Chikungunya virus: Difference between revisions
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| − | == |
+ | == Background == |
| + | === Microbiology === |
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| + | * Member of the ''Alphavirus'' genus within the ''Togaviridae'' family |
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| + | ** Closely related to [[O’nyong-Nyong virus]] |
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| + | * Four genotypes: East-Central-South African, West African, Indian Ocean, and Asian |
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| + | === Epidemiology === |
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| − | * History |
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| + | * The primary vectors are ''[[Aedes aegypti]]'' and ''[[Aedes albopictus]]'' mosquitoes |
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| − | ** Fever |
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| + | * Endemic in most of Africa, Southeast Asia, the Philippines, and South and Central America |
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| − | ** Rash |
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| + | ** There has been autochthonous transmission in Italy and Frace |
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| − | ** Arthralgias |
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| + | |||
| + | == Clinical Presentation == |
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| + | * Incubation period of 1 to 12 days |
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| + | * Fever, rash, and arthralgias |
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| + | * Fever may be "saddleback", with remittance at 4 to 8 days followed by recrudescence for 2 weeks |
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| + | * Arthritis is typically a symmetrical polyarticular arthritis that involves small joints and knees |
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| + | ** Resolves over months to a year (sometimes longer), but arthralgias (± arthritis) can persist for years |
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| + | * Rash is macular or maculopapular, and more often central but can involve palms and soles |
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| + | * Other common symptoms include headache, fatigue, nausea, vomiting, and conjunctivitis |
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| + | * Bloodwork shows leukopenia, thrombocytopenia, hypocalcemia, and mild to moderate transaminase elevation |
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| + | * Children are more likely to develop neurological symptoms (status epilepticus, complex seizures, and encephalitis) and dermatologic symptoms (bullous rash) |
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== Management == |
== Management == |
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| − | |||
* High-dose NSAIDs |
* High-dose NSAIDs |
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| − | * May need aggressive |
+ | * May need aggressive rheumatologic medications for arthritis |
* Supportive treatment |
* Supportive treatment |
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== Prognosis == |
== Prognosis == |
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| − | |||
* 12% risk of chronic arthralgias up to 3 years post-infection |
* 12% risk of chronic arthralgias up to 3 years post-infection |
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* Neonates and elderly at highest risk for neurological sequelae |
* Neonates and elderly at highest risk for neurological sequelae |
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Revision as of 22:58, 7 March 2020
Background
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
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 Presentation
- 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
