Chikungunya

Chikungunya

Working in the prehospital medicine field, I subscribe to a few different journals and online resources to stay current.  One of those resources recently had a headline, “What’s a more dangerous infectious disease threat than Ebola?”  That kind of headline grabs my attention, so, figuring I should know what’s a more infectious disease threat than Ebola, I clicked the linked and was brought to an article about Chikungunya, aka Chik.  I’ve heard about this mosquito borne illness before, it’s actually made its way to the Caribbean and every so often there’s a notice about it in my local hospital.  What I didn’t know is it has now made its way to the United States, so I thought it might be a good topic to explore.

Pronounced  “chik-en-gun-ye”, it  is a viral infection spread from mosquitoes to people. First identified in 1952 in Tanzania, the name originates from the Kimakonde language, and translates “to become contorted” or “that which bends up.”  It was first identified in the Caribbean in 2013 and   Florida in 2014 (although 2 cases have been reported in Michigan and 19 recently in Texas).  The incubation period is 3-7 days and the main symptoms are an acute fever and debilitating joint pain.  Most people infected become sick and symptoms can last for 7-10 days, although for some, the joint pain can last months to years.  Few people die from Chik, those more at risk of dying are the usual suspects, the elderly, newborns, and those with comorbidities such as heart disease, diabetes and hypertension.  The virus isn’t spread from person-to-person; the only known vector is mosquitoes.

Treatment is aimed at symptoms and includes:

  1. Rest
  2. Fluids (PO or IV)
  3. Acetaminophen for fever
  4. Pain management (NSAIDS, corticosteroids)

Note: Chikungunya is often confused with dengue fever making clinical diagnosis difficult.  Assume the patient has dengue until lab results rule it out. 

Although there isn’t a vaccine (boo!) it does appear people who are infected and recover develop immunity from future exposures (yay!).  Contracting chik does sound pretty painful, and living in the western hemisphere chikungunya exposure is significantly more likely, but whether or not it’s a more infectious disease threat than Ebola (a disease characterized by bleeding out of every orifice and having a fatality rate as high as 90%), I think is debatable.

For more info: http://www.cdc.gov/chikungunya/pdfs/chikv_clinicians.pdf

 

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