Chikungunya

Definition

Chikungunya is ( what it means )…………In Makonde language means contorted or “that which bends up” or double over in pain.

Chikungunya is a virus transmitted by the Aedes mosquito, commonly causing fever and severe joint pain. In Makonde language, it means contorted or “that which bends up” or “to double over in pain”.

Epidemiology

Chikungunya is endemic in tropical and subtropical countries, especially in Southeast Asia. In the last 5 months (Feb – June 2014), there has been 166 cases reported to the Ministry of Health, Singapore. This is a significant drop from 2013 where there were more than 20,000 reported cases.

Clinical symptoms

Chikungunya is caused by an alphavirus called Chikungunya virus. Chikungunya is rarely life-threatening like dengue fever but symptoms such as prolonged fatigue can be debilitating for the elderly. Most patients recover within a week but for some people, joint pain may persist for months. Newborn babies, older adults (>65 years old) and people with high blood pressure, diabetes or heart disease are at risk of more severe symptoms. Recovery from infection with the Chikungunya virus appears to confer lifelong immunity. The incubation period is 3 – 7 days although symptoms can appear up to 12 days later.

Symptoms of Chikungunya are similar to that of Dengue Fever. Symptoms include:

  • Sudden onset of high fever
  • Joint pain and swelling
  • Headache
  • Nausea/vomiting
  • Muscle pain
  • Rash
  • Oral ulcers

Diagnostic Tests

The diagnosis of Chikungunya may be confirmed either by nucleic acid test to detect the presence of viral DNA during the first few days of infection or by serology when the body produces antibody to the virus.

Treatment

There is no specific treatment to kill or control the Chikungunya virus. Medications are prescribed to reduce the severity of symptoms eg. treatment for fever, vomiting, headache and pain. It is important to drink sufficient fluids to prevent dehydration. Joint pains are usually controlled by anti-inflammatory drugs like NSAIDS or Coxibs.

Prevention

There is currently no commercially available Chikungunya vaccine. The best way to prevent Chikungunya is mosquito control and hence, prevention of mosquito bites. This can be done by:

  • Apply insect repellent on exposed skin and clothes when you go outdoors. DEET-containing synthetic repellents provide longer protection than plant-based repellents such as citronella oil, or lemon eucalyptus oil. Read the label and re-apply as directed.
  • Use air conditioning or mosquito coils indoors to reduce mosquito bites.
  • Stay indoors during the Aedes mosquito’s peak feeding times, typically early morning and late afternoon.
  • When outdoors, wear long sleeves and pants to cover limbs.
  • When travelling overseas, stay in accommodation that provides insecticide-treated mosquito nets over beds and mosquito screens for windows and doors.
  • Prevent mosquito breeding by removing any standing water in flower pots, plant saucers, buckets and containers.

 

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