo, MD3, Hugo Bueno, MD3, Shaveta Khosla, MPH4, Alfredo Mena Lora, MD2, Stockton Mayer, DO2, Jesus Feris Iglesias, MD1 and Maximo Brito, MD, MPH2, (1)Infectious Diseases Department, Robert Reid Cabral Children's Hospital, Santo Domingo, Dominican Republic, (2)Division of Infectious Diseases, University of Illinois at Chicago, Chicago, IL, (3)INTEC University, Santo Domingo, Dominican Republic, (4)School of Public Health, University of Illinois at Chicago, Chicago, IL

    Disclosures:

    V. Gomez, None

    R. Bernard, None

    A. Tran, None

    D. Crespo, None

    H. Bueno, None

    S. Khosla, None

    A. Mena Lora, None

    S. Mayer, None

    J. Feris Iglesias, None

    M. Brito, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.