COMPED 2006

Dr. Ashwani Agrawal
Consultant Pediatrician, Raipur

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Chikungunya virus (CHIKV) is a mosquito-transmitted alphavirus belonging to family Togaviridae. It was isolated for the first time from a Tanzanian outbreak in 1952. CHIKV is an enveloped, positive-stand RNA virus.

CHIKV is geographically distributed in Africa, India and South-East Asia. In Asia, CHIKV is transmitted from human to human mainly by A. aegypti. Recent reports of large scale outbreaks of fever caused b y chikungunya virus infection in several parts of Southern India have confirmed the re-emergence of this virus. It has been estimated that over 1,80,000 cases have occurred in India since December 2005. According to the National Institute of Virology, Pune, out of 362 found positive for chikungunya, antibodies, six for dengue fever and 15 related to both the fevers.

CHIKV infection can cause a debilitating illness, most often characterized by fever, headache, fatigue, nausea, vomiting, muscle pain, rash, and joint pain. The term 'chikungunya' is Swahili for 'that which bends up'. The incubation period (time from infection to illness) can be 2-12 days, but is usually 3-7 days. "Silent" CHIKV infections (infections without illness) do occur; but how commonly this happens is not yet known.

CHIKV is spread by the bite of an infected mosquito. Mosquitoes become infected when they feed on a person infected with CHIKV. Monkeys, and possibly other wild animals, may also serve as reservoirs of the virus. Aedes aegypti, a household container breeder and aggressive daytime biter which is attracted to humans, is the primary vector of CHIKV to humans.

Acute chikungunya fever typically lasts a few days to a couple of weeks, some patients have prolonged fatigue lasting several weeks. Additionally, some patients have reported incapacitating joint pain, or arthritis which may last for weeks or months. The incidence of chikungunya fever could be much higher than what has been previously reported.

The best way to avoid CHIKV infection is to prevent mosquito bites. There is no vaccine or preventive drug. Prevention tips are similar to those for dengue or West Nile virus:

• Use insect repellent containing a DEET or another EPA-registered active ingredient on exposed skin. Always follow the directions on the package.
• Wear long sleeves and pants (ideally treat clothes with permethrin or another repellent).
• Have secure screens on windows and doors to keep mosquitoes out.
• Get rid of mosquito [A.aegypti] breeding sites by emptying standing water from flower pots, buckets and barrels. If water storage is mandatory, a tight-fitting lid or thin layer of oil may prevent egg laying or hating.
• Additionally, a person with chikungunya fever or dengue should limit their exposure to mosquito bites in order to avoid further spreading the infection. The person should stay indoors or under a mosquito net.

Comped 2006 - Conference Abstracts. Pediatric Oncall [serial online] 2007 [cited 15 January 2007(Supplement 1)];4. Available from:
http://www.pediatriconcall.com/fordoctor/Conference_abstracts/
comped/Chikun.asp