Neurological Disease Associated with Chikungunya in Indonesia

Chikungunya virus (CHIKV) is recognized but rarely considered as a cause of central nervous system infec-tion in endemic areas. A total of 244 patients with acute meningoencephalitis in Indonesia were retrospectively tested to identify whether any CHIKV infection was associated with neurological manifestations, especially in provinces known for CHIKV endemicity. Cerebrospinal fluid (CSF) and blood specimens were tested using CHIKV-specific real-time reverse transcription polymerase chain reaction and IgM ELISA, alongside a panel of neurotropic viruses. We report four cases of suspected or confirmed CHIKV-associated neurological disease, including CHIKV RNA detection in CSF of one patient and in acute serum of another, and CHIKV IgM in CSF of three patients and in serum of a fourth. In conclusion, CHIKV should be considered as a cause of neurologic disease in endemic areas and especially during outbreaks, in addition to the more common arboviral diseases such as dengue and Japanese encephalitis viruses.

Automated summary

Chikungunya virus (CHIKV), although rarely considered, can cause neurological manifestations in endemic areas. This study identified four cases of CHIKV-associated neurological disease in Indonesia, highlighting the need to consider CHIKV as a cause of neurologic disease in these regions, especially during outbreaks.