Dengue and Chikungunya

Dengue and Chikungunya 

Dengue

Overview

Dengue (DENG-gey) fever is a mosquito-borne disease that occurs in tropical and subtropical areas of the world. Mild dengue fever causes a high fever, rash, and muscle and joint pain. A severe form of dengue fever, also called dengue hemorrhagic fever, can cause severe bleeding, a sudden drop in blood pressure (shock) and death.

Millions of cases of dengue infection occur worldwide each year. Dengue fever is most common in Southeast Asia and the western Pacific islands, but the disease has been increasing rapidly in Latin America and the Caribbean.

Researchers are working on dengue fever vaccines. For now the best prevention is to reduce mosquito habitat in areas where dengue fever is common.

Symptoms

Many people, especially children and teens, may experience no signs or symptoms during a mild case of dengue fever. When symptoms do occur, they usually begin four to seven days after you are bitten by an infected mosquito.

Dengue fever causes a high fever — 104 F degrees — and at least two of the following symptoms:

·         Headache

·         Muscle, bone and joint pain

·         Nausea

·         Vomiting

·         Pain behind the eyes

·         Swollen glands

·         Rash

Most people recover within a week or so. In some cases, symptoms worsen and can become life-threatening. Blood vessels often become damaged and leaky. And the number of clot-forming cells (platelets) in your bloodstream drops. This can cause a severe form of dengue fever, called dengue hemorrhagic fever, severe dengue or dengue shock syndrome.

Signs and symptoms of dengue hemorrhagic fever or severe dengue — a life-threatening emergency — include:

·         Severe abdominal pain

·         Persistent vomiting

·         Bleeding from your gums or nose

·         Blood in your urine, stools or vomit

·         Bleeding under the skin, which might look like bruising

·         Difficult or rapid breathing

·         Cold or clammy skin (shock)

·         Fatigue

·         Irritability or restlessness

When to see a doctor

Call or go to the nearest emergency room if you've recently visited a region in which dengue fever is known to occur and you develop emergency symptoms, such as severe abdominal pain, vomiting, difficulty breathing, or blood in your nose, gums, vomit or stools.

If you develop a fever and milder symptoms common to dengue fever, call your doctor.

Causes

Dengue fever is caused by any one of four types of dengue viruses spread by mosquitoes that thrive in and near human lodgings. When a mosquito bites a person infected with a dengue virus, the virus enters the mosquito. When the infected mosquito then bites another person, the virus enters that person's bloodstream.

After you've recovered from dengue fever, you have immunity to the type of virus that infected you — but not to the other three dengue fever virus types. The risk of developing severe dengue fever, also known as dengue hemorrhagic fever, actually increases if you're infected a second, third or fourth time.

Risk factors

Factors that put you at greater risk of developing dengue fever or a more severe form of the disease include:

·         Living or traveling in tropical areas. Being in tropical and subtropical areas increases your risk of exposure to the virus that causes dengue fever. Especially high-risk areas are Southeast Asia, the western Pacific islands, Latin America and the Caribbean.

·         Prior infection with a dengue fever virus. Previous infection with a dengue fever virus increases your risk of having severe symptoms if you're infected again.

Complications

If severe, dengue fever can damage the lungs, liver or heart. Blood pressure can drop to dangerous levels, causing shock and, in some cases, death.

Prevention

One dengue fever vaccine, Dengvaxia, is currently approved for use in those ages 9 to 45 who live in areas with a high incidence of dengue fever. The vaccine is given in three doses over the course of 12 months. Dengvaxia prevents dengue infections slightly more than half the time.

The vaccine is approved only for older children because younger vaccinated children appear to be at increased risk of severe dengue fever and hospitalization two years after receiving the vaccine.

The World Health Organization stresses that the vaccine is not an effective tool, on its own, to reduce dengue fever in areas where the illness is common. Controlling the mosquito population and human exposure is still the most critical part of prevention efforts.

So for now, if you're living or traveling in an area where dengue fever is known to be, the best way to avoid dengue fever is to avoid being bitten by mosquitoes that carry the disease.

If you are living or traveling in tropical areas where dengue fever is common, these tips may help reduce your risk of mosquito bites:

·         Stay in air-conditioned or well-screened housing. The mosquitoes that carry the dengue viruses are most active from dawn to dusk, but they can also bite at night.

·         Wear protective clothing. When you go into mosquito-infested areas, wear a long-sleeved shirt, long pants, socks and shoes.

·         Use mosquito repellent. Permethrin can be applied to your clothing, shoes, camping gear and bed netting. You can also buy clothing made with permethrin already in it. For your skin, use a repellent containing at least a 10 percent concentration of DEET.

·         Reduce mosquito habitat. The mosquitoes that carry the dengue virus typically live in and around houses, breeding in standing water that can collect in such things as used automobile tires. You can help lower mosquito populations by eliminating habitats where they lay their eggs. At least once a week, empty and clean containers that hold standing water, such as planting containers, animal dishes and flower vases. Keep standing water containers covered between cleanings.

Chikungunya 

What is Chikungunya?

Chikungunya is a mosquito-borne viral disease, very similar to dengue. The mosquitoes which spread it are Aedes aegypti and Aedes albopictus. These mosquitoes acquire the virus when they feed on an infected person. The virus spreads in the system of the mosquito and reaches its salivary glands. Soon after, when the mosquito feeds on a person, it infects him.

The infection lasts for 2 to 12 days.

If you notice any of the following symptoms, you need to consult your family physician or a general physician immediately:

• ·         Continuous high fever (above 38.5 degree Celsius)
• ·         Debilitating joint pain and redness or soreness in the joint areas
• ·         Rashes on the skin
• ·         Nausea
• ·         Vomiting
• ·         Sensitivity to light
• ·         Headache

How does Chikungunya occur?

Once the Aedes mosquito bites a person suffering from Chikungunya, the Chikungunya virus enters the mosquito’s system. After getting infected when the mosquito feeds on another person, the virus gets transmitted to the person.

The virus travels through his body and spreads to various glands in the body. It enters the bloodstream and causes inflammation of the blood vessels, causing them to swell and leak.The Chikungunya virus usually targets joints, muscles, skin, and less frequently, the liver, kidneys, eyes and the central nervous system.The Chikungunya virus mainly infects the muscle cells of the body. Once it infects a muscle cell, it keeps reproducing till the cell dies and then the viruses move onto a new cell.If you contract this disease you may experience severe muscle pains, joint pains, fever and rash.

What are the symptoms of Chikungunya? How is Chikungunya diagnosed?

The symptoms of Chikungunya include:

• ·         High fever
• ·         Severe muscle and joint pain
• ·         Severe headache
• ·         Nausea
• ·         Vomiting
• ·         Rash on the skin due to damaged blood vessels
• ·         Enlarged painful lymph node in the neck
• ·         Sore throat
• ·         Painful abdominal cramps
• ·         Cold fingers and toes
• ·         Dizziness
• ·         Constipation

Chikungunya symptoms can often be confused with the symptoms of dengue. However, certain symptoms such as debilitating joint pains are unique only to Chikungunya. In fact, it is said dengue plus arthritis is equal to Chikungunya.

In dengue, the muscle pain is very noticeable.

Diagnosis

A special blood test known as ELISA blood test (enzyme-linked immunosorbent assay) is done to confirm the presence of Chikungunya virus in a patient. During the test, if IgM antibodies are found (which can last up to one year in the blood) it confirms the presence of Chikungunya virus in the body.

These antibodies reveal the presence of the Chikungunya virus.

What are the complications of Chikungunya?

Some complications of Chikungunya include:

• ·         Neurological imbalances
• ·         Seizures
• ·         Myocarditis or inflammation of the heart muscle
• ·         Ocular disease or eye disease (uveitis, retinitis)
• ·         Jaundice caused by liver damage
• ·         Acute renal disease when kidneys get affected
• ·         Severe bullous lesions 
• ·         Neurological diseases, such as meningoencephalitis, Guillain-Barré syndrome, myelitis, or cranial nerve palsies

What is the treatment for Chikungunya?

Chikungunya is a self-remitting illness. There is no particular medication or treatment available for chikungunya.

The doctor may advise you to take plenty of rest, fluids, and provide you painkillers. Even while prescribing pain-killers, paracetamol is recommended for treating the pain and fever. Nonsteroidal anti-inflammatory drugs are never prescribed.

The usual treatment for the severe form of Chikungunya consists of:

·         Providing Intravenous (IV) fluid and electrolyte replacement

·         Monitoring blood pressure

·         Blood transfusion to replace blood loss, if any