Summary about Disease
Chikungunya is a viral disease transmitted to humans through the bite of infected mosquitoes, primarily Aedes aegypti and *Aedes albopictus*. It is characterized by fever and severe joint pain (chikungunya means "that which bends up," referring to the stooped posture adopted by sufferers). Other symptoms can include muscle pain, headache, nausea, fatigue, and rash. While death is rare, the joint pain can be debilitating and persist for weeks or months, sometimes even years.
Symptoms
Fever (usually sudden onset)
Severe joint pain (often affecting multiple joints, especially in the hands and feet)
Muscle pain
Headache
Nausea
Fatigue
Rash (maculopapular, appearing 2-5 days after onset)
Less common: gastrointestinal issues, neurological symptoms.
Causes
Chikungunya is caused by the Chikungunya virus (CHIKV), an RNA virus of the alphavirus genus in the Togaviridae family. The virus is transmitted to humans through the bite of infected Aedes aegypti and *Aedes albopictus* mosquitoes. These mosquitoes usually bite during the day.
Medicine Used
There is no specific antiviral treatment for Chikungunya. Treatment focuses on relieving symptoms:
Pain relievers: Over-the-counter pain relievers such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help reduce fever and pain. Aspirin should be avoided in children due to the risk of Reye's syndrome.
Rest: Adequate rest is important to allow the body to recover.
Fluids: Staying hydrated is crucial.
Physical therapy: May be recommended to help maintain joint mobility and reduce stiffness during the recovery phase.
In some cases, stronger pain medications or corticosteroids may be prescribed by a doctor for severe or persistent joint pain, but these are typically used cautiously due to potential side effects.
Is Communicable
Chikungunya is NOT directly communicable from person to person through casual contact. It is spread through the bite of an infected mosquito. A mosquito becomes infected when it bites a person who has Chikungunya. The infected mosquito can then transmit the virus to other people. There can be transmission of the virus from mother to new born around the time of birth.
Precautions
Avoid mosquito bites:
Use insect repellent containing DEET, picaridin, IR3535, oil of lemon eucalyptus (OLE), para-menthane-diol (PMD), or 2-undecanone. Follow the instructions on the product label.
Wear long-sleeved shirts and long pants.
Stay in air-conditioned or screened-in rooms.
Use mosquito nets if sleeping outdoors or in rooms that are not screened.
Mosquito control:
Eliminate standing water around your home (e.g., in flowerpots, tires, buckets, gutters).
Cover or empty containers that can hold water.
Use larvicides to treat water that cannot be drained.
If you are infected: Protect yourself from further mosquito bites to prevent further spread of the virus.
How long does an outbreak last?
The duration of a Chikungunya outbreak can vary depending on several factors, including mosquito control efforts, population immunity, and environmental conditions. Outbreaks can last for several weeks to several months in a community. The outbreak will resolve when there are no new hosts that can be infected.
How is it diagnosed?
Chikungunya is diagnosed through blood tests. These tests can detect the virus itself (viral RNA) or antibodies that the body produces in response to the infection. The specific tests used may include:
RT-PCR (Reverse Transcription Polymerase Chain Reaction): Detects the presence of the virus's RNA in the blood, typically during the first week of illness.
Serological tests (ELISA, Immunofluorescence): Detects antibodies (IgM and IgG) against the Chikungunya virus. IgM antibodies are typically detectable a few days after the onset of symptoms and may persist for several weeks to months. IgG antibodies appear later and can persist for years.
Plaque reduction neutralization test (PRNT): This test measures neutralizing antibodies and is more specific.
Timeline of Symptoms
Incubation period: 3-7 days (time between mosquito bite and symptom onset).
Acute phase: Typically lasts 5-10 days. Characterized by:
Sudden onset of fever
Severe joint pain
Other symptoms like headache, muscle pain, rash.
Post-acute phase: Several weeks to months.
Joint pain may persist, sometimes becoming chronic.
Fatigue may also continue.
Chronic phase: Months to years.
Some individuals develop chronic joint pain and stiffness.
Important Considerations
Differential Diagnosis: Chikungunya symptoms can resemble those of other mosquito-borne diseases like Dengue and Zika. Therefore, accurate diagnosis is crucial.
Chronic Joint Pain: A significant proportion of individuals infected with Chikungunya experience chronic joint pain, which can significantly impact their quality of life. Management of chronic pain may require a multidisciplinary approach.
Risk Groups: Older adults, individuals with pre-existing joint problems, and newborns infected around the time of birth may be at higher risk for more severe disease or chronic complications.
Travel: Travelers to areas where Chikungunya is prevalent should take precautions to avoid mosquito bites.
No Vaccine: As of the current date, there is no widely available vaccine for Chikungunya. Research and development efforts are ongoing.
Public Health Importance: Chikungunya outbreaks can place a significant burden on healthcare systems and economies. Public health measures, including mosquito control and surveillance, are essential for preventing and controlling outbreaks.