Viruses such as Chikungunya are transmitted by mosquito bites. In this blog post, we will discuss the causes, symptoms, diagnosis, treatment, and prevention of Chikungunya, which can affect the quality of life of those who are affected. Despite being rarely fatal, it can affect the quality of life of those who are affected for weeks or months.
Chikungunya is caused by the chikungunya virus (CHIKV), an alphavirus belonging to the Togaviridae family. Female mosquitoes of the Aedes species, mainly Aedes aegypti and Aedes albopictus, spread the virus by biting them. In addition to spreading dengue and Zika, these mosquitoes also transmit other diseases.
After an incubation period of about 10 days, mosquitoes can transmit the virus through saliva if they feed on the blood of a person who has chikungunya. Except in rare cases when blood is transfused, organs are donated, or mother-to-child transmission occurs during pregnancy or childbirth, the virus does not spread directly from person to person.
More than 110 countries around the world have reported chikungunya, including Africa, Asia, Europe, the Americas, the Caribbean, the Indian and Pacific Oceans. Mosquitoes are more likely to spread infection in areas where they are abundant and active, especially during the rainy season. Travelers to these areas should avoid mosquito bites.
The symptoms of chikungunya usually appear within 3 to 7 days after the mosquito bite, but they can range from 2 to 12 days. The most common symptoms are:
Fever, which can be high and sudden.
Joint pain, which can be severe and debilitating, affecting multiple joints, especially the hands, wrists, ankles, and feet. The joint pain can persist for weeks or months after the fever subsides.
Other symptoms may include headache, muscle pain, joint swelling, rash, nausea, vomiting, fatigue, and eye redness.
Some people may have mild or no symptoms, while others may have more severe or complicated cases. The factors that increase the risk of severe disease include:
Age: Newborns, older adults (65 years or older), and people with chronic conditions, such as high blood pressure, diabetes, or heart disease, are more likely to develop severe symptoms or complications.
Chikungunya immunity: Depending on the strain, people who have previously been infected may be immune to the virus. The risk of severe disease may increase for people who have been infected with similar viruses like dengue or Zika due to immune responses that cross-react with each other.
Coinfection: People who are infected with chikungunya and another virus, such as dengue or Zika, at the same time may have a worse outcome than those who are infected with one virus alone.
The complications of chikungunya may include:
Chronic joint pain or arthritis, which can affect the mobility and function of the joints.
Neurological disorders, such as meningitis, encephalitis, Guillain-Barré syndrome, or neuropathy, which can affect the brain, spinal cord, or nerves.
Eye problems, such as uveitis, retinitis, or optic neuritis, which can affect the vision or cause blindness.
Heart problems, such as myocarditis, pericarditis, or heart failure, which can affect the heart muscle, lining, or pumping ability.
Kidney problems, such as nephritis or renal failure, which can affect the kidney function or cause dialysis dependence.
Hemorrhagic or bleeding disorders, such as thrombocytopenia, disseminated intravascular coagulation, or hemorrhage, which can affect the blood clotting or cause bleeding in the skin, mucous membranes, or internal organs.
Death, which is rare but possible, especially in older adults or people with underlying conditions.
Laboratory tests, clinical symptoms, and the history of exposure are used to diagnose chikungunya. Chikungunya's clinical symptoms are similar to those of other diseases, such as dengue, Zika, malaria, and typhoid fever, so excluding these conditions is important. A travel history, the date and location of the mosquito bite, and contact with other people with chikungunya all play a role in the history of exposure.
The laboratory tests include:
Tests that detect the presence of a virus in a blood sample or other body fluid include reverse transcription polymerase chain reaction (RT-PCR) and viral isolation. In the early stages of infection, within a week of the onset of symptoms, these tests are more accurate and reliable.
The presence of antibodies to the virus in the blood can be detected by serological tests, such as enzyme-linked immunosorbent assay (ELISA) or immunofluorescence assay (IFA). In the later stages of the infection, after the first week of onset of symptoms, these tests are more accurate and sensitive.
Chikungunya is diagnosed by a positive result of either a viral detection test or a serological test. However, a negative result does not rule out the infection, as the tests may have limitations in their sensitivity, specificity, availability, or interpretation. The diagnosis should always be made on the basis of the clinical symptoms, the history of exposure, and the laboratory tests.
There is no specific antiviral treatment or vaccine for chikungunya. The treatment is mainly supportive and symptomatic, aiming to relieve the fever, pain, and inflammation. The treatment options include:
Rest and fluids, which can help the body recover and prevent dehydration.
The fever and pain can be reduced with pain relievers such as acetaminophen (Tylenol) or paracetamol. In addition, nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) or naproxen (Aleve), may be used after eliminating the possibility of dengue, since they can increase bleeding risk among dengue patients.
Inflammation and swelling of the joints can be reduced with corticosteroids, like prednisone or methylprednisolone. However, these drugs should be taken with caution and under medical supervision, as they can have serious side effects, including increased blood pressure, blood sugar, or infection risk.
Antihistamines, such as diphenhydramine (Benadryl) or loratadine (Claritin), which can reduce the itching and rash.
Itching and rash can be reduced with antihistamines, such as diphenhydramine (Benadryl) or loratadine (Claritin).oint pain or preventing chronic arthritis. However, the evidence for their effectiveness is limited and inconclusive, and they may have adverse effects, such as eye toxicity or heart problems.
Chikungunya treatment should be tailored to the severity and duration of symptoms, the presence of complications, and the response to treatment. Medications should also be monitored and adjusted by a healthcare provider, who can prescribe the appropriate dosage, frequency, and duration, as well as evaluate possible interactions, contraindications, or side effects associated with them.
The prevention of chikungunya is based on the avoidance of mosquito bites and the control of mosquito populations. The prevention measures include:
Wearing long-sleeved shirts and pants, applying insect repellent, and sleeping under a mosquito net or in an air-conditioned or screened room are all ways to protect yourself. Use insect repellent that contains one of the following ingredients: DEET, picaridin, IR3535, oil of lemon eucalyptus, or para-menthane-diol. Follow the label's instructions and reapply as needed. Children and pregnant or breastfeeding women should use the repellent with caution, as well as infants younger than 2 months.
Using environmental control, you can eliminate or reduce mosquito breeding areas such as stagnant water, containers, tires, or trash. It is best to empty, clean, cover, or treat the breeding sites with larvicides or biological agents, such as fish or bacteria. Insecticides, coils, or vaporizers should be used to kill or repel adult mosquitoes. It is important to conduct environmental control regularly and in collaboration with the local authorities and communities.
Taking the necessary precautions to prevent mosquito bites, seeking medical attention if symptoms develop during or after the trip, and being aware of chikungunya risk in the destination country, are all part of travel advice. It is also important for travelers to inform their healthcare provider of their travel history, especially if they have visited an area where chikungunya is active. In addition, travelers should avoid mosquito bites for the first week of their illness, since mosquitoes can spread the virus and infect other mosquitoes.
The prevention of chikungunya is the best way to avoid the infection and its complications. By following these measures, you can protect yourself and others from this disease. Remember, prevention is better than cure. Stay safe and healthy.
