Chikungunya

Key points about Chikungunya

• Chikungunya is an infectious disease caused by a virus transmitted by mosquito bites in tropical and subtropical areas.
• The disease is mainly characterized by fever, intense joint pain, headaches and a skin rash.
• It heals spontaneously but in many cases can progress to a very debilitating chronic inflammatory rheumatism.
• Prevention methods include protection against virus vectors and, in some cases, vaccination.

What is Chikungunya?

Le Chikungunya is an infectious disease due to Chikungunya virus belonging to the family of Alphavirus, transmitted by the bite of daytime mosquitoes of the genus Aedes (Aedes aegypti et Aedes albopictus or "tiger mosquito". These mosquitoes, which also transmit the dengue and Zika viruses, are present in tropical and subtropical areas.

Chikungunya around the world

The Chikungunya virus was first isolated in Tanzania in 1953. The name "chikungunya" is derived from a word in the Kimakonde language, spoken in southern Tanzania, meaning "to deform," describing the hunched appearance of patients suffering from severe joint pain. The endemic area covers Africa, the Indian Ocean, India, and Southeast Asia, and, since 2013, Latin America and the Pacific Islands. The true prevalence of Chikungunya virus fever is poorly understood due to a lack of reference laboratories in many tropical countries and frequent confusion with dengue fever because of the similarity of symptoms (painful fever), transmission by the same vectors, and overlapping distribution areas.

Symptoms of Chikungunya

The symptoms of chikungunya are characterized by a sudden, high fever, accompanied by intense joint pain primarily affecting the extremities (wrists, ankles, fingers). Other possible symptoms of chikungunya include... headacheSymptoms include myalgia, skin rashes, nausea, and rare systemic complications. Severe forms primarily affect newborns through transmission of the virus during childbirth from a viremic mother, people aged 65 and over, and patients with chronic illnesses. The frequency, severity, and mortality rate of the disease increase with age. In most cases, symptoms disappear naturally after about ten days, but in 30 to 40% of patients, the disease progresses to a chronic inflammatory phase characterized by persistent and severely debilitating joint pain lasting for months or even years.

The diagnosis of chikungunya

Le diagnosis of chikungunya Biological testing is useful for differentiating the CHIK virus from the dengue virus. It is performed by RT-PCR during viremia (days 1-7) and IgM ELISA serology after day 7. Cross-reactions with other alpha viruses are frequent.

Treatment of Chikungunya

Le treatment for chikungunya Treatment is purely symptomatic: analgesics and antipyretics. Paracetamol overdose contributes to liver damage, and non-steroidal anti-inflammatory drugs (NSAIDs) may play an aggravating role. The use of systemic corticosteroids should be cautious in cases of prolonged, debilitating arthralgia, and the need for a specialized prescription of methotrexate or biologics should be considered if the condition progresses to chronic inflammatory rheumatism.

Prevention

Personal protection measures against mosquito bites are recommended for all travelers exposed to mosquitoes, including the application of appropriate skin repellents, wearing loose-fitting, covering clothing, and using mosquito nets, possibly treated with insecticide. If possible, travel to areas experiencing a chikungunya outbreak should be postponed, especially for pregnant women, the elderly, or those with underlying health conditions. Two chikungunya vaccines are currently available (IXCHIQ® and VIMKUNYA®), and their suitability for vaccination should be determined and the injections administered during a medical consultation.