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

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

Advances in Rheumatology, July 2017

28751131

Claudia Diniz Lopes Marques, Angela Luzia Branco Pinto Duarte, Aline Ranzolin, Andrea Tavares Dantas, Nara Gualberto Cavalcanti, Rafaela Silva Guimarães Gonçalves, Laurindo Ferreira da Rocha, Lilian David de Azevedo Valadares, Ana Karla Guedes de Melo, Eutilia Andrade Medeiros Freire, Roberto Teixeira, Francisco Alves Bezerra Neto, Marta Maria das Chagas Medeiros, Jozélio Freire de Carvalho, Mario Sergio F. Santos, Regina Adalva de L. Couto Océa, Roger A. Levy, Carlos Augusto Ferreira de Andrade, Geraldo da Rocha Castelar Pinheiro, Mirhelen Mendes Abreu, José Fernando Verztman, Selma Merenlender, Sandra Lucia Euzebio Ribeiro, Izaias Pereira da Costa, Gecilmara Pileggi, Virginia Fernandes Moça Trevisani, Max Igor Banks Lopes, Carlos Brito, Eduardo Figueiredo, Fabio Queiroga, Tiago Feitosa, Angélica da Silva Tenório, Gisela Rocha de Siqueira, Renata Paiva, José Tupinambá Sousa Vasconcelos, Georges Christopoulos

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.