Nose Bleed in Viral Fever-Chikun Gunya
Patients with Nose bleed along with other symptoms like arthralgia, fever, skin rashes are seen often during the outbreak of chikun gunya.
Immediate blood counts-WBC and platelet counts have to be done. It is better to insert a medicated nasal pack and continue symptomatic treatment.Cloroquine one tablet twice seems effective in some cases. As this virus can cause decreased platelets and result in bleeding one has to be careful that the drugs that are used do not further drop the platelets or cause bleeding due to gastric inflammation and erosions or ulcers (e.g. effect of Aspirin).
What is chikun Gunya
In Swahili language (an African Language) ‘Chukun Gunya’ means “that which bends up”. This refers to the stooped posture of patients who are afflicted with severe joint pain.
ChikunGunya is a virus disease caused by Alpha virus, which belongs to the family of Togaviridae. The disease was first reported from Tanzania in 1953.Between 1960s and 1980s the virus was isolated from numerous countries in Africa and many areas of Asia.
ChikunGunya virus is most commonly transmitted to human beings through the bite of an Aedes mosquito, primarily Aedes aegypti. Mosquito usually transmits the disease by biting an infected person and then biting someone else. An infected person cannot spread the infection directly to other persons. Aedes mosquitoes bite during the day NOT at night.
Symptoms
Symptoms of Chikun Gunya Chikun Gunya usually starts suddenly with fever, chills, headache, nausea, vomiting, joint pain and skin rash including palm and sole of feet.. While recovery from Chikun Gunya is the expected out come rarely joint pain may be prolonged up to a year or more.
The time between the bite of a mosquito and the start of symptoms ranges from 1-12 days.
Very rarely the disease become fatal by producing complications like meningitis, encephalitis etc.
Blood tests
Routine blood count to look at platelets as sometimes the platelet count may fall. Blood Serology for detection of antigens or antibiotics. IgM capture ELISA to help distinguish the disease from dengue fever.
Treatment
Supportive care and rest
There has been no effective vaccine developed to prevent Chikungunya.
To relieve symptoms of fever and joint pain the drug commonly used is Paracetamol.
Rest is indicated during acute joint symptoms. Movement and mild exercise may improve stiffness and morning joint pains.
In unresolved arthritis that does not respond to aspirin and non-steroidal anti-inflammatory drugs, Chloroquine Phosphate (250 mg/day) has given some promising results.
Some studies have also shown that Chloroquine has some antiviral activity against this virus. However these are not conclusive studies .
Movement and mild exercise tend to improve stiffness and morning arthralgia.
Aspirin should not be given.
Prognosis
Most patients recover fully from Chikungunya virus infection. They get better after a few days to few weeks , however sometimes joint pain can persist for a longer period after the other symptoms have disappeared even months causing extreme pain immobility and disability.
