Dr Jobin Martin.com

Along came a man, limping  but not crying,

Behind him,a girl, her face reveals her agony,

A woman was at the back of the pack,

She seemed to be a cripple, the pain obvious on her face,

They belonged to the same family,

I was lost in thought for a while,

What would have brought a whole family to the doctor,

Is it scabies or tinea?

Or is it, hepatitis or  chickenpox,

I am the doctor and I will have to diagnose

There I was sitting, bewildered,but determined to find the cause.

Hence I began to examine the man,and found Swelling around the knee,

He was febrile and appear to be tired,

There were patches on his face,

And gave a history of mosquito bites,

All his neighbours were affected too,

All others showed the same findings,

Soon came to the realization,

The vector is a mosquito and the signs are consistent with,

A viral etiology,

I ruled out all other causes and came to a solid diagnosis,

It was nothing other than Chikungunya.

Chikungunya has become an endemic in Kerala, which is hailed to be numero uno, among all the states in India as far as the  health status is concerned. What makes Kerala so prone to chikungunya is, numerous pools of water and rubber plantations. It is the ideal place any mosquito can dream of!

The disease is characterized by severe pain and swelling on large joints of the body. These symptoms follow mosquito bite, and similar complaints may be present in a whole locality.

the only modality of treatment for this disease is absolute bed rest and oral antipyretics(paracetamol) and analgesics to relieve pain.

The more specific details are given below:

Causative organism: (Systematic name in 1997) Chikungunya virus
Alternative names: Buggy Creek virus
Alternative disease names: None

ICTV Acronym CHIKV
Properties: Family: Togaviridae
Genus: Alphavirus
A positive-sense, single-stranded RNA virus.
Vector involvement: The disease is spread by culex mosquitoes.

Symptoms

Sudden severe headache, chills, fever, joint and muscle pain are the commonest symptoms.

Key Diagnostic Tests.

Detection of antigens or antibody to the agent in the blood (serology)
ELISA is available
An IgM capture ELISA is necessary to distinguish the disease from dengue fever.

Differential Diagnosis(Similar diseases)

Dengue fever

Symptoms and effects.

After an incubation period of 3-12 days there is a sudden onset of flu-like symptoms including a severe headache, chills, fever (>40°C,104°F), joint pain, nausea and vomiting. The joints of the extermities in particular become swollen and painful to the touch. A rash may sometimes occur. Hemorrhage is rare and all but a few patients recover within 3-5 days. Some can suffer for joint pain for months. Children may display neurological symptoms.

Medical and Physical Countermeasures.

Vaccination (Immunoprophylaxis)

A vaccine is not available.

No specific therapies are available.

Supportive care

Symptoms are treated, e.g. with analgesics and anticonvulsants.

Paracetamol
Ibuprofen

Decontamination The virus is killed by common disinfectants, moist heat and drying. The vector (a mosquito) also needs to be controlled with insecticides.

Chikungunyavirus

Chikungunya virus is highly infective and disabling but is not transmissible between people. It would most likely be dispensed as an aerosol or by the release of infected mosquitos. The disabling joint pain and fever, the lack of a suitable animal reservoir in Western countries and its lack of lethality make it a very “clean” weapon that could be used against key civilian installations. The name comes from the Swahili for “that which bends up” that is a reference to the positions that victims take to relieve the joint pain.