- Chikungunya is making headlines again as a million cases have occurred this year. We covered Chikungunya virus in a prior article http://www.insanemedicine.com/?p=69 in insanemedicine.com.
- As a refresher, Chikungunya virus is an arbovirus endemic to Wet Africa that produces fever and arthritis in multiple locations. It is spread by the Aedes mosquito to humans, with primates as reservoirs. Aedes aegypti is one vector, that is present in the U.S. Southeast and lives in urban areas, frequenting small puddles of water. Aedes albopictus (Asian Tiger mosquito) is the other vector, and it spreads yellow fever, west nile, japanese encephalitis virus, and eastern equine encephalitis virus as well. It is found in the southeastern and mid-atlantic states areas.
- A person who gets Chikungunya fever from the bite of one of these mosquitos develops fevers of three to five days duration and about two to five days after this, the patient develops polyarthralgias (arthritis pains) in the hands, wrists, and ankles most commonly. This arthritis can cause sever pain that lasts days to months. Rash also occurs about three days after onset of illness and is small and flat in nature. In severe cases, death can result. Respiratory failure, encephalitis (brain infection), hepatitis, renal failure, myocarditis (heart inflammation) have been associated with severe infection.
The following is a link to updated information on the Chikungunya virus (Pan American conference) http://www.paho.org/hq/index.php?option=com_topics&view=article&id=343&Itemid=40931&lang=en
https://www.flickr.com/photos/pahowho/sets/72157645069134907/ < Pictures of infected victims.
- What is so special about this tropical infection in the United States? First, There is no immunity to this disease in the Americas, so it can spread rapidly. Secondly, 1.03 million people have contracted the disease, with 155 dying, especially in Martinique and Guadeloupe. There have been 11 cases in Florida.
- The economic impact of this disease are significant with many having chronic arthritis, unable to walk due to the pain. 20-30 % have chronic rheumatological symptoms. This results in disability and missed work.
- There is no specific treatment or cure. There is no vaccine available as of 2014.
- The best treatment for this disease is prevention, through the use of insect repellent and extermination of mosquitoes by removing their breeding grounds (areas of standing water) and through the use of insecticide.
- There have been 11 cases of Chikunguya virus in the U.S., and 1900 cases or so that have been imported to the U.S. through traveling. This number will probably rise over the next year.
- If you are traveling to South America or the Caribbean, be certain to carry insect repellent.
- More information can be found at the CDC website : http://www.cdc.gov/chikungunya/
- CDC reportable diseases website: http://wwwn.cdc.gov/nndss/