DOI: http://dx.doi.org/10.18203/2349-3933.ijam20180075

Analysis of chikungunya outbreak of 2016 in Rajasthan: a clinico-epidemiological study

Raman Sharma, Sunil Mahavar, Mayank Gupta, Sandeep Kumar, Jai Purohit, Gaurav Chauhan

Abstract


Background: To describe the diversity of clinical manifestations, laboratory findings and outcome of chikungunya fever in patients attending SMS Hospital, Jaipur during the epidemic of 2016 (September to November).

Methods: All cases of febrile illness with polyarthralgia/polyarthritis diagnosed as chikungunya were analyzed. Diagnosis was made by ELISA based IgM serology and RT PCR assay.

Results: A total of 200 cases were studied. All of them presented with fever, severe crippling joint pain & tenderness, headache, anorexia and body rash. On examination, there was periarticular edema, erythema, and tenderness in joints with post auricular and cervical lymphadenopathy. Unusual manifestations were hyper pigmentation of face and forehead and scrotal ulcers. On investigations patient had leucopenia with elevated level of SGOT, SGPT with normal bilirubin levels. Other complications observed were encephalopathy, encephalitis, myocarditis and hepatitis. There was no mortality in this group.

Conclusions: Chikungunya though prevalent is under-reported. The diagnostic certainty is mandated by presence of febrile transiently crippling polyarthragias / arthritis. On analyzing a large series, unusual clinical features may emerge.


Keywords


Chikungunya, Fever, Polyarthralgia

Full Text:

PDF

References


Weaver SC, Lecuit M. Chikungunya virus and the global spread of a mosquito-borne disease. N Engl J Med. 2015;372:1231.

Tsetsarkin KA, Chen R, Yun R. Multi-peaked adaptive landscape for chikungunya virus evolution predicts continued fitness optimization in Aedes albopictus mosquitoes. Nat Commun. 2014;5:4084.

Schuffenecker I, Iteman I, Michault A. Genome microevolution of chikungunya viruses causing the Indian Ocean outbreak. PLoS Med. 2006;3(7):e263.

Chretien JP, Anyamba A, Bedno SA. Drought-associated chikungunya emergence along coastal East Africa. Am J Trop Med Hyg. 2007;76:405-7.

Weaver SC, Osorio JE, Livengood JA, Chen R, Stinchcomb DT. Chikungunya virus and prospects for a vaccine. Expert Rev Vaccines. 2012;11:1087-101.

Mavalankar D, Shastri P, Bandyopadhyay T. Increased mortality rate associated with chikungunya epidemic, Ahmedabad, India. Emerg Infect Dis. 2008;14:412.

Furuya-Kanamori L, Liang S, Milinovich G. Co-distribution and co-infection of chikungunya and dengue viruses. BMC Infect Dis. 2016;16:84.

Waggoner JJ, Gresh L, Vargas MJ. Viremia and Clinical Presentation in Nicaraguan Patients Infected With Zika Virus, Chikungunya Virus, and Dengue Virus. Clin Infect Dis. 2016;63:1584.

Burt FJ, Rolph MS, Rulli NE. Chikungunya: a re-emerging virus. Lancet. 2012;379:662.

Lakshmi V, Neeraja M, Subbalaxmi MV. Clinical features and molecular diagnosis of Chikungunya fever from South India. Clin Infect Dis. 2008;46:1436.

Centers for Disease Control and Prevention. Chikungunya virus: Clinical Evaluation and Disease. Available form: https://www.cdc.gov/chikungunya/hc/clinicalevaluation.html (Accessed on October 20, 2016).

Centers for Disease Control and Prevention. Is it Chikungunya or Dengue? Available from: https://www.cdc.gov/chikungunya/pdfs/poster_chikv_denv_comparison_healthcare_providers.pdf (Accessed on October 24, 2016).