Chikungunya Research Paper

Chikungunya is a mosquito-borne arbovirus and a member of the genus Alphavirus and the family Togaviridae. The word ‘Chikungunya’ is derived from the Makonde language that translates the word in “that which bends up”. It is referred to the stooped posture associated with chronic and incapacitating arthralgia suffered by those infected patients (cited by Kondekar et al., 2006 in Her & Kam & Lin & Ng, 2009). Chikungunya was discovered during analysis of isolated blood samples of a febrile patient in 1952 in Tanzania (Her et al., 2009; Lahariya & Pradhan, 2006; Morrison, 2014; Nava-Frías & Searcy-Pavía & Juárez-Contreras & Valencia-Bautista, 2016; Weaver, 2014). CHIKV is known as an arthropod-borne virus, meaning the virus is transmitted by arthropods,
In the 1960s the first major outbreaks in India, Sri Lanka, Myanmar and Thailand were reported (Her et al., 2009; Weaver, 2014). Subsequently, smaller CHIKV outbreaks were reported in Indonesia in the 1980s and 10 years later in Malaysia (Her et al., 2009). From 2001 to 2007 a second major outbreak occurred on the Islands of the Indian Ocean, where attack rates of 35% - 75% were reported (Her et al., 2009; Morrison, 2014). The Reunion islands were affected the most. There were 265.000 clinical cases in a population of 770.000 citizens (incidence of 34%) followed by 237 deaths (Charrel et al., 2007; Devaux, 2012; Her et al., 2009). Using Disability-adjusted life years (DALYs) as an indicator, 55.000 DALYs were lost, out of which the majority consists of the working-age population of 20-60 years (Honório et al., 2015; Smalley & Erasmus & Chesson & Beasley, 2016). Due to the second major outbreak, CHIKV spread out to India again in 2006. India has a confirmed history of several outbreaks and is therefore seen as an endemic area (Lahariya et al., 2006). According to Lahariya (et al., 2006) the second CHIKV outbreak re-emerged with a gap of 32 years. Adding that CHIKV became more virulent it led to 1.3 million suspected cases (Charrel et al., 2007; Lahariya et al., 2006; Morrison, 2014).
After a bite of one of the vectors the virus needs an incubation time of 2-7 days (Devaux, 2012; Nava-Frías et al., 2016) prior to the onset of symptoms. The most common symptoms are joint pains/arthralgia, which manifests in 80% of the patients (Morrison, 2014). This symptom can persist for several months and is used to determine CHIKV in patients. It manifests in an acute phase as well as in a chronic phase. Most patients experience pain in the ankles and the wrists (CDC/PAHO, 2011; Morrison, 2014). Muscle pain and in 70% of all cases headache, nausea, vomiting, conjunctivitis, rash all over the body and sudden fever with a temperature between 39 and 40 degrees Celsius are recognizable symptoms (Devaux, 2012). In rare cases atypical manifestations can occur due to direct effect of CHIKV on the immunologic response. These can affect the neurological-, ocular-, cardiovascular, dermatological- and renal systems. Specifically, the clinical futures are paresis, neuropathy, optic neuritis, uveitis, myocarditis, photosensitive hyperpigmentation, nephritis, pneumonia and respiratory failure (CDC/PAHO, 2011). The virus affects all ages and both genders but the very young (neonates) and elderly are more susceptible to the above described symptoms and are therefore seen as high risk (CDC/PAHO, 2011). Neonates are at high risk because transmission can occur during the labor. The elderly