ABOUT CHIKUNGUNYA

What is Chikungunya ?

Chikungunya is a disease caused by a virus known as Chikungunya virus. This is a virus infection transmitted by a mosquito. The mosquitoes those are transmitting the disease to humans are mainly of two species of genus Aedes. These species of mosquitoes are day biters and they are active during day time only. Chikungunya virus is found in monkeys, birds, cattle and rodents, apart from human beings. This disease is in many ways similar to Dengue, including the transmitting mosquito.

Primary symptoms

Chikungunya features sudden onset of fever in humans. This fever may start within two to four days of exposure to virus transmission. The fever may be moderate to high and can last from two to seven days. Fever is accompanied by moderate to severe joint pain and this joint pain may last for several months after the remission of fever. In some cases, hiss joint pain has been reported to last for years together. People have been reported to die in Chikungunya and small children or elderly suffering from chronic diseases have succumbed to Chikungunya or have suffered from severe complications.

Secondary symptoms

Incubation period of Chikungunya virus is from one to twelve days. The disease is sometimes asymptomatic, mostly with fever and joint pains and Rash is developed at a later stage of Chikungunya. Secondary symptoms may include headache, fatigue, gastrointestinal problems and conjunctivitis.

Chikungunya can be defined in both Acute and chronic phase. Acute phase shows viral stage in first five days of infection in which virus is in blood of the patient. This is followed by convalescent stage lasting for ten days in which symptoms improve and the virus is not detectable in blood of patient. Onset of fever is between 102*F to 104*F lasting for may be ten days. Sometimes fever comes in phases, it comes and goes. Fever occurs when virus is released in blood of patient. Virus diminishes with the release of antigen produced by patient blood and fever subsides. Headache, insomnia and exhaustion may last for several days.

Following the fever, severe joint pain and stiffness may follow. This is onset of chronic stage. This pain and stiffness may last for years. This is a debilitating condition that can induce immobility. Typically the affected joints are in both arms and legs involving the joints symmetrically. Pains occur in peripheral joints, wrists, ankles, phalanges of fingers. Sometimes bigger joints like shoulders, elbows and knees are also affected. Chronic cases shows pain in muscles and ligaments.

Rash occurs at later stages. Digestive problems like nausea, vomiting or diarrhea may occur. Inflammation of eyes also may follow.

Neurological disorders have been reported in some cases. Bleeding may occur but rarely. Relapsation of Chikungunya after remission is a cyclical phenomenon that should be treated very carefully. It depends on production of antigen by the body. If the production is up to the standard level, relapsation of Chikungunya is not visible.

Diagnosis

Chikungunya can be diagnosed with confirmation by clinical, laboratory or skin diagnosis. Acute onset of high fever associated with severe joint pain leads to a clinical diagnosis probability. Patients’ travel to a Chikungunya infected place also suggests a case of the disease. Rash on skin also is a strong evidence of Chikungunya. However, definitive diagnosis can only be by laboratory isolation of Chikungunya virus.

No specific way to test for chronic signs and symptoms associated with Chikungunya fever is yet established.

Treatment

No specific treatment for Chikungunya is available currently. Clinical care of the patient is assured by inducing supportive care or symptomatic treatment. Patients are given paracetamol to take care of fever and pain of patient. Aspirin is avoided for probable bleeding chances. Corticosteroid is totally avoided as body must not be subjected to steroidal rebound phenomenon. High degree of intravenous irrigation is given to the patient for a long time.

Prognosis

Patients have reported death in Chikungunya. The death rate is not high. Patients over 65 years, suffering from chronic diseases like high blood pressure, diabetes, cancer, neurological disorders, kidney failures etc have a chance of succumbing to Chikungunya. Similarly neonates with malnutrition are very easy prey to Chikungunya. Neonates are at much danger as Chikungunya can be very easily transmitted from mother to the baby at the time of delivery of child or through mothers feed.

Prevention

Chikungunya is a disease that does not have any specific treatment or prevention in form of vaccines. Only escape is to prevent the disease from happening. The most effective prevention is to protect from bites of virus transmitting mosquitoes. Their population must be controlled by limiting their habitat. All standing water must be eliminated so mosquitoes cannot lay their eggs anywhere to breed. As an alternative, insecticides or biological control agents such as introducing fishes in standing water is a major remedy. Mosquito’s repellents may work but cannot be fully depended upon.

Use of medicated mosquito nets is highly recommended but Chikungunya transmitting mosquitoes bite during the day. Bite proof long sleeve shirts and trousers are effective alternatives for protection against Chikungunya. Houses must be protected by mosquito nets on doors and windows to keep them out of house.

Considering every aspect of the disease Chikungunya, the most effective way is to protect from the disease and prevent from mosquito bite.