Monday, July 18, 2011



Chikungunya fever is a viral disease transmitted to humans by the bite of infected mosquitoes. Chikungunya virus is a member of the genus Alphavirus, in the family Togaviridae.

Chikungunya fever is diagnosed based on symptoms, physical findings (e.g., joint swelling), laboratory testing, and the possibility of exposure to infected mosquitoes. There is no specific treatment for chikungunya fever; care is based on symptoms. Chikungunya infection is not usually fatal. Steps to prevent infection with chikungunya virus include use of insect repellent, protective clothing, and staying in areas with screens. Chikungunya virus was first isolated from the blood of a febrile patient in Tanzania in 1953, and has since been cited as the cause of numerous human epidemics in many areas of Africa and Asia and most recently in limited areas of Europe.

Chikungunya Prevention

The best way to prevent chikungunya virus infection is to avoid mosquito bites. There is no vaccine or preventive drug currently available. Prevention tips are similar to those for other viral diseases transmitted by mosquitoes, such as dengue or West Nile.

* Use insect repellent containing DEET, Picaridin, oil of lemon eucalyptus, or IR3535 on exposed skin. Always follow the directions on the package.

* Wear long sleeves and pants (ideally treat clothes with permethrin or another repellent).

* Have secure screens on windows and doors to keep mosquitoes out.

* Get rid of mosquito sources in your yard by emptying standing water from flower pots, buckets and barrels. Change the water in pet dishes and replace the water in bird baths weekly. Drill holes in tire swings so water drains out. Keep children's wading pools empty and on their sides when they aren't being used.

* Additionally, a person with chikungunya fever should limit their exposure to mosquito bites to avoid further spreading the infection. The person should use repellents when outdoors exposed to mosquito bites or stay indoors in areas with scre

Chikungunya Symptoms and Treatment

Chikungunya virus infection can cause a debilitating illness, most often characterized by fever, headache, fatigue, nausea, vomiting, muscle pain, rash, and joint pain. The term ‘chikungunya’ means ‘that which bends up’ in the Kimakonde language of Mozambique.

Acute chikungunya fever typically lasts a few days to a few weeks, but as with dengue, West Nile fever and other arboviral fevers, some patients have prolonged fatigue lasting several weeks. Additionally, some patients have reported incapacitating joint pain, or arthritis which may last for weeks or months. The prolonged joint pain associated with chikungunya virus is not typical of dengue. No hemorrhagic cases related to chikungunya virus infection have been conclusively documented in the scientific literature. Co-circulation of dengue fever in many areas may mean that chikungunya fever cases are sometimes clinically misdiagnosed as dengue infections, therefore the incidence of chikungunya fever could be much higher than what has been previously reported.

The incubation period (time from infection to illness) can be 2-12 days, but is usually 3-7 days. “Silent” chikungunya virus infections (infections without illness) do occur; but how commonly this happens is not yet known. Chikungunya virus infection (whether clinically apparent or silent) is thought to confer life-long immunity. Fatalities related to chikungunya virus are rare.

Pregnant women can become infected with chikungunya virus during all stages of pregnancy and have symptoms similar to other individuals. Most infections occurring during pregnancy will not result in the virus being transmitted to the fetus. The highest risk for infection of the fetus/child occurs when a woman has virus in her blood (viremic) at the time of delivery. There are also rare reports of first trimester abortions occurring after chikungunya infection. Pregnant women should take precautions to avoid mosquito bites. Products containing DEET can be used in pregnancy without adverse effects. Currently, there is no evidence that the virus is transmitted through breast milk.

There is no vaccine or specific antiviral treatment currently available for chikungunya fever. Treatment is symptomatic and can include rest, fluids, and medicines to relieve symptoms of fever and aching such as ibuprofen, naproxen, acetaminophen, or paracetamol. Aspirin should be avoided. Infected persons should be protected from further mosquito exposure (staying indoors in areas with screens and/or under a mosquito net) during the first few days of the illness so they can not contribute to the transmission cycle.

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