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Chikungunya Fever

Chikungunya Fever. Dr.Madhusudan.S. DIAGNOSIS TREATMENT PROGNOSIS. Clinical Diagnosis. Chikungunya fever is suspected when a child, presents with fever, rash and joint symptoms more so during an epidemic. Chikungunya in Children. Less likely to have joint symptoms

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Chikungunya Fever

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  1. Chikungunya Fever Dr.Madhusudan.S

  2. DIAGNOSIS • TREATMENT • PROGNOSIS

  3. Clinical Diagnosis • Chikungunya fever is suspected when a child, presents with fever, rash and joint symptoms more so during an epidemic.

  4. Chikungunya in Children • Less likely to have joint symptoms Even when present – milder , shorter duration. • High fever, febrile convulsions • G.I.Symptoms – vomiting,pain abdomen,constipation. • Lymphadenopathy – more common

  5. Mild haemorrhagic symptoms – epistaxis, petechial rash, positive tourniquet test.

  6. Differential Diagnosis

  7. Dengue-The closest imitator • Found in the same areas • Dual infections reported in some cases • Overlapping clinical features • Children – greater incidence of haemorrhagic symptoms than adults

  8. Laboratory Diagnosis IgG Vir IgM m-yrs 3-5wks 4 2 months 2-3 days 15 days 4-7 days

  9. Demonstration of the virus • Gold standard & most specific • Culture-vero cells -C6/36 Aedes albopictus cells • Intracerebral inoculation in newborn mice • PCR

  10. Demonstration of the antibodies Diagnostic test of choice: • IgM ab capture ELISA • IgG ab indicate past infection and without four fold rise of ab titre do not implicate the disease.

  11. Principle of ELISA ligand Ag AB Anti AB Enz

  12. Other Investigations • CBC-Leucopenia • Thrombocytopenia • ^AST,ESR,CRP • Chronic joint symptoms-synovial fluid Dec viscosity, poor mucin clot formation, WBC-2000-5000/mm3

  13. TREATMENT-SUPPORTIVE • Bedrest during fever • Antipyretics and tepid sponging • Analgesics and mild sedation • Aspirin avoided-bleeding/Reye’s Syndrome • Arthtritis-continued NSAID,movements,mild joint exercises • Children-lose excessive fluids-ORS • Break transmission cycle.

  14. ROLE OF CHLOROQUINE • 12%-Chr joint symptoms-partial response to NSAIDS. • Study in France-10 patients 250mg/day for 20 weeks • 7/10-patient 5/10 doctor • Further studies needed

  15. PROGNOSIS • Most recover in few weeks • 12%months to years • Pregnancy-fever may cause abortions,preterm labour,fetal distress. • Infants-90%-recover without sequelae

  16. “Thankfully, the disease has proved so mild ; had it been different , this city, the home to half a million human beings would have become one vast charnel house with nobody to bury the dead and few to save the living” James Mellis, Calcutta epidemic 1963-64

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