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Chikungunya

Posted Oct 03 2008 11:31am 1 Comment
According to New Strait Time, by 30th of July, 631 Chikungunya cases were reported in 4 states (Johor, Malacca, Negri Sembilan and Perak ). Of the number, only 15 people (2.4 per cent) had to be admitted to hospitals due to high fever and chronic pain in the joints.

It seems alarming that Malaysia now facing a new threat of disease. So, what is Chikungunya anyway?

In the Makonde (an ethnic group in Africa) language, "chikungunya" means "that which bends up", as joint pains are a major feature of both the acute and the chronic phases of the disease. Why Makonde? Well, the disease first detected there! [1]

First outbreak of chikungunya virus in Malaysia was believed occurred in Klang, between December 1998 and February 1999. The majority of the cases were in adults. Malaysia is heavily dependent on migrant workers from countries where chikungunya is endemic. It is speculated that the virus has been introduced into the country through the movement of these workers. [2]

Chikungunya (Genus: Alphavirus; RNA virus)


Chikungnya involved an African virus (RNA virus) and an Asian mosquito, which reflecting the globalization of vectorborne diseases. The Aisan mosquito involved, is none other than Aedes mosquito. So, if you think Aedes is nothing more than dengue fever, you are wrong! [3]



In fact, Chikungnya's symptoms are similar to dengue fever: fever, joints pain and the tendency of bleeding. Which can be differentiate by further observation of its symptoms, and also performing serology test (in Malaysia, University of Malaya has already developed the serology test).


So what are the symptoms of Chikungunya?

The incubation period of Chikungunya disease is from 2 to 4 days. [4]

Then, patients will have fever up to 39 ℃ (102.2 ℉), red spots or rashes of the trunk and occasionally the limbs, and arthralgia (joint pain) or arthritis (inflammation of the joints) affecting multiple joints. [5, 6] - Acute Phase

Other nonspecific symptoms can include headache, conjunctival injection, and slight photophobia.

Typically, the fever lasts for 2 days and then ends abruptly (dengue fever has longer period of fever).

Patients have complained of joint pains for much longer time periods depending on their age. [5, 6] - Chronic phase (not all patients will have it)


Talking about the treatment, it's kind of... No Specific Treatment!

Well, don't worry much, this disease is self-limiting, means, if the body's immune system is OK, the disease should be gone after a few days or weeks after the symptoms appeared.

The management of the disease includes rest, fluids and medications to relieve symptoms of fever and pain, such as ibuprofen, naproxen and paracetamol. Aspirin should be avoided (may cause refractory arthritis).


Infected patients should be protected from further mosquito exposure during the first few days of the illness so they cannot contribute to the transmission cycle of Chikungunya. [7]


References:
  1. Parola P, de Lamballerie X, Jourdan J, et al. Novel Chikungunya virus variant in travelers returning from Indian Ocean islands. Emerg Infect Dis 2006;12:1493-1499
  2. Lam SK, Chua KB, Hooi PS, Rahimah MA, Kumari S, Tharmaratnam M, Chuah SK, Smith DW and Sampson IA. Chikungunya infection--an emerging disease in Malaysia. Southeast Asian J Trop Med Public Health 2001; 32: 447-451
  3. Rémi N. Charrel, Xavier de Lamballerie, and Didier Raoult. Chikungunya Outbreaks — The Globalization of Vectorborne Diseases. NEJM 2007; 356:769-771
  4. Chhabra M, Mittal V, Bhattacharya D, Rana U, Lal S. "Chikungunya fever: A re-emerging viral infection". Indian J Med Microbiol 2008; 26: 5–12
  5. Simon F, Parola P, Grandadam M, Fourcade S, Oliver M, Brouqui P, Hance P, Kraemer P, Ali Mohamed A, de Lamballerie X, Charrel R, Tolou H. "Chikungunya infection: an emerging rheumatism among travelers returned from Indian Ocean islands. Report of 47 cases". Medicine (Baltimore) 2007; 86: 123–37
  6. Taubitz W, Cramer JP, Kapaun A, Pfeffer M, Drosten C, Dobler G, Burchard GD, Löscher T. "Chikungunya fever in travelers: clinical presentation and course". Clin. Infect. Dis 2007; 45: e1–4
  7. Fact Sheets on Chikungunya. Centers for Disease Control and Prevention, USA
Comments (1)
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I feel bad everyday about this, as I got infected by chikungunya, its going to 3rd months!Pls help me get out from this shit.........
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