Chikungunya is a virus that is transmitted to humans through the bite of an infected mosquito. This type of mosquito can also carry other diseases, such as dengue and yellow fever. Chikungunya is found all over the world, including the Caribbean, tropical areas of Asia, Africa, South America and North America. To date, there are no cures, vaccines or treatments for the disease. The only possible thing to do is to relieve the symptoms. It is important to recognize and treat the signs and symptoms of chikungunya, as well as being aware of the complications arising from the disease.
Steps
Part 1 of 3: Recognizing the Signs and Symptoms
Step 1. Look for symptoms in the acute phase of the disease
This phase consists of a quick but short period in which the pathology manifests. Symptoms may not appear until 2-12 days after being bitten by the infected mosquito. Generally, however, the symptoms are not evident for the first 3 or 7 days. When the acute phase begins, it lasts about 10 days, after which you begin to feel better. Here is a short list of symptoms:
- Fever: It usually reaches as high as 39 - 40.5 ° C and can last anywhere from 3 days to a week. Fever can follow a biphasic trend (ie it disappears for a few days and then returns with lower temperatures, of about 38, 3 - 38, 9 ° C). During this time the virus accumulates in the blood system, spreading to different parts of the body.
- Arthritis (joint pain): Joint pain usually occurs in the smaller joints, such as those of the hands, wrists, ankles, and larger ones, such as knees and shoulders, but not in the hips. More than 70% of victims experience pain that spreads from one joint to another once the previous one begins to improve. The pain is usually worse in the morning, but is reduced with moderate physical activity. The joints may also swell, become painful to the touch, and you may experience some inflammation in the tendons (tenosynovitis). This type of malaise usually resolves in 1-3 weeks, while the greatest pain subsides after the first week.
- Skin rashes: About 40-50% of victims have them. The most common rash is measles-like (maculopapular) rash, which presents with red rashes covered with bumps, which may appear 3 or 5 days after the onset of fever and which subside within 3 to 4 days. They typically begin to show up on the upper limbs and later affect the face and chest / trunk. Take off your shirt, check yourself in the mirror, and take note if you see a large area with red, itchy pimples. Make sure you also look at the back area, the back of the neck, and raise your arms to examine the armpits as well.
Step 2. Identify symptoms in the subacute phase
This phase occurs one to three months after the acute phase of the disease has ended. During this time, arthritis is the main symptom, but you may also suffer from blood vessel disorders, such as Raynaud's phenomenon.
This disorder consists of a reduction in blood circulation in the hands and feet, as a response to the body's exposure to cold or stress. Look closely at your fingertips and note if they are cold and appear dark or bluish in color
Step 3. Recognize the symptoms of the chronic phase
This phase begins 3 months after the initial one and is characterized by continuous pain in the joints; 33% of the victims experience joint pain (arthralgia) for 4 months, 15% for 20 months and 12% from 3 to 5 years. One study found that 64% of patients suffered from joint stiffness and / or pain for more than a year after contracting the infection. You may also experience relapses of fever, fatigue (abnormal physical weakness and / or low energy), arthritis (inflammation / swelling of the joints) in multiple joints, and tenosynovitis (inflammation of the tendons).
- If you already have joint problems caused by conditions such as rheumatoid arthritis, you are more likely to develop the chronic state of chikungunya.
- In rare cases, rheumatoid arthritis has been found soon after the initial stage of infection, although its onset is more common 10 months after exposure to the virus.
Step 4. Know the other symptoms
Although fever, rashes and joint pain are the most common and typical, many patients may also exhibit other discomforts. Among these the main ones are:
- Myalgia (muscle and back pain).
- Headache.
- Discomfort and pain in the throat.
- Abdominal pain.
- Constipation.
- Swelling of the lymph nodes in the neck.
Step 5. Distinguish chikungunya from other similar diseases
Since many symptoms of this condition resemble other ailments caused by mosquitoes, it is important to know how to differentiate them. Here is a list of diseases that can be confused with chikungunya:
- Leptospirosis: Pay attention to whether the calf muscles (those in the lower leg) are sore or painful when you walk. You should also check in the mirror to see if the whites of the eyes are bright red (subconjunctival hemorrhage). This disorder is caused by the rupture of fine capillaries. Try to remember if you have been in contact with animals or farm water because contaminated animals can spread the disease through water or soil.
- Dengue fever: Evaluate the odds of being bitten by a mosquito if you have traveled to tropical climate regions such as Africa, South America, Central America, the Caribbean, India or the southern states of the USA, as dengue is mainly present in these areas. Look in the mirror for bruising on the skin, redness or bleeding of the sclera, gum or oral bleeding, and continuous nosebleeds. In fact, bleeding is the main feature that distinguishes dengue from chikungunya.
- Malaria: Consider the possibility of being bitten by mosquitoes if you have traveled to areas of South America, Africa, India, the Middle East and South East Asia. Check in particular if you experience chills and chills followed by fever and sweating. These symptoms can last from 6 to 10 hours and you may have relapsing episodes.
- Meningitis: Check for outbreaks of this disease in densely populated areas or structures. If you have been in those areas you may have contracted the disease. Take your temperature to check for fever and pay attention if you notice stiff neck or pain / discomfort when moving it. You may also experience a severe headache and a feeling of tiredness / confusion.
- Rheumatic fever: this disease is more common in children or young people between 5 and 15 years of age. Check your child to see if he has multiple joint pain that moves from joint to joint (when one gets better, another becomes sore) and if he has a fever as with chikungunya. In this case, however, there are notable differences in symptoms, as the baby may exhibit uncontrolled movements or body jerks (Huntington's chorea), small painful lumps under the skin, and a rash. The rashes appear flat or slightly raised with jagged edges (erythema marginato) and may be patchy or circular with a darker pink outer ring and a lighter central area.
Part 2 of 3: Treating the Symptoms
Step 1. Know when to see a doctor
Your doctor may order a blood test to analyze it and look for chikungunya virus or other mosquito-borne diseases. You should go to the hospital even if you have the following symptoms:
- Fever lasting more than 5 days.
- Vertigo (which could be due to a neurological problem or dehydration).
- Cold fingers or feet (Raynaud's phenomenon).
- Bleeding from the mouth or under the skin (in this case it can be dengue).
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Poor urine production (could be due to dehydration which, in turn, damages the kidneys).
If the joint pain is really unbearable or does not improve after taking NSAID medications recommended by your doctor, he may prescribe hydroxychloroquine to be taken in doses of 200 mg orally once daily or 300 mg chloroquine phosphate once daily. day for 4 weeks
Step 2. Learn about the laboratory tests for chikungunya
Your doctor might take a blood sample for testing in the laboratory. There are several tests or diagnostic techniques for analyzing blood samples. The ELISA test (Immuno-Absorbent Assay linked to an Enzyme) looks for specific antibodies that fight the virus. These antibodies typically develop towards the end of the first week of the disease and their peak could last anywhere from three weeks to up to two months. If the test fails, your doctor may want to repeat the blood test to see if the antibodies have risen.
- Another test useful for checking the growth of antibodies is represented by viral cultures. These are typically done within the first 3 days of the disease when the virus is developing rapidly.
- RT-PCR (reverse transcriptase polymerase chain reaction) is a technique that exploits the viral proteins responsible for encoding a particular gene to replicate specific chikungunya genes. If it is indeed this disease, then the lab will notice more than normal virus genes, which are displayed on a computer graph.
Step 3. Rest
There is no specific / recommended treatment to cure this virus and there are no vaccines that can prevent infection. The only thing that can be done is to manage the symptoms. The World Health Organization recommends starting home care through rest to relieve symptoms and give the body time to recover. Try to rest in an environment that is not too humid or too hot, as this can aggravate joint pain.
Apply a cold pack to reduce pain and inflammation. You can use a bag of frozen vegetables, packaged meat, or an ice pack. Wrap the ice in a towel and apply it to the painful area. Make sure you don't put it in direct contact with the skin, as you could damage the tissues
Step 4. Take some pain relievers
If you have a fever and joint pain, take acetaminophen. You can take 2 tablets of 500 mg with water 4 times a day. Make sure you drink adequate amounts of water throughout the day. Since fever can cause dehydration and create an imbalance in electrolytes, you should drink at least 2 liters of water a day with the addition of salt (which mimics sodium).
- If you have pre-existing liver or kidney disease, you should consult your doctor before taking acetaminophen.
- Do not take aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen and so on. Chikungunya can appear similar to other mosquito-borne diseases, such as dengue which causes excessive bleeding. Aspirin and other NSAIDs can thin the blood and aggravate bleeding. You should talk to your doctor before taking these medications so that he can rule out the possibility that it is dengue.
Step 5. Exercise
Limit yourself to moderate exercise so as not to aggravate muscle or joint pain. If you can, make an appointment with a physical therapist or undergo specific treatments. This way you can stretch the muscles in the joint area and reduce pain and stiffness. Try to work out in the morning when joint conditions are at their worst. Try some of these simple moves:
- Sit in a chair. Extend one leg parallel to the floor and lift it for 10 seconds before placing the sole of the foot back on the ground; do the same exercise with the other leg. Repeat several times a day, doing 2 or 3 sessions of 10 repetitions per leg.
- Try to stay on your toes with your feet together and keep lifting and lowering yourself several times.
- Lie down on your side. Lift one leg for a second before placing it on the other. Repeat this exercise 10 times on each leg; then turn to the other side and repeat. Do a session of 10 lifts per leg several times a day.
- You can also decide to do low-intensity aerobic exercises. But be sure not to make too vigorous movements and not to use weights.
Step 6. Apply an oil or cream to irritated skin
The disease causes dry skin that can flake (xerosis) or itchy rashes (as with measles) but, although these are symptoms that do not require treatment, you can relieve itching and restore the skin's proper hydration and natural appearance.. Apply mineral oil, moisturizer, or calamine-based lotion. If you have itchy rashes, take oral antihistamines, such as diphenhydramine, following the directions on the package. This drug reduces the inflammatory cells that release the proteins responsible for itching.
- If you notice hyperpigmented areas of skin that persist over time, contact a dermatologist who will be able to recommend a good product. Do not be tempted by hydroquinone creams that you can buy online, the European Community has banned their use due to the serious side effects.
- Always ask your doctor for advice because the commercial offer of products and creams for the treatment of skin irritations is really wide.
Step 7. Try herbal remedies
It is believed that the combination of various herbs and plants can help relieve the symptoms of chikungunya. Since you can find many of these products in health food stores or health food stores, again you should seek your doctor's advice before taking any supplements or herbal remedies. Among these are:
- Eupatorium perfoliatum C 200: this is by far the best homeopathic remedy for chikungunya. It is the extract of a plant that you can use when you experience symptoms in the acute phase, as it is able to relieve joint aches and pains. To use it, take 6 drops at full strength for a month while you are experiencing symptoms.
- Echinacea: This is a flower extract that is often used to treat the symptoms of viral infection to strengthen the immune system. Take 40 drops a day, dividing them into three doses.
Part 3 of 3: Paying Attention to Complications and Preventing Chikungunya
Step 1. Check for any heart complications
In particular, be on the lookout for arrhythmia, an abnormal heart rhythm, which can be life-threatening. To check it, gently place the tips of the index and middle fingers on the wrist, under the thumb. You should feel the pulsation of the radial artery. Count the number of beats you perceive in one minute; if you count between 60 and 100, the situation is normal. Also observe the rhythm of the beats: it must be constant. If your heart rate is very high or your beats stop abnormally, you have an arrhythmia. Your doctor may also recommend that you have an electrocardiogram, which involves placing electrodes on your chest to check your heart rate.
The chikungunya virus can invade heart tissues causing inflammation (myocarditis) which causes the heart to beat abnormally
Step 2. Pay attention to neurological complications
Check for fever, fatigue, and mental confusion - all signs of encephalitis or inflammation of the brain. Inability to concentrate and disorientation are also other typical signs of infection. If you experience severe headache, neck pain and stiffness, sensitivity to light, fever, chills, double vision, nausea and vomiting, in addition to the symptoms of encephalitis, you may have meningoencephalitis, a serious condition that combines meningitis (inflammation of the spinal cord tissue that is connected to the brain) with encephalitis.
- If you have nerve damage that starts in the legs or arms, you may be suffering from Guillain Barré syndrome. Pay attention to the loss or decrease of tactile sensitivity, reflexes, and the ability to move on both sides of the body. Also check for pain in both sides of your body that resembles a stinging or tingling sensation with a burning sensation. This disorder can gradually worsen and escalate to damage to the nerves that run the respiratory muscles.
- If you have breathing problems, go to the emergency room right away.
Step 3. Pay attention to eye complications
Be careful if you experience pain in your eyes and if they water or redden easily. These are symptoms of inflammation of the eye lining caused by conjunctivitis, episcleritis, and uveitis. If you have uveitis, you may also notice blurry vision and sensitivity to light.
If you have difficulty seeing objects in front of you (central vision) and if the colors seem to become duller every day, you may be suffering from neuroretinitis
Step 4. Check your skin for signs of hepatitis
Look in the mirror to see if the skin or sclera of the eyes is not yellow (jaundice). These could be indicator signs of hepatitis, an inflammation of the liver. This inflammation can cause a discharge of liver secretions (bilirubin) which makes the skin yellow and itchy. In this case, seek immediate medical attention.
If left untreated, hepatitis can cause serious liver damage
Step 5. Check if you are dehydrated by checking for signs of kidney failure
Chikungunya can cause dehydration, as the blood cannot reach the kidneys properly, preventing them from performing normal function. This can cause kidney damage, so check your urine. If you notice that your urination has decreased dramatically and your urine is very concentrated and dark in appearance, go to the hospital.
Your doctor or those in the emergency room will give you more thorough laboratory tests and take measurements to detect kidney function
Step 6. Prevent chikungunya when traveling
Visit the Cesmet (Center for Preventive and Tropical Medicine) website to identify the areas of the world where this virus is endemic. If you have to travel to some of these geographic areas there are several things you can do to try to prevent the disease. The main preventive measures are:
- Walk or stay outside when it gets dark. Although the mosquito can bite at all hours, it is still more active during the daylight hours.
- Wear clothes with long sleeves and protect your body from mosquitoes as much as possible. Try to wear light-colored clothing to make it easier to spot mosquitoes and other insects if they lean on your clothes.
- Sleep under a mosquito net at night to protect yourself from mosquitoes while you sleep.
- Apply repellents that have more than 20% DEET. Other mosquito deterrents are eucalyptus, icaridin and IR3535. Generally, the higher the concentration of the active ingredient, the longer the efficacy.
