chikungunya.

Why am I talking about Chikungunya when Swineflu is in fashion?
Well a friend of mine has returned from Kerala, she was saying that the minute people turn with febrile symptoms, the doctors hand out pills, on the assumption of Chikungunya as it is still rampant there.
“Without a blood test?” --- Without a blood test. Why would it be important for a blood test after all paracetamol that is prescribed for Chikungunya is a relatively harmless drug that it is vended over the counter without prescription? Multivitamins can’t do much damage either. Fluid intake and rest are prescribed in all febrile conditions.
In a way this is a good thing to do, because people once infected by Chikungunya seem to develop a more serious condition called the tomato fever. What happens here, is there are tomato like rashes emerging on the hands and legs. The skin becomes hypersensitive, these tomato like rashes have fluids oozing out of them.
To the date 28.000 cases have been registered. The general profile of the disease is not known.
But what is scary is the differential diagnosis of Chikungunya is dengue. While Chikungunya is crippling dengue is fatal.
Chikungunya Vs Dengue:
vector:
Dengue Aedes aeaypti
Chikungunya Aedes aeaypti and aedes albopictus.
Clinical features:
Dengue normal fever(DNF) high fever abrupt onset sever headache, pain behind the eyes, muscles bone joints, nausea, vomiting and rashes.
Dengue hemorrhagic (DHF) just like DNF but hemorrhage is also seen. Hemorrhage when there is bleeding.
Chikungunya sudden onset, of fever, headache, chills, nausea, vomiting, sometimes joint pain and rashes are also seen.
Incubation:
Dengue 3- 5days.
Chikungunya 3-7 days.
This is why it is very easy to miss the diagnosis particularly when so much of hype is going around.
Laboratory tests:
Are important in diagnosis and treatment plan. The tests done are:
· Antibody test for IgM and IgG
· Total blood and platelet count
· White blood count.
Clinical features with IgM and IgG or both decrease WBC and platelet count usually confirms dengue. Normal or hemorrhagic.
Presence of IgG and isolation of virus by genetic coding is diagnostic of Chikungunya.
Dengue requires hospitalization ASAP there is a fear of the patient bleeding into a hemorrhagic shock,
While Chikungunya is usually self limiting, lot of fluids, rest, and paracetmol helps in relief from symptoms. Though joint pain persists for a long time.
References:
Kerala department of preventive health.
WHO Chikungunya awareness program.
Center for disease control.