Chikungunya Viral infection, Transmission, Symptoms, Diagnosis, Treatment and Prevention

                                                     Chikungunya

 

Chikungunya is caused by the chikungunya virus (CHIKV), which is an arthropod-borne virus (arbovirus) which is a member of Alphavirus genus belong to the Togaviridae family. They are small in size (about 60–70 nm-diameter), spherical, enveloped and positive-stranded RNA virus.

Transmission:

The Chikungunya virus infects humans and transmitted through the bite of an infected female mosquito. The virus is spread between two types of mosquitoes: Aedes albopictus and Aedes aegypti. It is not considered as contagious fever: however, in rare cases, the virus can be transmitted through contact with an infected individual’s blood.

Signs and symptoms:

Most common symptoms are high fever (sometimes as high as 104 °F) that lasts a few days and severe joint pain which last for few week to months. The symptoms are similar to dengue fever except bleeding. Chikungunya disease does not often result in death, but the symptoms can be severe and disabling. The typically symptoms usually begin 3-7 days after being bitten by an infected mosquito. Other symptoms include:

• Headache

•  Muscles pain

• Rashes

• Swelling around the joints

Less commonly, symptoms can be accompanied by a maculopapular rash (similar to measles or heat rash), conjunctivitis, nausea, and vomiting.

Diagnosis: For the detection of chikungunya, several tests can be performed: which includes,

•  Enzyme-linked immunosorbent assays (ELISA): which may confirm the presence of IgM and IgG anti-chikungunya antibodies. IgM antibody levels are highest 3 to 5 weeks after the onset of illness and persist for about 2 months.

• RT-PCR: Viral RNA can be easily detected by reverse transcriptase-polymerase chain reaction (RT-PCR) in serum specimens obtained from patients during the acute phase of infection. Chikungunya infections cause high levels of viremia (up to 1x10E6.8 plaque-forming units per mL), which typically last for 4–6 days after the onset of illness. RT-PCR can easily be performed within the first 7 days on an acute-phase specimen to confirm chikungunya virus infection.

•  PRNT: Plaque reduction neutralization tests (PRNT) are very useful for alphaviruses detection and are a gold standard for the confirmation of serologic test results but the disadvantage of PRNT is that it requires live viruses.

• Haemagglutination-inhibition tests: Another technique for the detection of chikungunya strain is Haemagglutination-inhibition, In this test, the Chikungunya is confirmed when symptoms such as fever and joint pain are seen along with a four-fold Haemagglutination inhibition antibody difference in the serum sample. This turns positive within 5 to 8 days of infection.

  

Treatment:

• There are no specific treatments for chikungunya and there is no vaccine available for the prevention of chikungunya virus.

• Treat the symptoms such as fever and pain for the treatment of fever and pain take medicine such as acetaminophen (Tylenol®) or paracetamol.

• Drink plenty of water and fluids to prevent dehydration.

• Get plenty of rest.

•  For longer-lasting aches, physiotherapy may be helpful.

  

Prevention:

The best prevention method is to minimizing contact with mosquitoes. Steps that can be taken to prevent chikungunya include:

 

• Use insects repellent containing DEET (N, N-Diethyl-meta-toluamide) or picaridin on the skin.

•  Wears cloth that covers the whole body.

• Stay indoors as much as possible especially during early morning and late afternoon.

• Sleep under a mosquito net.

• Use mosquito coils.

• Avoid traveling to those areas which are experiencing outbreaks.

If you have chikungunya prevent mosquito bite for the first week of chikungunya because during the first week of infection, chikungunya virus can be found in blood and passed the virus from infected person to a mosquito through mosquito bite which can spread the virus to other people.