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Chikungunya Fever
Ashok Swaroop*, Arvind Jain**, Maniram Kumhar***, Naveen Parihar****, Sachin Jain****
Abstract
Chikungunya fever is a viral disease resembling dengue, transmitted to humans by the bite of an infected Aedes aegypti mosquito. It
is endemic in East Africa and parts of Asia. Its recent epidemic has badly hit India especially southern and central India and like
malaria and dengue, this infection has almost become endemic. Symptoms of sudden onset of fever, chills, headache, nausea, vomiting,
joint pain with or without swelling, low back pain, and rash are very similar to those of dengue. But, unlike dengue, there is no
haemorrhagic or shock syndrome.Chikungunya is a self-limiting illness that requires no specific treatment.
Introduction
Aetiology
Virus classification
Group: Group IV [(+) SS RNA]
Family:Togaviridae
Genus: Alphavirus
Species: Chikungunya virus
Mode of transmission
?
Reservoir
?
* Professor and Head, ** Associate Professor, *** Assistant Professor, **** Senior Registrar, Department of General Medicine,
Jawahar Lal Nehru Medical College and Associate Group of Hospitals, Ajmer, Rajasthan.
Clinical features
?
Chikungunya virus is no stranger to the Indian subcontinent. Since its first isolation in Calcutta in 1963,
there have been several reports of chikungunya virus
infection in different parts of India. The last outbreak of
chikungunya virus infection occurred in India in 19717.
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photophobia, conjunctivitis, anorexia, nausea, and
abdominal pain.
?
Migratorypolyarthritismainlyaffectsthesmalljointsof
hands, wrists, ankles, and feet. Rash may appear at the
outset or several days after the illness i.e., in the
convalescence phase.
Diagnosis
The tests available are:
?
1.
Maculopapular rash.
2.
3.
4.
5.
6.
Treatment
7.
8.
9.
Fever typically last for two days and then abruptly comes
down. However, joint pain, headache, insomnia, and
various degrees of prostration last for a variable period,
usually for about 5 to 7 days. Chikungunya is a self-limiting
disease, and recovery is the rule, but little mortality has
been reported in the recent outbreaks in southern India.
In July 2006, a team analysed the virus RNA and
determined the genetic changes that have occurred in
various strains of the virus and identified the genetic
sequence which led to the increased virulence ofthe
recent strains12.
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Complications
Chikungunya is a self-limiting illness. The major causes for
morbidity are severe dehydration, electrolyte imbalance,
and hypoglycaemia.
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Major complications, though rare, are:
1.
2.
Neurological complications15:
a
.
Meningoencephalitis.
b.
Paresisoflimbs.
Information to travellers
c
.
Slurring of speech.
3.
Cardiovascular decompensation16.
4.
5.
References
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3
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6
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2
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4
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5
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7
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16. http://www.ecdc.eu.int/outbreaks/Chikungunyareunion.php.
17. http://agmed.sante.gouv.fr/pdf /10/chicungu.pdf.
18. http://www.globalpulse.net/archives/diseases/
chikungunya.
19. Centers for Disease Control and Prevention (CDC).
Chikungunya fever diagnosed among International
Travelers United States, 2005-2006. MMWR Morb Mortal
Wkly Rep 2006; 55: 1040-2.
20. Kamath S, Das AK, Parikh FS. Chikungunya.J Assoc Physicians
India 2006; 54: 725-6.
FLAVEDON MR ADVT.
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