Literature Review

Chikungunya
According to Alvarado et al., 2019, Chikungunya is an acute febrile illness (AFI),
caused by the chikungunya virus (CHIKV), that is transmitted by mosquitoes. a mosquito-borne
alphavirus belonging to the family Togaviridae, the virus is spread to humans by bites of an
infected female Aedes species Aedes aegypti or Aedes alobpictus.
The virus was first discovered or isolated from the patient in Tanzania during the outbreak of a
dengue-like illness that occurred in that area between 192 and 1953. The virus name got from the
word in the local dialect of the Mokande area in Tanzania and it literally translated as “bent over
in pain” many chikungunya patients have a stooped posture because chikungunya exhibit joint,
muscle, or bone pain, and may also have a skin rash and red eyes. From Alvarado’s et al., 2019
clinical diagnosis is that the chikungunya may be difficult to distinguish from the other cases like
dengue, adenoviral disease, influenza, leptospirosis, Zika, and Malaria. They test the blood for
viral RNA by reverse transcription-polymerase chain reaction (RT-PCR) or anti-CHIKV
antibodies allows for definitive diagnosis, However, the specificity and sensitivity of this
definition are not known and it may vary by timing of presentation and age of the patient.
According to the World Health Organization (WHO), chikungunya virus symptoms appear
between 4-7 days after the patient has been bitten by the infected mosquito and this includes:
 High fever (40°C/ 104°F)
 Joint pain (lower back, ankle, knees, wrists or phalanges)
 Joint swelling
 Rash
 Headache
 Muscle pain
 Nausea
 Fatigue
And Chikungunya is said to be rarely fatal. Symptoms are self-limiting and last for 2-3
days and the virus remains in the human system for 5-7 days even mosquitos feeding on the
infected person can also be infected and the virus can also affect or harm the infants during early
pregnancy , Yet chikungunya is not contagious from human to human it cannot spread from
person to person and chikungunya is spread by mosquito and cannot transmitted through air,
there are some clinical signs about chikungunya and dengue have in common which somehow
misdiagnosed in areas where dengue is common.

Recovery from the infection can help you to have life-long immunity to it but according
to Alvardo et al. that some people think that they cannot get infected again after the recovery
there are some cases that chikungunya is chronic and can be relapsed again.
There is no antiviral treatment to this disease although some vaccines and therapeutic candidates
are under development, The Centers for Disease Control recommends rest, stay hydrated and
Symptomatic treatment with analgesic and non-steroidal anti-inflammatory drugs is
recommended for those with fever and joint pain.

According to World Health Organization (WHO) countries that have been documented
endemic, epidemic about chikungunya are the following countries Asia: Human chikungunya
virus infection has been documented in Cambodia, East Timor, India, Indonesia, Laos, Malaysia,
Maldives, Myanmar, Pakistan, Philippines, Réunion, Seychelles, Singapore, Taiwan, Thailand,
and Vietnam.
Africa: Chikungunya occurs in Benin, Burundi, Cameroon, Central African Republic, Comoros,
Congo (DRC), Equatorial Guinea, Guinea, Kenya, Madagascar, Malawi, Mauritius, Mayotte,
Nigeria, Senegal, South Africa, Sudan, Tanzania, Uganda and Zimbabwe.
Europe and the Americas: Aside from the traveler minor cases only Italy have a major outbreak
and America had no any major outbreak so far.

References:
https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0007562#sec010

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6264817/#targetText=Chikungunya%20disease
%20is%20caused%20by,belonging%20to%20the%20family%20Togaviridae.&targetText=The%
20proportion%20of%20asymptomatic%20CHIKV,%25%20%5B3%E2%80%935%5D.
https://www.who.int/denguecontrol/arbo-viral/other_arboviral_chikungunya/en/

https://www.verywellhealth.com/what-is-it-like-to-have-chikungunya-1958984