The name “Chikungunya” has been derived from the word kungunyala of Kimakonde language which means “to become contorted”, and describes the bent look of sufferers with joint pain (arthralgia). Chikungunya is a vector-borne viral disease which has been witnessed during an outbreak in 1952 in southern provinces of Tanzania. It is an RNA virus that belongs to the alphavirus genus of the family Togaviridae. Chikungunya can be transmitted to humans by infected mosquitoes. As a disease, chikungunya resembles very close to dengue fever, which can be characterized by severe and mostly persistent joint pains (arthritis). This is also accompanied by fever and rash. However, chikungunya is not often life-threatening. The places where chikungunya occurs are in Africa, India, and Southeast Asia. Unlike other neglected diseases, it is primarily found in urban and peri-urban areas.
In India, a major epidemic of Chikungunya fever has been recorded during 1963 (Kolkata) closely followed by 1965 and 1973. Then few sporadic cases continued to be recorded in states like Maharashtra during 1983 and 2000. However, the year 2006 has seen it climb to its peak with 1390322 (1.39 million) suspected Chikungunya fever cases reported throughout the country. This year, till July 2017, 16976 clinically suspected chikungunya cases have already been recorded in India, with a recent highest of 64057 in 2016.
Currently, Chikungunya can be pointed as an example of emerging or re-emerging infectious diseases in developing countries. Chikungunya fever as suspected by public health specialists is mostly either misdiagnosed or go unreported.
Chikungunya is found to be caused by the chikungunya virus, which is classified in the genus Alphavirus and the family is Togaviridae. Aedes aegypti is the primary Aedes mosquito which is responsible for Chikungunya. It is spread by mosquito bites. Before the genome organization and replication strategy was been discovered, the chikungunya virus was placed in group-A and group-B of arboviruses, due to being an arthropod-borne virus and having single stranded positive-sense RNA genome. The chikungunya virus is believed to have originated in Africa about 200–300 years ago as shown by its molecular clock analysis.
We the human beings are found to be the reservoir or the primary source of chikungunya virus for Aedes mosquitoes. The chikungunya disease transmission is based on the mosquito, who bites an infected person and then further to someone else. Chikungunya is not a contagious disease and no infected person can directly spread the infection to anyone else. The most interesting fact about the vector is that these Aedes aegypti mosquitoes bite during the day time.
Surprisingly the dengue virus, just like chikungunya virus also get transmitted through same species of mosquito, Aedes aegypti and share same spatiotemporal territories. Both of themes are well-known to cause acute febrile illness with more or less identical symptoms in the early phase infection, but the clinical profiles differ as the infection progresses.
Often symptoms of chikungunya in infected individuals are mild and the infection may go unrecognized, or be misdiagnosed in areas where dengue occurs. To discuss chikungunya symptoms, the one which comes first is about the abrupt onset of fever which is frequently accompanied by chills, headache, nausea, vomiting, joint pain, and rash.
The other commonly identified signs and symptoms include muscle pain and fatigue. The word chikungunya, as already mentioned earlier in this article, refers to the contorted or stooped posture of patients who are affected with the severe joint pain (also known as arthritis), which is the most common feature of the disease.
The joint pain caused due to chikungunya, is very often unbearable and usually stays for a few days or may be prolonged to weeks. Therefore, the chikungunya virus can cause acute, sub-acute as well as chronic disease.
Most of the chikungunya affected patients recover fully, but there are some cases where joint pain may persist for several months, or even for years. There are even some occasional report of chikungunya cases with trouble in eyes, neurological and heart complications and even gastrointestinal complaints.
Serious complications are not very common with chikungunya cases, but in older people, this disease can contribute to the cause of death while in children, the chikungunya infection causes no symptoms.
The time between the bite of a mosquito carrying chikungunya virus and the start of symptoms ranges from one to twelve days.
Prevention is the primary way to protect oneself from chikungunya. No vaccine for chikungunya virus is available, nor drugs are available to cure the infection. Avoiding mosquito bites can be a precaution to stay away from chikungunya infection but better precautionary measure should include the elimination of mosquito breeding sites and create social awareness. For personal safety one can definitely follow the below steps:
- Use of mosquito repellents on skin and clothing.
- The rooms should be well-screened.
- Bed nets must be used while sleeping in not-screened or air-conditioned areas.
Wear long-sleeved shirts and long pants to avoid mosquito bite, even when one is working outdoors during day times.
But, the better way is always to have a holistic approach to eliminate chikungunya fever, rather than the temporary precautionary measures. Reducing the number of natural and artificial water-filled container habitats can be the primary objective towards prevention and control. The chikungunya mosquitoes rely heavily on those water reservoirs, as it supports the breeding of these mosquitoes. The affected communities should also be mobilized whenever required. In the case of outbreaks, insecticides must be sprayed to kill flying mosquitoes. This insecticidal spray should be applied to surfaces in and around containers where the mosquitoes land. A proper treatment of water in containers to kill the immature larvae can also support in eliminating chikungunya.
There are various effective home remedies for treating and controlling the symptoms of chikungunya.
- Ice Compression is effective to relieve joint pain. For this wrap the ice cubes in a hand towel and compressed it for 10 to 15 minutes of the affected joints. The direct application of ice should not recommend in the chikungunya.
- Fill the bathtub with warm water and add some Epsom salt and soak the body for half an hour can relax the body pain occur during chikungunya.
- Several analgesics and anti-inflammatory herbs like garlic, ginger, turmeric need to add in the diet during chikungunya.’
- Papaya leaves juice is a very effective home remedy to treat chikungunya.
- Massage the body with black seed oil can help to treat pain related to chikungunya.
A considerable limitation has been observed in the case of treatments for chikungunya fever as there is no specific treatment for chikungunya. The treatment in such cases wholly depends on supportive therapy that can relieve symptoms.
- The administration of non-steroidal anti-inflammatory drugs and plenty of rest may be beneficial for a patient with chikungunya fever.
- In the case of joint pain using antipyretics, optimal analgesics and fluids can also be the options.
- The patient infected with chikungunya should be isolated as much as possible from mosquitoes in order to avoid transmission of infection to other people. As already mentioned that there is no commercial chikungunya vaccine available in the market.
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