Chikungunya Fever in Japan Imported from the Caribbean Islands

  • Imai Kazuo
    Division of Infectious Diseases and Pulmonary Medicine, National Defense Medical College
  • Nakayama Eri
    Department of Virology 1, National Institute of Infectious Diseases
  • Maeda Takuya
    Division of Infectious Diseases and Pulmonary Medicine, National Defense Medical College
  • Mikita Kei
    Division of Infectious Diseases and Pulmonary Medicine, National Defense Medical College
  • Kobayashi Yukiko
    Department of Virology 1, National Institute of Infectious Diseases
  • Mitarai Aoi
    Narita Airport Quarantine Station
  • Honma Yasuko
    Narita Airport Quarantine Station
  • Miyake Satoru
    Narita Airport Quarantine Station
  • Kaku Koki
    National Defense Medical Research Institute, Department of Infectious Disease Epidemiology Analysis and Response Officer
  • Miyahira Yasushi
    Department of Global Infectious Diseases and Tropical Medicine, National Defense Medical College
  • Kawana Akihiko
    Division of Infectious Diseases and Pulmonary Medicine, National Defense Medical College

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A 53-year-old Japanese woman who was working as a volunteer in the Commonwealth of Dominica in the Caribbean islands presented with a high-grade fever and severe incapacitating generalized arthralgia. The Asian genotype of the chikungunya virus was confirmed using reverse transcription-PCR and serology, based on the presence of a specific neutralization titer and immunoglobulin M antibodies. She was diagnosed with post-chikungunya chronic arthritis based on persistence of her polyarthritis for 3 months and the presence of rheumatoid factor, immunoglobulin G-rheumatoid factor, and matrix metalloproteinase-3. Chikungunya virus should be considered as a causative pathogen in travelers returning from Caribbean islands. Clinicians should consider chikungunya fever in the differential diagnosis of patients who complain of chronic arthritis and have a history of travel to an endemic area.

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