Cases of chikungunya fever imported from the islands of the South West Indian Ocean to Paris, France

An outbreak of chikungunya fever has been occurring in the islands of the South West Indian Ocean since early 2005. We describe the clinical and biological manifestations observed in 80 patients presenting with confirmed imported chikungunya fever in our infectious disease department between March 2005 and August 2006. Forty eight patients were women (60%) and the median age was 50 years (range: 15-75). Median delay between onset of symptoms and consultation was 35 days (range: 2 days-9 months). All patients suffered from fever and joint pains. The median duration of fever was three days (range: 1-7). Joint pains were mainly peripheral, involving wrist, ankles and phalanges in more than 70% of the patients. An erythematous exanthema occurred in 60 patients (75%). Bleeding from the nose or gums was reported in nine patients (11%). Blood test anomalies, including lymphopenia, thrombopenia and moderate increased liver transaminase levels, were observed particularly during the first week of symptoms. After the first week of symptoms, the main complaints were persistent arthalgia, peripheral oedema, lethargy and sadness. At the time of this report, the treatment remains exclusively symptomatic and no vaccine is available which emphasizes the leading part played by anti vectorial measures..