Doc, what is Chikungunya?

Doc, what is Chikungunya?
Chikungunya is a viral disease that is transmitted by infected mosquitoes, specifically Aedes aegypti(same vector of Dengue virus). Affected patients have abrupt onset of fever and  complains of severe joint pain. Asymptomatic incubation period usually last 2-4 days but may last for up to 12 days, then followed by symptoms that include muscle pain, headache, nausea, fatigue and rash. The disease shares some clinical signs with dengue, and can be misdiagnosed in areas where dengue is common like the Philippines.

 "Chikungunya"  in the Kimakonde language, means "to become contorted" and describes the slumped or stooped appearance of sufferers with joint pain. Chikungunya virus was first isolated in Tanganyika (now Tanzania) in 1953 and later on epidemics were reported in West and Central Africa, similar outbreaks were reported in Southeast Asia and the Western Pacific.According to the World Health Organization (WHO), Chikungunya occurs in Africa, Asia and the Indian subcontinent. Human infections in Africa have been at relatively low levels for a number of years, but in 1999-2000 there was a large outbreak in the Democratic Republic of the Congo, and in 2007 there was an outbreak in Gabon.
    There is no known cure for the disease and treatment is only supportive and focused on relieving the symptoms like giving Paracetamol for fever, Non-Steroidal Anti-inflammatory drugs (NSAIDs) for joint and muscle pain, Oral Rehydrating Salts (ORS) for dehydration.
     The use of topical insect repellents is recommended but active substance concentration, surface of the skin to protect, number of daily applications and length of use should be taken into account. Infants less than two months old should not be given topical repellents.

Image from Vectorbase.org
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Dengue Hemorrhagic Fever

What is Dengue Hemorrhagic Fever?

Dengue hemorrhagic fever is a more severe form of the viral illness. Manifestations include headache, fever, rash, and evidence of hemorrhage in the body. Petechiae (small red or purple blisters under the skin), bleeding in the nose or gums, black stools, or easy bruising are all possible signs of hemorrhage. This form of dengue fever can be life-threatening and can progress to the most severe form of the illness, dengue shock syndrome.

What are the signs and symptoms of Dengue Fever?

A.Abrupt symptom onset 3-15 days after Mosquito Bite
B.Undulant Fever
1.Fever falls on Day 3
2.Fever rises again later
C.Chills
D.Sever frontal Headache
E.Arthralgias
F.Bone pain
G.Rash
1.Red Morbilliform or punctate rash
2.Rash starts on hands and feet
3.Rash spreads to trunk

What is New in Treatment of Dengue?

Given that dengue is an infection, treatment can be performed using the simple concept of 'getting rid of the pathogen and limiting the complications'. In general, the use of supportive and symptomatic treatment is widely used for dengue treatment, aiming to limit the complications of the infection. The application of fluid therapy has become key in dengue management and this is applied based on the severity of disease. In simple dengue, oral fluid replacement is sufficient and there is no need for hospitalization. In severe cases of dengue infection, fluid replacement should be carefully used and must be performed under close observation in a hospital. Parenteral, intravenous fluid replacement by either colloids or crystalloids should be considered in order to prevent shock.[51] The basic recommendation for intravenous fluid-replacement therapy is administration of 0.9% normal saline solution at a rate of 20 ml/kg/h in the first 2 h, followed by 10 ml/kg/h for 6 h, then the rate can be adjusted according to the status of the patient in the following 16 h.

image from A.D.A.M., DOH Website