Download Chikungunya

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Outline
 Introduction
 Epidemiology
 transmission
 Clinical manifestation
 Treatment
 Prevention
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Introduction
 Chikungunya is a virus that causes acute febrile
polyarthralgia (inflammatory disorder. It results in muscle
pain and stiffness in the body) and arthritis.
 The name is derived from a word in local language of
Tanzania meaning "that which bends up" or "stooped
walk”
 Multiple outbreaks occur Africa and beyond.
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Epidemiology
 Endemic areas — Africa, Asia
 Chikungunya virus, 1st indentified during an outbreak
in Tanzania in the 1950s
 Then spread to countries of central, southern, and
western Africa.
 Outside Africa, the first documented chikungunya
fever outbreak was in Thailand in 1958.
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Epidemiology
• Other outbreaks occurred in other Asian countries:• India, Sri Lanka, Malaysia, Indonesia,
• Spread — mainly through infected travelers between
regions where mosquitoes exist for perpetuation of
local transmission.
• Imported cases in European countries, USA and
Australia.
• Since 2004 it has caused outbreaks in various parts of
Asia
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How serious is Chikungunya?
December 9, 2013
PAHO issues Epidemiological Alert
How serious is Chikungunya?
June 6, 2014
4,486 confirmed cases
17 Caribbean countries
TRANSMISSION
 Aedes Aegypti & Aedes Albopictus
mosquitoes.
 The Reservoirs - Humans are the primary
reservoir during epidemic periods.

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TRANSMISSION
 Mosquitoes acquire the virus from a viremic
host.
 Following an average extrinsic incubation of 10
days, the mosquito transmits the virus to a
naïve host.
 So far there is no evidence to indicate a person-
to-person transmission of the disease.
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Risk & Immunity
 All individuals not previously infected with
CHIKV are at risk of acquiring the infection
 Once exposed, one will develop long term
immunity
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Make No Mistake
Clinical Manifestation
 Most individuals will present with symptomatic
disease after an incubation period of 3 – 7 days
(range: 1−12 days)
 Not all individuals infected with the CHIKV develop
symptoms. (between 3% - 28% does)
 CHIKV can cause acute, sub acute, and chronic
disease.
 Acute disease is characterized by an abrupt onset of
high fever (usually≥ 102°F/39°C) and severe joint pain.
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Clinical Manifestation
 Fever typically may lasts from several days to a
week.
 The fever may be continuous or intermittent
 A drop in temperature is not associated with
worsening of symptoms.
 Fever may be associated with a relative bradycardia
(slowness of heart rate < 60 beats/minute).
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Main characteristics
 Fever
 Headache
 Fatigue
 Nausea, vomiting
 Muscle pain
 Rash
 Joint pain
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Other common symptoms
 Redness in eye
 Difficulty in looking at light
 Severe fever with headache and joint pain
 Rashes on limbs and trunks
 Rash usually appears 2 – 5 days after onset of
illness and lasts 3 – 7 days in 50% of cases.
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High Risk Groups
 Infants and the elderly being at greatest risk for
more severe disease. (day sleepers, lower immune system)
 Co-morbidities have been identified as a risk factor
for severe disease. (chronic illnesses)
 Pregnancy – Most CHIKV infections that occur
during pregnancy will not result in viral
transmission to fetus.
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High Risk Group
 Rare reports of spontaneous abortions following
CHIKV infection in the mother.
 Neonates who had neurologic manifestations may
develop long-term disabilities.
 There is no evidence of viral transmission
through breast
 Fatalities related to CHIKV infection are
uncommon.
 Fatalities related to CHIKV infection are
uncommon.
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Chronic Presentation
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Treatment
 There is no specific antiviral drug treatment for
CHIKV.
 Symptomatic treatment.
- Rest
- Fluids
- Paracetamol
 Use of aspirin is not advised due to risk of
bleeding
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Prevention
 Prevent Mosquito Bites
 Mosquitoes which spread Chikungunya bite
during the daytime.
 Protect yourself from mosquito bites :
 Wear light coloured clothing and cover your
body as much as possible
 Use mosquito repellents containing DEET on
exposed skin
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Prevention
 Use mosquito coils and electric vaporization mats
both day and night
 Use mosquito nets
 Use door and window screens (mesh)
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Prevention
 Eliminate Mosquito Breeding Sites
 Mosquitoes live and breed in standing water in and
around the home.
 Do your part by preventing mosquito
breeding:
 Cover all drums, tanks, barrels and buckets that are
used to store water
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Prevention
 Get rid of all old tyres, tins, bottles, plastic
containers, coconut shells and anything in which
rain water settles
 Cover trash containers to keep out rain water
 Punch holes in the bottom of tins before placing
them in the garbage
 Keep flower pot saucers dry
 Avoid over-watering potted plants
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Aedes Mosquito
 The Aedes mosquito needs only 2ml of water for
breeding.
 After breeding the eggs can lay dormant up to one
year.
 A carrier mosquito is capable of transmitting the
virus to the next generation.
 The Chikungunya virus is sensitive to heat.
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Life Cycle of the Aedes aegypti
Lays egg 3 days
after taking a
blood meal
From Pupa to
Adult- 2 days
From eggs to
Larva - 1 – 3 days
From larva to
pupa - 4 days
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Common Breeding Sites
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Potential Breeding Grounds
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Potential Breeding Grounds
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Potential Breeding Grounds
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Potential Breeding Grounds
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Potential Breeding Grounds
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Potential Breeding Grounds
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Potential Breeding Grounds
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Potential Breeding Grounds
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Potential Breeding Grounds
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Chikungunya Prevention & Control is
in your hands – Do Something
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