Chickengunya.pptx

A brief description of chickengunya.

1. Chickengunya Presenter- Guided by- Dr. Twinkle Joshi Dr. Vaishali Kuchewar PG Scholar Professor

2. Introduction Infection  caused by the  Chikungunya virus  ( CHIKV ).  Symptoms include fever and joint pains. Virus - arbovirus transmitted by  arthropods(mosquitoes), so referred as   arbovirus  (arthropod-borne virus). Family - Togavirus Genus- alphavirus Vector- Aedes aegypti , A edes albopictus   Incubation period - 3–7 days First officially described in 1952 after an outbreak on the Makonde Plateau, Tanzania. The word ' chikungunya ' is derived from  Makonde language, “ kungunyala ” meaning "that which bends up“.

3. Epidemiology Asia, Africa, Europe and America   Majority cases- Brazil , Bolivia and Colombia  West Bengal- 1stcase Tamil nadu , Karnataka, Maharashtra, Gujarat E ndemic in 24 Indian states and 6 union territories

4. Transmission Vector - Aedes m osquitoes – Aggressive day time bite Major period of activity – sunrise and sunset Breeds in – collected clean water,rainwater Host - Man M ain virus reservoirs are monkeys   Transmission - only by mosquitoes picks up the virus from an infected person during the viraemic period (within five days from the day of starting of symptoms)

5. disseminates to salivary glands Uninfected mosquito bites viremic person Replication of virus in midgut Once infectious , mosquito is capable of transmitting virus for the rest of its life.  Bites healthy persons

6. Clinical features Fever 39°C (102.2 °F) with chills Skin - Petechial or Maculopapular Rash usually involving the limbs and trunk Arthralgia or Arthritis affecting multiple small Joints -worsens with work -saddle back pain -morning stiffness -migratory pain Ocular - Conjunctivitis, slight p hotophobia . Neurological – Carpal tunnel syndrome, paraesthesia Headache , nausea, vomiting, abdominal pain

7. Diagnosis Virus isolation- blood culture, peripheral blood smear RT-PCR – Within 7 days ESR CBC- leucopenia, thrombocytopenia ELISA- detect anti-CHIKV immunoglobulin IgM and IgG antibodies CRP PRNT - Plaque reduction neutralization tests (PRNT) quite specific for alphaviruses and are the gold standard for confirmation of serologic test results

8. Differential diagnosis

9. Management PREVENTION Mosquito repellant- Oil of lemon eucalyptus ( OLE), Para- menthane - diol Organophosphorous insecticides Fish- Gambusia and guppy fish Check for water-holding containers both indoors and outdoors. Thermofogging - ULV of malathion and sumithion

10. Fever – PCM 500 mg tds , increase fluid intake Cold sponging Analgesics- NSAIDs, cold compress over joints Hydroxychloroquine 200mg OD - helps those with chronic arthritis Chloroquine phosphate – 300 mg OD orally for 4 weeks Corticosteroids not recommended during the acute phase of disease, as they may cause immunosuppression and worsen infection No antiviral treatment is currently available, though testing has shown several medications to be effective in vitro.

11. Chronic arthritis - > two weeks of arthritis, ribavirin may be useful. Extreme cases- joint surgery Subcutaneous bleeding- FFP Platelets(<50k)- Platelet infusion + vit . K inj. (if PTINR >2.0) On Recovery -Exercise, cold compress -Physiotherapy - Hyperpigmented Rash- Calamine lotion Neurological- Amitryptyline , Gabapentin , pregabalin,etc Vaccines - No approved vaccines available.

12. Complications RARE uveitis, retinitis myocarditis hepatitis nephritis bullous skin lesions meningoencephalitis , Guillain-Barré syndrome cranial nerve palsies

13. Ayurvedic perspective VP Jwar “ शिरोरुक् पर्वणां भेदो   दाहो  रोम्णां प्रहर्षणम्| कण्ठास्यशोषो  वमथु स्तृष्णा मूर्च्छा भ्रमोऽरुचिः||८५|| स्वप्ननाशोऽतिवाग्जृम्भा वातपित्तज्वराकृतिः l” VK Jwar “ शीतको गौरवं तन्द्रा स्तैमित्यं  पर्वणां च रुक् ||८६|| शिरोग्रहः  प्रतिश्यायः कासः स्वेदाप्रवर्तनम्| सन्तापो मध्यवेगश्च वातश्लेष्मज्वराकृतिः l” Bhav prakash - sandhigata sanniptaj jwar Vatolban hina pitta hina kapha “ सन्ध्यस्थिशिरसः शूलं  प्रलापो गौरवं भ्रमः| वातोल्बणे स्याद् द्व्यनुगे तृष्णा कण्ठास्यशुष्कता ll ”

14. Thank you

15. Thought of the day