Background/Purpose:  To describe “chronic chikungunya (CHIK)” manifestations seen during the Caribbean outbreak from December 2013 to January 2015.

Methods: We report our experience as the only Rheumatology Department on Martinique Island. Patients were examined by a senior rheumatologist, using a standard care-report form, and CHIK was diagnosed collectively. The median time from acute CHIK to the first rheumatology consultation was calculated; severity was evaluated based on clinical scales and the degree of joint destruction. Each patient’s therapeutic strategy was recorded.

Results: The median time between acute CHIK and the first rheumatology consultation for the 147 patients analyzed was 8 months. After reviewing each patient’s chart, 19 (12.9%) had been given epidemic-influenced CHIK diagnoses. For the remaining 128 patients, with compatible history and positive serology, 4 distinct rheumatologic patterns were observed: 47 (31.9%) had reactivation of painful chronic mechanical manifestations; 9 (6.1%) had fibromyalgia; 45 (30.6%) met the criteria of spondyloarthritis, known for all before the CHIKV infection, and suffered a flare; and 27 (18.3%), with no history of joint disease, developed de novo bilateral symmetric chronic inflammatory joint disease in response to CHIKV infection.

Conclusion: The term “chronic CHIK syndrome” covers multiple etiologies. Compliance with the French Society of Rheumatology recommendations, careful history-taking and serologic verification help avoid errors inherent to the epidemic context and assure early therapeutic intervention for these patients, who should be managed by rheumatologists as early as possible to avoid late treatment onset.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/management-of-chronic-post-chikungunya-rheumatic-disease-the-martinican-experience/