Ross River virus transmission, infection, and disease: a cross-disciplinary review - PubMed (original) (raw)

Review

Ross River virus transmission, infection, and disease: a cross-disciplinary review

D Harley et al. Clin Microbiol Rev. 2001 Oct.

Abstract

Ross River virus (RRV) is a fascinating, important arbovirus that is endemic and enzootic in Australia and Papua New Guinea and was epidemic in the South Pacific in 1979 and 1980. Infection with RRV may cause disease in humans, typically presenting as peripheral polyarthralgia or arthritis, sometimes with fever and rash. RRV disease notifications in Australia average 5,000 per year. The first well-described outbreak occurred in 1928. During World War II there were more outbreaks, and the name epidemic polyarthritis was applied. During a 1956 outbreak, epidemic polyarthritis was linked serologically to a group A arbovirus (Alphavirus). The virus was subsequently isolated from Aedes vigilax mosquitoes in 1963 and then from epidemic polyarthritis patients. We review the literature on the evolutionary biology of RRV, immune response to infection, pathogenesis, serologic diagnosis, disease manifestations, the extraordinary variety of vertebrate hosts, mosquito vectors, and transmission cycles, antibody prevalence, epidemiology of asymptomatic and symptomatic human infection, infection risks, and public health impact. RRV arthritis is due to joint infection, and treatment is currently based on empirical anti-inflammatory regimens. Further research on pathogenesis may improve understanding of the natural history of this disease and lead to new treatment strategies. The burden of morbidity is considerable, and the virus could spread to other countries. To justify and design preventive programs, we need accurate data on economic costs and better understanding of transmission and behavioral and environmental risks.

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Figures

FIG. 1

FIG. 1

Map showing cities, towns, and geographical features discussed in the text, areas where RRV is endemic, and the 1979 to 1980 South Pacific epidemic of RRV disease.

FIG. 2

FIG. 2

Number of joint types that were painful over 7 months of postinfection follow-up for 47 cases of RRV disease, Cairns, 1998.

FIG. 3

FIG. 3

Clinical Health Assessment Questionnaire Functional Disability Index (FDI) regressed against time since symptom onset for RRV disease cases, Cairns, 1998.

FIG. 4

FIG. 4

Physical dimensions of the SF-36, age and sex standardized to the Queensland population and regressed against time since symptom onset for RRV disease cases, Cairns, 1998.

FIG. 5

FIG. 5

Psychological dimensions of the SF-36, age and sex standardized to the Queensland population and regressed against time since symptom onset for RRV disease cases, Cairns, 1998.

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