Local tabloids have reported several outbreaks of Chikungunya fever (say that 5 times fast!) recently throughout Indonesia. So it is no surprise that we are seeing cases here in Bali and will probably see more as the end of year holidays pass, and travelers zip around Indonesia en-masse, bringing with them good cheer and an array of communicable diseases as well.
Chikungunya fever is a viral disease transmitted to humans by the bite of infected mosquitoes. The Chikungunya virus has been the cause of numerous human epidemics in many areas of Africa and Asia (Including Indonesia), and most recently in a limited area of Europe.
What causes Chikungunya fever?
Chikungunya fever is caused by a virus which belongs to the genus Alphavirus. Humans become infected with Chikungunya virus by the bite of an infected mosquito. The Aedes aegypti and the Aedes albopictus mosquitoes are the primary carriers of chikungunya virus to humans. Ades aegypti is also a carrier for dengue fever and it is transmitted in the same way
Mosquitoes in turn become infected with Chikungunya virus when they feed on an infected person. Infected mosquitoes can then spread the virus to other humans when they bite them. Monkeys, and possibly other wild animals, may also serve as reservoirs of the virus.
Aedes aegypti breeds in household water catchments and is an aggressive daytime biter which is attracted to humans. The incubation period (time from infection to illness) can be 2-12 days, but is usually 3-7 days.
Chikungunya symptoms
Chikungunya virus infection causes symptoms that can be a debilitating illness in some, but hardly noticeable in others. The disease is most often characterized by:
• Fever
• Rash
• Headache
• Fatigue
• Nausea, vomiting,
• Muscle & joint pain,
“Silent” Chikungunya virus infections (infections without illness) do occur; but how commonly this happens is not yet known. Chikungunya virus infection (whether clinically apparent or silent) is thought to confer life-long immunity. Acute Chikungunya fever typically lasts a few days to a couple of weeks, but as with dengue, and other arboviral fevers, some patients have prolonged fatigue lasting several weeks. Additionally, some patients have reported incapacitating joint pain, or arthritis which may last for weeks or months.
Unlike Dengue fever fatalities related to Chikungunya virus are rare and appear to be associated to increased age or lowered immunity. (Dengue fever and Chikungunya are difficult to differentiate except on blood test for positive antibodies).
Treatment
There is no vaccine or specific antiviral treatment currently available for Chikungunya fever. Treatment is symptomatic and can include rest, fluids, and medicines to relieve symptoms of fever and aching such as ibuprofen, naproxen, acetaminophen, or paracetamol. Aspirin should be avoided. Infected persons should be protected from further mosquito exposure (staying indoors in areas with screens and/or under a mosquito net) during the first few days of the illness so they can not contribute to the transmission cycle.
Prevention
The best way to prevent Chikungunya virus infection is to avoid mosquito bites. Prevention tips are similar to those for other viral diseases transmitted by mosquitoes, such as dengue.
• Use insect repellent containing DEET, oil of lemon eucalyptus on exposed skin.
• Wear long sleeves and pants in light colors.
• Avoid the use of perfumes
• Have secure screens on windows and doors to keep mosquitoes out.
• Get rid of mosquito sources in your yard by emptying standing water from flower pots, buckets and barrels. Change the water in pet dishes and replace the water in bird baths weekly. Drill holes in tire swings so water drains out. Keep children’s wading pools empty and on their sides when they aren’t being used.
• Additionally, a person with Chikungunya fever should limit their exposure to mosquito bites to avoid further spreading the infection. The person should use repellents when outdoors exposed to mosquito bites or stay indoors in areas with screens or under a mosquito net.
