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Chikungunya – no it’s not an exotic meal or a piece of clothing!

HiRes

What is it?
Chikungunya is a virus spread to humans by the bite an infected Aedes aegypti mosquito.

Mosquito biting

They bite during daylight hours, breed in stagnant water and find us tasty.

These mosquitoes can be recognised by the white stripes around their legs, you’d have to catch one though to check!

They can also spread dengue and west Nile fever.

Interesting Fact:

The name chikungunya comes from a word in the Makonde language (one of the native languages in Tanzania) that means ‘that which bends up’. This is due to the crippling joint pain caused by the virus (Public Health England – April 2014)

Where in the world can it be found?

CHIKWorldMap-022415

Map from CDC website

How does Chikungunya make me feel?

The incubation period can be 2-12 days, but is normally 3-7 days.

It normally starts with a sudden onset of fever and pain in the joints.

The joint pain is often very unbearable, but usually lasts for a few days or may persist for weeks.
Other common symptoms can include:

  • Muscle pain
  • Fatigue
  • Nausea
  • Headache
  • Rash

Often diagnosis can be confused with other viral illnesses such as dengue fever in areas where these infections also occur. Symptoms can vary in each individual from mild or non-existent to severe.

Most people make a full recovery, but in some cases, joint pain and arthritis may continue for several months or even years.

Occasionally eye, neurological and heart complications can occur, and gastrointestinal complaints.

Serious complications are uncommon, but in older people the disease can contribute to the cause of death.

Children may develop neurological symptoms such as seizures as a complication of the disease.

Interesting Fact:

Chikungunya cannot be directly spread from person to person. When the mosquito feeds on the blood of a person infected with chikungunya, the virus enters and multiplies within the mosquito. After about 8 to 10 days, the mosquito can transmit the virus to another human by biting them, and can do this for the rest of its life.

If a person gets chikungunya abroad and becomes ill on their return to the UK, they can’t pass the infection onto anyone else. This is because the Aedes mosquito is not present in the UK, as the temperature is not consistently high enough for it to breed.

(Public Health England – April 2014)

What treatment is there?

There is no particular anti-viral treatment for chikungunya. Headache and fever symptoms can be treated symptomatically. Some people need to be admitted to hospital if their illness is severe or if complications arise.

Chikungunya can be diagnosed with a blood test.

 

How do I stop myself getting Chikungunya?

There is no vaccine or drug to prevent chikungunya.

The only way to prevent chikungunya is to avoid mosquito bites by using insect repellents and wearing appropriate clothing.  Aedes mosquitoes bite during the day particularly around dawn and dusk.

 

How can I stop mosquitos biting me?

Clothes are your best protection – normally only use repellents on remaining exposed areas of skin.

Wear loose fitting, light coloured clothing. Mosquitos can bite through tight clothing.

You can also treat clothes with permethrin spray (an insecticide that kills insects on contact) this should only be used on clothing NOT skin.

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Insect repellent
– DEET has been proven to be the most effective preparation in preventing mosquito bites, it is the repellent of choice in areas with diseases such chikungunya and dengue.

DEET has been used as an insect repellent for around 50 years and it is available in different concentrations.

50% concentration is recommended.

DEET can be used for children over the age of 2 months. For children, use clothing as the main barrier and repellent only where necessary.

It can be used in pregnancy and breast feeding women.

If you are using sunscreen, it is advised that repellent must be applied after sunscreen.

Remember to remove repellent with soap and water when it is no longer needed.

Do not spray directly onto faces, spray on hands first and then apply to face. Wash hands after applying to prevent contact with lips and eyes.

Never use on cuts, abrasions or irritated skin.

Always follow manufacturer’s instructions.

Alternative recommended insect repellents are those containing Picaridin 20% and these can be used for children aged two years and older (NATHNAC)

Oil of lemon eucalyptus-based repellent is also available however this repellent only lasts as long as 15% DEET and so needs applying more frequently. Lemon eucalyptus essential oil is a different product and is not recommended as an insect repellent. (NATHNAC)

It is best to avoid sunscreen that is combined with repellent.

If you think that you or your children are reacting to an insect repellent, stop using it, wash treated skin and then seek advice from a doctor.

In your room – Consider using plug in vaporisers that release an insecticide mist in your room

Try to stay in accommodation that is air-conditioned, this usually reduces the number of insects in your room.
Those that sleep during the day, particularly young children, or sick or older people, should sleep under a mosquito net that has been treated with insecticide. The World Health Organisation (WHO) recommends this type of net. The insecticide used in these nets mean that a mosquito will be killed on contact if it lands on the net. Cot nets are available.

Carry a sewing kit and tape to repair any holes or tears.

 

So what doesn’t work as an insect repellent?    

There is no proof (scientific or otherwise) that bath oils, electronic “buzzers”, essential oils, garlic, homeopathic remedies, odour baited mosquito traps, tea tree oil, skin moisturisers, smoking, vitamin B tablets or yeast extract (Marmite®), prevent insect bites.

Citronella based repellents are not recommended, as they do not protect you for very long. (NATHNAC)

 

Further advice about insect bite prevention can be found on the following websites:

Fit For Travel

NathNac

 

We sell a wide range of repellents, nets and insect bite avoidance devices in our clinics and on our online shop.

 

Come down and speak to one of our lovely team for advice.

 

Written by Nicki Harrison – Lead Nurse Sussex Travel Clinic

January 2015

 

 

Reference/bibliography list:

Fit for Travel – http://www.fitfortravel.nhs.uk/advice/disease-prevention-advice/chikungunya-fever.aspx

TRAVAX – http://www.travax.nhs.uk/diseases/non-vaccine-preventable/chikungunya.aspx

Gov.UK – Public Health England – https://www.gov.uk/chikungunya

WHO – http://www.who.int/mediacentre/factsheets/fs327/en/