With its frequent heavy rainfalls, heat and humidity, the wet season is just right for Aedes mosquitoes to breed and spread various ills among us. The first disease transmitted by aedes mosquitoes that most people think of is dengue fever but they also transmit Chikungunya. To add to the confusion, the initial symptoms of chikungunya are very similar to dengue fever. So let’s take a closer look at chikungunya. What are the symptoms and how does it differ from dengue?
What is chikungunya?
The word “chikungunya” is a Magondi or Zimbabwean word meaning "bending". Thus, it conveys the symptoms of the disease where joint pains force patients into bending their bodies. Also known as Aedes Arthritis, the disease is caused by the chikungunya virus. The vectors are female aedes Albopictus and Aedes Aegypti mosquitos found in both urban and rural areas. aedes mosquitoes are active during the day finding targets to suck their blood. Their numbers multiply in heavy rain and flooding.
How is chikungunya transmitted?
Besides the aedes mosquito vector, chikungunya can also be transmitted:
1. From an infected mother to their infant baby. This can happen theoretically but in practice there aren’t many reports of it.
2. Through giving or receiving contaminated blood.
Symptoms
Chikungunya symptoms are similar to dengue fever but less severe and the disease is usually not life threatening. Nevertheless, some patients endure chronic joint pain that lasts for some time. This symptom can lead to misdiagnosis as rheumatoid arthritis. Chikungunya has an incubation period of 3-7 days after being bitten by a virus-carrying aedes mosquito. The incubation period is followed by these symptoms:
In adults
· Acute high fever, as high as 40 degrees Celsius, that declines rapidly after a few days.
· Pain in both small joints such as fingers and large joints such as elbows and knees. Muscle aches. Arthritis symptoms. Simultaneous pain in several joints. The joint pains in patients aged 45 years and over may be chronic.
· Skin reddening as blood-carrying capillaries expand.
· Red rash on the limbs or all over the body.
· ‘Red eye’ but mostly without blood spots in the whites of the eyes.
· Loss of appetite, eating less.
· Nausea, vomiting, eye pain, headache.
· Fatigue, diarrhea.
In children
Similar symptoms to adults but less severe.
Chikungunya vs Dengue
· Fever
Both chikungunya and dengue patients have acute high fever. However, with chikungunya, the fever goes down at day 2, while with dengue patients, it subsides at day 4.
· Joint and muscle pain
Both chikungunya and dengue fever patients have headache, rashes, and joint and muscle aches. However, chikungunya patients have symmetrical arthritis outbreaks on both sides. They will also often feel pain in small joints such as in the hands and feet. Dengue patients feel severe muscle pain in the lower back, arms and legs. If the pain extends to joints, it usually manifests in knees and shoulders.
· Distribution of rashes
Chikungunya patients develop red rashes on the face and body, mainly the trunk, arms and legs. In dengue patients, the red rashes appear on the arms, legs and face
· Severity of complications
Chikungunya complications include various joint problems such as chronic pain, arthritis and tendonitis. However, unlike dengue, the chikungunya virus doesn’t cause plasma to leak from veins so patients don’t generally go into shock as they can with dengue. As such, chikungunya is less life-threatening.
Possible complications
Besides joint issues, on rare occasions some chikungunya patients may suffer more severe complications, namely:
o Iritis
o Retinitis
o Myocarditis
o Hepatitis
o Meningitis
o Nephritis
o Brain and spinal cord issues
o Inflammation
o Cranial nerve paralysis
o Guillain-Barre syndrome which afflicts facial muscles and eyes making their movement difficult
Diagnosis
Most symptoms of chikungunya are similar to other fever-type diseases such as dengue, influenza and zika. To get an accurate diagnosis blood and sputum samples are taken and sent to a laboratory for analysis.
Treatment
There is no specific drug that cures chikungunya. Treatment is therefore symptomatic, including:
o Drinking enough water and avoiding dehydration.
o Getting enough rest.
o Eating nutritious food.
o Taking antipyretic medicines and pain relievers such as paracetamol, ibuprofen, naproxen, and others.
o Refraining from taking aspirin and anti-inflammatory drugs until the patient is confirmed not to be suffering from dengue. This is because aspirin is sometimes associated with intestinal bleeding which is of particular danger to dengue fever patients.
o Regularly wipe the patient with a cool cloth to reduce the fever.
Chikungunya can be prevented even without a vaccine
So far, there is no vaccine that can protect against chikungunya but we can still avoid getting it by taking these precautions:
o Avoid being bitten by mosquitos. If you live somewhere with a lot of mosquitoes, sleep under a net or with the windows and doors closed so mosquitoes can't get in.
o Use mosquito repellent or a topical or spray type mosquito killer.
o If sleeping out in the open or with an open window, cover up with a long sleeve shirt, long pants and socks.
o Keep the house clean so there are no corners where mosquitoes can hide or breed.
o Inspect all water containers and water traps around the house to ensure they are properly closed or completely dry. Lids and plastic covers can also help deny mosquitoes places to lay their eggs.
o If there is a pond, fish such as guppies should be kept as they will naturally eliminate mosquito eggs and larvae.
o Dispose of rubbish and overturn or dispose of items prone to waterlogging such as basins, water bottles and glasses.
o Monitor hygiene in and around the home and try to keep the area mosquito free.
Although chikungunya symptoms are similar to dengue fever, it's not as serious and not life-threatening. Nevertheless, it can still cause suffering through fever and pain. If someone gets a high fever, get them straight away to a hospital to see a doctor. With an accurate diagnosis the condition can be treated safely and effectively. Also, keep your home from becoming a habitat and breeding ground for aedes mosquitoes. This is the safest long-term way of avoiding chikungunya and not having to worry about catching it.
Krungthai-AXA Life Insurance customers who feel sick and want to consult a doctor can use the Krungthai-AXA Telehealth service on the Emma by AXA application. In case of having a fever, get to a hospital and see a doctor right away.
For more information, click https://www.krungthai-axa.co.th/th/health-services/telehealth.
References
· Samitivej Hospital
https://bit.ly/3NMgwR6
· Faculty of Medicine, Siriraj Hospital
https://si.mahidol.ac.th/th/healthdetail.asp?aid=955&aid=955
· Bangkok Hospital
https://bit.ly/3HaX3H6
· Bumrungrad Hospital
https://www.bumrungrad.com/th/health-blog/january-2020/chikungunya-virus
https://www.bumrungrad.com/th/health-blog/january-2019/chikungunya
· King Chulalongkorn Memorial Hospital, Thai Red Cross Society
https://bit.ly/3xFuNte
· Pobpad website
https://bit.ly/3zuVxxU
· Phyathai Hospital
https://bit.ly/3HewfWC
