Chikungunya Virus: Symptoms, Diagnosis, & Treatment
- Publish Date: 2014/01/17 - (Rev. 2016/11/07)
- Author: Thomas C. Weiss
- Contact : Disabled World
Outline: Information regarding Chikungunya a viral disease with no current known cure spread by mosquitos.
'Chikungunya,' is a viral disease that is spread by mosquitos. The disease causes a person to experience fever and severe joint pain. Additional symptoms include headache, muscle pain, fatigue, nausea, and rash. The disease shares some clinical signs with dengue fever and may be misdiagnosed in areas where dengue is common.
Chikungunya is an infection caused by the chikungunya virus. It features sudden onset fever usually lasting two to seven days, and joint pains typically lasting weeks or months but sometimes years. The most common symptoms of chikungunya virus infection are fever and joint pain. Other symptoms may include headache, muscle pain, joint swelling, or rash. Chikungunya was one of more than a dozen agents researched as potential biological weapons. The mortality rate is a little less than 1 in 1000, with the elderly most likely to die.
Unfortunately, there is no cure for the disease at this time. Treatment is focused on relieving the symptoms people experience. The proximity of mosquito breeding sites to human habitation is a significant risk factor for chikungunya. Since the year 2004, chikungunya fever has reached epidemic proportion with a considerable amount of suffering and morbidity.
The disease happens in Asia, Africa, as well as the Indian subcontinent. In recent decades, mosquito vectors of chikungunya have spread to the Americas and Europe. In the year 2007, disease transmission was reported for the first time in an outbreak in northeastern Italy.
Chikungunya was first described during an outbreak in southern Tanzania in the year 1952. The disease is an alpha-virus of the family, 'Togaviridae.' The name, 'chikungunya,' is derived from a word in the Kimakonde langue and means, 'to become contorted.' It describes the stooped appearance of people with the disease who experience joint pain.
Chart showing areas affected by chikungunya
Chikungunya is characterized by an abrupt onset of fever often times accompanied by joint pain. Other common signs and symptoms include headache, muscle pain, fatigue, nausea, and rash. The joint pain is many times debilitating, yet usually last for a few days, although it might be prolonged to weeks.
The majority of people achieve a full recovery, but in some instances the joint pain may continue for several months or even years. Occasional instances of neurological, eye and heart complications have been reported, as well as gastrointestinal complaints. Serious complications are uncommon, although in seniors the disease may contribute as a cause of death. Many times, symptoms in people who become infected are mild and the infection can go unrecognized or be misdiagnosed in areas where dengue fever happens.
Transmission of Chikungunya
Chikungunya has been identified in almost 40 nations in Asia, Africa, the Americas and Europe. The virus is transmitted from person to person through the bites of infected mosquitos. The mosquitos commonly involved are, 'Aedes aegypti,' and, 'Aedes albopictus,' two species which may also transmit additional mosquito-borne viruses to include dengue fever.
The mosquitos may be found biting throughout daylight hours, although there might be peaks of activity in the early morning and late in the afternoon. Both of these mosquito species are found biting outdoors, but Aedes aegypti also feeds indoors. After being bitten by an infected mosquito, onset of chikungunya usually happens between 4-8 days, although it may range from 2-12 days.
Diagnosis and Treatment of Chikungunya
A number of methods can be used to achieve a diagnosis of chikungunya. Serological tests such as enzyme-linked immunosorbent assays (ELISA), might confirm the presence of IgG and IgM anti-chikungunya antibodies. IgM antibody levels are at their highest 3-5 weeks after the onset of illness and persist for around 2 months.
The virus may be isolated from a person's blood during the first few days of infection. Various, 'reverse transcriptase-polymerase chain reaction (RT-PCR),' methods are available, yet are of variable sensitivity. Some are suited for clinical diagnosis. RT-PCR products from clinical samples might also be used for genotyping of the virus, permitting comparisons with virus samples from different geographical sources.
Where treatment of chikungunya is concerned, there is no specific antiviral treatment for the disease. Instead, treatment is aimed mainly at relieving the symptoms infected people experience - particularly joint pain.
Preventing and Controlling Chikungunya
The proximity of mosquito vector breeding sites to human habitation is a significant risk factor for chikungunya as well as other forms of diseases that mosquitos transmit. Prevention and control relies largely on reduction of the number of natural and artificial water-filled container habitats that support the breeding of mosquitos. Doing so requires the mobilization of communities that are affected. During outbreaks, insecticides might be sprayed to kill flying mosquitos, applied to surfaces, around containers where mosquitos land, and used to treat water in containers with the goal of killing immature mosquito larvae.
For protection during outbreaks of chikungunya, clothes that minimize a person's skin exposure to biting by mosquitos during the day is greatly advised. Repellents can be applied to a person's exposed skin, or to their clothes. Repellents should contain DEET, IR3535, or Icaridin. For people who sleep during the daytime, especially young children, those who are already sick, or seniors - insecticide treated mosquito nets provide good protection. Mosquito coils or other types of insecticide vaporizers might also reduce indoor mosquito biting.
Basic precautions need to be taken by people who travel to areas that are at-risk. The precautions include wearing long sleeves, using repellents, wearing pants and ensuring that rooms are fitted with screens to prevent mosquitos from entering.
Chikungunya happens in Asia, Africa and the Indian subcontinent. Human infections in Africa have been at fairly low levels for a number of years, although in 1999-2000 there was a large outbreak in the Democratic Republic of the Congo. In the year 2007 there was an outbreak of chikungunya in Gabon.
Starting in February of 2005, a major outbreak of the disease happened in islands of the Indian Ocean. Large numbers of chikungunya cases in Europe were associated with the outbreak, mostly in 2006 when the Indian Ocean epidemic reached its peak. A large outbreak of the disease in India happened in 2006-2007.
Several other nations in Southeast Asia were also affected by the disease. Since 2005, Indonesia, India, Myanmar, Maldives, and Thailand have reported more than 1.9 million cases of chikungunya. In 2007, transmission was reported for the first time in Europe in a localized outbreak in northeastern Italy. There were 197 people who experienced the disease during the outbreak and it confirmed that mosquito-borne outbreaks by Aedes aegypti are certainly possible in Europe.
Chart showing Aedes albopictus breeding sites
Both Aedes aegypti and Aedes albopictus have been implicated in large outbreaks of chikungunya. While Aedes aegypti is confined within the tropics and subtropics, Aedes albopictus also happens in temperate and even cold temperature areas. In recent decades Aedes albopictus has spread from Asia and become established in areas of Africa, the Americas, as well as Europe. The species Aedes albopictus thrives in a wider range of water-filled breeding sites that Aedes aegypti, to include:
- Tree holes
- Rock pools
- Cocoa pods
- Vehicle tires
- Coconut husks
- Bamboo stumps
- Saucers under plant pots
The diversity of habitats explains the abundance of Aedes albopictus in both rural and peri-urban areas as well as shady city parks. Aedes aegypti is more closely associated with human habitation and uses indoor breeding sites, to include water storage vessels, flower vases and concrete water tanks in bathrooms. The species also has the same artificial outdoor habitats as Aedes albopictus. In Africa, several additional mosquito vectors have been implicated in disease transmission, including species of A. furcifer-taylori group and A. luteocephalus. Evidence exists that some animals, to include non-primates, might act as reservoirs.
- Joint pain is often debilitating and can vary in duration.
- There is no cure for the disease. Treatment is focused on relieving the symptoms.
- The proximity of mosquito breeding sites to human habitation is a significant risk factor for chikungunya.
- The disease shares some clinical signs with dengue, and can be misdiagnosed in areas where dengue is common.
- Chikungunya is a viral disease transmitted to humans by infected mosquitoes. It causes fever and severe joint pain. Other symptoms include muscle pain, headache, nausea, fatigue and rash.
- The disease occurs in Africa, Asia and the Indian subcontinent. In recent decades mosquito vectors of chikungunya have spread to Europe and the Americas. In 2007, disease transmission was reported for the first time in a localized outbreak in north-eastern Italy. Outbreaks have since been recorded in France and Croatia.
- January 2014, the Public Health Agency of Canada reported that cases were confirmed on the British Virgin Islands, Saint-Barthelemy, Guadeloupe, Dominica, Martinique, and French Guyana.
- In April 2014, chikungunya was also confirmed in the Dominican Republic by the Centers for Disease Control and Prevention (CDC). By the end of April, it had spread to 14 countries in all, including Jamaica, St. Lucia, St. Kitts and Nevis, and Haiti where an epidemic was declared.
- By the end of May 2014, over ten imported cases of the virus had been reported in the United States by people traveling to Florida from areas where the virus is endemic.
- On January 2015 there were 90,481 reported cases of chikungunya in Colombia.
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