Post by Neelam Nath ji on Chikungunya
Chikungunya fever is neither deadly nor contagious. There is absolutely nothing to fear.
What is Chikungunya?
Chikungunya is transmitted by mosquitoes, which breed in collected water. Direct transmission from one human to another has not been reported so far. Usually multiple members of a family fall sick at the same time because the transmitting mosquito is like a devil with a huge appetite for blood and cannot fly for more than 100 meters. In most cases, same mosquito bites multiple members of a family.
After the bite of an infected mosquito, onset of illness occurs usually between 4 and 8 days but can range from 2 to 12 days.
Chikungunya is “not” fatal
Yes. You read that right. Chikungunya infection does not kill people. What is really fatal is the heavy antibiotics dosage prescribed by the quacks. They often prescribe 2-4 antibiotics at a time, which is too heavy for the body to handle and eventually leads to multi-organ failure.
A body that is struck with fever is unable to digest food, let alone “digest” and metabolize heavy antibiotics, especially if they are the kind that are given after a heart/bone replacement surgeries or fractures.
They are required in such treatments because the exposure of operated tissues is much more to the bacteria present in the environment. They also help avoid any infections being picked from the hospital environment.
Symptoms of Chikungunya
The symptoms of Chikungunya appear between two to twelve days after the mosquito bite.
High fever and headache
Intense pain in the joints (ankles, wrists) that can persist for several weeks.
The joints of the extremities in particular become swollen and painful to touch.
A rash may sometimes occur.
Haemorrhage is rare, and all but a few patients recover within three to five days.
Some patients can suffer from joint pain for months even after recovery.
Lifestyle advice for treatment of Chikungunya
Complete bed rest for at least 7 days
Drink lots of water, at least 5 litres per day for a normal adult. Plain water leads to distention and too much glucose leads to cramps in the food pipe. Water has to be given indirectly by ORS (sachets or home made with lemon juice plus spoon of sugar and pinch of salt in per litre water.)
Take paracetamol for fever only if tests are negative for Dengue. No aspirin/combiflams etc. should be taken for fever.
7 days of rest is needed even after the body temperature has become normal, and it takes only 3 days to get normal from 104 with proper treatment.
Don't take heavy medications unless indicated by a culture test (done rarely if Ampicillin does not work for Typhoid cases.)
Wear cotton clothes.
Try drinking-
Weak tea with more milk and sugar.
Clear soups.
Roohafza in a glass of toned milk diluted with water in a ratio of 1:4, which means mix a glass of milk and 4 glasses of water with Roohafza.
Remember gurupurab & roadside stalls offering Amrit to every passer by? This takes care of basic protein given through milk, at least 2 glasses of milk/day.
Follow a no fat diet and rely more on liquid nourishment. Eat light food only (no fried food/maida/fats or heavier non-veg)
I emphasize on taking adequate bed rest multiple times throughout this article since that's the most important thing people seem to miss. I've seen this mostly in people who earn daily wages because they are too scared to take a few days off to take bed rest.
They will get back to work as soon as they feel their body temperature has lowered, which is a big mistake. This leads to exertional fever in these patients and they only get worse than before.
We must educate all the people around us who do not have the luxury of reading information online and who are the ones worst affected by this hype that has been created.
What can doctors do when they see a patient with 104 F ?
Take a detailed history of shiverings, joint pains, swellings, rash, duration of fever, headache & relation of fever to Paracetamol (Yes, most patients do take few doses before coming to doctor.)
Exclude Typhoid fever by doing a Widal Test (it costs 100-200 only.)
Do a platelet count to rule out dengue. Malarial parasite may not be always seen on the slide, as it only comes out of the liver at specific times, when the person will have high fever with shiverings.
Every foreigner coming for a visit to malaria affected areas is given 4 tablets of chloroquine as prevention.
With a 104 degree fever, there's no harm in taking 4 tablets of Chloroquine after eating a packet of biscuits with tea made with more toned milk. It helps you get carbs, proteins, and water through tea.
Chikungunya tests positive only on the 7th day and if treated well, it takes only 3 days to get well and be fever free. The joint pains & rashes take a few more days to fully heal.
Check if the platelet counts are within normal range, perform widal test for typhoid. If that is negative, then it can be diagnosed by process of ruling out other illnesses and observation of symptoms.
One can rule out Dengue/ Typhoid within 4 hours - yes good labs managed by MD doctors are giving excellent services through their collection agents within a radius of 10 kms.
Try to take care of every fever patient at home first because there's very little need for hospitalization if proper care is taken at home.
Do not get into politics of blame game between leaders, confusing junta about Chikungunya at Delhi. 4 people died at Sir Gangaram Hospital, but each one of them had actually landed at hospital with multi-organ failure.
Why are we only blaming Chikungunya? more