Chikungunya
For the first time ever in the USA, cases of locally acquired Chikungunya were recently reported in Florida residents. Thought originally to only be transmitted by mosquitoes, ticks have been found harboring the virus.
- Symptoms usually begin 3–7 days after being bitten by an infected mosquito.
- The most common symptoms are acute fever, severe and disabling joint pain, headache, muscle pain, joint swelling, or rash. Polyarthralgia, headaches, myalgia, arthritis, conjunctivitis, nausea, vomiting, and maculopapular rash are also possible symptoms. Uveitis, retinitis, myocarditis, hepatitis, nephritis, bullous skin lesions, hemorrhage, meningoencephalitis, myelitis, Guillain-Barré syndrome, and cranial nerve palsies are also associated with the virus. Clinical laboratory findings can include lymphopenia, thrombocytopenia, elevated creatinine, and elevated hepatic transaminases.
- Chikungunya disease can result in death, and the symptoms can become chronic, severe and disabling.
- People at risk for more severe disease include newborns infected around the time of birth, older adults (≥65 years), and people with medical conditions such as high blood pressure, diabetes, or heart disease.
- There is no medicine to treat chikungunya virus infection or disease.
Blood-borne transmission is possible; cases have been documented among laboratory personnel handling infected blood and a health care worker drawing blood from an infected patient.
In utero transmission has been documented. Intrapartum transmission has also been documented.
Clinical Signs & Symptoms
The majority of people infected with chikungunya virus become symptomatic. The incubation period is typically 3–7 days (range, 1–12 days). The disease is most often characterized by acute onset of fever (typically >39°C [102°F]) and polyarthralgia. Joint symptoms are usually bilateral and symmetric, and can be severe and debilitating. Other symptoms may include headache, myalgia, arthritis, conjunctivitis, nausea/vomiting, or maculopapular rash. Clinical laboratory findings can include lymphopenia, thrombocytopenia, elevated creatinine, and elevated hepatic transaminases.
Persons at risk for severe disease include neonates exposed intrapartum, older adults (e.g., > 65 years), and persons with underlying medical conditions (e.g., hypertension, diabetes, or cardiovascular disease). Some patients might have relapse of rheumatologic symptoms (e.g., polyarthralgia, polyarthritis, tenosynovitis) in the months following acute illness. Studies report variable proportions of patients with persistent joint pains for months to years.
More detailed information can be found on CDC’s chikungunya web page for healthcare providers
Chikungunya is not a nationally notifiable disease in the USA.
Rev Elev Med Vet Pays Trop. 1990;43(1):15-22.
[Ticks of the Ixodidae family as reservoir of arboviruses in the Republic of Guinea. II. Arboviruses].
[Article in French]
- 1Laboratoire de Virologie et de Microbiologie, IRBAG, Kindia, République de Guinée.
Abstract
From 1978 to 1985, 96,167 Ixodidae family were collected, from which 79 strains of the following arboviruses were isolated, i.e. 4 Bhanja strains, 9 CHF-Congo, 20 Dugbe, 24 Jos (viruses ecologically related to ticks), 10 Abadina, 7 Bluetongue, 1 Bunyamwera, 1 Chikungunya, (related to ticks for the first time), 1 Kindia and 2 Forecariah (new viruses).
The main sources for arbovirus isolation were ticks of the Amblyomma variegatum genus (78.5%) followed by ticks of the Boophilus (12.6%), Rhipicephalus (7.6%) and Haemaphysalis (1.3%) genera.
According to experimental data obtained in the laboratory and in the field involvement of A. variegatum as reservoir host for Abadina virus was established.
The seasonal dynamics characteristics of the propagation of this virus and its pathogenicity for cattle were also noticed.
Serological surveys on cattle (i.e. on about 7000 sera) showed that Abadina, Bluetongue, CHF-Congo, Dugbe viruses spread more actively, with 24-35% positive sera.
The rate of positive sera against Bhanja, Forecariah, Jos and RVF viruses did not exceed 0.9%.
During the study period, the arboviruses isolated from ticks did not play any important epidemiological role in human pathology of the Republic of Guinea.
PMID: 2263738 [PubMed - indexed for MEDLINE]