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Chikungunya Infection

Chikungunya infection is an illness caused by the chikungunya virus characterized by abrupt onset of high fever and flu like symptoms but is classically distinguished by the extremely severe and debilitating joint pains that result in near immobility.

In fact the word chikungunya is translated from the makonde language meaning “that which bends up” referring to the hunched up posture of affected individuals. While the symptoms of fever resolve quickly, severe joint pains may last for weeks to months.

Where does it occur?

This current epidemic originated in Kenya in 2004 and subsequently spread to the Indian Ocean islands of Comorros, Mauritius, Seychelles, Madagascar, Mayotte, Reunion islands and India. As of now the infection has spread to all of Southern Asia including Pakistan and Sri-Lanka; South East Asia including Indonesia, Malaysia, Singapore and Central & South Africa.

Travelers returning to their home countries after visiting above regions have been diagnosed with the illness in Italy, France and United States.

How is it transmitted?

The virus is transmitted through the bite of infected mosquitoes. Recently there have been 1 or 2 cases of possible human – human transmission in close contacts like health care providers.

What is the risk for travelers?

There is a moderate to high risk for travelers during outbreaks of illness as demonstrated by cases in Italy, France and United States during this outbreak among returning travelers.

How soon after exposure will I develop symptoms?

Symptoms commonly appear within 2-3 days of exposure but can be delayed up to 10 days later

What are the signs and symptoms?

Symptoms begin with sudden onset of fever – up to 102 F (39 C), fatigue, headache and intense joint pains affecting the larger distal joints like ankles, wrists, knees and elbows. Nearly half complain of abdominal pains and diarrhea. Many report a rash that is red in color and varies from small flat patches to prickly in nature.

Very rarely neurologic symptoms of headache, confusion and seizures occur. In severe cases, one may experience bleeding from gums or organs due to abnormalities in blood clotting.

Are there any lab tests to diagnose the illness?

Antibody (IgM/IgG) tests and PCR tests are available to be done on blood or body fluids. However the diagnosis is often based on initial suspicion of this illness based on symptoms and history of travel to an area of outbreak.

Is there any treatment?

There are no specific antibiotics to treat this illness, treatment is entirely supportive with fluids, rest and pain medications.

Is the infected person contagious?

In the vast majority of cases there has been no evidence for person to person spread, but there are 1-2 cases where this is suspected.

What preventive measures can be taken?

Avoid travel to countries undergoing an epidemic. If already in a region with the epidemic, avoid mosquito bites by taking the following precautions.

Avoid outdoor activities at dusk and dawn.

 Wear long sleeved clothing.

 Apply insect repellant containing 30% DEET to exposed skin and clothing.

 Stay in accommodations with screens on windows and openings.

 

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