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Outline
Introduction
Epidemiology
transmission
Clinical manifestation
Treatment
Prevention

Introduction
Chikungunya is a virus that causes acute
febrile polyarthralgia (inflammatory disorder. It
results in muscle pain and stiffness in the body)

and arthritis.
The name is derived from a word in local

language of Tanzania meaning "that which

bends up" or "stooped walk
Multiple outbreaks occur Africa and beyond.
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Epidemiology
Endemic areasAfrica, Asia
Chikungunya virus, 1st indentified during an

outbreak in Tanzania in the 1950s

Then spread to countries of central, southern,

and western Africa.

Outside Africa, the first documented

chikungunya fever outbreak was in Thailand in

1958.
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Epidemiology
Other outbreaks occurred in other Asian

countries:-

India, Sri Lanka, Malaysia, Indonesia,

Spread mainly through infected travelers

between regions where mosquitoes exist for

perpetuation of local transmission.

Imported cases in European countries, USA and

Australia.

Since 2004 it has caused outbreaks in various

parts of Asia

How serious is
Chikungunya?
December 9, 2013
PAHO issues Epidemiological Alert

How serious is
Chikungunya?
June 6, 2014
4,486 confirmed cases
17 Caribbean countries

TRANSMISSION
Aedes Aegypti & Aedes Albopictus

mosquitoes.
The Reservoirs - Humans are the

primary reservoir during epidemic

periods.

TRANSMISSION
Mosquitoes acquire the virus from a viremic

host.
Following an average extrinsic incubation of

10 days, the mosquito transmits the virus to

a nave host.
So far there is no evidence to indicate a

person-to-person transmission of the

disease.

Risk & Immunity

All individuals not previously infected

with CHIKV are at risk of acquiring

the infection
Once exposed, one will develop

long term immunity

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Make No Mistake

Clinical Manifestation
Most individuals will present with symptomatic

disease after an incubation period of 3 7 days

(range: 112 days)
Not all individuals infected with the CHIKV

develop symptoms. (between 3% - 28% does)

CHIKV can cause acute, sub acute, and chronic

disease.
Acute disease is characterized by an abrupt

onset of high fever (usually 102F/39C) and

severe joint pain.
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Clinical Manifestation
Fever typically may lasts from several days

to a week.
The fever may be continuous or intermittent
A drop in temperature is not associated with

worsening of symptoms.
Fever may be associated with a relative

bradycardia

(slowness of heart rate < 60 beats/minute) .

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Main
Fever
characteristics
Headache
Fatigue
Nausea, vomiting
Muscle pain
Rash
Joint pain

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Other common
symptoms

Redness in eye
Difficulty in looking at light
Severe fever with headache and joint pain
Rashes on limbs and trunks
Rash usually appears 2 5 days after

onset of illness and lasts 3 7 days in

50% of cases.
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Ac
u
Pre te
se
nta
tio
n

High Risk
Groups
Infants and the elderly being at greatest
risk for more severe disease.

(day sleepers,

lower immune system)

Co-morbidities have been identified as a

risk factor for severe disease.

(chronic illnesses)

Pregnancy Most CHIKV infections that

occur during pregnancy will not result in

viral transmission to fetus.
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High Risk Group

Rare reports of spontaneous abortions

following CHIKV infection in the mother.

Neonates who had neurologic manifestations

may develop long-term disabilities.

There is no evidence of viral transmission

through breast

Fatalities related to CHIKV infection are

uncommon.

Fatalities related to CHIKV infection are

uncommon.

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Chronic Presentation

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Treatment
There is no specific antiviral drug treatment

for CHIKV.
Symptomatic treatment.
- Rest
- Fluids
- Paracetamol
Use of aspirin is not advised due to risk
of bleeding

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Prevention
Prevent Mosquito Bites
Mosquitoes which spread Chikungunya bite

during the daytime.

Protect yourself from mosquito

bites :
Wear light coloured clothing and cover your

body as much as possible

Use mosquito repellents containing DEET on

exposed skin
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Prevention
Use mosquito coils and electric

vaporization mats both day and night

Use mosquito nets
Use door and window screens (mesh)

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Prevention
Eliminate Mosquito Breeding

Sites
Mosquitoes live and breed in standing water

in and around the home.

Do your part by preventing

mosquito breeding:
Cover all drums, tanks, barrels and buckets

that are used to store water

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Prevention
Get rid of all old tyres, tins, bottles, plastic

containers, coconut shells and anything in

which rain water settles
Cover trash containers to keep out rain

water
Punch holes in the bottom of tins before

placing them in the garbage

Keep flower pot saucers dry
Avoid over-watering potted plants
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Aedes Mosquito
The Aedes mosquito needs only 2ml of

water for breeding.

After breeding the eggs can lay dormant up
to one year.
A carrier mosquito is capable of transmitting

the virus to the next generation.

The Chikungunya virus is sensitive to heat.
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Life Cycle of the Aedes

aegypti
From eggs to
Lays egg 3 days
after taking a
blood meal

From Pupa to
Adult- 2 days

Larva - 1 3 days

From larva to
pupa - 4 days
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Common Breeding
Sites

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Potential Breeding
Grounds

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Potential Breeding
Grounds

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Potential Breeding
Grounds

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Potential Breeding
Grounds

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Potential Breeding
Grounds

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Potential Breeding
Grounds

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Potential Breeding
Grounds

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Potential Breeding
Grounds

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Potential Breeding
Grounds

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Chikungunya Prevention &

Control is in your hands Do
Something

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