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Pune, May 4, 2025 – A groundbreaking study by Pune doctors has revealed that last year’s chikungunya outbreak in Maharashtra led to severe and unexpected complications among children, including what may be the world’s first documented case of an infant requiring a liver transplant due to the infection.
The 2024 chikungunya outbreak was one of the worst in Maharashtra’s history, with over 5,000 cases reported statewide. Pune, a major hotspot, recorded 462 confirmed cases. Now, a team of doctors from Jehangir Hospital, Sahyadri Hospital, and Shaishav Children’s Hospital has published a study in the Journal of Pediatric Critical Care detailing the alarming effects of the virus on young patients.
Severe Complications Beyond Fever and Joint Pain
Traditionally, chikungunya is associated with fever and joint pain. However, the study of 117 children hospitalized between June and September 2024 found that the virus is likely evolving, causing life-threatening complications. Of these children, 36 required intensive care unit (ICU) admission due to severe symptoms.
“These children presented with serious neurological issues, respiratory distress, and even organ failure that required intensive care,” said Dr. Sagar Lad, neonatologist and paediatric intensivist at Jehangir and Sahyadri Hospitals, and one of the study’s authors.
A Landmark Case: Liver Transplantation
Most notably, one infant developed fulminant hepatic failure and survived only after receiving a liver transplant. “To our knowledge, this was the most unusual complication of the infection. After an extensive search, we believe this is the first reported case in literature where a liver transplant was necessary for chikungunya recovery,” Dr. Lad explained.
Other Rare and Severe Manifestations
The study also reported two cases of hemophagocytic lymphohistiocytosis (HLH), a rare and potentially fatal immune disorder, and six cases where children went into shock and required emergency cardiovascular support.
Neurological complications were particularly concerning. Over half of the children in the ICU (56%) experienced seizures, with some developing status epilepticus – a prolonged, life-threatening seizure condition. In a few cases, seizures escalated to refractory status epilepticus (RSE), which does not respond to standard treatments and can be fatal if not controlled.
Possible Viral Evolution
The doctors suggest that genetic changes in the chikungunya virus may be responsible for these severe manifestations, allowing the virus to multiply more rapidly and cause complex health issues beyond the usual symptoms.
“These findings suggest chikungunya, often dismissed as less dangerous than dengue, may be evolving into a more serious threat to public health,” Dr. Lad warned. He advised physicians to remain vigilant for atypical and severe presentations, especially during outbreaks.
Study Authors and Call to Action
The study was conducted by Dr. Sagar Lad (Jehangir and Sahyadri Hospitals), Dr. Pradeep Suryawanshi (Sahyadri Hospital), and Dr. Ashish Dhongade (Shaishav Children’s Hospital). The team urges continued research and heightened clinical awareness to address the evolving threat posed by chikungunya.
Disclaimer:
This article is based on information reported by the Times of India and the referenced medical study. The findings are subject to further research and peer review. For medical advice or concerns regarding chikungunya or its complications, please consult a qualified healthcare professional.
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