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Rev Bras Reumatol Engl Ed. 2017;57 Suppl 2:421-437. doi: 10.1016/j.rbre.2017.05.006. Epub 2017 Jul 25.

Recommendations of the Brazilian Society of Rheumatology for diagnosis and treatment of Chikungunya fever. Part 1 - Diagnosis and special situations.

[Article in English, Portuguese]

Author information

1
Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil; Universidade Federal de Pernambuco (UFPE), Hospital das Clínicas, Recife, PE, Brazil. Electronic address: claudia.reumatologia@gmail.com.
2
Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil; Universidade Federal de Pernambuco (UFPE), Hospital das Clínicas, Serviço de Reumatologia, Recife, PE, Brazil.
3
Universidade Federal de Pernambuco (UFPE), Hospital das Clínicas, Recife, PE, Brazil; Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Recife, PE, Brazil.
4
Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil.
5
Universidade Federal de Pernambuco (UFPE), Hospital das Clínicas, Recife, PE, Brazil.
6
Hospital Getúlio Vargas, Ambulatório de Chikungunya, Recife, PE, Brazil.
7
Universidade Federal da Paraíba (UFPB), João Pessoa, PB, Brazil.
8
Universidade Federal da Paraíba (UFPB), Hospital Universitário Lauro Wanderley (HULW), Serviço de Reumatologia, João Pessoa, PB, Brazil.
9
Universidade Estadual de Ciências da Saúde de Alagoas (UNCISAL), Maceió, AL, Brazil.
10
Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN, Brazil.
11
Universidade Federal do Ceará (UFC), Faculdade de Medicina, Departamento de Medicina Clínica, Fortaleza, CE, Brazil.
12
Universidade Federal da Bahia (UFBA), Instituto de Ciências da Saúde, Salvador, BA, Brazil.
13
Universidade Estadual do Piauí (UESPI), Faculdade de Medicina, Teresina, PI, Brazil.
14
Universidade Federal de Sergipe (UFS), Aracaju, SE, Brazil.
15
Universidade do Estado do Rio de Janeiro (UERJ), Disciplina de Reumatologia, Rio de Janeiro, RJ, Brazil.
16
Fundação Oswaldo Cruz (Fiocruz), Escola Nacional de Saúde Pública Sérgio Arouca (ENSP), Rio de Janeiro, RJ, Brazil.
17
Universidade Federal do Rio de Janeiro (UFRJ), Hospital Universitário Clementino Fraga Filho (HUCFF), Rio de Janeiro, RJ, Brazil.
18
Hospital dos Servidores do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
19
Hospital Estadual Eduardo Rabello, Serviço de Reumatologia, Rio de Janeiro, RJ, Brazil.
20
Universidade Federal do Amazonas (UFAM), Faculdade de Medicina, Manaus, AM, Brazil.
21
Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil; Universidade Federal de Mato Grosso do Sul (UFMS), Hospital Universitário Maria Aparecida Pedrossian (HUMAP), Serviço de Reumatologia, Campo Grande, MS, Brazil.
22
Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto (FMRP), Serviço de Reumatologia e Imunologia Pediátrica, Ribeirão Preto, SP, Brazil.
23
Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil; Universidade de Santo Amaro (UNISA), São Paulo, SP, Brazil.
24
Universidade de São Paulo (USP), Hospital das Clínicas, Ambulatório da Divisão de Moléstias Infecciosas de Parasitárias, São Paulo, SP, Brazil.
25
Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Hospital Miguel Arraes, Paulista, PE, Brazil.
26
Universidade Federal de Pernambuco (UFPE), Hospital das Clínicas, Divisão de Gestão do Cuidado, Recife, PE, Brazil.
27
CRP Fisioterapia, Rio de Janeiro, RJ, Brazil.
28
Universidade Estadual do Piauí (UESPI), Teresina, PI, Brazil; Sociedade Brasileira de Reumatologia, São Paulo, SP, Brazil.
29
Sociedade Brasileira de Reumatologia, São Paulo, SP, Brazil; Santa Casa de Misericórdia de Maceió, Maceió, AL, Brazil.

Abstract

Chikungunya fever has become a relevant public health problem in countries where epidemics occur. Until 2013, only imported cases occurred in the Americas, but in October of that year, the first cases were reported in Saint Marin island in the Caribbean. The first autochthonous cases were confirmed in Brazil in September 2014; until epidemiological week 37 of 2016, 236,287 probable cases of infection with Chikungunya virus had been registered, 116,523 of which had serological confirmation. Environmental changes caused by humans, disorderly urban growth and an ever-increasing number of international travelers were described as the factors responsible for the emergence of large-scale epidemics. Clinically characterized by fever and joint pain in the acute stage, approximately half of patients progress to the chronic stage (beyond 3 months), which is accompanied by persistent and disabling pain. The aim of the present study was to formulate recommendations for the diagnosis and treatment of Chikungunya fever in Brazil. A literature review was performed in the MEDLINE, SciELO and PubMed databases to ground the decisions for recommendations. The degree of concordance among experts was established through the Delphi method, involving 2 in-person meetings and several online voting rounds. In total, 25 recommendations were formulated and divided into 3 thematic groups: (1) clinical, laboratory and imaging diagnosis; (2) special situations; and (3) treatment. The first 2 themes are presented in part 1, and treatment is presented in part 2.

KEYWORDS:

Brasil; Brazil; Chikungunya fever; Consenso; Consensus; Epidemia; Epidemic; Febre Chikungunya

PMID:
28751131
DOI:
10.1016/j.rbre.2017.05.006
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