Chikungunya: symptoms, treatment and prevention

Chikungunya can also circulate with the help of monkeys,birds and cattle, but dengue spreads only through mosquitoes.  

Chikungunya was first reported in 1952, during an outbreak in southern Tanzania. It has now been identified in 60 countries including those in Asia, Africa, Europe, America and others. Listed in the World Health Organization’s R&D Blueprint (2016), the recently established Coalition for Epidemic Preparedness Innovations has it on their agenda to develop a vaccine for Chikungunya, along with other diseases such as MERS, Ebola and others.

What are the symptoms?

Abrupt onset of fever and severe joint pain. There can be other symptoms such as muscle pain, headache, nausea, fatigue and rash – that is, small red spots all over the body. The joint pain can be severe and sometimes prolonged. The disease does not induce immunity by itself and can recur.

The word Chikungunya, derived from the Kimakonde language which is spoken by the indigenous people of southern Tanzania, itself means that which is contorted. It refers to the contorted position taken by people when they are affected by joint pain.

How is it transmitted?

It is transferred from human to human by mosquitoes. The females of Aedes Aegyptii and Aedes albopictus are the main species of mosquito that spread the disease. These mosquitoes bite through the day.

How is it diagnosed? What are the tests that must be performed and how?

IgM titers – a way of measuring the rising level of, or concentration of, antibodies in the blood, which quantifies the body’s response to an active infection - are what are tested in the blood. More specifically, the blood test that doctors ask for is called the RT-PCR (Reverse Transcription Polymerase Chain Reaction) but it may not be available, so doctors test the drop in the number of leucocytes in the blood because of the viral infection.

The blood tests are repeated and a constant watch is kept on the blood count. If it drops, it is better to be under medical observation. At this stage, the doctors’ guidance is crucial.

What is the treatment?

There is no vaccine for chikungunya. Treatment is mainly symptomatic – such as giving painkillers to relieve the joint pain – using nonsteroidal anti-inflammatory drugs which are not asprin-based. Drugs are mainly analgesics and antipyretics. The patient is advised to take fluids.

Alternatives to Allopathy?

The Nilavembu decoction is suggested as a herbal treatment, and while many people believe in this, it has not yet been verified by studies. At present it is recommended to use this only in parallel with advice from a doctor.

Any preventive methods?

Avoid getting bitten by mosquitoes. Keep the surroundings clear of stagnant water or pools where mosquitoes can breed. Use mosquito nets and close windows in the evening to prevent mosquitoes from entering.

How does it differ from dengue?

Chikungunya can circulate with the help of monkeys, birds and cattle, but dengue spreads only through mosquitoes. While for dengue the symptoms subside in about 15 days, for Chikungunya the symptoms can prolong for 3-6 months. While Chikungunya’s main symptoms are high fever and excruciating joint pain, dengue manifests with high fever, drop in platelet count and rash.