Chikungunya Virus- What do you need to know?

What is Chikungunya?

Chikungunya, which literally means “to become contorted” in reference to the stooped appearance of those suffering from joint pain, is a virus that is spread to humans by the bites of mosquitoes infected with the virus. Chikungunya is caused by the chikungunya virus (CHIKV), an alphavirus. Mosquitoes, particularly Aedes aegypti and Aedes albopictus, are responsible for transmitting the virus. It is important to note that this disease does not spread from person to person through bodily contact or saliva.

Where is Chikungunya Prevalent?

Chikungunya is commonly found in tropical regions of Africa and Asia, where it has become a significant public health problem. Endemic areas include parts of India, Southeast Asia, and several African countries. In recent years, there have been outbreaks in temperate regions, such as Europe and the Americas, due to the colonization of Aedes mosquitoes in these areas.

Chikungunya Causes

Chikungunya is primarily caused by the chikungunya virus (CHIKV), which is transmitted through Aedes mosquitoes. Environmental factors and regions where these mosquitoes thrive play a significant role in the spread of the virus.

A. Mosquito-borne Virus

Humans are exposed to the chikungunya virus when an infected Aedes mosquito bites them. The main hosts of the virus during an outbreak are humans. The mosquito becomes infected when it bites a person who already has the virus, continuing the transmission cycle.

B. Environmental Factors and Regions

Aedes mosquitoes, particularly Aedes aegypti and Aedes albopictus, thrive in tropical and subtropical regions. These mosquitoes breed in stagnant water and are most active during daylight hours. Regions with warm climates and high humidity, such as parts of Africa, Asia, and the Indian subcontinent, are particularly susceptible to outbreaks.

C. Other Factors

• Similar Viruses: Dengue, Zika, and chikungunya viruses are all spread by mosquitoes and have similar clinical symptoms, which can complicate diagnosis and treatment.
• Blood Transmission: The chikungunya virus can be transmitted through blood. Medical professionals who draw blood from infected patients and laboratory workers handling infected blood are at risk.
• Mother-to-Child Transmission: Infected mothers can transmit the virus to their newborns during preterm deliveries. Research indicates a higher chance of abortion or fetal death if the mother is infected before the 22nd week of pregnancy. Symptoms in newborns can include fever, pain, poor feeding, and skin alterations, with severe cases leading to viral meningoencephalitis.

Government Reporting: It is crucial for doctors to report suspected chikungunya cases to state or local health departments to help with diagnosis and reduce the risk of local transmission.

Additional Read: Home remedy for dengue

Symptoms of Chikungunya

Chikungunya symptoms can be divided into two stages acute and chronic.

Acute Stage

Adults who are sick often feel very tired, lose their appetite, have muscle pain, get sick, and throw up. They may also feel confused for a short time. The first ten days after the disease starts are called the acute stage.

• High fever, joint pain, back pain, and headaches are the most common symptoms.
• Fever is usually high (typically > 39 °C [102 °F]), and antipyretics don’t help much.
• Adults who are sick often feel very tired, lose their appetite, have muscle pain, feel sick, and throw up.
• Elderly people who are sick sometimes feel confused for a short time.
• Peripheral joints, particularly interphalangeal joints, wrists, and ankles, are frequently painful and swollen.
• Some patients may also have a temporary maculopapular rash on their face and trunk that is sometimes swollen and itchy.
• Symptoms of the gastrointestinal tract are common.

Chronic Stage

• Within the first three months, most patients have generalised pain and inflammation in the joints and tendons within the first three months.
• Walking and object-handling difficulties can induce
• Rheumatism caused by CHIKV is the most common manifestation of the chronic stage.

Read more– Home Remedies for Joint Pain

Diagnosis of Chikungunya

A. Blood test

The standard way for a lab to diagnose a virus is to test serum or plasma for the virus, viral nucleic acid, virus-specific immunoglobulin (Ig) M, and virus-neutralizing antibodies.
A viral culture may identify the virus during the first three days of sickness. Serum frequently contains the chikungunya virus RNA.
So, patients whose samples were taken during the acute phase and came back negative should have samples taken during the convalescent phase (the later stage of an infectious disease or illness) to rule out the diagnosis for sure.

Some of the lab findings are:

• Leukopenia is characterised by a decrease in the number of white blood cells in the blood.
• Mild thrombocytopenia is a deficiency of platelets in the blood.
• A slight increase in C-reactive protein: The liver produces the protein known as C-reactive protein (CRP). When there is inflammation in the body, CRP levels rise.
• Hepatic cytolysis: This condition is frequently the result of the synthesis of reactive metabolites through the cytochrome P450 system that target the liver’s structural elements and can cause harmful immune allergic reactions or autoimmune hepatitis.
• Lymphopenia is a condition in which your blood does not contain enough white blood cells, known as lymphocytes.

B. Physical exam

• On the first x-rays of the hands and feet, half of the patients might have erosions and/or joint space narrowing.
• People have also talked about other types of joint destruction, such as severe relapses of psoriatic arthritis that had been under control, enteropathies, and periostitis.
• MRI scans seem to be able to pick up early changes in the joints and tendons caused by rheumatism caused by CHIKV.

Treatment of Chikungunya

Chikungunya treatment involves:

• Unfortunately, no antiviral medication has been shown to be effective against human CHIKV infection.
• As a result, only painkillers and nonsteroidal anti-inflammatory drugs are used to treat the acute stage (NSAIDs).
• Acetaminophen is the preferred medication. Because of the risk of bleeding, aspirin should be avoided. For additional information on dietary recommendations during recovery, refer to Chikungunya diet.

Prevention of Chikungunya

• There is currently no commercial CHIKV vaccine available. Because of the potential for viral persistence.
• Avoid travelling to regions where epidemics (disease outbreaks) are still active.
• Keeping windows and doors closed and staying indoors during peak mosquito activity times
• Reduce standing water.

Wear protective clothing

• Cover up with long sleeves and pants.
• Wearing loose-fitting clothes will help prevent bites by keeping your skin covered with sweat, which helps keep mosquitoes away from you as much as possible.
• When you go outside in the morning or evening (when mosquitoes are most likely to be out), wear clothes treated with permethrin.
• A chemical insecticide called permethrin can be used to coat clothing, shoes, bed nets, and camping supplies to kill or deter insects like mosquitoes and ticks.
• Use insect and mosquito repellents.

Conclusion

If you think you have been infected with the chikungunya virus, contact your healthcare provider right away so that they can determine if you need treatment or monitoring for signs of disease progression. You can get both brand-name and generic drugs by uploading your prescription to the Truemeds app. When you order medicines online, you may save money by choosing an alternative or generic medicine suggested by Truemed’s expert doctors. You can save up to 72% on your purchase and get free home delivery across India.

FAQs

Disclaimer: This information shouldn’t be used to diagnose or treat a medical condition, nor should it be used in a medical emergency. A qualified medical professional should be consulted to diagnose and treat all medical conditions.

References-

• Chikungunya Virus | Centers for Disease Control and Prevention Retrieved January 4, 2023, from https://www.cdc.gov/chikungunya/index.html
• Chikungunya fact sheet 2022 (December 8) Chikungunya Fact Sheet Retrieved January 4, 2023, from https://www.who.int/news-room/fact-sheets/detail/chikungunya