Chikungunya

Chikungunya is derived from the Kimakonde language spoken by the Makonde people and it means “something which bends up or is contorted”. The chikungunya fever was first detected in 1952 as an epidemic in African people who lived on the eastern border between Tanzania and Mozambique. This virus got its name from the fact that the people affected by chikungunya experienced severe musculoskeletal pain which made them walk in a stooped manner.

Chikungunya is an RNA (Ribonucleic acid) virus (CHIKV) belonging to the Alphavirus genus and is transmitted amongst humans by the bites of infected female mosquitoes (Aedes aegypti and Aedes albopictus). These mosquitoes mostly bite during the daylight hours but there can be instances of peak activity during early morning hours and late afternoons.

Chikungunya fever is characterized by extreme joint pains, joint swellings, nausea, and headache. It is rarely a fatal disease but can cause long-last symptoms which are severe and debilitating.

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We will learn a great deal about this fever in this article and cover details on chikungunya symptoms and treatment, chikungunya incubation period, side effects of chikungunya, and a few other aspects.

Symptoms of Chikungunya

Chikungunya fever has very similar symptoms to other viral diseases like dengue. The symptoms of chikungunya fever can appear within a few days after an individual has been bitten by an infected mosquito. Chikungunya incubation period is mostly 3 to 7 days during which infected people get symptomatic. The range of the chikungunya incubation period is 1 to 12 days.

The most significant chikungunya fever symptoms are fever and joint pain. But 

There are a Plethora of Other Symptoms that can Accompany this Disease as Listed below:

• High fever which can go up to 104 degrees Fahrenheit. 

• Headache

• Nausea

• Chikungunya fever rash usually on trunk and limbs

• Joint swelling

• Muscle and joint pain

• Nausea

• Fatigue

• Vomiting 

• Redness in the eyes

Some Rare Symptoms that Patients of Chikungunya can Experience are:

• Conjunctivitis

• Maculopapular rash which looks similar to heat rash or measles

• Bleeding or haemorrhage 

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Chikungunya Fever Diagnosis

Chikungunya fever can be diagnosed only by a blood test as the symptoms of this fever are not very different from other diseases like dengue and zika. If a person has visited an area where chikungunya has been found then they must see their healthcare provider in case any of the above symptoms appear. The mortality rate of a patient of chikungunya is 0.1%. These are the chikungunya fever diagnosis tests that are done to investigate this fever:

• Serum or Plasma Test - The patient’s serum or plasma is examined in the laboratory to detect the presence of viral nucleic acid or virus-specific Ig(immunoglobulin). They also look for neutralizing antibodies. In the initial  8 days of the virus, the lab can also identify the viral RNA of the virus in the serum.

• Viral Culture - The viral culture test can detect the virus in the first 3 days of the fever.

Geography of Chikungunya Fever

Chikungunya was once considered as the disease of the tropics but now we can see cases in more than 1/4th of countries all around the world. This fever has been identified in close to 40 countries till now. 

Chikungunya fever was first identified in Africa (Tanzania) in 1952 and there have been periodic outbreaks of this virus in Africa and Asia till the 1960s. The outbreaks are usually separated by a period of ten years. From the year 2001 to 2011, Chikungunya outbreaks have been reported by many countries as per the statistics outlined below:

• 2005 - 2006 - There was an outbreak of chikungunya in the  Indian Ocean islands of Réunion and Mauritius with more than 272,000 people getting infected by this virus. The main vector of this outbreak was presumed to be Ae. albopictus. 

• 2006 - Chikungunya infected more than 1,500,000 people in India where the implicated vector was Ae. aegypti.

• 2007 - A coastal village in Italy reported 197 cases and this outbreak was mainly due to the migration of infected people. This outbreak confirmed the fact that  Ae.albopictus can cause mosquito-borne outbreaks in Europe.

• 2014 - Europe had its highest episode of this fever with close to 1500 cases detected. France and the UK were the most affected countries in Europe.

• 2015 - There was a major outbreak in the regions of America. There were 37,480 confirmed cases in the Americas (693,489 suspected cases) which were reported to PAHO (Pan American Health Organization)

Chikungunya Treatment

No vaccine or any specific drug has come out to date to prevent or treat this virus. The symptoms must be treated with the following chikungunya treatment:

• Taking enough rest

• Drinking a lot of fluid else the patient might get dehydrated.

• Administrations of medicines such as acetaminophen, naproxen, ibuprofen, or paracetamol can alleviate pain and fever.

• Aspirin or any other non-steroidal anti-inflammatory drugs should not be taken.

• Prevent further transmission of chikungunya fever by protecting yourself from mosquito bites. During the first week of getting infected by chikungunya fever, the CHIKV virus can be found in the blood and an infected person can pass it through mosquito bites to others.

Side Effects of Chikungunya

One of the side effects of chikungunya is Chikungunya arthritis which can persist for many months after the infection has subsided. As per a study, 25% of affected people in the cohort of 500 patients had constant joint pains for 20 months after the infection. Immunomodulating medications are used to treat people who suffer from Chikungunya arthritis which can suppress the immune system. 

There were no viral RNA or proteins detected in the synovial fluid of affected people after 2 years of infection. This indicated that either arthritis related to chikungunya occurred due to induction of host autoimmunity or the virus is present in extremely low levels hence can not be detected in synovial fluid.