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Vieux 05/05/2005, 18h00
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Date d'inscription: mai 2004
Localisation: London, UK
Messages: 1 098
Chikungunya Fever


THE FACT FILE:

Organism
This is a virus causing a self-limiting feverish illness with rash and joint pains and swelling. The name means 'that which bends up', a reference to the severe joint pains associated with the infection.

Transmission
Chikungunya virus is transmitted by the bite of the aedes aegypti mosquito. Man appears to be the only natural reservoir of infection.

Regions affected
The virus is found in Africa, south-east Asia, India and the Philippines. The transmitting mosquito is also found in north and south America, giving the potential for new epidemics in these regions.

Prevention
Infection can be prevented by avoiding mosquito bites, through the use of long clothing, insect repellents and bed nets. It is also important to control mosquito populations by removing water filled containers near the house in which mosquitoes could breed and periodically spraying large areas of water near human habitation.

Immunisation
None available

Symptoms and Signs
After an incubation that ranges from 1 to 12 days, patients develop a rapid rise in temperature with associated shakes and chills. The fever may settle after a few days then recur, giving rise to a 'saddle-back' fever curve. Patients develop pain and swelling of their joints, particularly those of the hands and feet. They may also develop a red blotchy rash on the face and neck, spreading down the body to the limbs. They may note some bleeding, but this is usually minor. Other symptoms include headache, eye pain, sore throat, nausea and vomiting. The illness gradually resolves over around a week, although joint muscle aches may persist for several months.

Tests
Chikungunya fever is diagnosed on the basis of antibody tests, although these may cross react with similar viruses. The virus can be isolated with ease from blood during the feverish stage, although this is rarely done. The presentation of Chikungunya fever with fever, rash and joint pains may be difficult to distinguish from infection with rubella or other tropical viruses such as sindbis virus or O'nyong-nyong virus.

Treatment
There is no specific treatment.

Complications and Outcome
The infection is usually uncomplicated, but occasionally arthritis may be prolonged, particularly in adults. Children occasionally develop neurological problems such as fits. The outcome is usually good.
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