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Chikungunya
From Wikipedia, the free encyclopedia

Chikungunya

Classification and external resources

ICD-10

A92.0

ICD-9

065.4, 066.3

DiseasesDB

32213

MeSH

D018354

Chikungunya virus

Virus classification

Group:

Group IV ((+)ssRNA)

Order:

Unassigned

Family:

Togaviridae

Genus:

Alphavirus

Species:

Chikungunya virus

slightphotophobia and partial loss of taste. [2][3] Contents [hide]  1 Signs and symptoms o   1. of the genus Alphavirus. with an acute febrile phase of the illness lasting only two to five days. followed by a prolonged arthralgic disease that affects the joints of the extremities. usually two to three. or in some cases years. Its symptoms include a fever up to 40 °C (104 °F). a petechial or maculopapularrash of the trunk and occasionally the limbs. The pain associated with CHIKV infection of the joints persists for weeks or months.[1] There have been recent breakouts of CHIKV associated with severe illness.Chikungunya (in the Makonde language "that which bends up") virus (CHIKV) is an arthropod-borne virus. CHIKV infection causes an illness with symptoms similar to dengue fever. conjunctivitis.1 Diagnosis 2 Causes 3 Pathophysiology o  3.[5] .[4] Other nonspecific symptoms can include headache. and arthralgia or arthritis affecting multiple joints. that is transmitted to humans by virus-carrying Aedes mosquitoes.1 Type 1 Interferon 4 Prevention o            4.1 Vaccine research 5 Treatment 6 Prognosis 7 Epidemiology 8 Viral evolution 9 History 10 Use as a biological weapon 11 In popular culture 12 See also 13 References 14 Further reading 15 External links Signs and symptoms[edit source | editbeta] The incubation period of chikungunya disease ranges from one to twelve days.

The main virus reservoirs are monkeys. [8]  Serological diagnosis requires a larger amount of blood than the other methods. usually of the genus Aedes. Chikungunya virus belongs to alphavirus genus of the Togaviridae family. (July 2008) Chikungunya virus is indigenous to tropical Africa and Asia. However. CHIK fever epidemics are sustained by human-mosquito-human transmission. intense headache. including humans. some as long as two years. depending on their age.  Virus isolation provides the most definitive diagnosis. primarily fibroblasts and monocyte-derived macrophages. primary lymphocytesand monocytes and monocyte-derived dendritic cells are not susceptible to infection. virus isolation. Infection is cytopathic and associated with the induction of apoptosis in the infected cell. and false positives can occur with infection via other related viruses. (March 2008) Human epithelial and endothelial cells.[6][7] Diagnosis[edit source | editbeta] Common laboratory tests for chikungunya include RT-PCR. usually for about five to seven days. and serological tests. . bo-borne). the fever lasts for two days and then ends abruptly.Typically. but other species can also be affected. where it is transmitted to humans by the bite of infected mosquitoes. Lymphoid and monocytoid cells.  RT-PCR using nested primer pairs is used to amplify several chikungunyaspecific genes from whole blood. It is an "Arbovirus" (Ar-arthropod. Viral entry occurs through pH-dependent endocytosis. Results can be determined in one to two days.[8] Causes[edit source | editbeta] This section requires expansion. are susceptible to infection. such as o'nyong'nyong virus and Semliki Forest virus. insomnia and an extreme degree of prostration—last for a variable period.[8] The technique involves exposing specific cell lines to samples from whole blood and identifying chikungunya virus-specific responses. and uses an ELISA assay to measure chikungunya-specific IgM levels. but takes one to two weeks for completion and must be carried out in biosafety level 3 laboratories. Results require two to three days. other symptoms —namely joint pain.[4] Patients have complained of joint pains for much longer time periods. [9] Pathophysiology[edit source | editbeta] This section requires expansion.

and VISA—has been found to be an important factor. So far.[16] NS2 interferes with the JAK-STAT signaling pathway and prevents STAT from becoming phosphorylated. Type 1 Interferon[edit source | editbeta] Upon infection with chikungunya. 2011 saw similar results with the live attenuated strain CHIKV181/25 strain. rather than dying. MAVS. also known as N. the type 1 interferon deficient (IFN α/β -/-) mice were temporarily disabled and the partially type 1 interferon deficient mice did not have any problems.[11] Partidos et al.[15] Chikungunya counters the Type I interferon response by producing NS2.Infection is highly sensitive to the antiviral activity of type I and II interferon. White et al. The most effective means of prevention are protection against contact with the disease-carrying mosquitoes and mosquito control. mice that are partially type 1 deficient (IFN α/β +/-) are mildly affected and experience symptoms such as muscle weakness and lethargy.[13] Other studies have found that IRF3and IRF7 are important in an age-dependent manner. a non-structural protein that degrades Rpb and turns off the host cell's ability to transcribe DNA. found that interfering with IPS-1 decreased the phosphorylation of interferon regulatory factor 3 (IRF3) and the production of IFN-β. Adult mice that lack both of these regulatory factors die upon infection with chikungunya. In 2011. [10] Mice that lack the interferon alpha receptor die in 2–3 days upon being exposed to 10 2 chikungunya PFU. IPS-1—also known as Cardif. These include using insect repellents with substances such asDEET (N.[10] At the same time.N'-diethyl-3-methylbenzamide or . There currently is no licensed vaccine to protect against chikungunya virus. succumb to the virus if they are deficient in one of these factors. on the other hand.[17] Prevention[edit source | editbeta] The Aedes aegypti mosquito biting a person. no one knows the chikungunya specific pathogen associated molecular pattern. [14] Neonates.N-diethyl-meta-toluamide. the host's fibroblasts will produce type 1 (alpha and beta) interferon. while wild type mice survive even when exposed to as much as 102 PFU of the virus.[13] Nonetheless.[12] Several studies have attempted to find the upstream components of the type 1 interferon pathway involved in the host's response to chikungunya infection. However.

A Phase II vaccine trial. attenuated virus. and no vaccine is currently available. garments can be treated with pyrethroids. a substance derived from the lemon eucalyptus tree). Chloroquine is gaining ground as a possible treatment for the symptoms associated with chikungunya. sponsored by the US Government and published in the American Journal of Tropical Medicine and Hygiene in 2000. Securing screens on windows and doors will help to keep mosquitoes out of the house. In the case of the day-active Aedes aegypti and Aedes albopictus. but these have not been developed further due to shifting research priorities. since many contacts between the vector and the host occur outside. and as an antiinflammatory agent to combat the arthritis associated with the virus. this will have only a limited effect. PMD (p-menthane-3.8-diol.[19] A serological test for chikungunya is available from the University of Malaya in Kuala Lumpur. icaridin (also known as picaridin and KBR3023). Vaporized pyrethroids (for example in mosquito coils) are also insect repellents. Vaccine research[edit source | editbeta] Early-stage (phases 1 and 2) clinical trials have provided evidence in humans for safety and prophylactic efficacy of candidate vaccines. [18] Treatment[edit source | editbeta] Chikungunya on the right foot. developing viral resistance in 98% of those tested after 28 days and 85% still showed resistance after one year. used a live. There are no specific treatments for chikungunya. A University of Malaya study found that for arthritislike symptoms not relieved by aspirinand nonsteroidal anti-inflammatory drugs (NSAIDs). In addition. or IR3535.NNDB). however. Wearing bite-proof long sleeves and trousers (pants) also offers protection. a class of insecticides that often has repellent properties. chloroquine phosphate .

but recent research by the Pasteur Institutein Paris has suggested chikungunya virus strains in the 2005-2006 Reunion Island outbreak incurred a mutation that facilitated transmission by Asian tiger mosquito (Aedes albopictus). middle-aged patients recover in 1 to 2. [24] Chikungunya is generally spread through bites from Aedes aegypti mosquitoes.5 months. (March 2008) Recovery from the disease varies by age. no untoward effects are noticed after the infection. Recovery is longer for the elderly. Prognosis[edit source | editbeta] This section requires expansion. The fact sheet[9] on chikungunya advises against using aspirin. renal or hepatic abnormalities. and the viruses that cause eastern equine encephalitis and western equine encephalitis. naproxen and other NSAIDs that are recommended for arthritic pain and fever. East/Central/South African and Asian genotypes. Ocular inflammation from Chikungunya may present as iridocyclitis. Epidemiology[edit source | editbeta] Cases of chikungunya fever (between 1952 and 2006) have been reported in the countries depicted in red on this map.(250 mg/day) has given promising results. Younger patients recover within 5 to 15 days.[22] the Ross River virus in Australia. and have retinal lesions as well.[23] Three genotypes of this virus have been described: West African. In pregnant women. The severity of the disease as well as its duration is less in younger patients and pregnant women.[25] .[21] Pedal oedema (swelling of legs) is observed in many patients. the cause of which remains obscure as it is not related to any cardiovascular. Chikungunya virus is an alphavirus closely related to the o'nyong'nyong virus.[20] Unpublished studies in cell culture and monkeys show no effect of chloroquine treatment on reduction of chikungunya disease. ibuprofen.

and put him into intensive care because the infection had left the baby unable to breathe by himself or to drink milk. and then to the Philippines and more recently Malaysia. albopictus could mean an increased risk for chikungunya outbreaks in other areas where the Asian tiger mosquito is present. but without laboratory confirmation. .[31] The disease was first described by Marion Robinson[32] and W. A recent epidemic in Italy was likely perpetuated by A. albopictus was caused by a point mutation in one of the viral envelope genes (E1). meaning "that which bends up". The extant ECSA strains —which include the first isolate of this virus— evolved between 1924 and 1943. 28. to prevent mother-fetus virus transmission. The estimated overall mutation rate is 4.[26][27] Enhanced transmission of chikungunya virus by A.[23] On 28 May 2009 in Changwat Trang of Thailand where the virus is endemic. the provincial hospital decided to deliver byCaesarean section a male baby from his chikungunya-infected mother.33 × 10−4 nucleotide substitutions per site per year—a rate similar to those found in other viruses with RNA genomes.[29] Viral evolution[edit source | editbeta] This virus was first identified in Tanzania in the 1953 appears to have evolved from an alphavirus ~1713 AD (95% credible interval: 1573–1843) in Africa. following an outbreak in 1952 on the Makonde Plateau. the physicians discovered the baby was already infected with the virus.Concurrent studies by arbovirologists at the University of Texas Medical Branch in Galveston. along the border between Mozambique and Tanganyika (the mainland part of modern day Tanzania).H. However. The Asian group split into two clades: an Indian lineage which has probably become extinct and a Southeast Asian lineage. albopictus. The recent Indian Ocean basin outbreak that began in 2004 appears to have originated from the ECSA group back in 2002 (95% credible interval: December 2001 to December 2003).R. Khwanruethai Sutmueang. a Trang native.[28] In Africa. Texas. Lumsden[33] in 1955. after delivering the baby. The physicians presumed the virus might be able to be transmitted from a mother to her fetus. confirmed definitively that enhanced chikungunya virus infection of A.[24][30] The East/Central/South African (ECSA) and Asian strains diverged within the last 150 years (95% HPD: 1879 to 1927).[30] History[edit source | editbeta] Main article: Chikungunya outbreaks The word chikungunya is thought to derive from a description in the local Makonde dialect. chikungunya is spread via a sylvatic cycle in which the virus largely resides in other primates in between human outbreaks. The Southeast Asian lineage spread from Thailand toIndonesia. of the contorted posture of patients afflicted with the severe joint pain and arthritic symptoms associated with this disease.

Pradhan SK (December 2006). ^ Powers AM. 2. "Changing patterns of chikungunya virus: re-emergence of a zoonotic arbovirus".0. "Emergence of chikungunya virus in Indian subcontinent after 32 years: A review". Virol. The first recorded outbreak of this disease may have been in 1779. Africa.[36] In popular culture[edit source | editbeta] The season 8 episode of the television series Bones entitled "The Pathos in the Pathogens" (episode 23) centers around a genetically engineered strain of chikungunya. Logue CH (September 2007).PMID 17175699. . J Vector Borne Dis 43 (4): 151– 60. the lingua franca of the region.82858-0. the term chikungunya is derived from the Makonde root verb kungunyala. Gen. J. and Southeast Asia. See also[edit source | editbeta]     Chikungunya outbreaks: outbreaks of the disease. Robinson glossed the Makonde term more specifically as "that which bends up". and "chickengunya". [34] This is in agreement with the molecular genetics evidence that suggests it evolved around the year 1700. chikungunya virus outbreaks have occurred occasionally in Africa.[35] Use as a biological weapon[edit source | editbeta] Chikungunya was one of more than a dozen agents the United States researched as potential biological weapons before the nation suspended its biological weapons program.According to the initial 1955 report about the epidemiology of the disease. in 1952. meaning to dry up or become contorted. "chicken gunaya". PMID 17698645. Subsequent authors apparently overlooked the references to the Makonde language and assumed the term derived from Swahili. but recent outbreaks have spread the disease over a wider range. Many other erroneous spellings and forms of the term are in common use including "chicken guinea". 2004 to present DEET O'nyong'nyong virus: a similar virus Vector (epidemiology) References[edit source | editbeta] 1. 88 (Pt 9): 2363– 77. [citation needed] Since its discovery in Tanganyika. The erroneous attribution of the term as a Swahili word has been repeated in numerous print sources.1099/vir. ^ Lahariya C. South Asia. In concurrent research.doi:10.

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J Gen Virol 88 (9): 2363– 77. 35. PMID 4938938. Infect. accessed 14 November 2008. et al. PLoS Med.pmed. (January 2009). Michault A. (July 2006). External links[edit source | editbeta]   WHO site on disease outbreak news Mosquito-borne African virus a new threat to West Update on increasing threat. et al. "Evolutionary rates and timescale comparison of Chikungunya viruses inferred from the whole genome/E1 gene with special reference to the 2005-07 outbreak in the Indian subcontinent". ^ Cherian SS. PMC 1463904.82858-0. PMID 18940268. European Centre for Disease Prevention and Control. doi:10.09. doi:10.34.2008.  Powers AM. 9 April 2002. 23 January 2008. 042–079) .243. J Hist Med Allied Sci 26 (3): 243– 62. Logue CH (2007). doi:10.meegid. ^ "Chemical and Biological Weapons: Possession and Programs Past and Present".0030263. Further reading[edit source | editbeta]  "Chikungunya". Genet.0.doi:10. Walimbe AM.1371/journal. from Reuters  Virus Pathogen Database and Analysis Resource (ViPR): Togaviridae [show]    V T E Zoonotic viral diseases (A80–B34. James Martin Center for Nonproliferation Studies. Jadhav SM.  Schuffenecker I. "Changing patterns of chikungunya virus: reemergence of a zoonotic arbovirus".3. Evol.1093/jhmas/XXVI. Retrieved May 20. "Chikungunya and dengue: a case of mistaken identity?". PMID 16700631. 3 (7): e263. ^ Carey DE (July 1971). 36.1099/vir. 2013. "Genome microevolution of chikungunya viruses causing the Indian Ocean outbreak".004.1016/j. Middlebury College. 9 (1): 16– 23. Iteman I.PMID 17698645.

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