Chikungunya

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Chikungunya

  1. 1. Dr.N.C.Nanda Jt.Director, Head of Paediatrics, IGH Rourkela
  2. 2. <ul><li>Incubation period – 2-3 days </li></ul><ul><li>Adults most common </li></ul><ul><li>- Typical </li></ul><ul><li>- Affects & damages- Cartilage/Connective tissue </li></ul><ul><li>- Immunological etiology suspected </li></ul><ul><li>- Self limiting </li></ul><ul><li>- Dramatic & Insiduous </li></ul><ul><li>- Sequelae - Month/Years, High morbidity </li></ul><ul><li>- Tried - Fever </li></ul><ul><ul><li>- Arthralgia </li></ul></ul><ul><ul><li>- Rashes </li></ul></ul><ul><ul><li>- Headache, GI symptoms, retro orbital pain, chills, </li></ul></ul><ul><ul><li> weakness, malaise, rarely bleeding </li></ul></ul>
  3. 3. <ul><li>Atypical </li></ul><ul><li>- Myocarditis </li></ul><ul><li>- Haemorrhagic episode </li></ul><ul><li>- Meningitis/ Meningo encephalitis/ febrile seizure </li></ul><ul><li>- Dermatological problems </li></ul>
  4. 4. <ul><li>Usual - 2-3Wk </li></ul><ul><li>20% - Few Wk </li></ul><ul><li> < 10% - Few months </li></ul><ul><li> 10% - Recurrences </li></ul><ul><li>Arthropathy - Stiffness/Painful episodes/Recurrent joint effusion (Elderly patients, HLA B27) </li></ul><ul><li>- Restriction of movement </li></ul><ul><li>- Tendonitis </li></ul><ul><li>Neuro/Emotional sequalae </li></ul>
  5. 5. <ul><li>Clinical </li></ul><ul><li>Lab </li></ul><ul><li>- Demonstration - specific IgM antibodies (ELISA)(7 th Day- 6 months) </li></ul><ul><li>- Isolation of Virus (Culture) </li></ul><ul><li>- Molecular demonstration of Viral RNA (RT-PCR) </li></ul><ul><li>- Haematology - Leucopenia/ Platelet/ ESR/ CRP </li></ul>
  6. 6. <ul><li>Dengue </li></ul><ul><li>RA/ Rh fever </li></ul><ul><li>Parvo.B19 </li></ul><ul><li>Rubella </li></ul><ul><li>Hepatitis B </li></ul><ul><li>Syst. Psoriatic Arthritis </li></ul><ul><li>Ross River Virus </li></ul><ul><li>Reiter’s syndrome </li></ul><ul><li>LBA/ Spondylitis </li></ul><ul><li>Suppurative arthritis </li></ul><ul><li>Drug/Allergic Rashes </li></ul><ul><li>Others - Leptospirosis </li></ul><ul><li>- Malaria </li></ul><ul><li>- Brucellosis </li></ul><ul><li>- SINDBIS Virus infection </li></ul>
  7. 7. <ul><li>Symptomatic, Cold Compress </li></ul><ul><li>Drugs (No salicylates/ Nimesulide ) </li></ul><ul><li>Steroid/NSAIDS </li></ul><ul><li>Rest </li></ul><ul><li>Physiotherapy/Surgery/Yoga </li></ul><ul><li>Occup.assistance </li></ul><ul><li>α- IFN & Ribavirin - synergistic effect( Invitro) </li></ul><ul><li>Chloroquine phosphate </li></ul><ul><li>Vaccine ??? Ph.II trial </li></ul><ul><li>Newer </li></ul>
  8. 8. <ul><li>Vector control measures </li></ul><ul><li>Personal protection </li></ul><ul><li>Vaccine </li></ul><ul><li>Public health measures </li></ul>
  9. 9. Thank You

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