EXPERT ADVICE Your Questions Answered Chicken Guinea, Chik Or Chikungunya. Chikungunya Virus Classification Is Chikungunya disease the same as
Asia and Southeast Asia including India, Thailand,
dengue fever? Is there any medicine to prevent this mysterious disease?
In Malaysia, an outbreak was first reported in Port
Klang in 1999. As of September 2008, a Health
Ministry’s statement had reported 1,975 cases in
“mysterious” disease since its official
Malaysia, over half (1,098) of which occurred in
discovery in Tanzania, Africa in 1953; with
its first outbreak at the Makonde Plateau
CHIKV is an insect-borne – mainly by mosquitoes
– arbovirus of the genus, Alphavirus, which is
Chikungunya is a Makonde word (the local language
transmitted to humans by Aedes mosquitoes. It is
in southern Tanzania and northern Mozambique)
thought that monkeys and other wild mammals
meaning ‘that which bends or folds up’ – referring
may serve as reservoirs for the virus. The two species
to the severe pain and crippling of the joints that
of Aedes mosquitoes involved are Aedes aegypti
causes the stooped appearance of sufferers.
and Aedes albopictus (Tiger mosquito).
The Chikungunya virus (CHIKV) outbreaks have
Symptoms
occurred occasionally in sub-Saharan Africa, South
8 NOV/DEC 2008 • OH! EXPERT ADVICE
• Sudden high fever (which can reach 39°C/
India and Sri Lanka. During the 2005-2006 outbreaks
on the Island of La Réunion, a French territory east
• Severe arthralgia (joint pains) – mainly in hands
of Madagascar, CHIKV infection was associated with
at least 260 deaths in mostly elderly patients.
• Skin rashes (redness and occurring on the face
It is unclear if CHIKV was directly responsible or
coincidentally present in such cases.
Other symptoms in the first few days of infection:
Treatment
There is no specific treatment for the CHIK fever
• Conjunctival (eye) infection and slight
– and treatment is mainly symptomatic ie rest,
fluids, and analgesics and non-steroidal anti-
inflammatory medications (e.g. ibuprofen, naproxen
or paracetamol) to relieve pain and swelling.
The acute fever occurs briefly (usually about 5-
7 days). However, some patients experience
prolonged joint pains for weeks or months.
Recent developments from French authorities
In contrast to dengue, CHIK fever is characterised
have shown a possible role for hydroxychloroquine
by a shorter febrile episode, persistent arthralgia in
or chloroquine phosphate as a treatment for
some cases, and absence of fatalities. The presence
arthralgia in CHIK fever. (Both drugs are being used
of a rash, conjunctivitis, arthralgia and myalgia are
Prevention
Due to many similar clinical symptoms with dengue
There is no vaccine against this virus, so preventive
fever, a laboratory confirmation of the presence
measures depend entirely on avoiding mosquito
of IgM and IgG anti-chikungunya antibodies is
bites, which occur mainly during the daytime, and
important. Such a serological test is available at the
eliminating mosquito breeding sites.
University of Malaya in Kuala Lumpur, Malaysia.
Additionally, a CHIK-infected person should limit
Although Chikungunya is historically not associated
exposure to mosquito bites – by staying indoors or
with severe haemorrhage (bleeding) or death in
using a mosquito net – to avoid further spreading
Malaysia, such cases have occurred, albeit rarely, in
the virus. OH! To avoid mosquito bites:
which are common around human dwellings and
• wear clothes that cover as much skin as possible;
workplaces, such as water storage containers,
• use mosquito repellents on exposed skin and on
saucers under potted plants and drinking bowls
clothing, in accordance with label instructions;
for domestic animals, as well as discarded tyres and
• use mosquito nets to protect babies, older and sick
people and others who rest during the day. The
effectiveness of mosquito nets can be improved
To reduce mosquito breeding:
• remove discarded containers from around the
• use mosquito coils and insecticide vaporisers
• for containers that are in use, turn them over
or empty every 3 - 4 days to prevent mosquito
breeding, including any water-filled containers
The Aedes mosquitoes that transmit chikungunya
indoors. Alternatively, completely cover them to
virus breed in a wide variety of rain-filled containers
NOV/DEC 2008 • OH! 9
[email protected] | www.ashleyfure.net | (b. 1982, USA) Harvard University – Cambridge, Massachusetts PhD Candidate in Music Composition, Expected Completion May 2013 Cursus 2, October 2010 – June 2011 Cursus 1, September 2008 – April 2009 Harvard University – Cambridge, Massachusetts Master of Arts in Music Composition with Distinction, June 2006 Bachelor of Music in
MOC Online Clinical PIP Report 1. Describe, in detail, your primary role in this project I took the lead in studying the problem and initiating a solution. I however could not take credit for defining the instigating problem. I was the principal designer of the Anticoagulation Form (i.e. the Form). Despite mandate from hospital administration that some type of written documentation schem
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