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How do you manage chikungunya in infants?

Female
Female
asked Dec 26, 2009 at 02:42AM in Infectious Diseases
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    answered Feb 07, 2010 at 06:57AM
    Dear Ms.
    I can take no credit for this, other than to know how to "cut & paste" This is from the WHO (World Health Organization) web site.
    Your question was posted on Dc 26th. I hope and pray that the child found treatment for his/her symptoms.
    Link: WHO, Chikungunya
    Key facts
    •Chikungunya is a viral disease that is spread by mosquitoes. It causes fever and severe joint pain. Other symptoms include muscle pain, headache, nausea, fatigue and rash.
    •The disease shares some clinical signs with dengue, and can be misdiagnosed in areas where dengue is common.
    •There is no cure for the disease. Treatment is focused on relieving the symptoms.
    •The proximity of mosquito breeding sites to human habitation is a significant risk factor for chikungunya.
    •The disease occurs in Africa, Asia and the Indian subcontinent. In recent decades mosquito vectors of chikungunya have spread to Europe and the Americas. In 2007, disease transmission was reported for the first time in Europe, in a localized outbreak in north-eastern Italy.
    Chikungunya is a mosquito-borne viral disease first described during an outbreak in southern Tanzania in 1952. It is an alphavirus of the family Togaviridae. The name ‘chikungunya’ derives from a root verb in the Kimakonde language, meaning "to become contorted" and describes the stooped appearance of sufferers with joint pain.
    Signs and symptoms
    Chikungunya is characterized by an abrupt onset of fever frequently accompanied by joint pain. Other common signs and symptoms include muscle pain, headache, nausea, fatigue and rash. The joint pain is often very debilitating, but usually ends within a few days or weeks. Most patients recover fully, but in some cases joint pain may persist for several months, or even years. Occasional cases of eye, neurological and heart complications have been reported, as well as gastrointestinal complaints. Serious complications are not common, but in older people, the disease can contribute to the cause of death. Often symptoms in infected individuals are mild and the infection may go unrecognized, or be misdiagnosed in areas where dengue occurs.
    Transmission
    The virus is transmitted from human to human by the bites of infected female mosquitoes. Most commonly, the mosquitoes involved are Aedes aegypti and Aedes albopictus, two species which can also transmit other mosquito-borne viruses, including dengue. These mosquitoes can be found biting throughout daylight hours, although there may be peaks of activity in the early morning and late afternoon. Both species are found biting outdoors, but Ae. aegypti will also readily feed indoors.
    After the bite of an infected mosquito, onset of illness occurs usually between four and eight days but can range from two to 12 days.
    Diagnosis
    Several methods can be used for diagnosis. Serological tests, such as enzyme-linked immunosorbent assays (ELISA), may confirm the presence of IgM and IgG anti-chikungunya antibodies. IgM antibody levels are highest three to five weeks after the onset of illness and persist for about two months. The virus may be isolated from the blood during the first few days of infection. Various reverse transcriptase–polymerase chain reaction (RT–PCR) methods are available but are of variable sensitivity. Some are suited to clinical diagnosis. RT–PCR products from clinical samples may also be used for genotyping of the virus, allowing comparisons with virus samples from various geographical sources.

    Treatment
    There are no specific drugs to cure the disease. Treatment is directed primarily at relieving the symptoms, including the joint pain. There is no commercial chikungunya vaccine.

    Disease outbreaks
    Chikungunya occurs in Africa, Asia and the Indian subcontinent. Human infections in Africa have been at relatively low levels for a number of years, but in 1999-2000 there was a large outbreak in the Democratic Republic of the Congo, and in 2007 there was an outbreak in Gabon.

    Starting in February 2005, a major outbreak of chikungunya occurred in islands of the Indian Ocean. A large number of imported cases in Europe were associated with this outbreak, mostly in 2006 when the Indian Ocean epidemic was at its peak. A large outbreak of chikungunya in India occurred in 2006 and 2007. Several other countries in South-East Asia were also affected. In 2007 transmission was reported for the first time in Europe, in a localized outbreak in north-eastern Italy.

    .


    Related links
    Chikungunya fever archive
    For more information contact:WHO Media centre
    Telephone: +41 22 791 2222
    E-mail: mediainquiries@who.int
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