Mayaro virus disease

Mayaro virus disease is a mosquitoborne zoonotic pathogen endemic to certain humid forests of tropical South America. Infection with Mayaro virus causes an acute, self-limited dengue-like illness of 3-5 days' duration.^[1] The causative virus, abbreviated MAYV, is in the family Togaviridae, and genus Alphavirus. It is closely related to other alphaviruses that produce a dengue-like illness accompanied by long-lasting arthralgia. It is only known to circulate in tropical South America.^[1]

Epidemiology

The virus’s transmission cycle in the wild is similar to the continuous sylvatic cycle of yellow fever and is believed to involve wild primates (monkeys) as the reservoir and the tree-canopy-dwelling Haemagogus species mosquito as the vector.^[1] Human infections are strongly associated with exposure to humid tropical forest environments. Chikungunya virus is closely related, producing a nearly indistinguishable, highly debilitating arthralgic disease. On February 19, 2011, a Portuguese-language news source reported on a recent survey which revealed Mayaro virus activity in Manaus, Amazonas State, Brazil.^[2] The survey studied blood samples from 600 residents of Manaus who had experienced a high fever; Mayaro virus was identified in 33 cases. Four of the cases experienced mild hemorrhagic (bleeding) symptoms, which had not previously been described in Mayaro virus disease. The report stated that this outbreak is the first detected in a metropolitan setting, and expressed concern that the disease might be adapting to urban species of mosquito vectors, which would make it a risk for spreading within the country. A study published in October 2011 demonstrated that Aedes aegypti can transmit MAYV, supporting the possibility of wider transmission of Mayaro virus disease in an urban setting.^[3]

Recent Cases

An outbreak in Chuquisaca Department, Bolivia, involving twelve persons, was reported in May 2007.^[4]

In January 2010, a French tourist developed high-grade fever and severe joint pain manifestations following a 15 day trip in the Amazon basin, Brazil, and was diagnosed with MAYV infection in France. This case is the first reported in a traveler returning from an endemic South American country to Europe.^[5] Mayaro virus disease has also been transported into the United States by two visitors infected in eastern Peru^[6] and into the Netherlands by a couple infected while vacationing in Surinam.^[7]

The first outbreak of Mayaro virus disease in humans in Venezuela was reported in early June 2010, with 69 cases diagnosed in Ospino, Portuguesa state, and an additional two in San Fernando de Apure, Apure state, on 7 June 2010, for a total of 71 reported cases as of 8 June.^[8] A virologist noted that the symptoms induced by Mayaro virus in the New World are atypical in the New World, supporting the theory that Mayaro virus is an Old World virus that was introduced to the New World, possibly via the slave trade.^[9]

Treatment

Recent research has suggested that macrophage migration inhibitory factor plays a critical role in determining the clinical severity of alphavirus-induced musculoskeletal disease and may provide a target for development of antiviral pharmaceuticals for Mayaro virus and other arthrogenic alphaviruses, such as Ross River virus, chikungunya, Sindbis virus, and O'nyong'nyong virus.^[10]

References

1. ^ ^{a b c} Receveur MC, Grandadam M, Pistone T, Malvy D. Infection with Mayaro virus in a French traveller returning from the Amazon region, Brazil, January, 2010. Euro Surveill. 2010;15(18):pii=19563. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19563.
2. ^ Redação NotíciasNX: "Manaus tem surto de vírus semelhante ao da dengue", http://www.noticiasnx.com.br/2010/index.php?option=com_content&view=article&id=25048:-manaus-tem-surto-de-virus-semelhante-ao-da-dengue-&catid=47:ultimas-noticias, Sábado, 19 de Fevereiro de 2011 09:39.
3. ^ Long, Kanya C., Sarah A. Ziegler, Saravanan Thangamani, Nicole L. Hausser, Tadeusz J. Kochel, Stephen Higgs and Robert B. Tesh. 2011. Experimental Transmission of Mayaro Virus by Aedes aegypti. American Journal of Tropical Medicine and Hygiene 85(4): 750-757.
4. ^ Agencia EFE: Seis regiones de Bolivia afectadas por brote de epidemias tras las lluvias, http://noticias.terra.com/noticias/articulo/html/act834981.htm, La Paz, 13 May 2007.
5. ^ International Society for Infectious Diseases: PRO/AH/EDR> Mayaro virus disease - France ex Brazil, http://www.promedmail.org/pls/apex/f?p=2400:1001:4169803579523517::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,82598, 07-MAY-2010.
6. ^ R. B. Tesh, D. M. Watts, K. L. Russell, C. Damodaran, C. Calampa, C. Cabezas, G. Ramirez, B. Vasquez, C. G. Hayes, C. A. Rossi, A. M. Powers, C. L. Hice, L. J. Chandler, B. C. Cropp, N. Karabatsos, J. T. Roehrig, and D. J. Gubler. 1999. Mayaro virus disease: an emerging mosquito-borne zoonosis in tropical South America. Clinical Infectious Diseases 28(1): 67-73; http://www.ncbi.nlm.nih.gov/pubmed/10028074.
7. ^ R. J. Hassing, I. Leparc-Goffart, S. N. Blank, S. Thevarayan, H. Tolou, G. van Doornum, and P. J. van Genderen. 2010. Imported Mayaro virus infection in the Netherlands. Journal of Infection 61(4): 343-345; http://www.ncbi.nlm.nih.gov/pubmed/20600300.
8. ^ Giuliana Chiappe: “Detectan dos casos más de fiebre mayaro en Apure”, http://www.eluniversal.com/2010/06/06/pol_art_detectan-dos-casos-m_1928906.shtml, 00:19 GMT, 7 June 2010.
9. ^ Professor E A Gould: “ProMED: Mayaro Virus Disease – Venezuela (02): Comment”, http://www.promedmail.org/pls/apex/f?p=2400:1001:2651078590147519::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,83114, June 07, 2010.
10. ^ Herrero, L. J., Nelson, M., Srikiatkhachorn, A., Gu, R., Anantapreecha, S., Fingerle-Rowson, G., Bucala, R., Morand, E., Santos, L. L., Mahalingam, S. 2011. Critical role for macrophage migration inhibitory factor in Ross River virus-induced arthritis and myositis. Proceedings of the National Academy of Sciences USA, http://www.pnas.org/content/early/2011/06/29/1101089108.short?rss=1, published ahead of print July 5, 2011.