Dr. Syeda Fahmida Hossain

Chikungunya is a viral disease transmitted to humans by infected mosquitoes.The virus is transmitted from human to human by the bites of infected female mosquitoes. The mosquitoes involved are Aedes aegypti and Aedes albopictus, two species which can also transmit other mosquito-borne viruses, including dengue.

These mosquitoes can be found biting throughout daylight hours. They  breed in clean water collections in containers, tanks, disposables, junk material in domestic and peri-domestic situations besides natural habitats like tree holes, plantations etc.

Like Dengue, its transmission is also related to rainfall and temperature. After the bite of an infected mosquito, onset of illness occurs usually between 3 and 7 days but can range from 2 to 12 days.
Chikungunya is characterized by an abrupt onset of fever, in some reaching 39- 40ºc, with chills and rigor, frequently accompanied by joint pain. The fever varies from low grade to high grade, lasts a few days . Joint involvement is symmetric and often ankles, wrists and
small joints of hands are worse affected.

Other common signs and symptoms include muscle pain, headache, nausea, fatigue, rash, swelling around the joints. The joint pain is often very debilitating, but usually lasts for a few days or may be  prolonged to weeks, on rare occasions, may even persist for months to years. Most patients recover fully with in 7 – 10 days.
It is rarely fatal, but the symptoms can be severe, long-lasting and debilitating. Once a person has been infected, he or she is likely to be protected from future infections.
The symptoms of chikungunya virus are similar to those of other diseases such as dengue fever. Only a blood test can definitively diagnose chikungunya.
It is important to rule out dengue fever as quickly as possible because of its higher rate of mortality - up to 50% if untreated, compared with 0.1% for chikungunya.

People at risk for more severe disease include newborns infected around the time of birth, older adults (≥65 years), pregnant and people with medical conditions such as high blood pressure, diabetes, or heart disease.

There is no vaccine to prevent or medicine to treat chikungunya virus.
 Treatment is directed primarily at relieving the symptoms, including
Adequate  rest.
Drink fluids to prevent dehydration.
Take  paracetamol to reduce fever and pain.
Cold compression may help in reducing joint pain.
Avoid self medication with  aspirin and other non-steroidal anti-inflammatory drugs (NSAIDS until dengue can be ruled out to reduce the risk of bleeding).
 Antihistamin can be used for itching.
Patient may need hospitalization in following conditions
frequent syncopal attacks
Decrease urine output
bleeding manifestations .

persons not responding or having persistent joint pain or disabling arthritis even after three days of symptomatic treatment  
High risk Group ( persons above sixty years , infants below one year of age, Pregnancy).

During the first week of infection, chikungunya virus can be found in the blood and passed from an infected person to another mosquito through mosquito bites. An infected mosquito can then transmit the virus to other people.

To prevent further spread of the virus, it is important for people to avoid mosquito bites during the first week of illness.
Because the major mode of chikungunya transmission is via mosquitoes, the best methods of prevention involve minimizing contact with mosquitoes.

Prevention and control relies heavily on reducing the number of natural and artificial water-filled container habitats that support breeding of the mosquitoes and with the use of insect repellent and mosquito nets.

Although chikungunya is very rarely fatal, the symptoms are distressing and can be long-lived. Avoiding mosquitoes is key.

The writer is a
Jr. Consultant, Medicine,
United Hospital Limited