Chikungunya virus: Difference between revisions

From IDWiki
m (β†’β€: typo)
Β 
(4 intermediate revisions by the same user not shown)
Line 1: Line 1:
βˆ’
== Background ==
 +
==Background==
βˆ’
=== Microbiology ===
 +
===Microbiology===
βˆ’
* Member of the ''Alphavirus'' genus within the ''Togaviridae'' family
  
βˆ’
** Closely related to [[o’nyong-nyong virus]]
  
βˆ’
* Four genotypes: East-Central-South African, West African, Indian Ocean, and Asian
  
   
  +
*Member of the ''Alphavirus'' genus within the ''Togaviridae'' family
βˆ’
=== Epidemiology ===
  
  +
**Closely related to [[o’nyong-nyong virus]]
βˆ’
* The primary vectors are ''[[Aedes aegypti]]'' and ''[[Aedes albopictus]]'' mosquitoes
  
  +
*Four genotypes: East-Central-South African, West African, Indian Ocean, and Asian
βˆ’
* Endemic in most of Africa, Southeast Asia, the Philippines, and South and Central America
  
βˆ’
** There has been autochthonous transmission in Italy and Frace
 
   
  +
===Epidemiology===
βˆ’
== Clinical Presentation ==
  
βˆ’
* Incubation period of 1 to 12 days
  
βˆ’
* Fever, rash, and arthralgias
  
βˆ’
* Fever may be "saddleback", with remittance at 4 to 8 days followed by recrudescence for 2 weeks
  
βˆ’
* Arthritis is typically a symmetrical polyarticular arthritis that involves small joints and knees
  
βˆ’
** Resolves over months to a year (sometimes longer), but arthralgias (Β± arthritis) can persist for years
  
βˆ’
* Rash is macular or maculopapular, and more often central but can involve palms and soles
  
βˆ’
* Other common symptoms include headache, fatigue, nausea, vomiting, and conjunctivitis
  
βˆ’
* Bloodwork shows leukopenia, thrombocytopenia, hypocalcemia, and mild to moderate transaminase elevation
  
βˆ’
* 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
βˆ’
== Management ==
  
  +
*Endemic in most of Africa, Southeast Asia, the Philippines, and South and Central America
βˆ’
* High-dose NSAIDs
  
  +
**There has been autochthonous transmission in Italy and Frace
βˆ’
* May need aggressive rheumatologic medications for arthritis
  
βˆ’
* Supportive treatment
  
   
  +
==Clinical Manifestations==
βˆ’
== Prognosis ==
  
  +
βˆ’
* 12% risk of chronic arthralgias up to 3 years post-infection
  
  +
*Incubation period of [[Usual incubation period::1 to 12 days]]
βˆ’
* 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 (Β± 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)
  +
  +
==Differential Diagnosis==
  +
{| class="wikitable"
  +
!Feature
  +
![[Dengue]]
  +
![[Zika]]
  +
!Chikungunya
  +
|-
  +
|Asymptomatic
  +
|40-80%
  +
|35-85%
  +
|3-28%
  +
|-
  +
|Fever
  +
| +++
  +
| ++
  +
| +++
  +
|-
  +
|Rash
  +
| +
  +
| +++
  +
| ++
  +
|-
  +
|Conjunctivitis
  +
|–
  +
| ++
  +
| +
  +
|-
  +
|Arthralgia
  +
| +
  +
| ++
  +
| +++
  +
|-
  +
|Myalgia
  +
| ++
  +
| +
  +
| +
  +
|-
  +
|Headache
  +
| ++
  +
| +
  +
| ++
  +
|-
  +
|Hemorrhage
  +
| ++
  +
|–
  +
|–
  +
|-
  +
|Shock
  +
| +
  +
|–
  +
|–
  +
|-
  +
|Thrombocytopenia
  +
| +++
  +
| +
  +
|–
  +
|-
  +
|Leukopenia
  +
| ++
  +
|–
  +
| ++
  +
|}
  +
==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]]

Latest revision as of 14:13, 22 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 (Β± 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)

Differential Diagnosis

Feature Dengue Zika Chikungunya
Asymptomatic 40-80% 35-85% 3-28%
Fever +++ ++ +++
Rash + +++ ++
Conjunctivitis – ++ +
Arthralgia + ++ +++
Myalgia ++ + +
Headache ++ + ++
Hemorrhage ++ – –
Shock + – –
Thrombocytopenia +++ + –
Leukopenia ++ – ++

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
Retrieved from "https://idwiki.org/index.php?title=Chikungunya_virus&oldid=6348"
Powered by MediaWiki
Powered by Semantic MediaWiki