- Main symptoms of Chikungunya
- How long the symptoms last
- How to confirm the diagnosis
- Severity signs and symptoms
- How the transmission happens
- How the treatment is done
- Chikungunya in pregnancy and babies
Chikungunya is a viral disease caused by the bite of the Aedes aegypti mosquito, whose main complication is the appearance of pain and swelling in the joints, which can last for up to 3 months. However, there are reports that these symptoms can remain for up to 3 or 6 years, and there is also tendonitis and changes in sensation in the hands.
The most common initial symptoms of Chikungunya are fever and severe pain in the joints, especially in the back, which is the main differential of dengue. Symptoms usually appear 7 days after being bitten by the mosquito and last up to 14 days. Swelling of the joints can appear up to 60 days after the beginning of the first signs and symptoms.
Since there is no specific treatment for this disease, it is necessary for the body to eliminate the virus, with only treatment to relieve symptoms. In addition, as there is no vaccine against the disease, the most reliable way to prevent the disease is to avoid mosquito bites.
Main symptoms of Chikungunya
Typical symptoms of Chikungunya include:
- High fever, above 39º C that appears suddenly; Intense pain and swelling in the joints that can affect the tendons and ligaments; Small red spots on the skin that appear on the trunk and throughout the body including the palms and soles of the feet; Pain in the back and also in the muscles; Itching all over the body or only in the palms of the hands and soles of the feet, there may be flaking of these places; Excessive tiredness; Hypersensitivity to light; Constant headache; Vomiting, diarrhea and abdominal pain; Chills; Redness in the eyes; Pain behind the eyes.
In women there are especially red spots on the body, vomiting, bleeding and sores in the mouth, while in men and older people the most common is pain and swelling in the joints and fever that can last for several days.
How long the symptoms last
In the vast majority of cases, symptoms disappear after 14 days or even earlier, if proper treatment is started with rest and medications to relieve discomfort.
However, there are also reports of several cases in which some symptoms persisted for more than 3 months, characterizing a chronic phase of the disease. At this stage, the most common symptom is persistent joint pain, but other signs may also appear, such as:
- Hair loss; Sensation of numbness in some regions of the body; Raynaud's phenomenon, characterized by cold hands and white or purplish fingertips; Sleep disturbances; Difficulties in memory and concentration; Blurred or blurred vision Depression.
The chronic phase can last up to 6 years, and it may be necessary to use medications to treat these and other symptoms, in addition to physical therapy sessions to relieve pain and improve movement.
How to confirm the diagnosis
The diagnosis can be made by a general practitioner by the signs and symptoms that the person presents and / or through the blood test that helps guide the treatment of the disease.
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For the diagnosis of chikungunya fever, blood tests can be performed. The changes that may be present are:
- Leukopenia with lymphopenia less than 1, 000 cells / mm3 (common) Thrombocytopenia less than 100, 000 cells / mm3 (rare) High erythrocyte sedimentation rate and C-Reactive ProteinHepatic enzymes, crestinine and creatinophosphokinase (CPK) are slightly elevated.
The disease is confirmed when the patient has characteristic symptoms in times of epidemic; when you visited endemic sites up to 2 weeks before the onset of symptoms and also through confirmation:
- Virus isolation tests, PCR, Presence of IgM antibodies collected during the presence of symptoms When there is an increase of up to 4 times the amount of antibodies, which can be observed between 15 and 45 days after the onset of symptoms or 10 to 14 days in the acute phase; Presence of antibodies through the plaque reduction neutralization test (PRNT).
Not all patients need to undergo these tests, which should be ordered when there are atypical symptoms or in severe cases.
It is important to know how to differentiate CHIKV from other diseases that can cause similar symptoms such as: Dengue, which is the main suspect, or others such as septic arthritis, malaria, leptospirosis and rheumatic fever. For differentiation, epoch epidemic times and other symptoms characteristic of other diseases must be taken into account.
It can be malaria when the patient has been in endemic areas, and leptospirosis is suspected when the patient has been in contact with flood waters or has professions as a garbage man or bricklayer and has pain in the calves. It can be rheumatic fever when there are symptoms such as pain in the throat that must be investigated by examining the oropharynx, which shows Streptococci , and the possibility of septic arthritis when there was a history of local trauma.
Up to 30% of infected people have no symptoms and the disease is discovered in a blood test, which can be ordered for other reasons.
Severity signs and symptoms
In rare cases Chikungunya manifests itself without fever and without pain in the joints, but the following changes may appear that indicate that the disease is serious and the person may need to be hospitalized:
- In the nervous system: seizures, Guillain-barré syndrome (characterized by loss of strength in the muscles), loss of movement with the arms or legs, tingling; In the eyes: Optical inflammation, in the iris or retina, which can become severe and impair vision. In the heart: Heart failure, arrhythmia and pericarditis; On the skin: Darkening of certain areas, appearance of blisters or aphthous ulcers; In the kidneys: Inflammation and kidney failure. Other complications: blood, pneumonia, respiratory failure, hepatitis, pancreatitis, adrenal insufficiency and increase or decrease in antidiuretic hormone.
These symptoms are rare but can happen in some people caused by the virus itself, by the response of the person's immune system or due to the use of medications.
How the transmission happens
The main form of transmission of chikungunya is through the bite of the Aedes Aegypti mosquito, which is the same that transmits dengue. However, during pregnancy, if the pregnant woman is bitten by the mosquito, chikungunya can also pass to the baby at the time of delivery.
This disease, similar to dengue, Zika and Mayaro is not passed from one person to another.
How the treatment is done
The treatment usually lasts about 15 days and is done with the use of painkillers, such as acetominophen or paracetamol, to relieve fever, tiredness and headache. In cases of extreme pain, the doctor may recommend the use of other stronger drugs against pain and inflammation. However, it is not recommended to take medications without a prescription, as it can cause serious changes, such as medicated hepatitis.
The duration of treatment depends on the age of the infected person, with young people taking an average of 7 days to heal, while the elderly can take up to 3 months.
In addition to medicines, other important tips are placing cold compresses on the joints to relieve swelling and discomfort, as well as drinking fluids and resting, to allow the body to recover more easily.
Check out these and other tips in the following video:
Chikungunya in pregnancy and babies
The symptoms and the form of treatment during pregnancy are the same but the disease can pass to the baby during delivery, with a risk of 50% of the baby being infected, however very rarely abortion can occur.
When the baby is infected, it may show symptoms such as fever, not wanting to breastfeed, swelling in the extremities of the hands and feet, as well as spots on the skin. Despite the child's lack of appetite, she can continue to be breastfed because the virus does not pass through breast milk. In children under the age of 2, the doctor may decide to have the child admitted to the hospital for treatment.
Chikungunya fever in newborn babies can be severe leading to serious complications because the central nervous system can be affected with the possibility of seizures, meningoencephalitis, cerebral edema, intracranial hemorrhage. Hemorrhages and involvement of the heart with ventricular dysfunction and pericarditis may also occur.
