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The Laboratory Report - Summer 2014

THE LABORATORY REPORT Summer 2014 Page 2 The Houston Methodist Molecular Diagnostics Laboratory Now Offers A Rapid, PCR-Based Chikungunya Test Chikungunya is a mosquito-borne disease caused by infection with Togaviridae Alphavirus. The Togaviridae family of viruses also includes rubella virus and several viruses that cause encephalitis. While the rubella virus is an air-borne pathogen, all viruses that fall into the Alphavirus genus, including chikungunya, are transmitted by arthropods. Specifically, chikungunya is transmitted by Aedes mosquitoes, which are common in tropical and subtropical zones and are present in the southern United States, including Texas. Epidemiologically, chikungunya is endemic in Africa, Australia, India, Thailand, and many Caribbean islands. In 2005-2006, it caused a major epidemic on La Reunion Island in the Indian Ocean, and subsequently migrated to India, where over 1.5 million cases were detected. The virus made its first appearance in the Western Hemisphere in 2013, when it was diagnosed in a non-traveler patient on the French side of St. Martin in the Caribbean. To date, all cases of chikungunya viral illness diagnosed in the United States are related to infections acquired during travel. However, local transmission in Houston is a distinct possibility. The first case in Texas, a patient from Williamson County near Austin who recently returned from the Caribbean, was confirmed earlier in July. Chikungunya disease pathogenesis is similar to several other mosquito-borne diseases and causes flu-like symptoms that include fever, headaches, rash, and marked lower extremity edema. What sets chikungunya apart is the disease-associated polyarthralgia or joint pain, which could become severe and may persist for years. This characteristic gave the disease its name, which comes from the Makonde language spoken in Tanzania and Mosambique and translates to “that which bends up,” referring to the contorted posture abserved among patients afflicted with severe joint pain. Chikungunya virus infection can be confirmed by PCR or serological testing. Importantly, while the serologic antibody titer test takes 9 days to complete, the PCR-based detection has a 48-hour turnaround time. The Molecular Diagnostics Laboratory at Houston Methodist Hospital has validated and is now performing a PCR test to detect chikungunya virus. In fact, the first chikungunya case in Harris County was diagnosed with our PCRbased test. For more information on this assay or any Molecular Diagnostics Laboratory test, please contact: Dr. Randall Olsen (RJOlsen@houstonmethodist.org) Dr. Bryce Portier (BPPortier@houstonmethodist.org) Ms. Heather Hendrickson (HLHenderson@houstonmethodist.org) The Molecular Diagnostics Laboratory can be reached by phone at 713-441-5727. The Houston Methodist Molecular Diagnostics Laboratory diagnoses the first chikungunya case in Harris County


The Laboratory Report - Summer 2014
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