This lesson plan provides an overview of chikungunya fever and its prevention. The objectives are to define chikungunya, understand its epidemiology, causes, classification, modes of transmission, signs and symptoms, diagnosis, treatment, complications, and prevention. The lesson will be delivered to nursing students through a lecture and discussion using methods like PowerPoint, blackboard, models and handouts. The assignment is for students to explain how to prevent chikungunya fever in infants.

1. LESSON PLAN ON
CHIKUNGUNYA AND ITS
PREVENTION
SUBMITTED TO SUBMITTED BY
RAJ
2 ND YEAR M.SC (N)
VARADAN COLLEGE OF NURSING

2. OBJECTIVES
GENERAL OBJECTIVES
At the end of the class the participants will be able to gain knowledge regarding chikungunya fever and its
prevention and will be able to apply that knowledge in their practical life situation.
SPECIFIC OBJECTIVES
At the end of the class participants will be able to:
• To define the chikungunya fever
• To know the historical epidemiology
• To identify the causes of chikungunya fever
• To list out the classification of chikungunya
• To know about the mode of transmission of chikungunya fever
• To discuss about the clinical manifestations of chikungunya
• To diagnose the chikungunya fever
• To enumerate the treatment of chikungunyafever
• To explain about the complications of chikungunyafever
• To discuss about the prevention of chikungunya fever

3. STUDENT PROFILE
NAME OF THE INSTITUTION : institute of nursing
COURSE : M.Sc. nursing 2nd year
SUBJECT : Nursing
TOPIC : chikungunya fever and its prevention
NAME OF THE RESEARCH GUIDE : Mrs.
: Associate Professor
NAME OF THE CO-GUIDE :Mrs.
Associ
ate
Profess
or
NAME OF THE RESEARCHER : Mr.
PARTICIPANTS OF THE STUDY : junior students
DURATION : 1hour
METHOD OF TEACHING : Lecture cum discussion
MEDIA OF TEACHING : Power point, Black board. Chart
,model,handout.

4. S.NO TIME OBJECTIVES CONTENT TEACHING
ACTIVITY
LEARNING
ACTIVITY
A.V
AIDS
EVALUATION
1.
2.
1min
2min
To introduce
the topic
To define the
chikungunya
INTRODUCTION
Chikungunya is a mosquito-borne viral disease
first described during an outbreak in southern
Tanzania in 1952. It is an RNA virus that belongs
to the alpha virus genus of the family Togaviridae.
The name “chikungunya” derives from a word in
the Kimakonde language, meaning “to become
contorted”, and “that which bends up” describes
the stooped appearance of sufferers with joint pain
(arthralgia).The fever is locally also named as
“Langrajor”
DEFINITION
“ It is spread by bite of “Aedes aegypti” mosquito
which usually bite during day light hours. The
name is derived from Swahili word meaning “that
which bends up” .Describes that posture patient
assume to relieve the severe joint pains.
Or
Teaching
activity
Teaching
activity
Learning
activity
Learning
activity
Black
board
Ohp What is the
definition of
chikungunya?

5. 3. 2min To know the
epidemiology
“Chikungunya is caused by the chikungunya virus
(CHIKV), an arthropod-borne virus (arbovirus).
Chikungunya fever is one of the most
important mosquito-borne viral diseases”.
HISTORY OF EPIDEMIOLOGY
Epidemiological criteria: residing or having visited
epidemic areas, having reported transmission
within 15 days prior to the onset of symptoms. In
late 2013, the first local (autochthonous)
transmission in the Americas was documented. In
India it was first reported in 1963 at Calcutta. Its
recent epidemic which started in December 2005,
involving southern and central India has grabbed
Teaching
activity
Learning
activity
Black
board
When
chikungunya
identified in
India?

6. much attention. Chikungunya is not considered to
be fatal. However, in 2005 - 2006, 200 deaths have
been associated with chikungunya of Reunion
Island and widespread outbreak in southern India.
A recent report of large scale outbreaks of
chikungunya virus in southern India has confirmed
the re-emergence of this virus. The precise reasons
for the re-emergence in the Indian sub-continent as
well as in southern India, of this viral infection, are
due to a variety of social, environmental,
behavioral and biological changes.

7. 4.
5.
2min
1min
To identify the
etiology of
chikungunya
fever
To describe the
risk factors
ETIOOLOGY OF CHICKEN GUNYA FEVER
Causative organism – Chikungunya virus
Alternate name – Buggy Creek virus
ICTV acronym – CHIKV
Humans and other primates are the natural hosts
for the chikungunya virus. The virus is spread to
humans by the bite of an infected female, Aedes
species mosquito – Aedes aegypti or Aedes
albopictus.
RISK FACTORS OF CHIKUNGUNYA FEVER
People of all ages can become infected with
CHIKV and suffer a debilitating illness, but only
20% of the people that are infected will suffer any
illness symptoms. Infants, senior citizens, and
people already suffering from other underlying
illnesses are at greater risk of a severe illness. To
date no locally-acquired cases have been reported
among Virginia residents. T here is a risk of
Teaching
activity
Teaching
activity
Learning
activity
Learning
activity
Chart
Chart
What are the
causes of
chikungunya
fever?
Who are the
risk factors of
chikungunya?

8. 6.
7.
1min
2min
To list out the
classification
of
chikungunya
To enumerate
the mode of
transmission
infected travelers transmitting CHIKV to local
Asian tiger mosquitoes which are the most
common nuisance mosquito in urban areas of
Virginia.
VIRUS CLASSIFICATION
Group: Group IV [(+) SS RNA]
Family: Togaviridae
Genus: Alphavirus
Species: Chikungunya virus
MODE OF TRANSMISSION
 Chikungunya is spread by the bite of an
infected Aedes mosquito, primarily Aedes
aegypti.
 Recently, research by the Pasteur Institute
in Paris has found a mutation that enables
it to be transmitted by Aedes albopitcus
(Tiger mosquito), which appears to be the
cause of the recent epidemic in Asia.
 Few cases of mother to foetus infection
have been reported from Asia, which
Teaching
activity
Teaching
activity
Learning
activity
Learning
activity
Chart
Chart
What is the
classification of
chikungunya ?
What is the
mode of
transmission of
chikungunya?

9. 8. 3min To identify the
signs and
symptoms of
chicken gunya
occurs between 3 and 4 months of
pregnancy.
RESERVOIR
 Humans are the major source of reservoir
of chikungunya virus for mosquitoes.
 Some non human primates like monkeys
are the reservoir in Africa, in which it is
transmitted by Aedes fureifer and Africans.
CLINICAL MANIFESTATIONS OF
CHIKUNGUNYA FEVER
 Full-blown disease is most common among
Teaching
activity
Learning
activity
Ppt What are the
symptoms of
chikungunya ?

10. adults in whom the clinical picture may be
dramatic.
 The abrupt onset of clinical manifestations
follows an incubation period of 2 to 3 days.
 Silent CHIKV infections do occur, but the
number and incidence is not yet known.
Fever is sudden onset, high grade (> 40° C,
104° F) with chills and rigors; fever is
biphasic or saddle back (fever subsides in 2
to 3 days and than comes back after 1 day);
the second phase of fever is usually
associated with bradycardia.
 Fever is associated with constitutional
symptoms such as headache, photophobia,
conjunctivitis, anorexia, nausea, and
abdominal pain.
 Arthralgia/arthritis in chikungunya has
been quite crippling in recent outbreaks in
southern India. Migratory polyarthritis
mainly affects the small joints of hands,
wrists, ankles, and feet. Rash may appear
at the outset or several days after the illness

11. i.e., in the convalescence phase.
Dermatological manifestations observed in a
recent outbreak of chikungunya fever in southern
India include the following4:
1. Maculopapular rash.
2. Blotchy, nasal erythema.
3. Freckle-like pigmentation over centro-facial
area.
4. Flagellate pigmentation on face and extremities.
5. Lichenoid eruption and hyperpigmentation in
photo distributed areas.
6. Multiple aphthous–like ulcers over the scrotum,
crural areas, and axilla.
7. Lymphoedema in acral distribution (bilateral/
unilateral).
8. Multiple ecchymotic spots (children).
9. Vesiculobullous lesions (infants).
10. Subungual haemorrhage.
11. Photourticaria.
12. Acralurticaria.

12. Fever typically last for two days and then abruptly
comes down. However, joint pain, headache,
insomnia, and various degrees of prostration last
for a variable period, usually for about 5 to 7 days.
Chikungunya is a self-limiting disease, and
recovery is the rule, but little mortality has been
reported in the recent outbreaks in southern India.
In July 2006, a team analysed the virus RNA and
determined the genetic changes that have occurred
in various strains of the virus and identified the
genetic sequence which led to the increased
virulence of the recent strains
 The symptoms are most often clinically
indistinguishable from those observed in
dengue fever.
 Indeed, simultaneous isolation of both

13. 9. 2min To diagnose
the
chikungunya
fever
dengue and chikungunya from the sera of
some patients has been reported earlier,
indicating the presence of dual infections
 Therefore, it is very important to clinically
distinguish dengue from chikungunya virus
infection.
 Unlike dengue, haemorrhagic
manifestations are relatively rare, and as a
rule, shock is not observed in chikungunya
virus infection.
 Other important clinical conditions for
differential diagnosis are West Nile fever,
O’nyong-nyong fever.
DAIGNOSTIC INVESTIGATIONS OF
CHIKUNGUNYA FEVER
Diagnosis The tests available are:– Detection of
antigen and antibody in serum by ELISA test.
 IgM capture ELISA is necessary to
distinguish the disease from dengue fever.
 These tests are available at National
Teaching
activity
Learning
activity Ppt
What are the
diagnostic
investigations?

14. Institute of Virology at Pune, Maharashtra.
 Chikungunya virus infection should be
considered in patients with acute onset of
fever and polyarthralgia, especially
travelers who recently returned from areas
with known virus transmission.
 Laboratory diagnosis is generally
accomplished by testing serum or plasma
to detect virus, viral nucleic acid, or virus-
specific immunoglobulin (Ig) M and
neutralizing antibodies.
 Viral culture may detect virus in the first 3
days of illness; however, chikungunya
virus should be handled under biosafety
level (BSL) 3 conditions.
 During the first 8 days of illness,
chikungunya viral RNA can often be
identified in serum.
 Chikungunya virus antibodies normally
develop toward the end of the first week of
illness. Therefore, to definitively rule out
the diagnosis, convalescent-phase samples

15. 10. 2min To understand
the treatment
of
chikungunya
should be obtained from patients whose
acute-phase samples test negative.
 Common laboratory tests for
chikungunya include for instance RT-PCR
and serological tests
TREATMENT OF CHIKUNGUNYA FEVER
There is no specific treatment for
chikungunya. The illness is usually self-
limiting and will resolve with time.
Supportive care with rest is indicated
Teaching
activity
Learning
activity
Mode
l
How you will
treat the
chikungunya
fever ?

16. during the acute joint symptoms.
Ibuprofen, paracetamol relieve symptoms
of fever and aching.
Movement and mild exercise tend to
improve stiffness and morning arthralgia,
but heavy exercise may exacerbate
rheumatic symptoms.
In unresolved arthritis refractory to
NSAIDs, chloroquine phosphate (250
mg/day for several weeks) has given good
results.
Vaccine for commercial purpose is not
available and is under trial.

17. 11. 2min To know the
complications
COMPLICATIONS OF CHIKUNGUNYA
FEVER
Chikungunya is a self-limiting illness. The major
causes for morbidity are severe dehydration,
electrolyte imbalance, and hypoglycaemia.
Recovery is the rule, but 10 - 15% patients had
chronic joint pain and stiffness.
Major complications, though rare, are:–
1. Bleeding disorder (epistaxis, UGI bleed) as it
causes thrombocytopenia, superadded by
injudicious use of NSAIDs.
2. Neurological complications: a.
Meningoencephalitis. b. Paresis of limbs.
c. Slurring of speech.
3. Cardiovascular decompensation.
Teaching
activity
Learning
activity
Mode
l
What are the
complications ?

18. 12. 5min To explain
about the
prevention
4. Pneumonia and respiratory failure.
5. Deaths – Few deaths have been reported in the
recent epidemic in Reunion Island and in southern
India.
PREVENTION OF CHIKUNGUNYA FEVER
As there is no vaccine available yet, the only way
to prevent it is to eliminate mosquito breeding
sites and to prevent mosquito bites.
 Aedes mosquito vector for this disease
breeds in artificial accumulations of water
in and around human dwellings, such as
water found in disused wares, broken
bowls, flower pots, earthen pots. Therefore,
these sites should be eliminated by
responsible human behaviour and social
education.
Teaching
activity
Learning
activity
Flash
cards
How to prevent
the
chikungunya
fever?

19.  Aerosol spray of ultra low volume
quantities of malathion or sumithion (230
ml/litre) has been found to be effective.
 Mosquito net and repellents which contain
20 - 50% DEET (N, N-diethyl-meta-
tolnamido) should be used to prevent
mosquito bites.

20.  As mosquito bites during daytime,
mosquito repellants should be used during
daytime also and, not only during the night.
 Use of full sleeve clothing is effective in
preventing mosquito bites.

21. 13.
14.
2min
1min
To discuss
about the
chikungunya
To summaraise
the topic
CHIKUNGUNYA FEVER ABOUT MOTHER
 Chikungunya fever with pregnancy There
have been cases of mother-to-infant
infection which have occurred between 3
and 4 months into pregnancy.
 Before and after that period in pregnancy,
cases have not been recorded.
 IgG that is produced around day 15, passes
through the placenta and confers immunity
to the foetus.
 However, there is a 48 per cent risk of
infection at birth if the virus is present in
the mother’s blood.
 Such an infection in the foetus is rarely
serious, and more than 90 per cent of the
infected newborns recover quickly without
sequelae.
SUMMARY
I summaraise my topic with the definition
Teaching
activity
Learning
activity
Hand
out
What are the
transmission of
infant ?

22. 15.
16.
1min
1min
To conclude
the topic
To give
assignment
,epidemiology,etiology,classification,mode of
transmission,reserviour,clinical manifestations,
diagnostic investigations,treatment and prention of
chikungunya fever.
CONCLUSION
I conclude my topic with providing information to
control over the chikungunya in infant from
mother and mother will conclude to get complete
information on chikungunya fever about
prevention methods
ASSIGNMENT
How to prevent the chukungunya fever in infant?

23. 17. BIBLIOGRAPHY
1. Robinson Marion. “An epidemic of virus
disease in southern province, Tanganyika territory,
in 1952 - 53; I. Clinical Features.Trans Royal
Society Trop Med Hyg 1955; 49: 28-32. 2. Shah
KV, Gibbs CJ Jr, Banerjee G. Virological
investigation of the epidemic of haemorrhagic
fever in Calcutta: isolation of three strains of
Chikungunya virus. Indian J Med Res 1964; 52:
676-83. 3. http://www.medindia.netChikungunya
Affects Eight state.htm. 4.
http://en.wikipedia.org/wiki/Chikungunya. 5.
http://timesofindia.indiatimes.com. 6.
Chikungunya and Dengue in the south west Indian
Ocean. Epidemic and Pandemic Alert and
Response (EPR). http://
www.who.int/csr/don/2006. 7. Parik.
Disappearance of chikungunya virus from India
and southern Asia. Trans R Soc Trop Med Hyg
1986; 80: 491. 8. Yergolkar PN, Tandale BV,
Arankalle VAet al. Chikungunya outbreaks caused

24. by African genotype, India. Emerg Infect Dis
2006; 12: 1580-3. 9. http://www.who.int
/entity/csr/don 2006_02_17/es. 10. Powers AM,
Branlt AC, Jesh RB, Weaver SC. Re-emergence of
chikungunya and O’nyong-nyong viruses:
evidence for distinct geographical lineage and
distant evolutionary relationship. J Gen Virol
2000; 81: 471-9. 11. Neogi DK, Bhattacharya N,
Mukherjee KK et al. Sero survey of chikungunya
Antibody in Calcutta metropolis. J Commun Dis
1995; 37: 19-22.