Chikungunya virus: Difference between revisions

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== Background ==
==Background==
=== Microbiology ===
===Microbiology===
* Member of the ''Alphavirus'' genus within the ''Togaviridae'' family
** Closely related to [[o’nyong-nyong virus]]
* Four genotypes: East-Central-South African, West African, Indian Ocean, and Asian


*Member of the ''Alphavirus'' genus within the ''Togaviridae'' family
=== Epidemiology ===
**Closely related to [[o’nyong-nyong virus]]
* The primary vectors are ''[[Aedes aegypti]]'' and ''[[Aedes albopictus]]'' mosquitoes
*Four genotypes: East-Central-South African, West African, Indian Ocean, and Asian
* Endemic in most of Africa, Southeast Asia, the Philippines, and South and Central America
** There has been autochthonous transmission in Italy and Frace


===Epidemiology===
== Clinical Manifestations ==
* Incubation period of [[Usual incubation period::1 to 12 days]]
* [[Causes::Fever]], [[Causes::rash]], and [[Causes::arthralgias]]
* Fever may be "saddleback", with remittance at 4 to 8 days followed by recrudescence for 2 weeks
* Arthritis is typically a symmetrical polyarticular arthritis that involves small joints and knees
** Resolves over months to a year (sometimes longer), but arthralgias (± arthritis) can persist for years
* Rash is macular or maculopapular, and more often central but can involve palms and soles
* Other common symptoms include headache, fatigue, nausea, vomiting, and conjunctivitis
* Bloodwork shows leukopenia, thrombocytopenia, hypocalcemia, and mild to moderate transaminase elevation
* Children are more likely to develop neurological symptoms (status epilepticus, complex seizures, and encephalitis) and dermatologic symptoms (bullous rash)


*The primary vectors are ''[[Aedes aegypti]]'' and ''[[Aedes albopictus]]'' mosquitoes
== Management ==
*Endemic in most of Africa, Southeast Asia, the Philippines, and South and Central America
* High-dose NSAIDs
**There has been autochthonous transmission in Italy and Frace
* May need aggressive rheumatologic medications for arthritis
* Supportive treatment


==Clinical Manifestations==
== Prognosis ==

* 12% risk of chronic arthralgias up to 3 years post-infection
*Incubation period of [[Usual incubation period::1 to 12 days]]
* Neonates and elderly at highest risk for neurological sequelae
*[[Causes::Fever]], [[Causes::rash]], and [[Causes::arthralgias]]
*Fever may be "saddleback", with remittance at 4 to 8 days followed by recrudescence for 2 weeks
*Arthritis is typically a symmetrical polyarticular arthritis that involves small joints and knees
**Resolves over months to a year (sometimes longer), but arthralgias (± arthritis) can persist for years
*Rash is macular or maculopapular, and more often central but can involve palms and soles
*Other common symptoms include headache, fatigue, nausea, vomiting, and conjunctivitis
*Bloodwork shows leukopenia, thrombocytopenia, hypocalcemia, and mild to moderate transaminase elevation
*Children are more likely to develop neurological symptoms (status epilepticus, complex seizures, and encephalitis) and dermatologic symptoms (bullous rash)

==Management==

*High-dose [[NSAID|NSAIDs]]
*May need aggressive rheumatologic medications for arthritis
*Supportive treatment

==Prognosis==

*12% risk of chronic arthralgias up to 3 years post-infection
*Neonates and elderly at highest risk for neurological sequelae


[[Category:Togaviridae]]
[[Category:Togaviridae]]

Revision as of 13:48, 5 August 2020

Background

Microbiology

  • Member of the Alphavirus genus within the Togaviridae family
  • Four genotypes: East-Central-South African, West African, Indian Ocean, and Asian

Epidemiology

  • The primary vectors are Aedes aegypti and Aedes albopictus mosquitoes
  • Endemic in most of Africa, Southeast Asia, the Philippines, and South and Central America
    • There has been autochthonous transmission in Italy and Frace

Clinical Manifestations

  • Incubation period of 1 to 12 days
  • Fever, rash, and arthralgias
  • Fever may be "saddleback", with remittance at 4 to 8 days followed by recrudescence for 2 weeks
  • Arthritis is typically a symmetrical polyarticular arthritis that involves small joints and knees
    • Resolves over months to a year (sometimes longer), but arthralgias (± arthritis) can persist for years
  • Rash is macular or maculopapular, and more often central but can involve palms and soles
  • Other common symptoms include headache, fatigue, nausea, vomiting, and conjunctivitis
  • Bloodwork shows leukopenia, thrombocytopenia, hypocalcemia, and mild to moderate transaminase elevation
  • Children are more likely to develop neurological symptoms (status epilepticus, complex seizures, and encephalitis) and dermatologic symptoms (bullous rash)

Management

  • High-dose NSAIDs
  • May need aggressive rheumatologic medications for arthritis
  • Supportive treatment

Prognosis

  • 12% risk of chronic arthralgias up to 3 years post-infection
  • Neonates and elderly at highest risk for neurological sequelae