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Chikungunya Fever


Chikungunya fever, is a viral illness that is spread by the bite of infected mosquitoes. The disease resembles dengue fever, and is characterized by severe, sometimes persistent, joint pain (arthritis), as well as fever and rash. It is rarely life-threatening. Nevertheless widespread occurrence of diseases causes substantial morbidity and economic loss

Epidemiology

Epidemics of fever, rash and arthritis, resembling Chikungunya fever have been recorded as early as 1824 in India and elsewhere. However, the virus was first isolated between 1952-1953 from both man and mosquitoes during an epidemic of fever that was considered clinically indistinguishable from dengue, in the Tanzania.

Chikungunya fever displays interesting epidemiological profiles: major epidemics appear and disappear cyclically, usually with an inter-epidemic period of 7-8 years and sometimes as long as 20 years. After a long period of absence, outbreaks of CHIK fevers have appeared in Indonesia in 1999.

Chikungunya in Asia (1960-1982)

Between 1960 and 1982, outbreaks of Chikungunya fever were reported from Africa and Asia. In Asia, virus strains have been isolated in Bangkok in 1960s; various parts of India including Vellore, Calcutta and Maharastha in 1964; in Sri Lanka in 1969; Vietnam in 1975; Myanmar in 1975 and Indonesia in 1982.

Recent occurrences of chikungunya fever

After an interval of more than 20 years, chikungunya fever has been reported from several countries including India, and various Indian Ocean islands including Comoros, Mauritius, Reunion and Seychelles.

Chikungunya fever in India

Till 10 October 2006, 151 districts of eight states/provinces of India have been affected by chikungunya fever. The affected states are Andhra Pradesh, Andaman & Nicobar Islands, Tamil Nadu, Karnataka, Maharashtra, Gujarat, Madhya Pradesh, Kerala and Delhi.

More than 1.25 million cases have been reported from the country with 752,245 cases from Karnataka and 258,998 from Maharashtra provinces. In some areas attack rates have reached up to 45%.

Chikungunya and dengue fevers

The clinical manifestations of chikungunya fever have to be distinguished from dengue fever. Co-occurrence of both fevers has been recently observed in Maharashtra state of India thus highlighting the importance of strong clinical suspicion and efficient laboratory support.

Laboratory Investigation

The clinical manifestations of chikungunya fever resemble those of dengue fever. Laboratory diagnosis is critical to establish the cause of diagnosis and initiate specific public health response.

Treatment, prevention and control

Treatment

Chikungunya fever is not a life threatening infection. Symptomatic treatment for mitigating pain and fever using anti-inflammatory drugs along with rest usually suffices. While recovery from chikungunya is the expected outcome, convalescence can be prolonged (up to a year or more), and persistent joint pain may require analgesic (pain medication) and long-term anti-inflammatory therapy.

Prevention and control

No vaccine is available against this virus infection. Prevention is entirely dependent upon taking steps to avoid mosquito bites and elimination of mosquito breeding sites.

To avoid mosquito bites:

* Wear full sleeve clothes and long dresses to cover the limbs;

* Use mosquito coils, repellents and electric vapour mats during the daytime;

* Use mosquito nets – to protect babies, old people and others, who may rest during the day. The effectiveness of such nets can be improved by treating them with permethrin (pyrethroid insecticide). Curtains (cloth or bamboo) can also be treated with insecticide and hung at windows or doorways, to repel or kill mosquitoes.

* Mosquitoes become infected when they bite people who are sick with chikungunya. Mosquito nets and mosquito nets and mosquito coils will effectively prevent mosquitoes from biting sick people.

To prevent mosquito breeding

The Aedes mosquitoes that transmit chikungunya breed in a wide variety of manmade containers which are common around human dwellings. These containers collect rainwater, and include discarded tires, flowerpots, old oil drums, animal water troughs, water storage vessels, and plastic food containers. These breeding sites can be eliminated by

* Draining water from coolers, tanks, barrels, drums and buckets, etc.;

* Emptying coolers when not in use;

* Removing from the house all objects, e.g. plant saucers, etc. which have water collected in them

* Cooperating with the public health authorities in anti-mosquito measures.

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wahhh medical blog yg best!!!!

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Dear Sir/Madam,
All relevant aspects are highlighted in the article.
However, the most essential part in chikungunya and dengue debilitating diseases are transmitted by Aedes sp., which has to be tackled only through educating every one of the individual in any part of the continent in the globe.
Intensive education on removal of source of breeding of these mosquitoes must be given the top most priority until we receive a good vaccination from the researcher.
Let us train the present generation of above ten years to concentrate on vector control through source reduction methods to avoid transmission of the dreadly diseases in the world.
With kind regards,
DR. T. MARIAPPAN,
Scientist, VCRC,
Puducherry-6.
E-mail: thirumari@yahoo.com
tmappan@gmail.com
Phone: +91-413-2272219

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witty angel,
thanx 4 ur comment. this is medical blog 4 whom need to know about medical...i hope all malaysian should know a letter bit about basess of medical...

dr T. Mariappan,

thanx 4 ur comment. i really agree with u. primary prevention is the most importence and should give a priority such as intensive health education to the people. we should remove all their origin such as sourse of breeding of aedes mosgito es,indeed.
talking about vacination. There are no specific treatments for Chikungunya. There is no vaccine currently available. A Phase II vaccine trial, sponsored by the US Government and published in the American Journal of Tropical Medicine and Hygiene in 2000, used a live, attenuated virus, developing viral resistance in 98% of those tested after 28 days and 85% still showed resistance after one year.
A serological test for Chikungunya is available from the University of Malaya in Kuala Lumpur, Malaysia.
in my place, i got 2 suspected cases today. i have to study more on this..

anyway thanx 4 ur comment and ur opinion..thanx a lot.

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chikungunya...hurm at my home place ramai yg kena this disease..melaka kan one of the 'havoc' place wtih this..huhuh...good info..

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wahida,
now chikungunya outbreak in johor..melaka i think outbreak since early this year. in my place rantau panjang and pasir mas also note a lot of chikungunya cases. there was 3 cases was admitted to our ward..

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alahai.. dah de 3 cases dah kat R.Panjang & P.Mas? uhuhu..

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farah,
farah kt psir mas kan? so kene hati2 skit ngan chikungunya ya...ia x de la bahaya cam denggi..jgn risau. ia x menyebabkn demam berdarah. kalu ada apa2 masalah dtg hospp pasir mas jer jumpa dr zek untuk mendapat rawatan..

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a'ahh.. farah kat pmas.. area jln r.panjang lama.. ok.. no prob sir! hehe..

pagi ni farah rasa xsedap badanla.. lemah2 sume sendi n cam xbermaya je.. cam nak demam g2.. uhuhu so scary.. Nauzubillah..

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farah,
kalu demam chikungunya memang rasa feverish ngan sakit2 sendi...dr zek rasa farah kene gi check darah kt mana hosp atau klinik yg berdekatan...really...skg ni area farah tu byk chikungunya kes...demam dia rasa cam denggi jer tp sakit sendinya lebih skit...

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uhuhu.. kena g cek kat klinik berdekatan? mmm... automatically sendi2 farah jadi elok balik dah.. takut doktor.. ehehe..

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