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Introduction
Causes of Chikungunya
Sign and symptoms
Diagnosis of Chikungunya
Treatment of Chikungunya
Prevention and Control of Chikungunya
Recent outbreak of Chikungunya in India
History of Chikungunya
Dengue and Chikungunya
Chikungunya cases in India
Introduction:
Chikungunya is a viral disease that is very similar in symptoms and
etiology to the disease, dengue fever. The virus responsible for
chikungunya is alphavirus, which is transmitted through the aedes aegypti mosquito, which is active only in the
daytime. The aedes aegypti mosquito is the same mosquito that is responsible for the transmission of dengue fever among
humans. The condition of chikungunya is generally not fatal, and it can be remedied within five to seven days with proper treatment.
Chikungunya was first recognized in Eastern Africa in the 1950s. The disease is endemic in many parts of the tropics. Outbreaks have occurred in recent years in Africa, Southeast Asia, India,
Sri Lanka and the Indian Ocean islands. Besides India the outbreaks were also reported in Malaysia and Indonesia in 2006. Imported cases of chikungunya fever have
also been reported in Europe, US, South America and Asia amongst travelers returning from chikungunya fever affected areas.
Causes of Chikungunya
Chikungunya is a viral disease transmitted through the agency
of mosquitoes. The responsible chikungunya virus is the alphavirus, which is carried by the aedes aegypti breed of mosquito.
When this mosquito bites an infected person, then the virus gets transferred into its body.
Now when the mosquito bites a healthy person, the virus is now transferred into the body of the healthy person. Thus the healthy person gets affected.
Monkeys, and possibly other wild animals, may also serve as reservoirs of the virus.An infected person cannot spread the infection directly to other persons
The mosquito that acts as the carrier of the virus is active only in the daytime. It normally bites people during either dawn or dusk.
The aedes aegypti mosquito is quite area-bound. In fact, the mosquito does not leave its natural habitat, i.e. the stagnant
water in which it breeds, by more than a few meters. Chikungunya spreads so quickly that it may turn into an epidemic. |
Eggs of Aedes
Aedes aegypti mosquitoes
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Sign and symptoms
Chikungunya symptoms begin almost immediately after the viral infection. Some of the symptoms are:-
Fever with very high temperature
Acute pain all over the body
Sharp pain in the joints accompanied by swelling
Severe headache
Profuse rashes
Conjunctivitis
Loss of taste in the tongue
Mouth ulcers
The fever of chikungunya normally comes back to normal within two to three days, but the other symptoms persist for
over a week or more. The fever is quite different from normal fever since it is accompanied by chills and feelings of nausea and vomiting.
The time between the bite of a mosquito carrying chikungunya virus and the start of symptoms ranges from 1 to 12 days.
Diagnosis of Chikungunya
Common laboratory tests for chikungunya include RT-PCR, virus isolation, and
serological tests. Chikungunya is diagnosed by blood tests (ELISA). Since the clinica appearance of both chikungunya and dengue are similar,
laboratory confirmation is important especially in areas where dengue is present. Such facilities are, at present, available at National Institute of Virology
(NIV), Pune and National Institute of Communicable Diseases (NICD), Delhi .
Treatment of Chikungunya
There is no specific drug treatment against chikungunga virus.
Treatment of chikungunya fever usually includes bed rest, fluid replacement and medication for fever as
Paracetamol and pain relief. Use of aspirin should be avoided as aspirin can increase the risk of bleeding.
Hospitalization may be required for more severe cases. At present, there is no effective vaccine for the prevention of
chikungunya fever. Supportive therapy that helps ease symptoms, such as administration of non-steroidal anti-inflammatory drugs, and getting plenty of rest, may be beneficial.
Research by an Italian scientist, Andrea Savarino, and his colleagues together with a French
government press release in March 2006 have the claim that chloroquine might be effective in treating
chikungunya. A recent study report that a novel consensus-based approach to vaccine design for Chikungunya virus, employing a DNA vaccine strategy.
Ayurveda attributes the reasons of spread of diseases to the pollution of air, water and land. Ayurveda suggests the following medicines for pacifying
fever: Amritarishta, Vilvadi gulika (tablets) and Sudarsanam Gulika (tablets). In pain and swellings at joints of limbs the following treatments are
beneficial: take Punarnavasana internally and warm the joints by pressing small warmed cloth bags bundled with thavidu (rice bran).
There are certain Ayurvedic herbs that have a potential to reduce the symptoms of
chikungunya such as Angoor (Grapes), Gaajar (Carrots) and Tulsi ( Basil Tulsi).Tulsi leaves are used for chikungunya patients as they are effective in reducing the fever.
Prevention and Control of Chikungunya
The following guidelines must be strictly followed in case chikungunya is in the air:-
All stagnant water must be treated and removed. Stagnant water is where the infecting mosquito aedes aegypti breeds. Use insect repellants such as DEET or promythrin in the vicinity.
Where the water cannot be removed but used for cattle or other purposes, Temephos can be used once a week at a dose of 1 ppm (parts per million).
Pyrethrum extract (0.1% ready-to-use emulsion) can be sprayed in rooms (not outside) to kill the adult mosquitoes hiding in the house. In case there is an outspread of
chikungunya, wear long pants and long sleeves shirts.
The doors and windows of the houses must be kept closed, especially in the dawn and dusk periods.
Chikungunya becomes an epidemic through people who travel from an affected area to an unaffected area. For
this reason, it is very necessary to regulate travelers, from a place that has several cases of chikungunya.
Persons infected with chikungunya fever should be isolated from further mosquitoes bites
to reduce the risk of further transmission of the virus. |
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Recent outbreak of Chikungunya in India
In India a major epidemic of Chikungunya fever was reported during the last millennium viz.; 1963
(Kolkata), 1965 ( Pondicherry and Chennai in Tamil Nadu, Rajahmundry , Vishakapatnam and Kakinada in Andhra
Pradesh; Sagar in Madhya Pradesh; and Nagpur in Maharashtra) and 1973,
(Barsi in Maharashtra ). Thereafter, sporadic cases also continued to be recorded especially in Maharasthra state during 1983 and 2000.
After flooding and heavy rains in Rajasthan, India in August 2006, thousands of cases were detected in
Rajsamand, Bhilwara, Udaipur, and Chittorgarh districts, and also in adjoining regions of Gujarat and Madhya
Pradesh. During June 2007 in Pathanamthitta, Kottayam and Alappuzha districts of South
Kerala, India claimed more than 50 lives, though no mortality has definitively been linked to chikungunya virus. It is confirmed officially that there are 7000 confirmed Chikungunya patients in these areas.
History of Chikungunya:
The Chikungunya disease was first described by Marion
Robinson and W.H.R. Lumsden in 1955, following an first outbreak occurred in East Africa in 1952-1953. Soon thereafter epidemics were noted in the Philippines (1954,1956
and 1968), Thailand , Cambodia , Vietnam , India , Burma and Sri Lanka.
Since 2003, there have been outbreaks in the islands of the Pacific Ocean, including Madagascar , Comoros , Mauritius , and Reunion
Island . In January 2006, in an epidemic that is currently ongoing in Reunion Island , over ten thousand cases have been reported. It
is suspected that many cases of chikungunya are either misdiagnosed or go unreported.
In December 2006, there were outbreaks of 3,500 confirmed cases in the Maldives, and over 60,000 cases in Sri Lanka, with over 80
deaths. In October 2006, more than a dozen cases of chikungunya were reported in Pakistan.
In early 2007, chikungunya spread from Kerala and Tamil Nadu to Sri Lanka and many people were infected.
On January 24, 2008, 10 were infected in the first outbreak in Singapore.
Dengue and Chikungunya
The same mosquito-borne virus (aedes aegypti
mosquito) that can cause an extremely painful, debilitating illness of Dengue also caused
for the disease of Chikungunya.
Chikungunya cases in India
The states affected by chikungunya are Andhra
Pradesh, Karnataka, Kerala, Maharasthra, Madhya Pradesh, Tamil Nadu, Gujarat and Delhi. In the year 2006, total number of 1390322 suspected Chikungunya fever cases were reported from the country. |
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Do you know ?
* Chikungunya fever is a viral disease common in the
tropics, particularly in areas where mosquitoes
are not controlled.
* Chikungunya fever is transmitted by the bite of an
infected Aedes aegypti or Aedes albopictus mosquito.
* The disease is now endemic. In India it resurfaced in
2006, after a gap of 33 years.
* Symptoms: Severe joint pain, high fever, headache,
fatigue, nausea and vomiting
* Danger: Internal bleeding or shock
* Treatment: Fluids; Paracetamol, rest |
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