Chikungunya Fever in Children

Chikungunya fever, a viral disease transmitted by mosquitoes, poses a significant health concern, particularly for children. It has been around in Sri Lanka sporadically, but there are reports of an increasing occurrence of it in more recent times. While often associated with debilitating joint pain in adults, its manifestations in children can present unique challenges. Understanding the nuances of this disease is crucial for effective management and prevention.

- DR B. J. С. PERERA

Chikungunya fever is caused by the chikungunya virus (CHIKV), an alphavirus transmitted to humans through the bites of infected Aedes aegypti and Aedes albopictus mosquitoes. These are the same mosquitoes that transmit dengue and Zika viruses, highlighting the overlapping risks in many areas of the world. It is entirely possible for chikungunya and dengue to co-circulate in the same area, leading to co-infections in individuals.

When a mosquito bites a person infected with CHIKV, it ingests the virus. After a period of growth and multiplication of the virus within the mosquito, the virus can be transmitted to another person through subsequent bites. Therefore, the mosquito acts as a vector or an intermediate transmitting agent that spreads the disease, but not as a reservoir of the disease. The spread of chikungunya is influenced by environmental factors that support mosquito breeding, such as stagnant water and warm climates. Urbanization and poor sanitation can exacerbate the problem by creating breeding grounds for these mosquitoes.

In some rare instances, particularly in infants and very young children, chikungunya can lead to neurological complications, such as involvement of the brain, known as encephalitis. This is associated with a change in the level of alertness, drowsiness, convulsions and weakness of limbs. Equally rarely, some studies indicate that children can experience bleeding tendencies and haemorrhagic manifestations more often than adults.

Diagnosis is typically made through evaluating the patient's symptoms and medical history, as well as by special blood tests that can detect the presence of CHIKV antibodies (IgM and IgG) or the virus itself through PCR testing.