How to Recover from Chikungunya

Chikungunya is a virus, transmitted to humans through the bite of an infected mosquito. The number one transmission agent for the disease is the yellow fever mosquito, an insect living in tropical areas like South America or Africa. There is no medication on the market to fight this virus -- instead, you address the symptoms and your body fights off the virus over time. If you or someone you know is suffering from Chikungunya, scroll to Step 1 to start understanding how the recovery process works.

Identifying the Symptoms 

 1    Look for the symptoms in the acute phase. The symptoms of this disease cover three phases, but most patients experience only the acute phase, with symptoms lasting anywhere from 3-12 days. Thereafter, the illness disappears in 87% of cases, as the body's immune system eventually fights it off, like any cough or cold. But during this period, symptoms may be as follows:

·         Fever. Fever may be low- or high-grade. It first rises for the first 24 hours to 48 hours, returns back to normal temperature, and rises back to above-normal levels even up to 40°C (104°F) after being afebrile for a day or two. Fever returns to normal within two weeks from the start.

·         Joint pains (arthritis). Joint pains are severe in character, migratory, tend to be worse during mornings, are relieved by light exercise, but worsened by strenuous and aggressive movements. Joint pains occurs immediately after or at the same time as the fever. Joints usually involved are the wrists, ankles, knees, and elbows, small joints of the hands and feet, and sometimes, the shoulders and hips.

·         Skin rash. Skin rash occurs in half of patients with Chikungunya. Skin rash consists of small reddish spots or bumps (maculopapular) but may be vesicles and/or blisters. This rash appears two days to five days after the fever. The rash usually occurs on the trunk, legs, soles, palms, and face.

·  

    Other symptoms include: headache, nausea, vomiting, inflammation of the conjunctiva of the eyes (conjunctivitis), back pain, diarrhea, and sores or ulcers of the tongue and/or mouth.

 

2          Know the symptoms of the subacute phase. The subacute phase of Chikungunya occurs from a month to three months after the acute phase of illness ends. During the subacute phase, the main symptom is arthritis. Aside from this, disorders of blood vessels like Raynaud’s phenomenon can occur.

• Raynaud’s phenomenon is a condition where there is decreased blood flow to the hands and feet in response to cold or emotional stress.

3          Recognize the chronic phase. The chronic phase of Chikungunya occurs beyond three months and persists even up to two years to three years. The main symptom occurring in this stage is prolonged and severe arthritis, fatigue, depression, and body weakness.

• Persistent joint pains occur in Chikungunya patients who are 45 years old or older, with severe joint pains at the start of illness, and with existing osteoarthritis even before the start of the Chikungunya illness.
• The subacute and chronic phase occurs in 13% of patients with Chikungunya.

4          Know that in some cases, the disease can be asymptomatic. However, is not yet known how commonly this happens. What's more, it lasts for days in some and months in others. In severe cases, arthritis or joint pain can incapacitate patients even for months in a row.

• Also in some cases, patients suffer from skin manifestations such as scaling, excoriated lesions on the skin, itching, and red spots on the skin surface. Eye redness and the difficulty of looking at bright light are also documented.

5          To be sure, see a doctor and get the disease diagnosed. Chikungunya is diagnosed with the help of the ELISA blood test. This test uses antibodies and enzymes to detect the presence of the pathogen agent. This is the most effective way in diagnosing the disease, because all the other symptoms are very similar to other common illnesses.

• The diagnosis is positive when joint pain and fever are seen along with other test results. First of all, virus isolation is performed. The procedure last for about two weeks and it must be carried out in high level biosafety laboratories. The procedure consists in exposing certain cell lines to blood samples. The specific virus responses are then identified.
• The RT-PCR (Reverse transcription polymerase chain reaction) is a test used to detect the virus. The technique amplifies a range of Chikungunya genes present in the blood, highlighting them during the microscopic exam. The time needed for the results is about two or three days.

Treating the Symptoms:

There is no specific cure nor treatment for Chikungunya. All one can do is treat the symptoms (symptomatic treatment). Currently, there is no antiviral drug to fight against the Chikungunya virus.

 

1          Treat the fever. Fever is described as a temperature of 37.80°C (100.4°F) or higher. What is usually given is Paracetamol at 500 mg per tablet every 4 hours to 6 hours interval for adults if febrile. Paracetamol for children is given at 10 milligrams per kilogram of body weight every 4 hours to 6 hours if febrile.

o    Note: Ask for prescription for Paracetamol from your physician. Do not take medicines on your own. Aside from Paracetamol, do sponge bathing until the temperature returns to normal. Use tap water and not ice water for sponge baths because of rebound return of fever or fever tends to be higher immediately after using ice water.

2          Treat the joint pains or arthritis with pain-relievers prescribed by your physician. Joint pains due to Chikungunya during the acute phase of illness can be relieved by taking tablets of non-steroidal anti-inflammatory drugs, a group of pain relievers stronger in effect than Paracetamol.

o    Examples of these NSAIDs are diclofenac, celecoxib, naproxen, ibuprofen. Ask for a prescription of any of these drugs from your physician -- he or she will be able to prescribe the best one for you.

o    For chronic arthritis during the subacute and chronic phase of illness, follow-up with a rheumatologist is important for further treatment with the following anti-arthritic medications: methotrexate, salazopyrine, leflunomide, steroids (like prednisone) or hydroxychloroquine, or even TNF-α blockers.

3          Do short durations of mild exercise. Low-impact aerobic exercises are those which involve mild stretching and slow movements; avoid vigorous or aggressive movements. Examples would be swimming, cycling on a stationary bike, and some of the exercises described below:

o    Sit on a chair. Extend one leg parallel to the floor and hold for 10 seconds or count slowly up to 10. Then lower the leg with the sole flat on the floor. Do the same with the other leg. Repeat several times a day, having two sets to three sets of ten repetitions of this exercise per leg per trial.

o    Try standing on your toes with both feet close together and repeating up and down, up and down.

o    Turn to your side. Raise one leg upwards for a second before bringing it down atop your other leg. Do this ten times for that leg. Then, turn to the other side, and repeat the same exercise for the other leg. Do a set of ten raises of each leg several times a day.

o    You can also do your own low-impact aerobic exercise. The idea is not to do aggressive movements and using weights. This is a big NO-NO. These mild exercises may relieve the  joint pain.

4          Use homeopathy for recovery. You will usually experience rashes and high fever, if suffering from Chikungunya. You can use remedies such as:

o    Echinacea. You can use this purple flower to make a great, healthy tea. It will help you by boosting your immune system and eliminating the pathogen agent from your system. Just mix one part of dried Echinacea flowers with a quarter part of dried peppermint and boil the mix with water. Drink this tea daily for great effectiveness.

o    Gelsemium. This is also a great herb that can help you by decreasing your body temperature and ease the other flu like symptoms like headaches and muscular pain. Use these dried flowers to prepare yourself a tea. Put two tablespoons of Gelsemium flowers and leaves in a pot with boiling water and leave it for 15 minutes. Drink one or two cups after each meal

.

5          Use acupressure. This method has been proven to be effective in relieving joint pain. You can visit an acupressure expert for treatment. You can also try it yourself, at home. Here's how:

o    Massage your middle two fingers to relieve pain in leg joints and the other two, outer fingers, for pain in the arm joints.

o    In cases when the stomach or liver are affected by the disease, massaging the pressure points for these two areas will definitely help. Massage the point found half of an inch below the little finger, on the palm, for liver problems. Massaging the area just below the palm will help you get rid of the stomach issues.

 

6          Take good care of yourself. Here are some basics to ensure that Chikungunya doesn't stick around:

o    Have a solid eight hours of sleep at night and other nap periods if necessary. Rest in a warm environment.

o    Apply cold compresses to the affected joints in order to decrease pain and reduce joint damage.

o    Consume plenty of water at 2 liters in 24 hours at home to prevent dehydration from fever and for well-being. Be sure that urine output is more than 30 milliliters per hour or at least 720 ml per 24 hours.

o    Use pain-relievers and massage for headache. For headache, using paracetamol as described above, would help. Napping for a few minutes or massage your forehead or scalp should help relieve the headache, too.

 

7        See a physician or be hospitalized if you encounter complications. If symptoms persist beyond two weeks from the start of the illness, be sure to see a doctor. Nevertheless, Chikungunya can confer on the affected person prolonged or life-long immunity or protection from recurrence of this disease. Most likely, you'll be fine eventually and never get it again.

 

Understanding the Disease

1          Know how it can affect your eyes. Eye problems due to Chikungunya are varied. Problems may involve the conjunctiva, the iris, the anterior and posterior chambers of the eyes, the retina and even the optic nerve (the main nerve supply of the eye). A person may even go blind. However, most of these eye conditions resolve once Chikungunya resolves or if steroids are given.

• The most common eye conditions in Chikungunya are conjunctivitis, eye pain, and pain behind the eyeball, which may occur during the acute phase.
•  

2          Know how it can affect the brain and blood. Chikungunya may affect the meninges or coverings of the brain, the spinal cord, the brain itself, and the nerves. Brain and nerve disorders due to Chikungunya are varied and beyond the scope of this discussion. Some disorders of common knowledge would be seizures, nerve pain, and altered mental condition of the patient.

• As for blood complications, there may be mild bleeding conditions in Chikungunya like bleeding under the conjunctiva of the eyes, nose- and gum bleeding. Unlike dengue, bleeding in Chikungunya is self-limiting or will not persist for long and eventually stop.

3          Know how it can affect the heart and blood vessels. Some conditions seen in Chikungunya would be myocarditis (inflammation of the heart muscle), pericarditis (inflammation of the heart covering or the pericardium), heart failure, irregular heart beats, and abnormal blood flow. However, know that these complications of Chikungunya are rare and occur only in the subacute to chronic phase of Chikungunya.

4          Know how the disease presents itself. Chikungunya fever is a disease presenting mainly as fever, joint pains (arthritis), and rash. The term “chikungunya” comes from the Kimakonde dialect and means “to be contorted” due to the bent appearance of those with the disease. This disease presents in a similar fashion as dengue.

• What differentiates Chikungunya fever from dengue fever is the absence of excessive bleeding and shock, and the persistence of joint pains in Chikungunya. Incubation period is 1-12 days before symptoms occur in a patient.

5          Know the germ which causes Chikungunya. It is caused by a RNA virus, an arbovirus of the Alphavirus genus of the Togaviridae family. It is transmitted through a bite by two mosquitoes, namely Aedes aegypti and Aedes albopictus. These are daytime mosquitoes which are active a few hours before sunrise and for several hours before sunset.

• Nevertheless, there have been cases of transmission of the virus from the mother to her unborn baby once the mother is bitten by these mosquitoes and develops the disease.

6`         Know where Chikungunya is common. Chikungunya is present where its mosquito vectors are common. Chikungunya is found in areas with heavy rainfall and abound during the rainy season. Areas where Chikungunya is common would be West and East Africa, countries around the Indian Ocean, most of Asia, Southeast Asia.

• Imported cases of Chikungunya occur even in USA and Europe. Imported cases mean a traveler who was infected with a disease and goes back to his country with the disease.

7          Understand the disease mechanism. The disease was first described in Tanzania in 1952. The disease was inactive for a long period of time, before outbreaking in India in 2005. The virus affects groups of all ages, of both genders, and has an incubation period of three to twelve days. The disease has a severe and aggressive onset. The acute stage of the disease is followed by the chronic phase, in which the symptoms are exacerbated. 15% of infected people develop chronic symptoms.

• The virus has gone through a mutation in recent times, meaning that its replication and transmission have been facilitated.
• The virus (CHIKV) causes a self-limiting disease. This means that it will resolve itself without any specific treatment. Mortality among Chikungunya sufferers is very rare, and is mostly due to the complications.
• Prevent the disease by avoiding mosquito bites. You can easily do this by wearing long pants and long sleeve shirts. You can also use mosquito repellant all the time, on exposed skin. Be sure you have your windows and doors fitted with insect screens. Treat your bed with insecticide before sleeping and use a fine net to protect the elder and children.

Extracted from www.wikihow.com