Chikungunya: Causes, Diagnosis & Treatments

Chikungunya is a mosquito-borne disease, similar to dengue that can be passed from one person to another. The disease is spread by the bite of Aedas aegypti and Aedes albopictus mosquito. They acquire the virus after feeding on an infected person. The infection usually lasts for 2 to 12 days. It causes fever and joint pain. If the symptoms of the infection are severe and are not taken proper care, Chikungunya can be fatal.

It is majorly transmitted when an infected female mosquito bites a person. The infection is not considered to be contagious; however, the virus can be transmitted through contact of an infected individual’s blood.

Some cases of the infection are caused due to human to human contact, but it is not known how this disease is transmitted among humans. Even, monkeys can also be infected through this virus.

Here in this article, know about the symptoms, prevention and everything else that you should know about Chikungunya.

History of Chikungunya:

The first case of Chikungunya was detected in 1952 at Makode plateau in Africa. The word Chikungunya means ‘to become contorted’ or ‘to walk bent over’ that describes the bent posture of patients associated with joint pain. It is an RNA virus that is a member of Togaviradae family. Its first case was detected during an outbreak in Tanzania in 1952. Earlier, it was a tropical disease because it was originated in Africa, Asia and India.

Symptoms of Chikungunya:

When the Aedes mosquito bites an infected person, the virus enters the mosquito system. After getting infected, the mosquito feeds on some other person and the virus gets transmitted to that person. The virus travels through the patient’s body and spreads to different glands in the body by entering the bloodstream. This results in the inflammation of blood vessels that causes them to swell and leak. This infection targets joints, muscles, skin majorly while targets kidneys and the central nervous system as well. This infection affects the muscles of the body that keeps reducing till the cell dies and the virus moves on to a new cell.

The symptoms of Chikungunya are very similar as that of Dengue that usually appear after a few days the mosquito has bitten an individual.

Some of the symptoms of Chikungunya are as following:

  • High fever
  • Muscle and joint pain
  • Nausea
  • Headache
  • Vomiting
  • Sore throat
  • Abdominal pain
  • Dizziness
  • Constipation
  • Coldness in fingers and toes
  • Rashes on skin

Sometimes the symptoms of Chikungunya can be confused with dengue. But the debilitating symptoms of joint pain are only unique to Chikungunya. One should immediately consult a doctor as soon one notice the symptom. The doctor would take the sample of your blood to check the signs whether your body is fighting the virus or not.

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Diagnosis of Chikungunya:

  • Only blood test can diagnose Chikungunya as its symptoms are similar to any other disease like dengue. If an individual is affected with similar symptoms mentioned above or if the individual has visited an area where there is an outbreak of chikungunya, they should visit the doctor as soon as possible.
  • It is important to eliminate dengue fever quickly because of the high immortality rate-up to 50% if untreated, compared to 0.1% for Chikungunya.
  • A blood test known as ELISA (Enzyme linked immunosorbent assay) blood test is carried out to confirm the presence of the virus. If the IgM antibodies are found (that can be found in the patient’s body up to 1 year in the blood) in the body, then it is confirmed that the person is infected with Chikungunya.
  • The virus can be identified using nucleic acid or viral isolation during the first week of illness. Serological diagnosis can be performed by detecting specific IgM antibodies in serum specimen after 4-5 days of the onset of the virus. Specific IgM can persist for months in particular with patients who have long-lasting arthralgia. Serological cross-reactions between alpha viruses have been reported.

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Treatment of Chikungunya:

The virus is barely fatal, but its symptoms are severe and exhausting. Many patients can recover from the infection within a week, but the joint pain persists in many cases. Even after a year, 20% patients complain about recurring joint pain. As such there are no specific drugs that can treat chikungunya, therefore doctors recommend complete bed rest and ask to take increase the intake of fluids. Some of over-the-counter medicines help in treating joint pain and fever. These include:

  • Naproxen
  • Ibuprofen
  • Acetaminophen

For long–lasting aches, physiotherapy might show positive results. In such cases, doctors advise the patients to take plenty of rest, fluids and painkillers. Paracetamol is recommended for treating pain and fever, while NSAIDs are never prescribed. The treatment of Chikungunya consists of:

  • Providing intravenous (IV) fluid and electrolyte replacement
  • Monitoring the blood pressure
  • Blood transfusion to avoid blood loss

The virus is harsh on infants, people above 65 years of age, with high blood pressure and heart disease. If you know someone who is suffering with any of the following conditions, talk to the doctor immediately.

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Vaccine for Chikungunya:

There is no vaccine for Chikungunya yet, but the disease is brief and is rarely fatal. Its medication focuses on relieving the symptoms rather than the cause. The vaccine for the disease consists of virus like particles rather than weakened viruses. The virus-like-particles (VLP) based vaccines can improve the immune responses that are similar to those of generated by naturally acquired immunity. These VLPs are not infectious and cannot be duplicated.

Complications of Chikungunya:

  • Uveitis
  • Retinitis
  • Myocarditis
  • Hepatitis
  • Nephritis
  • Hemorrhage
  • Meningoencephalitis
  • Myelitis
  • Guillain-Barré syndrome
  • Cranial nerve palsies

Prevention of Chikungunya:

The major cause of Chikungunya transmission is through mosquito bite; therefore, the most suitable methods of prevention involve reducing the contact with mosquitoes.

Listed below are some of the steps that should be taken to prevent this virus.

  • Use insect repellent that contains DEET or picaridin on skin and clothing.
  • Wear clothes that cover the entire body.
  • Stay indoors especially during early morning and late afternoon.
  • Avoid traveling to areas experiencing outbreaks.
  • Use products that contains oil of lemon eucalyptus or PMD (p-Menthane-3,8-diol)
  • Stay in air-conditioning rooms
  • Use mosquito net while sleeping.
  • Use mosquito coils and insecticide vaporizers.
  • Throw extra water in things like flower pots and buckets in your house or hotel room.
  • If anybody has suffered with Chikungunya before, they are not likely to get it again.

Outbreak of Chikungunya:

The outbreak of this infection is usually large with high percentage of people infected with the disease. The first case of Chikungunya was detected in Tanzania in 1952 that later caused periodic epidemics in Africa and Asia since 1960’s. Some of the recent outbreaks in the history are:

  • 1999 to 2000: Democratic Republic of the Congo
  • 2005 and 2006: Indian Ocean islands and some parts of Europe
  • 2006 and 2007: India and other countries in the region
  • 2007: Gabon
  • 2011 to 2014: The Pacific Islands
  • 2014: The Caribbean islands, Central America, South American countries, and the United States

The transmission of the disease occurs during or after the rainy season. It may also occur during another period of the year.

Difference between Chikungunya and Dengue

Dengue is spread by the same type of mosquitoes while Chikungunya is, and has many other similar symptoms. Doctors may recommend acetaminophen to reduce fever and pain if you have either of the disease, as Tyenol does not increase the risk of bleeding. It's also possible to have both chikungunya and dengue at the same time. Both diseases are confirmed after getting the blood reports.

However, dengue is considered to be more dangerous than Chikungunya.

Lifestyle tips for treating Chikungunya

Here are some of the lifestyle tips that everyone should follow.

  • Bed rest for 7 days
  • Drink plenty of water: Adults should drink at least 5 liters per day
  • Take paracetamol for fever only if tests are negative.
  • 7 days of rest even after body temperature is normal.
  • Avoid taking heavy medications
  • Prefer wearing cotton clothes.
  • Try drinking the following drinks:
  • Tea with more sugar and milk
  • Clear soups
  • Roohafza with toned milk diluted with water
  • Follow a low fat diet with more on liquid nourishment. Eat light and take enough bed rest.

Long term effects of Chikungunya

The disease may cause long term health effects that reduce the quality of life. The disease is not fatal in most cases, and most patients recover quickly and are free from the symptoms within a few weeks. The most common long term side effect of the disease is joint pain (Arthalgia). Persistent joint pain is found among patients who had severe infection.

Patients of this disease are found to be in discomfort when it comes to indulging daily activities such as walking and getting dressed even after 1 and half years. It has been found that the disease can lead to the susceptibility of rheumatoid arthritis.

Pregnant women are at a higher risk, but no cases of miscarriages haves been reported till now. The disease is not transmitted to the baby. However, the Chikungunya virus can be transmitted to the baby.

  • Treatment: Persistent joint pain is treated with NSAIDs and Corticoids. Physiotherapy and milk exercise can help in healing pain and fast recovery. Exercise might also help in muscle strengthening and reducing the pain.
  • In order to avoid pain, try performing this exercise; sit on a chair and extend legs parallel to the floor for few seconds before lowering it. Do it for at least 10 times at one go. One should do this 2 or 3 times a day.
  • Walk for 10 to 20 minutes and avoid sitting for long periods of time at a stretch.
  • Do simple movement exercises by moving fingers, hands and elbows.

Chikungunya in India

Most number of cases that started from 2006 is reported in India. Out of which, majority were from Kerala, Andhra Pradesh and Tamil Nadu.

In India, majority of cases have been reported from Delhi. The number of people exposed to this virus is very high in Southern India. The virus seems to attack women more than men.

Common Myths About Chikungunya

Myth #1: Dirty water is the breeding ground for chikungunya mosquitoes.

Fact: No, this is the misconception related to chikungunya. This virus does not spread because of dirty water. But eggs can be laid in clean water as well. The water if stays stagnant for 5 days, it can be the breeding ground for Aedas Aegypti that causes yellow fever.

Mosquitoes can breed in discarded tires, empty vase and water stored in drums and buckets.

Myth #2: Chikungunya can be treated with antibiotics.

Fact: So far there is no cure for Chikungunya. No vaccine can cure this disease. Prevention and control of mosquitoes can only ensure protection against this virus.  The treatment of Chikungunya is focused on managing symptoms, rather the infection.

Myth #3: Use of insecticide sprays helps in preventing mosquitoes.

Fact: Sprays have been proved beneficial in controlling mosquito’s population, using only insecticides cannot ensure 100% security as mosquitoes might get killed, but their larvae and eggs cannot get killed. Therefore, maintaining hygiene is very important. Do not allow the water to collect anywhere in the house.

Myth #4: Chikungunya can cause joint deformity.

Fact: The symptoms of Chikungunya include joint and muscle pain that are quite similar to rheumatoid arthritis or other rheumatologic diseases. The vector-borne disease cannot deform the joints. Many patients recover completely but in some cases, the joint pains may continue for several weeks and months.

Myth #5: A low platelet count is not necessarily the sign of Chikungunya.

Fact: People often tend to confuse low platelet count with Chikungunya. Many other viral infections that are not dangerous can lower the platelet counts. Common cold or viral fever can also lower the platelet count. People diagnosed with anemia too have faced issues like low blood count.

Frequently Asked Questions (FAQs) about Chikungunya:

1) Which doctor should be consulted for Chikungunya?

In such case, one can visit a general physician or family doctor.

2) Does the patients infected with Chikungunya require hospitalization?

No, not necessarily. Most patients can be treated at home by monitoring their blood tests. The patient needs to be admitted only if they are suffering with joint pains or if there is any complication.

3) Can Chikungunya be cured?

It is a viral disease that can be transmitted to humans by infected mosquitoes. It has the same clinical signs just like Dengue, Zika and can be misdiagnosed in areas where there is an outbreak. As such, there is no cure for the disease. No vaccine is available. Its treatment is focused on curing the symptoms. The infection rarely causes some infections.

If you are infected with the disease, try taking antipyretics that helps in reducing fever, analgesics that works as pain relievers and fluids. Over-the-counter medicines can be used treat pain and fever that includes NSAIDs like Ibuprofen, Motrin and naproxen.

4) Is Chikungunya deadly?

Death from Chikungunya is quite rare, but the virus can cause serious problems, in adults with chronic illness. People who have been infected with this virus once, are likely to be protected from this disease in the future.

5) For how long does the virus stays in the system?

The symptoms of Chikungunya can last for 2-3 days. The virus remains in the system for 5-7 days and mosquito feeding on a person during this period can also become infected.

Post-chikungunya arthritis can last up to three months or a year (in some cases). In this disease, medicines are only effective in dealing with pain and reducing the recovery period.

6) How dengue and Chikungunya are different from each other?

They both are viral infections spread by Aedas mosquitoes. Dengue is caused by Aedas aegypti and Chikungunya is caused by Aedas albopictus. Both types of mosquitoes can spread both the diseases.

7) Is Chikungunya sexually transmitted?

The virus is spread when mosquito bites an infected person and then bites someone else. It rarely happens that the virus can be spread from mother to child during delivery. Till now, there is no such evidence that it can be spread through breastfeeding or sexual contact.

8) What type of diet is recommended in Chikungunya?

Person infected with Chikungunya should take coconut, green vegetables, soups and homemade dal. Also, food items rich in Vitamin C.

9) How can this infection be prevented?

There is no such prevention for Chikungunya. But you can take following measures to prevent the virus:

  • Do not keep stagnant water in home, schools and workplaces to avoid mosquitoes.
  • Apply insect repellant that contains DEET.
  • Whenever outside, try wearing full sleeves clothes.
  • Keep the garbage in closed containers.
  • Discard old tires that are of no use.
  • Measures should be taken in the affected areas of outbreak, elimination of adult mosquitoes through aerial spraying with insecticides can be considered.
  • Due to the absence of antiviral drugs, the treatment is sympotomatic including the non-salicylate analgesics and NSAIDs.

10) How severe is Chikungunya?

Chikungunya is rarely fatal, but older people might die after getting infected by this disease. Some people can recover within a week or a month. Some people experience joint pain that can last for months. Newborns that are exposed during delivery, people above the age of 65 or who are suffering with diabetes and high blood pressure are vulnerable to infection.

The mosquitoes that cause the infection are typically bite during the day and morning, also they might bite during night.

11) How can the symptoms be treated?

One should get plenty of water. Do not skip fluid as it may cause dehydration. Take medicines like acetaminophen and avoid aspirin and NSAIDs .

12) What is the incubation period for this infection?

Approximately 3-28% of people are infected with this disease will remain asymptomatic. Those who develop symptomatic symptoms, the incubation period is for 3-7 days. It is mostly characterized by fever (above than 102 C) and joint pain.

13) Can chikungunya happen twice?

Those who have been infected with this disease once are immune for life. However, the pain may last from weeks to months. Persistent joint pain can be treated with NSAIDs corticosteroids and physical therapy.

14) Is Chikungunya fatal?

The disease does not kill people. But the heavy dosage of antibiotics can cause harm. If you are prescribed 2-4 antibiotics at a time, whose dosage is quite heavy, it may lead to multiple organ failure. It is considered to be fatal for those with cancer, diabetes and thalassemia.

15) What if I have fever above 104F?

If you are having high fever around 104F, you can take 4 tablets of Chloroquine after having biscuits with tea made with toned milk. It helps a person in getting carbs, proteins and water. Chikungunya tests are positive only after 7th day. If treated well, it takes 3 days to recover from the infection. The joint pains and rashes take few days to heal.

16) Is breastfeeding considered to be safe during the infection?

There is no such evidence that this virus is transmitted through breast milk. Against the defense from child, it is always advised to use net and repellants to reduce the risk of mosquito bite.

17) What is the impact of Chikungunya during pregnancy?

During pregnancy, women get the infection at any stage. However, the chances of passing the infection to the fetus are very less. If the woman is infected at the time delivery, the child can easily get Chikungunya. Therefore, it is important to ensure that women are safe in the disease-infected areas.

18) How travelers can prevent themselves from Chikungunya?

There is no vaccine available to cure the disease. The only way to prevent disease is to lower the mosquito bites.

  • Apply insect repellant that contains DEET.
  • Always wear full sleeves clothes.
  • Keep the garbage in closed containers.
  • Do not use permethrin directly on skin.

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Last updated on : 20-12-2018

Disclaimer : Docprime doesn’t endorse or take any guarantee of the accuracy or completeness of information provided under this article and these are the views strictly of the writer. Docprime shall not be held responsible for any aspect of healthcare services administered with the information provided on this article.

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