ChikungunyaA92.0
Synonym(s)
DefinitionThis section has been translated automatically.
PathogenThis section has been translated automatically.
Enveloped double-stranded RNA virus of the genus Alphavirus in the family Togaviridae, belonging to the Semliki Forest virus complex.
Occurrence/EpidemiologyThis section has been translated automatically.
First described in Tanzania and Uganda (1952), occurs in East and West Africa, India, Southeast Asia, Philippines, Pacific and Indian Ocean islands. 2005 major outbreak in La Reunion and Mauritius. 2006 outbreak in India (approximately 1.25 million infected).
Also occurred for the first time in Italy in 2007 (Ravenna) with approximately 197 cases.
Deaths have been described (exact numbers are missing).
EtiopathogenesisThis section has been translated automatically.
Clinical featuresThis section has been translated automatically.
Incubation period: 3-7 (maximum 2-12) days, biphasic course:
Abrupt onset with high fever, chills, fatigue, severe pain in joints and muscles (approx. 1-7 days)
Remission (2 days duration).
Renewed rise in fever, severe arthralgia of the small joints, headache, maculo-papular exanthema with healing under scaling, petechiae on the hard palate, conjunctivitis, swelling of the lymph nodes, gastrointestinal symptoms.
Healing after 1-2 weeks, but arthralgias can persist for months.
Long lasting immunity.
DiagnosisThis section has been translated automatically.
lymphopenia, thrombopenia, anaemia, increase in CRP, LDH, AST, ALT, CK
Serology (ELISA): Detection of IgM and IgG antibodies (5 days and later after onset of symptoms)
PCR (in blood): < 5 days after onset of symptoms
Cell culture.
Differential diagnosisThis section has been translated automatically.
Complication(s)This section has been translated automatically.
Persistent arthralgias
pericarditis, myocarditis
Neurological disorders, meningitis
Hepatitis
very rarely hemorrhagic fever.
TherapyThis section has been translated automatically.
Only symptomatic therapy: non-steroidal anti-inflammatory drugs, chloroquine.
Synergistic effects of interferon-alpha and ribavirin are described in the treatment.
ProphylaxisThis section has been translated automatically.
Note(s)This section has been translated automatically.
Remember! Pathogen detection required to be reported according to § 7 of the Infection Protection Act, as the pathogen can be a possible trigger of haemorrhagic fever; the doctor is only required to report suspected cases of haemorrhagic fever.
Notice! Chikungunya means in the Bantu language: "the bent walking one".
LiteratureThis section has been translated automatically.
Borgherini G et al (2007) Outbreak of chikungunya on reunion island: early clinical and laboratory features in 157 adult patients. Clin Infect Dis 44: 1401
Charrel RN et al (2006) Toscana virus RNA in Sergentomyia minuta files. Emerg Infect Dis 12: 1299
- Charrel RN et al (2007) Chikungunya outbreaks--the globalization of vectorborne diseases. N Engl J Med 356: 769
Mourya DT, Mishra AC (2006) Chikungunya fever. Lancet 368: 186
Pialoux G et al (2007) Chikungunya, an epidemic arbovirosis. Lancet Infect Dis 7: 319
- Simon F et al (2007) Chikungunya Infection: An Emerging Rheumatism Among Travelers Returned From Indian Ocean Islands. Report of 47 Cases. Medicine (Baltimore) 86: 123