Chikungunya fever: symptoms, transmission, prevention and cure

Along with dengue and zika, chikungunya fever is one of the concerns that come with summer. The rise in temperature promotes an increase in the total number of mosquitoes circulating, and many of them can bring these diseases, which, if left untreated, can have serious health consequences.

Understand more about chikungunya fever in the following text!

What is Chikungunya Fever?

Chikungunya fever is an infectious disease caused by the CHIKV virus and transmitted by the mosquitoes Aedes aegypti and Aedes albopictus . It is mainly characterized by high fever (about 39 ºC) and severe pain in the joints.

Its first case was detected in 1952, in Tanzania, and the term “chikungunya” derives from Swahili, one of the country’s languages, and means “those that bend”, due to the curvature with which patients can reach due to the severe pain caused by the disease. On Brazilian soil, the disease was only confirmed in 2014, however, since then, concerns have been great.

It is estimated that the disease causes 3 million infections per year worldwide. At the national level, it is estimated that by June 2018, more than 47 thousand cases of chikungunya were reported to the Ministry of Health, which represents an approximate incidence of 23 cases per 100 thousand inhabitants.

Until the virus reached South America, it passed through countries like Kenya, Comoros, Reunion Islands and other islands in the Indian Ocean. In 2006, it reached India, Sri Lanka, the Maldives, Singapore, Malaysia and Indonesia. In 2007, chikungunya was identified in Italy and, in 2010, there were cases reported in France and the United States.

Chikungunya and dengue: understand the difference

Dengue and chikungunya fever are very similar. However, dengue is a more serious disease, requiring greater proximity during treatment. The differences, in addition to the virus, are very discreet, and in chikungunya fever, shock and hemorrhage are rare symptoms.

The initial symptoms are more acute in chikungunya, but the duration of the fever is much shorter. Body aches are also more localized, that is, they affect tendons and joints instead of the whole body, as in the case of dengue.

Causes

The disease is caused by the chikungunya virus, which is transmitted through the mosquito Aedes aegypti (same mosquito that transmits dengue and zika) and also Aedes albopictus .

Although they are part of the same species, the two mosquitoes have some differences between them:

  • Aedes aegypti: lives in urban areas and the female feeds, preferably, on human blood. Their larvae are normally found in artificial deposits, such as vase dishes, accumulated garbage, tires and bottles with standing water;
  • Aedes albopictus: present mainly in rural areas, its larvae are found in natural deposits, such as holes in trees and fruit peels. However, this does not prevent artificial containers abandoned in forests from serving as breeding grounds for the mosquito.

Read more: Learn more about the dengue, zika and chikungunya viruses

Streaming

Regarding the form of transmission, it is known that the only way for the disease to be transmitted is through the mosquito bite. Therefore, preventing this from happening is the only way to prevent chikungunya.

After the bite, the virus can show symptoms between 4 to 8 days (incubation time).

It is a fact that there are asymptomatic cases, however, according to the Center for Infectious Disease Research and Policy , about 72 to 97% of infected patients will experience some type of symptom.

Attention!

There is no transmission of the disease between people, however, if the mosquito bites a person infected with the virus, it can be transmitted to another person if the same mosquito bites it.

Transmission between mother and baby can occur during delivery (vertical transmission). There is no evidence that the mother transmits the disease to the fetus during pregnancy.

As the transmitter of chikungunya is the same as that of dengue, it is possible, yes, to have both diseases at the same time.

Groups of risk

As much as the mosquito can bite anyone and at any age, some groups are more susceptible to developing the disease, as their immunity is compromised. Are they:

  • Seniors;
  • Children under 1 year;
  • Pregnant women;
  • People who already have some type of disease.

If any person in these groups is infected with the virus, take them to the emergency department immediately.

Symptoms of Chikungunya Fever

Much of the symptoms of chikungunya are very similar to those of dengue, so the large number of early diagnoses.

Know the symptoms of each phase:

Acute phase

Also called the febrile phase, the acute phase is characterized by a sudden fever accompanied by pain in the joints, in the back, skin rashes, headache and fatigue . These symptoms usually persist for seven days on average.

Understand the main symptoms:

  • High fever, equal to or higher than 39 ºC;
  • Severe pain and swelling in the joints, which can affect tendons and ligaments in more than 90% of cases;
  • Dermatitis (inflammation of the skin);
  • Back pain (back pain) and muscles in general;
  • Extreme fatigue;
  • Hypersensitivity to light;
  • Constant headache;
  • Vomiting, diarrhea, abdominal pain;
  • Chills;
  • Redness in the eyes, similar to conjunctivitis;
  • Intense pain behind the eyes.

In rare cases, neurological disorders have also been reported, such as Guillain-Barré syndrome, paralysis, meningoencephalitis, flaccid paralysis and neuropathy.

Subacute phase

In the subacute phase, fever tends to disappear, and there is a possibility that joint pain will improve or worsen. Asthenia (decreased physical strength), generalized itching and the appearance of injuries to the body can also occur.

In addition, some patients may develop peripheral vascular disease (reduced blood flow to the limbs), fatigue and depressive symptoms.

If the symptoms persist for more than 3 months after the onset of the disease, the patient is considered to be in the chronic phase of the disease.

Chronic phase

During the epidemics of the disease that have caused the world, it has been observed that chikungunya can cause long-term symptoms after acute infection. Among the symptoms, the following stand out:

  • Long-term arthritis: seen after an outbreak in 1979;
  • Long-term musculoskeletal pain: in 2006, in an outbreak in La Reunion, more than 50% of people over 45 reported this symptom;
  • Painful joints: in this same outbreak, 60% of people reported the symptom, even after 3 years of infection;
  • Arthralgia (type of joint pain): a study in France found that 59% of people suffer from this symptom 2 years after infection;
  • Muscle pain, joint pain or asthenia (type of organic weakness): after an epidemic in Italy, 66% of people reported these types of pain after 1 year of acute infection.

The causes of these symptoms are not yet well defined, so the importance of being attentive if they appear.

Diagnosis

Chikungunya fever can be diagnosed using three different criteria: clinical, epidemiological and laboratory.

Clinically, high fever and severe pain in the joints already indicate a supposed case of the disease. Therefore, as a result, a doctor should be consulted (general practitioner, for example) in order to investigate the causes and reasons for these symptoms.

Regarding epidemiology, the doctor will most likely ask questions about whether the patient has traveled or spent time in regions where chikungunya is recurrent in the last 12 days (potential virus incubation time).

Regarding the laboratory tests available to diagnose the presence of the virus in the patient’s body, three different types can be found:

Serology

This test seeks to identify the presence of antibodies in the body and is carried out through blood collection and subsequent laboratory examination.

Real-time PCR (RT-PCR)

The PCR in real time is a blood test to search for C-reactive protein, which indicates that an infection is occurring. Unlike ordinary PCR, real-time takes less time to show results (2 to 3 hours).

Viral isolation

Another test done via blood collection, viral isolation seeks to isolate the virus in the blood and detect or discard its presence in the body.

Hurt tem cura?

Chikungunya has a cure, so much so that, once infected with the virus, the individual is immune for the rest of his life. As there is still no type of treatment for the disease itself, experts focus on treating recurrent symptoms.

What is the treatment?

Unfortunately, there are no drugs that fight infection with the virus itself. However, as the disease tends to heal on its own, doctors often resort to the following treatments:

  • Non-steroidal anti-inflammatory drugs, such as naproxen ;
  • Painkillers without acetylsalicylic acid (such as paracetamol ), as this substance can increase the risk of bleeding;
  • Immunotherapy, which consists of administering human antibodies (immunoglobulin) anti-CHIKV to patients infected by the virus;
  • Ribavirin , if chronic arthritis remains for more than two weeks.

Careful!

If you have been diagnosed with chikungunya, you should not use drugs based on acetylsalicylic acid, such as aspirin , as these drugs increase the risk of bleeding.

After about 10 days, most patients begin to experience an improvement in general health and joint pain. However, after that time, there may be a relapse in the signs and the patient may present rheumatic symptoms, that is, joint pain, which can become chronic.

In addition to the use of these treatments, it is also recommended:

  • Eating foods rich in magnesium, to strengthen the immune system;
  • Rest, as it allows the body to regenerate;
  • The consumption of 1.5 to 2 liters of water daily, so that dehydration is avoided;
  • Physiotherapy, if the joint pain persists even after the fever has passed.

Attention!

NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained on this site is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

Complications

There are rare cases in which chikungunya presents without fever and pain, but they can happen. If any of the following changes occur, the indication that the disease is serious is high:

  • Nervous system: seizures, Guillain-Barré syndrome, loss of movement of arms or legs, tingling;
  • Eyes: optical inflammation, in the iris or retina;
  • Heart: heart failure, arrhythmia and pericarditis;
  • Skin: darkening of certain areas, appearance of blisters or aphthous ulcers;
  • Kidneys: inflammation and kidney failure;
  • Other complications: blood complications, pneumonia, respiratory failure, hepatitis, pancreatitis, adrenal insufficiency and an increase or decrease in antidiuretic hormone.

Typically, these complications arise because of the patient’s weakened immune system or because of the use of certain medications.

Prevention

Unfortunately, there is still no vaccine to prevent infection caused by the chikungunya virus. Therefore, the only way to prevent the disease is to avoid being bitten by the transmitting mosquitoes.

Check out some tips:

  • Use window screens to keep mosquitoes out of your home;
  • Do not leave standing water, so you prevent the mosquito from proliferating;
  • If time permits, wear long pants and T-shirts;
  • Use insect repellents (give preference to those with DEET, picaridin, IR3535 and eucalyptus oil or para-mentano-diol in their composition).

Read more: Repellent for pregnant women (icaridine, DEET), brands, which is the best?

Common questions

Is chikungunya a weaker dengue?

No! Chikungunya fever is caused by a virus other than the one that causes dengue. So the symptoms may even be similar, but as the causes are different, they are different diseases.

Can a person have dengue, zika and chikungunya at the same time?

Yea! The 3 diseases can happen at the same time, which greatly increases the chances of serious complications. In general, the Aedes mosquito usually carries only one virus, but the person can be bitten several times by different mosquitoes.

Can chikungunya kill?

It depends. Until today, chikungunya deaths have only occurred in patients who already had other diseases, such as respiratory, cardiac, coagulation problems, uncontrolled diabetes and patients debilitated by AIDS or cancer .

Can chikungunya cause microcephaly?

No. There is no reported case of microcephaly associated with chikungunya fever even in pregnant women who have had the disease.

Can chikungunya make a person paralyzed?

No . Chikungunya does not cause nerve paralysis, but it can cause temporary immobility in patients due to generalized swelling and acute and severe pain, which can affect the body’s joints.

Can Chikungunya be transmitted through unprotected sex?

No. The disease transmitted by Aedes that has been proven to be sexually transmitted is Zika and so far, there are no reports of sexually transmitted chikungunya fever.


Chikungunya is more and more worrying, as the number of cases is increasing more and more.

Share this article with your network of contacts, because the more people have access to this information, the greater the prevention against the virus and the transmitting mosquito!

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