Post by Master Kim on Jan 5, 2015 22:39:31 GMT -5
Chikungunya - en.wikipedia.org/wiki/Chikungunya
Chikungunya (/ˌtʃɪkənˈɡʌnjə/ chi-kən-guun-yə; Makonde for "that which bends up") is an infection caused by the Chikungunya virus. It features sudden onset fever usually lasting two to seven days, and joint pains typically lasting weeks or months but sometimes years. The mortality rate is a bit less than 1 in 1000, with the elderly most likely to die.
The virus is passed to humans by two species of mosquito of the genus Aedes: A. albopictus and A. aegypti. The strain of chikungunya spreading to the US from the Caribbean is most easily spread by A. aegypti. Concern exists that this strain of chikungunya could mutate to make the A. albopictus vector more efficient. If this mutation were to occur, chikungunya would be more of a public health concern to the US because the A. albopictus or Asian tiger mosquito is more widespread in the US and is more aggressive than the A. aegypti. Animal reservoirs of the virus include monkeys, birds, cattle, and rodents. This is in contrast to dengue, for which only humans and primates are hosts.
The best means of prevention is overall mosquito control and the avoidance of bites by any infected mosquitoes. No specific treatment is known, but medications can be used to reduce symptoms. Rest and fluids may also be useful.
Signs and symptoms
The incubation period of chikungunya disease ranges from two to twelve days, typically three to seven. Between 72 and 97% of those infected will develop symptoms. Symptoms include sudden onset, sometimes biphasic fever typically lasting from a few days to a week, sometimes up to ten days, usually above 39 °C (102 °F) and sometimes reaching 41 °C (104 °F), and strong joint pain or stiffness usually lasting weeks or months but sometimes lasting years. Rash (usually maculopapular), muscle pain, headache, fatigue, nausea or vomiting may also be present. Inflammation of the eyes may present as iridocyclitis, or uveitis, and retina lesions may occur.
Typically, the fever lasts for two days and then ends abruptly. However, headache, insomnia and an extreme degree of prostration last for a variable period, usually about five to seven days.
Chronic disease
Observations during recent epidemics have suggested chikungunya may cause long-term symptoms following acute infection. During the La Reunion outbreak in 2006, more than 50% of subjects over the age of 45 reported long-term musculoskeletal pain with up to 60% of people reporting prolonged painful joints three years following initial infection. A study of imported cases in France reported that 59% of people still suffered from arthralgia two years after acute infection. Following a local epidemic of chikungunya in Italy, 66% of people reported muscle pains, joint pains, or asthenia at one year after acute infection. Long-term symptoms are not an entirely new observation; long-term arthritis was observed following an outbreak in 1979. Common predictors of prolonged symptoms are increased age and prior rheumatological disease. The cause of these chronic symptoms is currently not fully known. Markers of autoimmune or rheumatoid disease have not been found in people reporting chronic symptoms. However, some evidence from humans and animal models suggests chikungunya may be able to establish chronic infections within the host. Viral antigen was detected in a muscle biopsy of a people suffering a recurrent episode of disease three months after initial onset. Additionally, viral antigen and RNA were found in synovial macrophages of a person during a relapse of musculoskeletal disease 18 months after initial infection. Several animal models have also suggested chikungunya virus may establish persistent infections. In a mouse model, viral RNA was detected specifically in joint-associated tissue for at least 16 weeks after inoculation, and was associated with chronic synovitis. Similarly, another study reported detection of a viral reporter gene in joint tissue of mice for weeks after inoculation. In a nonhuman primate model, chikungunya virus was found to persist in the spleen for at least six weeks.....
Chikungunya (/ˌtʃɪkənˈɡʌnjə/ chi-kən-guun-yə; Makonde for "that which bends up") is an infection caused by the Chikungunya virus. It features sudden onset fever usually lasting two to seven days, and joint pains typically lasting weeks or months but sometimes years. The mortality rate is a bit less than 1 in 1000, with the elderly most likely to die.
The virus is passed to humans by two species of mosquito of the genus Aedes: A. albopictus and A. aegypti. The strain of chikungunya spreading to the US from the Caribbean is most easily spread by A. aegypti. Concern exists that this strain of chikungunya could mutate to make the A. albopictus vector more efficient. If this mutation were to occur, chikungunya would be more of a public health concern to the US because the A. albopictus or Asian tiger mosquito is more widespread in the US and is more aggressive than the A. aegypti. Animal reservoirs of the virus include monkeys, birds, cattle, and rodents. This is in contrast to dengue, for which only humans and primates are hosts.
The best means of prevention is overall mosquito control and the avoidance of bites by any infected mosquitoes. No specific treatment is known, but medications can be used to reduce symptoms. Rest and fluids may also be useful.
Signs and symptoms
The incubation period of chikungunya disease ranges from two to twelve days, typically three to seven. Between 72 and 97% of those infected will develop symptoms. Symptoms include sudden onset, sometimes biphasic fever typically lasting from a few days to a week, sometimes up to ten days, usually above 39 °C (102 °F) and sometimes reaching 41 °C (104 °F), and strong joint pain or stiffness usually lasting weeks or months but sometimes lasting years. Rash (usually maculopapular), muscle pain, headache, fatigue, nausea or vomiting may also be present. Inflammation of the eyes may present as iridocyclitis, or uveitis, and retina lesions may occur.
Typically, the fever lasts for two days and then ends abruptly. However, headache, insomnia and an extreme degree of prostration last for a variable period, usually about five to seven days.
Chronic disease
Observations during recent epidemics have suggested chikungunya may cause long-term symptoms following acute infection. During the La Reunion outbreak in 2006, more than 50% of subjects over the age of 45 reported long-term musculoskeletal pain with up to 60% of people reporting prolonged painful joints three years following initial infection. A study of imported cases in France reported that 59% of people still suffered from arthralgia two years after acute infection. Following a local epidemic of chikungunya in Italy, 66% of people reported muscle pains, joint pains, or asthenia at one year after acute infection. Long-term symptoms are not an entirely new observation; long-term arthritis was observed following an outbreak in 1979. Common predictors of prolonged symptoms are increased age and prior rheumatological disease. The cause of these chronic symptoms is currently not fully known. Markers of autoimmune or rheumatoid disease have not been found in people reporting chronic symptoms. However, some evidence from humans and animal models suggests chikungunya may be able to establish chronic infections within the host. Viral antigen was detected in a muscle biopsy of a people suffering a recurrent episode of disease three months after initial onset. Additionally, viral antigen and RNA were found in synovial macrophages of a person during a relapse of musculoskeletal disease 18 months after initial infection. Several animal models have also suggested chikungunya virus may establish persistent infections. In a mouse model, viral RNA was detected specifically in joint-associated tissue for at least 16 weeks after inoculation, and was associated with chronic synovitis. Similarly, another study reported detection of a viral reporter gene in joint tissue of mice for weeks after inoculation. In a nonhuman primate model, chikungunya virus was found to persist in the spleen for at least six weeks.....
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