Chikungunya

Chikungunya is a viral fever that is transmitted to humans when bitten by an infected mosquito. Chikungunya is the Swahili word for 'that which bends up'. Persons suffering this viral condition develop a stoop due to the excruciating joint pains and body aches. This strain of virus was first isolated and identified in the 1950s in Tanzania. Chikungunya virus is noticed in tropical countries. Aedes aegypti (the yellow fever mosquito) is the primary vector of chikungunya virus to humans. Typically these mosquitoes are infected due to feeding on infected humans, monkeys or other animals. It however does not get transmitted among people. Daytime mosquitoes are the main carriers.

Typical symptoms of Chickungunya include fever, headache, nausea, rash, fatigue and joint pains. The infection can last anywhere from a few days to a couple of weeks. Chikungunya virus is classified as an arthritis virus since patients complain of incapacitating joint pains or arthritis. There is no vaccine or treatment for Chikungunya fever. The patient is advised plenty of rest and fluids. Infected persons are often prescribed ibuprofen or Paracetamol for relief. In most cases, Chikungunya is self-limiting and is rarely fatal. In some cases, persons suffering from a bout of Chikungunya are likely to experience body pain and joint pain for weeks or even months after the viral attack.

Fever

Fever is an elevation of body temperature and defined as a core temperature higher than 38 C (100.4 F) in infants and higher than 38.3 C (100.9 F) in adults. Normal body temperature range is between 36 and 37.8 degree C (96.8 and 100.4 degree F). If a person has an oral temperature above 98.6 F (37 C), it is considered as fever. In some cases, there is a variation of up to 1 F (0.6 C). Fever is a symptom and not a disease. Fever, by itself is an indicator that the body is building an immune response to an infection. Most viruses and bacteria cannot survive at higher temperatures and fever is the body's fighting mechanism. Any body temperature up to 100 F is considered low grade fever. It is usually noticed along with sore throat, cough, joint pain, chills and nausea. Most fevers of this nature are self-limiting; and medication is given to provide comfort to the patient. Most of the time fever is only a symptom which can be treated symptomatically with antipyretics. Acetaminophen and ibuprofen are prescribed to control fever.

Fever results from the production of prostaglandin E2 (PGE2) in the hypothalamus due to endogenous or exogenous pyrogens. The cause is identified by physical examination and a thorough history - the onset of fever, level, duration, pattern if any and other symptoms.

Normally a person can sustain a body temperature of up to 104 degree F (40 degree C) with relative safety. But when the fever temperature rises above 104 ° it may cause cellular damage to brain, blood and internal organs. To prevent damage from high fever cooling treatments may be of help. Cold compresses, cold packs or sponge baths or ice bags /chemical cold packs are used to bring down the high fever.

Do not swathe a patient with fever in blankets but keep him comfortable. Bath in tepid water can help, but never ice cold water. The patient must be well hydrated. Some immunosuppressed or elderly patients might not exhibit a big rise in temperature in spite of a serious infection. Most often , CBC (complete blood count) is done to look for raised WBC count. Other useful indicators are urine test, gram stains and chest x-ray. If fever is also accompanied by abdominal pain, CT scan of the abdomen is suggested to look for possible appendicitis, diverticulitis and Cholecystitis.

The degree of fever elevation is not an indicator of the severity of the illness. Fever can be due to dengue, chikungunya, chicken pox, measles, malaria or other infections. Metabolic disturbances can cause body temperature to be elevated. In rare cases, fever is due to heart disease, serious illness, AIDS or cancer. Toxic shock, meningitis and peritonitis are other serious causes for high fever.

In some cases, the cause for fever is not easy to diagnose. Fever due to upper respiratory tract infection usually lasts for about 3-5 days.

Do not confuse fever with Hyperthermia, where the body temperature rises due to external sources. Here fever is also accompanied by palpitations, fainting, shivering, aches and confusion or hallucinations. When fever rises, the respiratory rate and heart rate rise. When children below 1 year suffer fever, they should be examined by a healthcare professional. Never use aspirin in children during a viral infection.