Chikungunya virus: Difference between revisions

From IDWiki
()
()
Line 1: Line 1:
== 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 09:48, 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