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Chikungunya Fever

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Chikungunya Fever

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In rapidly urbanizing cities, it has become a regular phenomenon to have a post-monsoon surge of fever cases. Chikungunya is also one of them. Read the article to get to know about Chikungunya fever.

Medically reviewed by

Dr. K. Shobana

Published At September 27, 2016
Reviewed AtJuly 26, 2022

Fever has many causes, viral being one of them. Viral fever is prevalent during the change of seasons. Different viruses like the influenza virus, flavivirus, etc., can cause febrile illnesses. The viral infection can be acquired either through direct contact with the patient (droplet infection) or by a vector, as in the case of dengue and chikungunya, where one develops the disease by a mosquito bite.

What Is Chikungunya Fever?

Chikungunya is caused by the bite of the Aedes aegypti mosquito. It usually bites during the daytime, while malaria, a Plasmodium disease, occurs through the bite of the female Anopheles mosquito.

What Is the Distribution of Chikungunya Fever?

The Caribbean islands of America registered the first case of Chikungunya fever in 2013. Later, it then spread to different parts of the world. Since its first outbreak, countries of Europe, Africa, Asia, the Pacific ocean, and the Indian ocean have experienced sporadic attacks now and then. The risk of transmission of the virus increases with infected travelers moving from one country to another.

What Are the Signs and Symptoms of Chikungunya Fever?

  • After the bite of an infected mosquito, it takes around three to seven days for the individual to exhibit the symptoms.

  • Chikungunya is characterized by high fever, severe joint pain, nausea, vomiting, and loss of appetite. The most remarkable feature is joint pain which is sometimes so intense that it renders the patient unable to walk.

  • In a few patients, rashes are also associated with chikungunya fever.

  • Fever usually subsides in five to seven days; however, it may take even up to 14 days in a few patients. Joint pain may persist for up to four weeks.

  • Although chikungunya fever does cause severe disabling symptoms, death is not common with it. Therefore, the mortality rates are meager with chikungunya fever.

  • Also, not all patients experience severe symptoms. Only the below individuals have an increased risk of developing a severe form of the disease:

    • Newborns.

    • Older adults above the age of 65 years.

    • Individuals with underlying chronic medical conditions like diabetes, hypertension, and cardiac diseases.

How Is Chikungunya Fever Transmitted?

  1. Transmission Through Mosquitoes:

The most common transmission route of chikungunya fever occurs through the bite of mosquitoes. Aedes aegypti and Aedes albopictus mosquitoes are responsible for transmitting chikungunya fever, which can bite both during the day and night. When a mosquito bites an infected individual, the virus is transmitted to the mosquito. Eventually, the mosquito becomes infected, and when this infected mosquito bites another healthy individual, transmission occurs.

2. Transmission From Mother to Child:

There have been rare cases of mother-to-child transmission that occur during gestation. However, there is no evidence to support the transmission of the virus through breastfeeding.

3. Transmission Through Blood:

Although theoretically, there has been supportive evidence regarding the spread of the chikungunya virus through blood transmission, there is no clinical evidence for the same.

How Is Chikungunya Fever Diagnosed?

  • Serology tests and virology tests are the available diagnostic tests.

  • A serology test taken to diagnose chikungunya fever is an Enzyme-linked immunosorbent assay (ELISA). The presence of IgM and IgG antibodies for the chikungunya virus is an essential characteristic feature that helps diagnose. In the case of the ELISA test, the IgM antibodies will be present in large numbers between the third and fifth weeks. However, it can last for a couple of months.

  • Virological test methods like reverse transcription-polymerase chain reaction (RT-PCR) also aid in diagnosis. This method diagnoses the infection during the first week of acquiring chikungunya fever.

  • In addition, the patients' travel history helps with the diagnosis of chikungunya fever.

  • Diagnosing chikungunya fever with the help of symptoms alone is challenging because the symptoms exhibited are similar to that of Dengue fever and Zika infection.

What Is the Treatment for Chikungunya Fever?

  • Treatment is symptomatic with Paracetamol and NSAIDs (nonsteroidal anti-inflammatory drugs). NSAIDs should be given only after confirming an average platelet count. This is because both chikungunya fever and dengue have similar symptoms. Taking medications like Aspirin or nonsteroidal anti-inflammatory drugs can increase the risk of bleeding in patients with dengue fever. Therefore, these drugs should be prescribed only after dengue fever has been ruled out.

  • Lots of fluids should be taken by the patient for a quick recovery. In patients who are HLA-B27 positive, the symptoms might persist for a more extended period.

  • Is there any vaccination available against chikungunya fever?

  • As of now, there is no available vaccine to prevent the occurrence of chikungunya fever. Several vaccines have been developed but are still under clinical trials, and it might take years for them to be available to the general public.

How Can We Prevent Chikungunya Fever?

With no available vaccines, preventing the bite of mosquitoes is the sole method available for the prevention of chikungunya fever. The following methods can prevent the bite of mosquitoes:

  1. Wear long-sleeved shirts and full pants to cover your arms and legs. Do not leave any area exposed for the mosquitoes to bite.

  2. Wear clothes that have been treated with 0.5% Permethrin. It should not be directly used over the skin.

  3. Use insect repellents with an environmental-protection agency (EPS) registered insect repellents.

  4. The following are the list of insect repellents that the EPA has approved:

    1. Oil of lemon eucalyptus.

    2. DEET.

    3. 2-undecanone.

    4. Picaridin.

    5. IR3535.

    6. Para-menthane-diol.

  5. Para-menthane-diol and oil of lemon eucalyptus (OLE) should not be used in children below three years.

  6. Insect repellents should be sprayed onto the surface of irritated skin, hands, wounds, eyes, or mouth. It should only be applied to the child's face by spraying it to your hands.

  7. Protect your babies by using mosquito nets for strollers and baby carriers.

  8. Do not allow water to stagnate in areas near your residency to prevent the breeding of mosquitoes.

  9. Use mosquito nets in the doors and windows.

  10. Use air-conditioners.

What Can I Do to Prevent the Spread of Chikungunya Fever?

If you have been diagnosed with chikungunya fever, do not allow mosquitoes to bite you, especially around the first week. The chikungunya virus will be available in the blood during the first week, and when a mosquito bites you, it can become infected. This infected mosquito can transmit the virus to another healthy individual and continue the transmission chain.

Conclusion:

Chikungunya fever is a viral disease transmitted through mosquitoes. Despite no vaccination, the spread of the disease can be significantly controlled by preventing mosquito bites. When experiencing symptoms, reach out to a healthcare provider and get the best possible treatment. Also, avoid the bite of mosquitoes to prevent the spread.

Frequently Asked Questions

1.

What Is Chikungunya’s Incubation Period?

The incubation period is the number of days between the initial exposure of the pathogen and the consecutive development of symptoms. The incubation period of chikungunya fever is 3 to 8 days from the day of the bite of an infected mosquito. However, it can range from 1 to 12 days.

2.

Who Is Prone to Chikungunya Fever?

People living or traveling to tropical and subtropical countries and people living in communities with compromised individual or community sanitation that increase the risk of mosquito breeding during an ongoing epidemic are prone to mosquito-borne infections.

3.

What Is the Reason for Joint Pain in Chikungunya?

Once an individual acquires chikungunya, the body tries to fight off the viral infection and the virus by releasing certain chemicals called inflammatory mediators to attack the virus. This infection-inflammation process eventually ends up damaging cells of the joints, muscle, etc., resulting in inflammation of the joints.

4.

What Foods Should I Avoid for Chikungunya?

- Caffeinated drinks and beverages.
- Carbonated drinks.
- Oily and fatty foods.
- Meat.
- Junk foods.
- Sugary foods.
- Spicy foods.
- Alcohol.
- Processed and frozen foods.

5.

What Long-Term Effects Does Chikungunya Cause?

The below-listed long-term health effects of chikungunya are pronounced in older patients and those with severe chikungunya.
- Chronic joint pain.
- Joint stiffness and swelling.

6.

Does Exercise Help Reduce Joint Pain in Chikungunya?

Yes. Practicing the range of motion exercises and strengthening exercises can improve joint flexibility and help subside joint pain to some extent.

7.

When Will Chikungunya Fever Subside?

Fever due to chikungunya usually subsides within 7 to 10 days of onset.

8.

What Does Untreated Chikungunya Do?

Being a viral infection, chikungunya does not have a permanent cure as of now. However, to relieve symptoms such as headache, fever, joint and muscle ache pain killers, and fever medications might be used along with rest and plenty of water.

9.

How Can I Quickly Cure Chikungunya?

Chikungunya resolves on its own and does not have any treatment to cure it. The following measures might be beneficial in fast recovery:
- Adequate rest.
- Drinking plenty of fluid.
- Paracetamol and painkillers to treat pain and fever.
- Having nutritious foods.

10.

Which Medicine Treats Chikungunya Efficiently?

To date, there is no medicine available to cure chikungunya permanently. But medicines such as Paracetamol, Ibuprofen, and Naproxen help relieve fever and joint or body pain and provide symptomatic relief.

11.

Which Fruit Helps Improve Chikungunya Symptoms?

- Orange.
- Lemon.
- Pomegranate.
- Berries.
- Melons.
- Pineapple.
- Papaya.
- Guava.

12.

Which Is More Concerning, Dengue or Chikungunya?

When compared between dengue and chikungunya, dengue can be more concerning due to its longer fever duration, chances of dengue hemorrhagic fever associated with bleeding in the nose, stomach, gums, skin, dengue shock, and death in extreme conditions.

13.

Can an Affected Person Spread Chikungunya by Touch?

Chikungunya cannot spread from one person to another by touching or by any other means. Infected mosquitoes usually transmit the virus and infection in people they bite. Also, a healthy mosquito can acquire the infection from a chikungunya-affected person when it bites them and transmit it to another healthy individual when it bites them.
Dr. Anshuman Srivastava
Dr. Anshuman Srivastava

Internal Medicine

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