Outbreak of Neuro-Chikungunya in Northeastern Brazil

Chikungunya virus, an alphavirus often associated with large epidemic outbreaks, has a serious social impact. The main symptoms are fever, rash and arthralgia, but recently neurologic complications have been described as an important cause of morbidity. During a large outbreak in at least five towns in poor states of the Brazilian northeast over recent months, 22 patients with chikungunya confirmed by serologic tests who presented some degree of neurologic involvement were assessed in our department. Changes in consciousness were present in almost half of the patients and epileptic seizures and persecutory delusions were present in three and four patients, respectively. As in Brazil there are insufficient serologic tests for patients with a clinical picture of neuro-chikungunya, this is probably a very underdiagnosed disease. The outcomes of the neurologic symptoms were good in all patients of the current series, in contrast with the permanent sequelae reported by other authors.