Chikungunya: Symptoms, Causes, Diagnosis & Treatment

Chikungunya is a viral disease caused by an arboviral alphavirus, which is transmitted to humans by infected mosquitoes, Aedes aegypti, and Aedes albopictus. These mosquitoes mainly bite during the day. This virus may also circulate within a number of animals including birds and rodents.

Symptoms may occur 2 to 12 days after exposure and include fever, joint pain, headache, muscle pain, joint swelling, and a rash. Joint pain usually lasts for months while other symptoms may get better within a week. Neonates, people over 65 years of age, and those with other health problems, are at greater risk to have severe complications.

The death rate of Chikungunya is slightly less than 1 in 1000.

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How Does Chikungunya Affect Your Body?

The Chikungunya virus is passed when a female Aedes mosquito bites a person. It is estimated that Chikungunya virus is able to replicate in human epithelial and endothelial cells, primary fibroblasts and monocyte-derived macrophages to cause fever, headache, rash, nausea, vomiting, myalgia and disabling joint pain. Chikungunya can damage collagen and alter connective tissue metabolism in cartilage and joints to produce severe acute arthritis. This arthritis is characterized by necrosis and fibrosis, as indicated by high levels of urinary proline, hydroxyproline and mucopolysaccharides observed in patients during the acute phase of the infection.

What Are The Causes of Chikungunya?

  • Chikungunya is generally transmitted from female Aedes mosquito to humans.
  • It may also be transmitted to a child from the mother during pregnancy, or at birth while breastfeeding.

What Are The Risk Factors of Chikungunya?

The following are the risk factors of Chikungunya:

  • Aedes mosquito bites
  • Travel to/residence in endemic area
  • Outdoor exposure
  • Environmental factors favoring breeding of mosquitoes
  • An infant with an infected mother
  • Low educational level
  • Age > 40 years
  • Male gender
  • Blood transfusion
  • Blood group O positive
  • Comorbid illnesses (risk of more severe disease)
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What Are The Symptoms of Chikungunya?

Symptoms of Chikungunya are generally self-limiting and last for 2–3 days. The symptoms of Chikungunya can be misdiagnosed with dengue, especially in areas where dengue is common. The symptoms of Chikungunya are as follows:

  • High fever
  • Severe muscle and joint pain
  • A severe headache
  • Nausea
  • Vomiting
  • Enlarged lymph node on the neck
  • A sore throat
  • Abdominal cramps
  • Dizziness
  • Constipation
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How is Chikungunya Diagnosed?

ELISA blood test – Enzyme-Linked Immunosorbent Assay (ELISA) is done to confirm the presence of Chikungunya virus in a patient. During the test, if IgM antibodies are found, it confirms the presence of chikungunya virus in the body.

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How to Prevent and Control Chikungunya?

  • Use insect repellant – This may help in preventing bites from mosquitoes. Do not use insect repellant on children, younger than 3 years old.
  • Wear long-sleeved shirts and pants – Protective clothing helps in preventing mosquito bites.
  • Control mosquitoes indoor and outdoor – Use screens on windows, stay in air-conditioned rooms, clear puddles of stagnant water, and clean empty utensils or things to prevent breeding of mosquitoes.

Treatment of Chikungunya – Allopathic Treatment

Treatment for the severe form of Chikungunya:

  • Intravenous (IV) fluid and electrolyte replacement.
  • Blood transfusion to replace blood loss.

The medications used to treat fever and joint swelling are as follows:

  • NSAIDs (naproxen)
  • Paracetamol (acetaminophen)
  • Ribavirin – This is given for more than two weeks of arthritis

NOTE: Aspirin and corticosteroids are not recommended because the former increases the risk of bleeding, and the latter may cause immunosuppression and worsen infections.

Treatment of Chikungunya – Homeopathic Treatment

  • Polyporus Pinicola – This medicine is for Chikungunya fever with a headache and joint pains and has congestion in the head with a hot flushed face.
  • Rhus Tox – This medicine helps in controlling joint pains. Chills during fever are prominent. This medicine also relieves a backache during fever.
  • Eupatorium Perfoliatum – This medicine is for high fever with severe pain in bones. Relief in the pain usually follows perspiration.
  • Merc Sol – This medicine helps with worsening of pain at night and is usually given to patients who have increased thirst and excessive salivation.
  • Gelsemium – This is prescribed when excessive drowsiness, sleepiness and desire to lie down are felt by a patient afflicted with Chikungunya fever.
  • Ipecac – This medicine is used for relieving nausea and vomiting experienced in Chikungunya fever.
  • Euphrasia – This medicine is for treating conjunctivitis in a person with Chikungunya.

Chikungunya – Lifestyle Tips

The following lifestyle tips are recommended for Chikungunya:

  • Complete bed rest for at least 7 days.
  • Drink lots of water, given indirectly by ORS.
  • Take paracetamol for fever (only if tests are negative for dengue fever).
  • Wear light, cotton clothes.
  • Try drinking tea with more milk and sugar.
  • Follow a no fat diet and avoid fried food.

What Are The Recommended Exercises For a Person With Chikungunya?

In the morning, move all your joints slowly at least twice to avoid high pain and stiffness due to inactivity.

Chikungunya & Pregnancy- Things to Know

  • There’s no known effect of Chikungunya on pregnancy.
  • In rare cases, the infection can be passed to the child. However, this is treatable.

Common Complications Related to Chikungunya

Some complications related to Chikungunya include:

  • Seizures
  • Myocarditis or inflammation of the heart muscle
  • Uveitis or retinitis
  • Jaundice
  • Acute renal disease
  • Neurological diseases (Meningoencephalitis, Guillain-Barre syndrome, myelitis, or cranial nerve palsies)

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