CHIKUNGUNYA

Chikungunya (CHIK) is a viral disease.

The word “chikungunya” is a Swahili word which means “walking bent over” because of the stopped posture of patients.

The disease was first described in Tanzania in 1952.

Chikungunya virus is an arbovirus (alphavirus of the family of Togaviridae); it is a RNA virus.

The disease is transmitted from human to human by the bite of an Aedes mosquito (aedes aegipty, aedes albopictus): mosquitoes are daytime vectors with highest activity at the beginning and the end of the day.

CHIK is endemic in sub-Saharian Africa, southeastern Asia and on the Indian subcontinent. In March 2005 the disease appeared in the Comor Islands and then in Mauritius and Mayotte, in the island of  La Réunion, in the Seychelles, in the Madagascar.

The CHIK is an acute infection of sudden onset. The incubation period is usually 4-7 days (with a range of 1-12 days).
Fever rises abruptly (39°-40°C) accompanied by intermittent shaking chills, migrating arthralgias (polyarticular) (predominantly affect the small joints of the hands, wrists, ankles and feet), generalized myalgia, an itchy maculopapular rash typically on the trunk and limbs.

In the most severe cases there are headache, nausea and vomiting, conjunctival injection. Younger patients could suffer of haemorragic symptoms, such as bleeding from the nose or gums.

In La Réunion island some cases of meningo-encephalitis have been reported.

• non-steroid anti-inflammatories,

• non-salicylic ananlgetics,

• rest in bed is indicated during the acute joint symptoms. To avoid heavy exercise but mild exercise tends to improve stiffness and morning arthralgia.

No vaccine for chikungunya fever is to-day available.

Prevention is the best way to avoid CHIK infection; it is based on personal protective measures (to avoid to be bitten by mosquitoes) especially during the hours of highest mosquitoes activity (morning and late afternoon).

These are the recommendations:

• Wear long sleeve – long leg clothes;

• Use  insect repellent on the exposed (es. DEET) (not for newborn children under three months and only after the consult of a physician or pharmacist for pregnant women and children under the age of 12 years);

• Treat clothes with permethrin.