Observational studyPLoS neglected tropical diseases2026
Chikungunya viral load in cerebrospinal fluid and blood is not associated with severity of neurological manifestations in children.
Observational study in PLoS neglected tropical diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundChikungunya virus (CHIKV) can induce severe neurological manifestations in children. Investigating the role of the viral load (VL) in the blood and cerebrospinal fluid (CSF) could be of interest in understanding the mechanisms that mediate severity. This study aimed to analyze the characteristics of neurological manifestations of CHIKV in young patients at diagnosis and follow-up, with a particular focus on the potential relation between the severity of neurological involvement and the VL in the CSF and blood. METHODOLOGY/PRINCIPAL
findingsWe conducted an observational longitudinal retrospective single-center study during the Chikungunya outbreak of 2014 on the French Caribbean Island of Martinique. We included children (excluding newborns) requiring lumbar puncture and who had positive CHIKV RT-PCR in the blood. Blood and CSF VL were assessed, and sociodemographic, clinical and biological characteristics were recorded. Among 651 children with a positive CHIKV RT-PCR in the blood; 86 were included, of whom 84 had positive RT-PCR in the CSF. Seven children developed probable encephalitis. Neurological manifestations were deemed severe in eight patients (9.3%), intermediate in 11 (12.8%) and non-severe in 67 (77.9%). Mean VL was 9.8 log in blood and 4.9 log in CSF. While mean blood and CSF VL were significantly higher in children aged <1 year, there was no significant association between blood and CSF VL and neurological severity. An initial follow-up carried out on 20 children one to six months after infection, showed good recovery. Additionally, 45 children underwent a neurology consultation 4 years later, of whom 8 (17.8%) presented with neurodevelopmental impairment.
conclusionOur results suggest that the CHIKV can invade the CNS at a high level during the acute phase of infection, but does not seem to be associated with the severity of neurological manifestations in children at the acute phase or with long-term cognitive development.
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