As Chikungunya fever is called a (sub) tropical viral disease that is transmitted by mosquitoes and is manifested based pronounced joint pain and high fever. The course and prognosis are good for Chikungunya fever, which occurs rarely in Germany.
What is Chikungunya fever?
According to DigoPaul, Chikungunya fever is a (sub) tropical disease from the spectrum of hemorrhagic fever that rarely occurs in Germany and can be traced back to a viral infection as a result of a bite with infected mosquitoes from the Aedes genus.
The viral disease is mainly found in sub-Saharan Africa, on the Indian subcontinent and the islands of the Indian Ocean. Following the mosquito bite, the first characteristic symptoms manifest themselves after an incubation period of around one to twelve days, such as high fever, pronounced joint pain that makes it impossible to walk upright, as well as lymph node edema (swelling), pain in the limbs, headache, exhaustion and / or stomach ache. Intestinal discomfort.
In addition, a skin rash can be observed in about half of those affected and minor bleeding from the mucous membranes and skin in a quarter. Infections with Chikungunya fever are notifiable in Germany.
Chikungunya fever is due to infection with the chikungunya virus (CHIKV), which belongs to the genus alpha viruses.
Although, from a theoretical point of view, several different mosquito species can transmit the virus, only the yellow fever mosquito (Aedes aegypti) and the Asian tiger mosquito (Aedes albopictus), which also transmit dengue fever and yellow fever, have so far been proven to be clear carriers of Chikungunya fever.
With the exception of a few documented individual cases, the pathogen is not transmitted directly from person to person (via the bloodstream), but through the bite of a mosquito to people, which in advance of the host carrying the pathogen (primates such as monkeys, rodents, People).
In addition, transmissions from pregnant women who were infected with Chikungunya fever to the unborn child have been observed (diaplacental transmission).
Symptoms, ailments & signs
Chikungunya fever is primarily a very high fever. This fever also has an extremely negative effect on the quality of life of the person affected and reduces it. The patients continue to suffer from permanent tiredness and fatigue, so that they cannot actively participate in everyday life.
It also leads to very severe headaches that cannot be relieved with the help of pain relievers. If the Chikungunya fever is not treated, conjunctivitis also occurs, which in the worst case and especially if left untreated, can lead to complete loss of vision. Those affected also suffer from pain in the joints and muscles and can therefore not be physically active.
There are significant restrictions on movement, so that most patients are dependent on outside help in their everyday lives. As a rule, with Chikungunya fever, the affected person’s joints also swell significantly and bleeding or reddening of the skin occurs. The skin can also be affected by a rash. Chikungunya fever is relatively easy to treat in most cases. However, in some cases it happens that the joint pain only subsides after a few months and therefore does not go away immediately.
Diagnosis & course
In the early stages of the disease, chikungunya fever is difficult to distinguish from other tropical fever diseases such as dengue fever or malaria.
For the diagnosis of Chikungunya fever, the stay of the person affected in one of the endangered areas and the typical symptoms of the virus disease, in particular pronounced tenderness on one or both wrists, provide the first information about a possible disease. In addition, the causative agent of Chikungunya fever can be detected directly in the course of a blood analysis or by cultivation in the laboratory during the first three to five days.
In the later course of the disease (eighth to tenth day) a diagnosis can be made by detecting the antibodies specific for Chikungunya fever (IgM, IgG). The prognosis for Chikungunya fever is good and the viral disease usually heals spontaneously after one to two weeks. Only in individual cases (around five to ten percent) does the joint pain only subside after months or years.
In most cases, the chikungunya fever will go away on its own. However, joint pain can often occur for several weeks and patients feel tired and limp. A small percentage of those infected can also suffer from joint problems for several months or even years.
Chikungunya fever is only very rarely fatal. On average, around four out of 100 people infected die of the disease, and the risk of a fatal outcome is slightly higher in children. In some patients, however, serious complications such as meningitis, cardiovascular failure or lung failure occur again and again. In addition, the tropical disease can also lead to liver inflammation (hepatitis) or severe neurological disorders.
Chikungunya fever can also affect the nervous system or liver, especially in young children. People with heart failure, blood sugar problems or high blood pressure, newborns and people over 65 years of age are particularly at increased risk of developing the disease. Pregnancies are also a dangerous risk factor, as the mother can pass the disease on to the child.
When should you go to the doctor?
People who are about to travel to India, Southeast Asia or Africa should get vaccinated against the Chikungunya virus as a precaution. Consult a doctor immediately if an infection is suspected. A typical warning sign that requires medical clarification is the strong fever, which is usually associated with chills, headaches and aching limbs. The severe joint pain is particularly characteristic. Those returning from vacation who experience severe pain in their arms and legs should speak to their family doctor.
The same applies if skin rashes or conjunctivitis suddenly appear that cannot be attributed to any other cause. A severe course of Chikungunya fever is unlikely, but rapid treatment allows the symptoms to subside more quickly and without complications.
Parents, children and pregnant women should always see a doctor if they suspect a serious illness. This is especially true if bleeding is observed – a sign of the so-called hemorrhagic course, which can be fatal if left untreated. If the symptoms do not subside after three to four days at the latest, a doctor’s visit is required.
Treatment & Therapy
So far, there is no effective vaccine against Chikungunya fever for the causal therapy of the viral disease. Only in the last few years has the disease, which has been known since the 1950s, come into focus in the western world, so that it is only now that clinical pilot tests for vaccination protection are taking place.
Accordingly, the therapeutic measures for those affected by Chikungunya fever have so far been limited to a reduction in the symptomatic symptoms. In order to minimize the sometimes very pronounced joint pain, non-steroidal anti – inflammatory drugs and analgesics (pain relievers) as well as fever-lowering and anti-inflammatory agents are used, which may have to be administered over a longer period of time.
Physical measures can help to minimize the joint complaints typical of Chikungunya fever, especially if they do not go away over a long period of time. In addition, in some cases, to avoid dehydration (dehydration) due to high fever, infusions are used to improve the fluid balance.
Chikungunya fever sufferers should also avoid taking acetylsalicylic acid. Acetylsalicylic acid impairs the function of the blood platelets, which are present in low concentrations in Chikungunya fever.
Outlook & forecast
In most cases, Chikungunya fever can be treated well, so that the disease progresses positively and is completely cured. Especially with early diagnosis, there are usually no particular complications.
If the disease is discovered later, the disease can cause further inflammation, such as inflammation of the liver or pneumonia, if left untreated. Neurological disorders can also occur. Chikungunya fever leads to death of the patient only very rarely and especially without treatment.
Often times, severe disease only occurs in people of old age or in people with acute illness, as a result of which the immune system is weakened. If chikungunya fever occurs during pregnancy, the disease can also spread to the child and infect the child.
Since the disease cannot be treated causally, only the symptoms of the fever are treated with the help of medication. As a rule, the symptoms subside after about a week. Only in a few cases do those affected suffer from severe joint pain for several months and require intensive medical treatment.
Since there is currently no vaccine against Chikungunya fever, the disease can only be prevented by exposure prophylaxis. This includes mosquito repellants and wearing long-sleeved clothing when in endangered areas. Since the mosquitoes that transmit pathogens are also active during the day, long trousers and shirts should be worn both at night and during the day. People who have already had chikungunya fever have lifelong immunity.
Since the Chikungunya virus cannot be combated directly, there is no common aftercare or follow-up treatment. Only symptoms are dealt with during treatment. During this time, bed rest is particularly important. Once the fever is over, it is important to slowly get going again. The circulation may not be going well after a long period of lying down.
It is also important to drink enough even after the fever. During the fever you lose a lot of water, which then has to be returned to the body. A doctor will need to check whether additional pain relievers are needed after the fever. Physiotherapy is often prescribed after the treatment to counteract any persistent joint pain.
After the symptoms have been relieved and the fever has decreased, the doctor will check whether the blood values are back in the normal range and determine which possible follow-up services are still necessary. Patients should take care not to overexert themselves after the illness and gradually and slowly go back to the normal daily routine. A fever like Chikungunya fever can, depending on its strength, weaken the body and the immune system and drive blood pressure into the cellar.
You can do that yourself
According to the current medical status, there is no drug available that directly combats the virus pathogen causing Chikungunya fever, so that only symptomatic treatment is possible.
The first symptoms of chikungunya virus disease are high fever and severe, sometimes unbearable muscle and joint pain, which can be relieved with antipyretic drugs and painkillers. Paracetamol and non-steroidal anti-inflammatory drugs such as ibuprofen or naproxen have proven to be effective. From Aspirin and other salicylates is not recommended, however, as this can worsen the effects of Chikungunya fever by excessive bleeding can be caused by the inhibition of platelet clotting.
In some cases, chikungunya fever is accompanied by a rash that usually goes away on its own, leaving no need for treatment. In order to support the healing process, it is advisable to keep bed rest and to drink plenty of water to counteract the dehydration and mineral loss associated with the high fever. After the fever has subsided, it makes sense to exercise lightly in order to get the muscles and joints used to the strain again.
So far there is no vaccination against Chikungunya fever, which is transmitted by mosquitoes of the Aedes genus mainly in Asia and Africa. Prophylaxis is therefore only possible in the form of appropriate protective clothing and repellents.