LAUSR

Background World Health Organization suggested case definitions to suspect and diagnose chikungunya virus infection which are: possible case, probable case and confirmed case. Although useful, when applied in practice, its lack definition for specific joint involvement and absence of other systemic symptoms apart from fever, leads to a broad clinical spectrum which increases the need for laboratory tests. Objectives To establish agreement on clinical criteria of CHIKV infection based on clinical expertise of specialists from affected areas of Colombia and to develop a set of clinical criteria. Methods A group of specialists in rheumatology, epidemiology and bacteriology from different parts of Colombia with experience in diagnosis and treatment of CHIKV patients from the epidemic of 2014–2015 met to reach agreements on clinical characteristics of CHIKV infection. A series of questions were formulated and agreement in percentage was calculated on the following answers: totally agree, agree, not in agree or disagree, disagree and totally disagree. Agreement was set when the sum to the answers totally agree and agree or disagree and totally disagree of was ≥50%. When agreement was not reached, the moderator performed a discussion with the opinions of the confronting members of the group and after that reformulated the question. This procedure was made until agreement was reached. With the results a set of clinical criteria was proposed. Results The agreement percentage to the formulated questions are depicted in table 1. Disagreement was achieved with mucosal imvolvement (100%), G/I involvement (88%), and arthralgia and arthritis in shoulders (63% and 100%) and in elbows (100%).Table 1. Agreement Percentage to Formulated Questions on CHIKV Clinical Characteristics Do you consider as clinical criteria: Totally Agree Agree Not in Agree or Disagree Disagree Totally Disagree Type of Agreement (Total) Symmetrical joint involvement 100 0 0 0 0 Agree (100) Abrupt onset of symptoms 100 0 0 0 0 Agree (100) Fever 38 50 12 0 0 Agree (78) Rash 13 75 0 12 0 Agree (88) Myalgia 25 75 0 0 0 Agree (100) Fatigue 63 25 12 0 0 Agree (88) Arthralgia in wrists 50 25 13 0 12 Agree (75) Arthritis in wrists 75 13 0 12 0 Agree (88) Arthralgia in hands 88 12 0 0 0 Agree (100) Arthritis in hands 88 12 0 0 0 Agree (100) Arthralgia in knees 13 63 0 12 12 Agree (76) Arthritis in knees 13 63 12 0 12 Agree (76) Arthralgia in ankles 100 0 0 0 0 Agree (100) Arthritis in ankles 100 0 0 0 0 Agree (100) Arthralgia in feet 50 38 0 12 0 Agree (88) Arthritis in feet 75 13 0 12 0 Agree (88) Conclusions Agreement was achieved in abrupt onset of symptoms, and the presence of fever, rash, myalgia, fatigue, and symmetrical arthritis or arthralgia of wrists, hands, knees, ankles and feet. A set of clinical criteria was proposed (figure 1). Disclosure of Interest None declared