Chikungunya
Outbreak of Chikungunya
in Johor Bahru, Malaysia
SUMMARY In 2008, an outbreak of chikungunya
infection occurred in Johor. We performed a retrospective review of all
laboratory confirmed adult chikungunya cases admitted to Hospital Sultanah
Aminah, Johor Bahru from April to August 2008, looking into clinical and
laboratory features. A total of 18 laboratory confirmed cases of chikungunya
were identified with patients presenting with fever, joint pain, rash and
vomiting. Haemorrhagic signs were not seen. Lymphopenia, neutropenia,
thrombocytopenia, raised liver enzymes and deranged coagulation profile were
the prominent laboratory findings. We hope this study can help guide physician
making a diagnosis of chikungunya against other arborviruses infection.
Chikungunya is a mosquito-borne disease due to
alphavirus and transmitted by mosquito vector Aedes genus (mainly Aedes albopticus
and Aedes aegypti). It is characterized by abrupt onset of fever and severely
debilitating polyarthralgia/arthritis associated occasionally with
maculopapular rash and vomiting.
RESULTS
A total of 117 patients who were admitted for
suspicion of chikungunya during the period of study had blood sent for
chikungunya testing. However, only blood test results for 35 patients were
available for review.
Chikungunya Symptoms
Chikungunya virus infection can cause a
debilitating illness, most often characterized by fever, headache,
fatigue, nausea, vomiting, muscle pain, rash, and joint pain. The term
‘chikungunya’ means ‘that which bends up’ in the Kimakonde language of
Mozambique.
Acute chikungunya fever typically lasts a few days to a few weeks, but as with
dengue, West Nile fever and other arboviral fevers, some patients have
prolonged fatigue lasting several weeks. Additionally, some patients have
reported incapacitating joint pain, or arthritis which may last for weeks or
months. The prolonged joint pain associated with chikungunya virus is not typical of dengue.
The fever can occur for a period ranging from 1 to 7 days (usually about 5
days). Chikungunya is commonly mistaken for Dengue Fever due their similar
clinical symptoms.
Prevention
The best way to prevent chikungunya virus
infection is to avoid mosquito bites. There is no vaccine or preventive drug
currently available. Prevention tips are similar to those for other viral
diseases transmitted by mosquitoes, such as dengue or West Nile.
- Use insect repellent containing DEET, Picaridin, oil of lemon eucalyptus, or
IR3535 on exposed skin. Always follow the directions on the package.
- Wear long sleeves and pants (ideally treat clothes with permethrin or another
repellent).
- Have secure screens on windows and doors to keep mosquitoes out.
- Get rid of mosquito sources in your yard by emptying standing water from
flower pots, buckets and barrels. Change the water in pet dishes and replace
the water in bird baths weekly. Drill holes in tire swings so water drains out.
Keep children’s wading pools empty and on their sides when they aren’t being
used.
Additionally, a person with chikungunya fever should limit their exposure to
mosquito bites to avoid further spreading the infection. The person should use
repellents when outdoors exposed to mosquito bites or stay indoors in areas
with screens or under a mosquito net.
Seek immediate medical attention from the nearest clinic
or hospital if you experience signs and symptoms of Chikungunya.
Can Chikungunya cause death?
In Malaysia, Chikungunya has never been reported
as causing haemorrhage (bleeding) or death. However, some patients experience
prolonged symptoms. Aged patients could suffer from recurrent joint aches
ranging from several months to a year.
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