1. CLINICAL FEATURES OF CHIKUNGUNYA Dr. Manjunath reddy.K.P.

2. Clinical features Clinical features What type of illness does chikungunya virus cause? CHIKV infection can cause a debilitating illness, most often characterized by fever, headache, fatigue, nausea, vomiting, muscle pain, rash, and joint pain. The term ‘chikungunya’ is Swahili for ‘that which bends up.’ The incubation period (time from infection to illness) can be 2-12 days, but is usually 3-7 days. “Silent” CHIKV infections (infections without illness) do occur; but how commonly this happens is not yet known. Acute chikungunya fever typically lasts a few days to a couple of weeks, but as with dengue, West Nile fever, o'nyong-nyong fever and other arboviral fevers, some patients have prolonged fatigue lasting several weeks. Additionally, some patients have reported

3. Clinical features incapacitating joint pain, or arthritis which may last for weeks or months. The prolonged joint pain associated with CHIKV is not typical of dengue. Co-circulation of dengue fever in many areas may mean that chikungunya fever cases are sometimes clinically misdiagnosed as dengue infections, therefore the incidence of chikungunya fever could be much higher than what has been previously reported. No deaths, neuroinvasive cases, or hemorrhagic cases related to CHIKV infection have been conclusively documented in the scientific literature. CHIKV infection (whether clinical or silent) is thought to confer life-long immunity. incapacitating joint pain, or arthritis which may last for weeks or months. The prolonged joint pain associated with CHIKV is not typical of dengue. Co-circulation of dengue fever in many areas may mean that chikungunya fever cases are sometimes clinically misdiagnosed as dengue infections, therefore the incidence of chikungunya fever could be much higher than what has been previously reported. No deaths, neuroinvasive cases, or hemorrhagic cases related to CHIKV infection have been conclusively documented in the scientific literature. CHIKV infection (whether clinical or silent) is thought to confer life-long immunity.

4. The symptoms of Chikungunya (also called as Chicken Guinea) include fever which can reach 39°C, (102.2 °F) a petechial or maculopapular rash usually involving the limbs and trunk, and arthralgia or arthritis affecting multiple joints which can be debilitating.petechialmaculopapularrasharthralgia There can also be headache, conjunctival infection and slight photophobia. In the present epidemic in the state of Andhra Pradesh in India, high fever and crippling joint pain is the prevalent complaint. Fever typically lasts for two days and abruptly comes down, however joint pain, intense headache, insomnia and an extreme degree of prostration lasts for a variable period, usually for about 5 to 7 days.photophobia

5. DermatologicalDermatological manifestations Dermatological Dermatological manifestations (data on file) observed in a recent outbreak of Chikungunya fever in Southern India (by Dr.Arun C. Inamadar, Dr.Aparna Palit, Dr. V V Sampagavi, Dr.N S Deshmukh,Dept of Dermatology, BLDEA's SBMP Medical College & Hospital, Bijapur, Karnataka, aruninamadar@rediffmail.com) are as follows: Dermatological manifestations (data on file) observed in a recent outbreak of Chikungunya fever in Southern India (by Dr.Arun C. Inamadar, Dr.Aparna Palit, Dr. V V Sampagavi, Dr.N S Deshmukh,Dept of Dermatology, BLDEA's SBMP Medical College & Hospital, Bijapur, Karnataka, aruninamadar@rediffmail.com) are as follows: Dermatological

6. Dermatological manifestations Dermatological 1. Maculopapular rash 1. Maculopapular rash 2. Nasal blotchy erythema 2. Nasal blotchy erythema 3. Freckle-like pigmentation over centro-facial area 3. Freckle-like pigmentation over centro-facial area 4. Flagellate pigmentation on face and extremities 4. Flagellate pigmentation on face and extremities 5. Lichenoid eruption and hyperpigmentation in photodistributed areas 5. Lichenoid eruption and hyperpigmentation in photodistributed areas 6. Multiple aphthous-like ulcers over scrotum,crural areas and axilla 6. Multiple aphthous-like ulcers over scrotum,crural areas and axilla

7. DermatologicalDermatological manifestations Dermatological 7. Lympoedema in acral distribution (bilateral /unilateral) 7. Lympoedema in acral distribution (bilateral /unilateral) 8. Multiple ecchymotic spots (Children) 8. Multiple ecchymotic spots (Children) 9. Vesiculobullous lesions (infants) 9. Vesiculobullous lesions (infants) 10. Subungual hemorrhage. 10. Subungual hemorrhage. Histopathological examination revealed perivascular lymphocytic infiltrate. Histopathological examination revealed perivascular lymphocytic infiltrate.