@article{fdi:010063678,
  title = {{F}irst reported chikungunya fever outbreak in the {R}epublic of {C}ongo, 2011},
  author = {{M}oyen, {N}. and {T}hiberville, {S}. {D}. and {P}astorino, {B}. and {N}ougairede, {A}. and {T}hirion {P}errier, {L}aurence and {M}ombouli, {J}. {V}. and {D}imi, {Y}. and {L}eparc-{G}offart, {I}. and {C}apobianchi, {M}. {R}. and {L}epfoundzou, {A}. {D}. and de {L}amballerie, {X}avier},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {C}hikungunya is an {A}edes -borne disease characterised by febrile arthralgia and responsible for massive outbreaks. {W}e present a prospective clinical cohort study and a retrospective serological study relating to a {CHIK} outbreak, in the {R}epublic of {C}ongo in 2011. {M}ethodology and {F}indings: {W}e analysed 317 suspected cases, of which 308 (97.2%) lived in the city of {B}razzaville (66.6% in the {S}outh area). {A}mongst them, 37 (11.7%) were {CHIKV}+ve patients (i.e., biologically confirmed by a real-time {RT}-{PCR} assay), of whom 36 (97.3%) had fever, 22 (66.7%) myalgia and 32 (86.5%) arthralgia. {A}ll tested negative for dengue. {T}he distribution of incident cases within {B}razzaville districts was compared with {CHIKV} seroprevalence before the outbreak (34.4% in 517 blood donors), providing evidence for previous circulation of {CHIKV}. {W}e applied a {CHIK} clinical score to 126 patients recruited within the two first day of illness (including 28 {CHIKV}+ves (22.2%)) with sensitivity (78.6%) and specificity (72.4%) values comparing with those of the referent study in {R}eunion {I}sland. {T}he negative predictive value was high (92%), but the positive predictive value (45%) indicate poor potential contribution to medical practice to identify {CHIKV}+ve patients in low prevalence outbreaks. {H}owever, the score allowed a slightly more accurate follow-up of the evolution of the outbreak than the criterion "fever+arthralgia". {T}he complete sequencing of a {C}ongolase isolate ({B}razza_{MRS}1) demonstrated belonging to the {E}ast/{C}entral/{S}outh {A}frican lineage and was further used for producing a robust genome-scale {CHIKV} phylogenetic analysis. {C}onclusions/{S}ignificance: {W}e describe the first {C}hikungunya outbreak declared in the {R}epublic of {C}ongo. {T}he seroprevalence study conducted amongst blood donors before outbreak provided evidence for previous {CHIKV} circulation. {W}e suggest that a more systematic survey of the entomological situation and of arbovirus circulation is necessary in {C}entral {A}frica for better understanding the environmental, microbiological and sociological determinants of emergence.},
  keywords = {{CONGO}},
  booktitle = {},
  journal = {{P}los {O}ne},
  volume = {9},
  numero = {12},
  pages = {e115938 [21 ]},
  ISSN = {1932-6203},
  year = {2014},
  DOI = {10.1371/journal.pone.0115938},
  URL = {https://www.documentation.ird.fr/hor/fdi:010063678},
}