New Chinese Virus or Chikungunya Fever

New Chinese Virus or Chikungunya Fever

Chikungunya virus enters the human body through the bite of a mosquito and causes illness characterized by fever and joint pain. The virus is not deadly, but the acute form of the illness can have long-term negative effects on the body, with persistent pain symptoms. So far, there is no cure or vaccine for the disease; only preventive measures can be taken.

What kind of disease is Chikungunya?
As mentioned, Chikungunya is a viral disease transmitted to humans through the bite of infected Aedes aegypti or Aedes albopictus mosquitoes. These mosquitoes can also transmit dengue and Zika viruses.

The name Chikungunya comes from the Makonde language of Tanzania, meaning “that which bends up,” referring to the stooped posture caused by severe joint pain. It was first identified in 1952 during an outbreak in Tanzania. Patients affected by the disease often bend due to joint pain, especially in the legs.

Chikungunya was first detected in Tanzania in 1952 and later spread to neighboring African countries and Asia. It appeared in Thailand in 1967 and in India in 1970. Since 2004, its spread has accelerated worldwide, and it is now recognized in 110 countries. Previously known mainly in Asian, European, and African regions, as well as in the Indian and Pacific Oceans, its first documented local transmission in the Americas was in 2013 in the Caribbean Sea. Since then, more than 1.5 million cases have been reported in the Caribbean islands, Latin America, and the United States. Isolated cases have also been reported in Canada and Mexico.

Spread and Epidemiology
The virus is maintained in a human–mosquito–human transmission cycle. International travel and trade have played a major role in its global spread.

Aedes mosquitoes bite during the day, lay eggs in water containers, and feed in open spaces. When a mosquito bites an infected person, it ingests the virus, which multiplies inside the mosquito over several days and then reaches the salivary glands. When the mosquito bites another healthy person, it transmits the virus through its saliva, continuing the cycle of infection.

Because this disease is blood-borne, healthcare workers and laboratory staff are also at risk. Transmission from mother to child through the placenta is rare and usually occurs in the fourth, fifth, or sixth month of pregnancy. It is not transmitted through breastfeeding.

Symptoms
Chikungunya typically begins with sudden high fever, often exceeding 102°F (38.9°C), accompanied by skin rashes and joint pain severe enough to cause immobility. Other symptoms include muscle pain, headache, fatigue, and nausea. Joint pain can last weeks or even months.

The incubation period (time from infection to first symptoms) is usually 4–8 days, but may range from 2 to 12 days.

Main symptoms include:

• Sudden high fever

• Headache

• Joint pain

• Muscle pain (myalgia)

• Nausea and vomiting

• Joint swelling

• Inflammation of the eye’s inner membrane

• Skin rash or hives

Most patients experience all of these symptoms, but 3–28% remain asymptomatic. Fever usually lasts 4–7 days and can appear in two phases.

Diagnosis
If a patient comes from an area where the disease is common and has fever and joint pain, a blood test for Chikungunya antibodies should be done. The virus attacks epithelial, endothelial, fibroblast, and macrophage cells, triggering a strong immune response. Interferons in particular help limit viral replication.

Early diagnosis is based on clinical symptoms, epidemiological background, and laboratory tests. One method is ELISA testing to detect antibodies (IgM), which appear in the late first week, peak within 3–5 weeks, and can last up to 8 months. The virus can be directly detected in blood during the first days of illness. Dengue and Zika should be ruled out during testing.

Complications
Most patients recover fully, but joint pain may last months or even years. Some develop chronic rheumatologic conditions such as polyarthritis, tenosynovitis, or Raynaud’s syndrome. The virus can also cause severe problems in the skin, eyes, heart, and nervous system.

Rare but serious complications include:

• Myocarditis (inflammation of heart muscle)

• Eye inflammation

• Hepatitis (liver inflammation)

• Kidney disease

• Meningitis, cranial nerve paralysis, and other neurological issues

Studies show that 5–80% of patients may experience chronic fatigue and persistent joint pain months or years after infection. Infection usually provides lifelong immunity. Death from Chikungunya is rare, but the disease is more severe in children, the elderly (over 65), and those with high blood pressure, diabetes, or heart disease.

Treatment
There is no specific antiviral treatment for Chikungunya. Care focuses on symptom relief:

1. Use fever-reducing medications

2. Use pain relievers

3. Drink plenty of fluids

Similarity with Dengue
Chikungunya and dengue often occur in the same regions and have similar symptoms. Until dengue is ruled out, suspected Chikungunya patients should not be given aspirin or NSAIDs, as these can increase the risk of internal bleeding in dengue patients.

Once Chikungunya is confirmed, long-term joint pain can be managed with NSAIDs, corticosteroids (topical), and physiotherapy.

Prevention
There is no vaccine or specific preventive drug. The best prevention is to avoid mosquito bites:

1. Avoid wearing short-sleeved shirts and shorts in mosquito-prone areas.

2. Apply mosquito repellents to clothing and exposed skin.

3. Ensure living spaces are mosquito-proof.

4. Use mosquito nets.

5. Treat sleeping areas with insecticides.

6. Avoid areas with mosquito habitats like stagnant water and dense vegetation.

7. Postpone travel to areas with outbreaks.

8. Empty standing water from containers like buckets, flowerpots, and tanks.

9. Check and eliminate other potential water storage sites.

10. Remove trash and debris around the home.

Important advice:
If you have recently traveled to tropical or warm regions and suspect you may have Chikungunya, see an infectious disease doctor and get a blood test as recommended.

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