Chikungunya Virus Infection

An alphavirus, typically found inSoutheast Asia, or Africa  that can be transmitted to humans by the bite of Aedes mosquitoes. After an incubation period of about a week, headache, nausea, vomiting, the virus produces high fevers, and severe joint pain, usually in the wrists or ankles.

Chikungunya Virus Infection

Chikungunya Virus

pathogenesis of Chikungunya —

• The pathogenesis of the severe and persistent joint symptoms that characterize chikungunya virus infections is uncertain.
• Chikungunya is a single-stranded RNA virus of the genus Alphavirus (Togaviridae family).
• Some data suggest that macrophage-derived products such as tumor necrosis factor-alpha, interferon-gamma, and macrophage chemoattractant protein-1 may play important roles in the joint tissue damage

The name chikungunya is derived from a local language of Tanzania meaning “that which bends up” or “stooped walk” because of the incapacitating arthralgia caused by the disease.

• Chikungunya is an arthropod-borne virus (arbovirus) endemic to West Africa that causes acute febrile polyarthralgia and arthritis.
• Chikungunya had traditionally been perceived as a tropical disease until an outbreak in Italy in 2007,
• Chikungunya Virus infection is a disease transmit­ted by the Aedes and Culex mosquito similar to den­gue viral infection.
• he major chikungunya virus mosquito vectors are Aedes aegypti and Aedes albopictus, they also capable of transmitting dengue virus, which, like chikungunya virus.

ChikungunyaVirus infection is a disease transmit­ted by the Aedes and Culex mosquito

ChikungunyaVirus infection is a disease transmit­ted by the Aedes and Culex mosquito

• Chikungunya means ‘that which bends up’ (patient doubles up with joint pains).
• Rapid spread of chikungunya virus has been observed in outbreaks involving the Indian Ocean islands, where attack rates have been extremely high in previously unexposed populations
• Chikungunya virus is endemic in parts of West Africa where it appears to be maintained in a cycle involving humans, Aedes mosquitoes, primates and perhaps other animals.
• The disease is found in Africa and Asia.

The appearance and spread of chikungunya virus in India was observed after a hiatus of almost 32 years In India, nearly 1.4 million cases of chikungunya fever were reported in 2006, and outbreaks have continued to occur.

• Chikungunya virus spreads by means of travel of infected individuals between regions where competent mosquitoes exist for perpetuation of local transmission.
• In India the disease is found in Kolkata, Chennai and Karnatak.
• The disease is common in adults. Incubation period is 2-3 days.

Clinical features of Chikungunya

Clinical features of Chikungunya

• Following acute illness (usually lasting 7 to 10 days),
• There is fever, severe arthralgia, chills, headache, photophobia, conjunctival injection, anorexia, nau­sea, abdominal pain.
• some patients may experience persistent rheumatologic signs and symptoms including arthritis/arthralgia,
• morning pain and stiffness edematous polyarthritis of fingers and toes,  and severe tenosynovitis ( of hands and ankles)
• There is migratory polyarthritis of hands, wrists, ankles and feet and sometimes larger joints also.
• Rashes appear within one or two days on the trunk and limbs.
• There may be petechiae and epistaxis. There is recovery in a few weeks.
• There may be persistent stiffness and joint pains, especially in HLA-B27 patients.

Clinical features of Chikungunya

Lab findings of Chikungunya

• There may be leukopenia,
• increased AST,
• C-reactive protein,
• decreased platelet count.

Chikungunya Treatment

• Treatment of chikungunya infection consists of supportive care including anti-inflammatory agents that relieve symptoms in many patients and analgesic agents
• Cefixime and Fluoroquinolones like Ofloxacin may be given.
• A live attenuated vaccine has been developed for pre­vention.
• Prevention consists of minimizing mosquito exposure