When Chikungunya Rears Its Head
Health Today Malaysia|March 2019

During the first few weeks of 2019, Thailand experienced a sustained increase in chikungunya infection rate in the southern part of the country. According to Thai health officials, the outbreak was a continuation from 2018. More than 700 cases have been reported for this year mainly from the provinces of Songkhla, Pattani and Phuket.

Mak Wen Yao

Chikungunya is an infection caused by Chikungunya virus that is transmitted by Aedes aegypti and Aedes albopictus mosquitos. The chikungunya virus is passed to humans when a bite from an infected mosquito breaks the skin and introduces the virus into the body. In other words, the virus spreads from an already infected human to a mosquito, and then to another human. These mosquitoes feed mainly during daytime and can be found both indoors and outdoors. The mosquitos can also potentially transmit dengue and Zika virus.

The chikungunya disease was first described in southern Tanzania in 1952 where the name ‘Chikungunya,’ derived from the Makonde language that means ‘to become contorted,’ was used to describe the clinical appearances of patients who suffer terrible joint pains.

The disease mainly affects people living in Africa, Asia and the Indian subcontinent where outbreaks occur from time to time. Malaysia and Thailand are no exception.

SIGNS & SYMPTOMS

Not all infected individuals will exhibit signs and symptoms of the disease. According to the U.S. Centers for Disease Control and Prevention (CDC), 3% to 28% of people remain asymptomatic. On the other hand, patients who develop symptoms of the disease will first undergo a period of incubation that typically lasts three to seven days.

Two symptoms characterize the disease: the sudden onset of high fever, where the temperature ranges above 39ºC, and joint pains. Typically, fevers will last for several days (up to one week). Some patients may experience what is called a ‘biphasic fever’ where the initial temperature surge lasts for several days, subsidies, and then spikes for the second time.

Joint pains are generally severe and sometimes can be debilitating. Multiple joints from both sides, commonly those in the hands and feet, are involved and pain usually occurs symmetrically. Chikungunya patients may also experience other symptoms such as headache, muscle pain, nausea and vomiting, or develop rashes on their body.

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