CHIKV

Recently, we have heard about Chikungunya fever outbreak in malaysia. 136 people tested positive for CHIKV from the 631 cases detected at 20 localities in Johor, Malacca, Negri Sembilan and Perak.

Chikungunya virus

-insect-borne virus (Aedes aegypti mosquitoes)

-Alphavirus genus

-symptoms are quite similar to dengue virus fever

• Fever 2 to 5days
  
• The temperature may remit for 1-2 days, resulting in a "saddle-back" fever curve.
  
• prolonged arthralgia of extremities (not so much of larger joints), often polyarticular and migratory in nature
  
• maculopapular rash may or may not be present 
  
• other symptoms includes headache, conjunctival injection, and slight photophobia
  

Common laboratory tests for chikungunya include:-

1) RT-PCR(result is ready in 1-2 days), 

2) virus isolation (result is ready in 1-2 weeks), and 

3) serological tests (Result is ready 2-3 days but with false positive ie O'nyong'nyong virus and Semliki Forest Virus)

Treatment:

1) supportive

2) Vaccine in Phase II trial 

3) Chloroquine phosphate (250 mg/day)

Prevention

1) insect repellents

2) wears a long sleeves and long pants

3) garments can be treated with pyrethroids

4) mosquito coils

5) screens the windows and doors

6) keep surrounding clean (minus the empty cans/ tyre/ container - breeding ground for aedes moquitoes)

References:

1) Chikungunya cases escalate, TheStar, Thursday July 31, 2008.

http://thestar.com.my/news/story.asp?file=/2008/7/31/nation/21964401&sec=nation

2) http://www.myhealth.gov.my/myhealth/eng/dewasa_content.jsp?lang=dewasa&sub=0&bhs=may&storyid=1193386725877

3) http://www.smtbd.com/products.html

4) OnSite Rapid Test for the detection of Chikungunya Fever http://www.ctkbiotech.com/Default.aspx?tabid=118

5) www.dph.gov.my/survelans/Guidelines%202006/SURVEILLANCE%20AND%20MANAGEMENT%20OF%20CHIKUNGUNYA%20DISEASE.pdf

 

6) Edelman, R et al. "Phase II Safety and Immunogenicity Study of Live Chikungunya Vrirus Vaccine TSI-GSD-218", American Journal of Tropical Medicine and Hygiene 62 (6): 681–685.

7) http://www.vadscorner.com/alphaviruses.html

Notes:

Chikungunya means "that which bends up" description for the classical clinical presentation of these patients due to generalised joint pain that is not relieved by NSAID nor Aspirin.

Further information can be obtained from the ministry’s website, www.moh.gov.my or call +603-88810600/0700 during office hours.