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 Introduction
 Epidemiology
 transmission
 Clinical manifestation
 Treatment
 Prevention
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 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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 Endemic areas — Africa, Asia
 Chikungunya virus, 1 st 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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• 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
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December 9, 2013
PAHO issues Epidemiological Alert

June 6, 2014
4,486 confirmed cases
17 Caribbean countries

 Aedes Aegypti & Aedes Albopictus mosquitoes.
 The Reservoirs - Humans are the primary reservoir during epidemic periods.

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 Mosquitoes acquire the virus from a viremic host.
 Following an average extrinsic incubation of 10 days, the mosquito transmits the virus to a naïve host.
 So far there is no evidence to indicate a personto-person transmission of the disease.
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 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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Clinical Manifestation
 Most individuals will present with symptomatic disease after an incubation period of 3 – 7 days
(range: 1−12 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≥ 102°F/39°C) and severe joint pain.
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 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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 Fever
 Headache
 Fatigue
 Nausea, vomiting
 Muscle pain
 Rash
 Joint pain
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 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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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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-
 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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 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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 Use mosquito coils and electric vaporization mats both day and night
 Use mosquito nets
 Use door and window screens (mesh)
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 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
Lays egg 3 days after taking a blood meal
From eggs to
Larva - 1 – 3 days
From Pupa to
Adult- 2 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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Chikungunya Prevention & Control is in your hands – Do Something
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