16
UWI TODAY
– SUNDAY 1ST FEBRUARY, 2015
SYMPTOMS
The symptoms cover three phases, but most patients
experience only the acute phase, with symptoms
lasting anywhere from 3-12 days. Thereafter, the illness
disappears in 87%of cases, as the body’s immune system
eventually fights it off, like any cough or cold. But during
this period, symptoms may be as follows:
Fever
. Fever may be low or high grade. It first rises for
the first 24 to 48 hours, returns to normal temperature,
and rises back to above-normal levels even up to 40°C
(104°F) after being afebrile for a day or two. Circulatory
collapses can occur in this phase. Fever returns to normal
within two weeks.
Joint pains
. Joint pains are severe in character, migratory,
tend to be worse during mornings and after longer
immobility, are relieved by light exercise, but worsened
by strenuous and aggressive movements. Joint pains
occur immediately after or at the same time as the fever.
Joints usually involved are the wrists, ankles, knees, and
elbows, small joints of the hands and feet, and sometimes,
the shoulders and hips. Pre-altered joints are often more
affected. The pain sometimes seems to originate from the
insertions of tendons.
Skin rash.
Skin rash occurs in half of patients with
Chikungunya. Skin rash consists of small reddish spots
or bumps (maculopapular) but may be vesicles and/or
blisters. This rash appears two days to five days after the
fever. The rash usually occurs on the trunk, legs, soles,
palms, and face. Other symptoms include headache,
nausea, vomiting, inflammation of the conjunctiva of
the eyes (conjunctivitis), back pain, diarrhea, and sores
or ulcers of the tongue and/or mouth.
Thesubacutephase.
The subacutephaseof Chikungunya
occurs from one to three months after the acute phase
of illness ends. During the subacute phase, the main
symptom is arthritis. Aside from this, disorders of blood
vessels like Raynaud’s phenomenon can occur. Raynaud’s
phenomenon is a condition where there is decreased
blood flow to the hands and feet in response to cold or
emotional stress.
The chronic phase.
The chronic phase of Chikungunya
occurs beyond three months and persists even up to
two to three years. The main symptom of this stage
is prolonged and severe arthritis, fatigue, depression,
and body weakness. Persistent joint pains occur in
Chikungunya patients who are 45 years old or older,
with severe joint pains at the onset, and with existing
osteoarthritis even before the start of the Chikungunya
illness. The subacute and chronic phase occurs in 13% of
patients with Chikungunya.
Chikungunya is a virus
,
transmitted to humans through the bite of an infected
mosquito. There is no medication on the market to fight this virus; instead, you
address the symptoms and your body fights off the virus over time. The virus affects
groups of all ages, of both genders, and has an incubation period of three to twelve
days. The disease has a severe and aggressive onset. The acute stage of the disease
is followed by the chronic phase, in which the symptoms are exacerbated; 15% of
infected people develop chronic symptoms. The virus has gone through a mutation in
recent times, meaning that its replication and transmission have been facilitated. The
virus (CHIKV) causes a self-limiting disease. This means that it will resolve itself without
any specific treatment. Mortality among Chikungunya sufferers is very rare, and is
mostly due to complications.
The disease can be asymptomatic. However, it is not
yet known how commonly this happens. What’s more,
it lasts for days in some and months in others. In severe
cases, arthritis or joint pain can incapacitate patients for
months. Also in some cases, patients suffer from skin
manifestations such as scaling, excoriated lesions on
the skin, itching, and red spots on the skin surface. Eye
redness and the difficulty of looking at bright light are
also documented.
See a doctor and get the disease diagnosed.
Chikungunya is diagnosed with the help of the ELISA
blood test. This test uses antibodies and enzymes to
detect the presence of the pathogen agent. This is the
most effective way in diagnosing the disease, because
all the other symptoms are very similar to other common
illnesses.
Tell the
InsectVector
Control Division
The Ministry of Health’s website urges citizens
“to inform the Insect Vector Control Division
(612-IVCD/4823) if either you or a relative
has been diagnosed with Chikungunya or
Dengue fever by a physician.”
Coping with
Chikungunya
The diagnosis is positive when joint pain and fever
are seen along with other test results. First of all, virus
isolation is performed. The procedure lasts about two
weeks and must be carried out in high level biosafety
laboratories. The procedure consists in exposing certain
cell lines to blood samples. The specific virus responses
are then identified. The RT-PCR (Reverse transcription
polymerase chain reaction) is a test used to detect the
virus. The technique amplifies a range of Chikungunya
genes present in the blood, highlighting them during
the microscopic exam. The time needed for the results is
about two or three days.
TREATING THE SYMPTOMS
There is no specific cure or treatment for Chikungunya. All
one can do is treat the symptoms. Currently, there is no
antiviral drug to fight against the Chikungunya virus.
Treat the fever.
Fever is described as a temperature
of 37.80°C (100.4°F) or higher. What is usually given is
Paracetamol at 500 mg per tablet every 4 to 6 hours
for adults if febrile. Paracetamol for children is given at
10mgs per kg of body weight every 4 hours to 6 hours if
febrile. Ask for a prescription for Paracetamol from your
physician. Do not takemedicines on your own. Aside from
Paracetamol, do sponge bathing until the temperature
returns to normal. Use tap water and not ice water for
sponge baths because rebound return of fever tends to
be higher immediately after using ice water.
Treat the joint pains or arthritis with pain relievers
prescribed by your physician. Joint pains due to
Chikungunya during the acute phase of illness can
be relieved by taking tablets of non-steroidal anti-
inflammatory drugs, a group of pain relievers stronger
in effect than Paracetamol.
Doshortdurationsofmildexercise.
Low-impact aerobic
exercises are those which involve mild stretching and
slow movements; avoid vigorous or aggressive
movements. Examples would be walking, swimming,
and cycling on a stationary bike.
(Reproduced from
)
The
Chikungunya
Effect
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TODAY
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