The document provides information about Chikungunya virus infection. It discusses that the virus is transmitted by Aedes mosquitoes and causes fever and joint pains. The epidemiology, transmission, clinical features, diagnosis, management and Ayurvedic perspectives of Chikungunya infection are summarized. Prevention involves mosquito repellents and controlling mosquito breeding. There is no vaccine or specific antiviral treatment available currently.

1. Presenter- Guided by-
Dr. Twinkle Joshi Dr. Vaishali Kuchewar
PG Scholar Professor

2. Introduction
• Infection caused by the Chikungunya virus (CHIKV). Symptoms
include fever and joint pains.
• Virus- arbovirus
transmitted by arthropods(mosquitoes), so referred
as arbovirus (arthropod-borne virus).
• Family- Togavirus
• Genus- alphavirus
• Vector- Aedes aegypti, Aedes albopictus
• Incubation period- 3–7 days
• First officially described in 1952 after an outbreak on the
Makonde Plateau, Tanzania.
• The word 'chikungunya' is derived from Makonde language,
“kungunyala” meaning "that which bends up“.

3. Epidemiology
• Asia, Africa, Europe and America
• Majority cases- Brazil, Bolivia
and Colombia
• West Bengal- 1stcase
• Tamil nadu, Karnataka,
Maharashtra, Gujarat
• Endemic in 24 Indian
states and 6 union
territories

4. Transmission
• Vector - Aedes mosquitoes –
• Aggressive day time bite
• Major period of activity – sunrise and sunset
• Breeds in – collected clean water,rainwater
• Host - Man
• Main virus reservoirs are monkeys
• Transmission -
• only by mosquitoes
• picks up the virus from an infected person during the viraemic
period (within five days from the day of starting of symptoms)

5. disseminates to
salivary glands
Uninfected mosquito bites
viremic person Replication of
virus in midgut
Once infectious, mosquito is
capable of transmitting virus for
the rest of its life.
Bites healthy
persons

6. Clinical features
• Fever 39°C (102.2 °F) with chills
• Skin- Petechial or Maculopapular Rash usually involving the
limbs and trunk
• Arthralgia or Arthritis affecting multiple small Joints
-worsens with work -saddle back pain
-morning stiffness -migratory pain
• Ocular- Conjunctivitis, slight photophobia.
• Neurological – Carpal tunnel syndrome, paraesthesia
• Headache, nausea, vomiting, abdominal pain

8. Diagnosis
• Virus isolation- blood culture, peripheral blood smear
• RT-PCR – Within 7 days
• ESR
• CBC- leucopenia, thrombocytopenia
• ELISA- detect anti-CHIKV immunoglobulin IgM and
IgG antibodies
• CRP
• PRNT - Plaque reduction neutralization tests (PRNT)
quite specific for alphaviruses and are the gold standard for
confirmation of serologic test results

9. Differential diagnosis

10. Management
PREVENTION
• Mosquito repellant- Oil of lemon eucalyptus (OLE), Para-
menthane-diol
• Organophosphorous insecticides
• Fish- Gambusia and guppy fish
• Check for water-holding containers both indoors and
outdoors.
• Thermofogging- ULV of malathion and sumithion

11. • Fever – PCM 500 mg tds, increase fluid intake
• Cold sponging
• Analgesics- NSAIDs, cold compress over joints
• Hydroxychloroquine 200mg OD - helps those with chronic
arthritis
• Chloroquine phosphate – 300 mg OD orally for 4 weeks
• Corticosteroids not recommended during the acute phase of
disease, as they may cause immunosuppression and worsen
infection
• No antiviral treatment is currently available, though testing
has shown several medications to be effective in vitro.

12. • Chronic arthritis - > two weeks of arthritis, ribavirin may be
useful.
• Extreme cases- joint surgery
• Subcutaneous bleeding- FFP
• Platelets(<50k)- Platelet infusion + vit. K inj. (if PTINR >2.0)
• On Recovery
-Exercise, cold compress
-Physiotherapy
-Hyperpigmented Rash- Calamine lotion
• Neurological- Amitryptyline, Gabapentin, pregabalin,etc
• Vaccines - No approved vaccines available.

13. Complications
RARE
• uveitis, retinitis
• myocarditis
• hepatitis
• nephritis
• bullous skin lesions
• meningoencephalitis,
• Guillain-Barré syndrome
• cranial nerve palsies

14. Ayurvedic perspective
• VP Jwar
• “शिरोरुक् पर्वण ां भेदो द हो रोम्णां प्रहर्ष्म ्|
कण्ठणस्यशोर्ो र्मथुस्तृष््ण मूर्च्णष भ्रमोऽरुच िः||८५||
स्वप्ननणशोऽततवणग्जृमभण वणतपित्तज्वरणकृ ततिःl”
• VK Jwar
• “शीतको गौरवां तन्द्रण स्तैममत्यां पर्वण ां च रुक्||८६||
शिरोग्रहः प्रततश्यणयिः कणसिः स्वेदणप्रवतषनम्|
सन्द्तणिो मध्यवेगश् वणतश्लेष्मज्वरणकृ ततिःl”
• Bhav prakash- sandhigata sanniptaj jwar
• Vatolban hina pitta hina kapha
• “सन्ध्यस्थथशिरसः िूलां प्रलणिो गौरवां भ्रमिः|
वणतोल्ब्े स्यणद् द््यनुगे तृष््ण कण्ठणस्यशुष्कतणll”

16. Thought of the day