Chikunguya in the Dominican Republic

The fever caused by the Chikunguya virus represents a new problem for the Ministry of Health in the Dominican Republic. Chikunguya began in February 2014, but before in December 2013, the Pan-American Health Organization, alerted the countries of the region of Americas. This disease for the first time affected the Dominican Republic, a very susceptible population, since it is transmitted by the mosquito Aedes aegypti. This type of mosquito is present in the entire country, which is the reason why a great number of cases were presented.

The origin of the word Chikunguya comes from the African language Makonde, which means: to bend by pain.

It is transmitted through the mosquito bite that can also produce dengue and yellow fever. This mosquito is easily recognized because it has a white circular stripe on the legs. When these mosquitoes bite a person with Chikunguya the transmission cycle starts.

Symptoms.

  • Sudden high fever, accompanied by multiple bilateral or symmetrical pains of variable intensity. In some cases the pain is so intense that it produces functional disability.
  • After a few days, a pruritic macular rash may occur.
  • Other: headache, diffuse back pain, myalgia, nausea, vomiting and conjunctivitis.

Subacute and chronic symptoms can occur from days, months or even years from the onset of symptoms. The main manifestation is arthritis.

Among the atypical manifestations of Chikunguya is neurological, ocular, cardiovascular, dermatological, renal, damage among others.

Among the complications described associated with Chikunguya:

  • Respiratory failure
  • Cardiovascular decompensation
  • Meningoencephalitis
  • Acute hepatitis

Severe cutaneous manifestations:

  • Shock and bullous lesions

The majority of these manifestations are observed in patients over 65 years of age and in children younger than one year and in patients with chronic diseases, diabetes, lupus among others.

The diagnosis is basically clinical, starting from the definition of the case suspected and family, community or work contact with other cases.

The differential diagnosis should be made with disease prevalent in the country, dengue, for the following reasons:

  • They are viruses transmitted by the same vector
  • Clinical manifestations are similar

Among the differential diagnoses with other diseases :

  1. Leptospirosis
  2. Malaria
  3. Childhood exanthematic diseases
  4. HIV infection
  5. Infectious mononucleosis

Measures to prevent are:

  1. Avoid conserving water in containers outside, tanks of deposits or water for domestic use
  2. Avoid accumulating garbage among others

If you have symptoms, go to your nearest health center for care and treatment.

Contributed by: Dr. Maria Reyes

Family and Community Doctor, NPH Dominican Republic

 

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