Feb 15

The differences between chikungunya and dengue fever.

By taqidoc Medicine Add comments

Types

Chikungunya

Dengue
Causative agent a virus which belongs to the genus Alphavirus, in the family Togaviridae. any of four closely related viruses, or serotypes: dengue 1-4.

(DENV 1, DENV 2, DENV 3, DENV 4)

Infection with one serotype does not protect against the others.
Season widespread in most parts of the country but is most active after the rains.
Mode of transmission Infected Aedes Aegypti /albopictus bite
Incubation period Time from infection to illness 2-12 days but is usually 3-7 days In order for transmission to occur the mosquito must feed on a person during a 5- day period when large amounts of virus are in the blood; this period usually begins a little before the person become symptomatic.  Some people never have significant symptoms but can still infect mosquitoes.  After entering the mosquito in the blood meal, the virus will require an additional 8-12 days incubation before it can then be transmitted to another human. The mosquito remains infected for the remainder of its life, which might be days or a few weeks.
Symptoms
  1. Fever
  2. Headache
  3. Fatigue
  4. Nausea
  5. Vomiting
  6. Muscle pain
  7. Rash
  8. Joint pain

It can also be asymptomatic.

Acute chikungunya fever typically lasts a few days to a couple of weeks.

Some patients have reported incapacitating joint pain, or arthritis which may last for weeks or months.

 Symptoms of infection usually begin 4 – 7 days after the mosquito bite and typically last 3 – 10 days.  In order for transmission to occur the mosquito must feed on a person during a 5- day period when large amounts of virus are in the blood.

High fever and at least two of the following:

  • Severe headache
  • Severe eye pain (behind eyes)
  • Joint pain
  • Muscle and/or bone pain
  • Rash
  • Mild bleeding manifestation (e.g., nose or gum bleed, petechiae, or easy bruising)
  • Low white cell count

Generally, younger children and those with their first dengue infection have a milder illness than older children and adults.

Warning sign:

(emergency) if

  • Severe abdominal pain or persistent vomiting
  • Red spots or patches on the skin
  • Bleeding from nose or gums
  • Vomiting blood
  • Black, tarry stools (feces, excrement)
  • Drowsiness or irritability
  • Pale, cold, or clammy skin
  • Difficulty breathing
Diagnostic testing 1. Based on the patient’s clinical features, places and dates of travel (if the patient is from a non-endemic country or area), activities, and epidemiologic history of the location where infection occurred.

2. Lab test à to detect virus-specific IgM and neutralizing antibodies in serum or CSF.

3. In fatal cases, nucleic acid amplification, histopathology with immunohistochemistry, and virus culture of biopsy or autopsy tissues can also be useful.

 1.Diagnosis of dengue fever is generally easy in endemic areas and during epidemics due to the typical symptoms and characteristic signs of dengue fever. But if the cases are mild, they may look like other viral disease.

2.Laboratory diagnosis of dengue fever is done by IgM ELISA (enzyme linked immunosorbant assay), paired serology during recovery or by antigen-detection ELISA during the acute phase. There is also leucopenia (lees number of leukocytes or white blood cells, generally less than 5,000) and thrombocytopenia (reduced number of platelets in circulating blood). Dengue virus also can be easily isolated from blood in the acute phase by using mosquito inoculation or mosquito cell culture.
Treatment Symptomatic treatment:

1.Rest

2.Drink plenty of fluid

3.Use analgesics
Analgesics:

Ibuprofen, naproxen, acetaminophen, or paracetamol.

Aspirin should be avoided.

 Analgesics:

Like paracetamol and acetaminophen.

Avoid ibuprofen,naproxen or aspirin.
Can pregnant women become infected and pass the infection to their child? Yes. Most infections will not result in the virus being transmitted to the fetus. The highest risk for infection of the fetus/child occurs when a woman has virus in her blood (viremic) at the time of delivery Yes. Transmission to the fetus is rare.
Can the virus transmitted to a child by breastfeeding? No. No.

Research shows the presence of anti-dengue antibodies in breast milk and colostrum, which suggests that breastfeeding actually protects your baby from the dengue virus in case of a dengue infection.
Mortality rate Fatalities are rare. DHF is a more severe form of dengue infection. It can be fatal if unrecognized and not properly treated in a timely manner. DHF is caused by infection with the same viruses that cause dengue fever. With good medical management, mortality due to DHF can be less than 1%.
Prevention Avoid mosquito bites.

  1. Use insect repellent.
  2. Wear long sleeves and pants.
  3. Have secure screens on windows and doors to keep mosquitoes out.

Get rid of mosquito sources such as emptying standing water from flower pots etc.

Limit exposure to mosquito bites for infected person to avoid further spread.

References:

http://www.babycenter.in/pregnancy/complications/dengue/

http://nethealthsite.com/diseases-with-d/52-dengue-fever.html

http://www.cdc.gov/ncidod/dvbid/Chikungunya/CH_FactSheet.html

http://www.cdc.gov/dengue/

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