Chikungunya Virus: Difference between revisions

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===Epidemiology===
===Epidemiology===


==Clinical Presentation==


==Diagnosis==
==Diagnosis==
===Physical Examination===
Physical examination is the primary method for diagnosing a patient with Chikungunya disease. Patients will present with high-grade fevers that can be as high as 105 ° F, shaking/chills, and headaches. Other common symptoms in severe cases include arthralgia and rash. Arthralgia is usually the most problematic symptom of Chikungunya disease. Small joints in the hands, wrists, and ankles are most commonly affected, with not much involvement of the larger joints. Arthralgia ceases within 1-2 weeks of pain onset in most patients, but 10-12% may have persistent arthralgia that lasts from months to years.{Medscape} Manifestations of disease are also seen on the skin in the form of a erythematous maculopapular rash on the torso.{Medscape} This rash appears red with flat, small bumps present also. In some patients, a tourniquet test may be performed to gauge the level of capillary fragility and hemorrhagic tendency; but it has proven to not be a reliable diagnostic tool.
===Diagnostic Criteria===
Patients who are suspected to have the virus present the symptoms mentioned previously during physical examination. However, because Chikungunya disease has many of the same symptoms as dengue fever, malaria, and more, the ability to omit infection by all other diseases aid in the diagnosis of CHIKV.  A more straightforward diagnosis can be made if the patient has traveled to an area where recent outbreaks of CHIKV have occurred.


==Treatment and Prevention==
==Treatment and Prevention==
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===Alternative Treatment===
===Alternative Treatment===
===Prevention===





Revision as of 16:20, 29 July 2015

Etiology/Virology

Baltimore Classification

Group IV: (+) ssRNA Virus

ICTV Classification

Family: Togaviridae Genus :Alphavirus Species: Chikungunya Virus

Description

By classification using the Baltimore Classification, Chikungunya Virus (CHIKV) is a positive-sense single-stranded RNA virus. CHIKV can also be further classified as an Arbovirus or Arthropod Bourne Virus because of its transmission via mosquitoes. The alphavirus genus is known to be small, spherical viruses with envelopes and are 60-70 nanometers in diameter. The genome of CHIKV encodes for four nonstructural proteins and three structural proteins. {NCBI} Also, alphaviruses viruses further classified into seven complexes varying by different antigenic

Pathogenesis

Transmission

Epidemiology

Diagnosis

Physical Examination

Physical examination is the primary method for diagnosing a patient with Chikungunya disease. Patients will present with high-grade fevers that can be as high as 105 ° F, shaking/chills, and headaches. Other common symptoms in severe cases include arthralgia and rash. Arthralgia is usually the most problematic symptom of Chikungunya disease. Small joints in the hands, wrists, and ankles are most commonly affected, with not much involvement of the larger joints. Arthralgia ceases within 1-2 weeks of pain onset in most patients, but 10-12% may have persistent arthralgia that lasts from months to years.{Medscape} Manifestations of disease are also seen on the skin in the form of a erythematous maculopapular rash on the torso.{Medscape} This rash appears red with flat, small bumps present also. In some patients, a tourniquet test may be performed to gauge the level of capillary fragility and hemorrhagic tendency; but it has proven to not be a reliable diagnostic tool.

Diagnostic Criteria

Patients who are suspected to have the virus present the symptoms mentioned previously during physical examination. However, because Chikungunya disease has many of the same symptoms as dengue fever, malaria, and more, the ability to omit infection by all other diseases aid in the diagnosis of CHIKV. A more straightforward diagnosis can be made if the patient has traveled to an area where recent outbreaks of CHIKV have occurred.


Treatment and Prevention

Conventional Treatment

Chikungunya virus is usually not fatal. Currently, there are no antiviral treatments for the disease either; this is probably because the immune system can eliminate the virus on its own. Treatments are usually centered around symptom management and include hydration, management of electrolyte balance, hemodynamic monitoring, rest, and pain management with medication. However, use of nonsteroidal anti-inflammatory drugs (NSAIDS) are not advised because of a possible missed dengue fever diagnosis, which could lead to increased hemorrhaging and death.

Alternative Treatment

Prevention

There are no vaccines available for CHIKV currently. The only method of prevention is vector control on a personal and community level. People traveling to areas where there have been reported cases and/or traveling to areas that the A. Aegypti or A. albopictus species are located should be cautious. It is recommended that these people wear long-sleeved shirts and long pants, apply mosquito repellent, and have screens on windows. In the community, it is beneficial to remove mosquito breeding sites and have large scale spraying of mosquito repellent. The virus can only be spread when a mosquito bites an infected human and then transfers the virus to another human. Because of this, avoiding mosquito bites is the best prevention.

Damage Response Framework