Chikungunya

What is Chikungunya?

Chikungunya is a viral disease spread by mosquitoes. Chikungunya symptoms include severe and persistent joint pain, body rash, headache and fever. Initial symptoms are similar to dengue fever. It is usually NOT life threatening. But the joint pains can last for a long time and full recovery may take months. Usually patient gets life long immunity from infection and hence re-infection is very rare.

History of Chikungunya Disease

Chikungunya(pronounced as chiki-en-GUN-yah) disease was first detected in 1952 in africa at a place called Makonde Plateau. This is a border area between Tanzania and Mozambique. The name "chikungunya" is from the Makonde language and its meaning is "that which bends up". This is a reference to the Chikungunya symptom where patients walk in a stooped posture due to joint pain. Chikungunya is also known as Chicken guinea, Chicken gunaya and Chickengunya. The presence of the word Chicken has also lead to a lot of misconceptions about the disease.Chikungunya outbreaks are usually recorded within an interval of 7-8 years. Between 1960 and 1980 a number of outbreaks were reported from Asia and Africa. It made a comeback in recent years and is now being reported regularly from India, Indonesia, Maldives and Thailand. In 2006, a large outbreak of Chikungunya was reported from La Réunion Island (France) with estimates of over 100,000 people infected and 200 deaths. In 2010, many cases were reported from Delhi. Due to its non fatal nature, a large number of Chikungunya infections go unreported.

What causes Chikungunya Fever?

Chikungunya disease is a viral disease transmitted in humans by the bite of infected mosquitoes. Aedes aegypti mosquito (also called yellow fever mosquito) is the primary transmission agent of Chikungunya Virus. This is usually found in tropics and hence Chikungunya is predominantly seen in asian countries. In recent cases, another mosquito species named Aedes albopictus is found to be a carrier. Aedes aegypti bites during day time and hence day time mosquito bite is the main reason for transmission.Presence of stagnated water in and around human inhabitation is one of the main causes of increased aedes mosquito population. This in turn causes a large number of mosquito bites leading to the rapid spread of Chikungunya virus.

Chikungunya Symptoms

Chikungunya typically starts with one or more of the following symptoms - chills, fever, vomiting, nausea, head ache and joint pain. The attack is sudden and sometimes it is accompanied with rashes. Severe joint pain is the main and the most problematic symptom of Chikungunya.Other less commonly seen symptoms include mouth ulcers, loss of taste and conjunctivitis. The fever usually subsides in a couple of days, but other symptoms may last for a longer duration. In some cases joint pain persisted for years.

Treatment of Chikungunya

There is no antiviral drug or medicine specifically for Chikungunya. But since chikungunya is cured by immune system in almost all cases there is no need to worry. Treatment usually is for the symptoms and include taking sufficient rest, taking more fluid food and medicines to relieve pain (paracetamol for example). Aspirin should be avoided.Alternative medical systems such as ayurveda and homeopathy has specific treatments for Chikungunya. Many of these treatments are helpful in reducing the symptoms especially the joint pain.

We are yet to find a vaccine for Chikungunya. The good news is that a number of Chikungunya vaccines are in experimental stage. Currently the only way to prevent Chikungunya disease to avoid mosquito bites! Chikungunya virus spreads from human to human only through mosquito carrier. Hence mosquito breeding control is the best way to fight Chikungunya.

Prevention of Chikungunya

Fever Prevent mosquito bite Currently there is no vaccine for Chikungunya. There is only way to prevent Chikungunya fever - don't get bit by a mosquito! This is easier said than done in a tropical area such as India. Some of the following precautions can help reduce the risk of mosquito bites,Reducing the risk of mosquito biteMosquito net Use mosquito net when sleeping during daytime.Wear dress which covers most of the body. Also there are repellents available which can be applied on dress materials.Use mosquito coils or repellents(which contains Picaridin, oil of lemon eucalyptus or DEET). But you should be aware that prolonged use of these are not recommended. Also ensure adequate ventilation when these are used.Use curtains or window nets which prevent entry of mosquitos to the house.Use of cream or spray that can be applied on skin. This masks body odour and effectively you are invisible from mosquito. Very handy if you are visiting an area where Chikungunya is reported.Another way to reduce the mosquite bite is to take steps to reduce its breeding. This needs to be a community effort since only one individual alone cannot achieve much. Some of the following steps can be taken to reduce mosquito breeding in your area,Reducing mosquito breeding Mosquito breeding sites The circled areas on the image displayed on the right side shows possible mosquito breeding sites.Drain all the water collected around your house (for example in a pot or water cooler).Ensure that drainages etc. are either closed or chemicals are applied which kill mosquito larvae (larvicides).Another technique is to collect water in a container and once mosquitos lay eggs in it destroy them. This technique can be quite effective if multiple people apply it at their area.If there is a pond which contains stagnant water, biological method is best. Fish varieties such as guppy can be introduced in the pond which will eat all the mosquito larvae.Note that most infection happens occur outside the house and hence mosquito control is the most effective way to prevent Chikungunya outbreak. It is also important that patients with infection don't get bitten by mosquito.