Chikungunya is an infectious disease caused by a virus that is spread by the bite of a mosquito. It is common in Africa, India and Southeast Asia, but there was an outbreak of the disease in Brazil in 2015; there were more than 20,000 cases across the country, with three deaths, and the numbers have already reached 39,000 cases in five months of 2016. The disease is characterized by the sudden onset of high fever (greater than 38.9 °C), causing severe polyarthralgia (pain in multiple joints) or symmetrical joint pain. Distal joints such as wrists, hands, ankles and knees are affected, unlike proximal ones such as hips and shoulders. Chikungunya also causes severe myalgia (muscle pain) and allergies. Joint discomfort stands out among the symptoms, as it is very debilitating and prolonged, lasting for years and causing the patient to walk with a very weak gait. In fact, the word “chikungunya” means, in some East African languages, “those who bend”. Although there is no cure for the disease, it is possible to take steps to reduce pain and discomfort while recovering.
Method 1 of 4: Diagnosing Chikungunya
Step 1. Determine if there is muscle pain
The chikungunya virus is transmitted through the bite of the Aedes Aegypti mosquito; when it enters the body, it moves through blood vessels, affecting the epithelial and endothelial cells, known as fibroblasts, which make up muscle tissue. As the disease progresses, fibroblasts are damaged and epithelial and endothelial cells die. Injury to muscle fibroblasts leads to pain in the muscles of the body.
Step 2. Identify other symptoms of chikungunya
The patient may present various manifestations in addition to discomfort in the joints and muscles, such as:
- High fever (38.9 °C or more).
- Severe lethargy.
- Inability to get up and walk, or a walk that clearly causes difficulty, with a stiff body due to severe pain and swelling in the joints.
- Slightly raised red spots that do not itch. They will appear on the extremities and on the trunk.
- Blisters on the palms and soles of the foot, leading to peeling of the skin.
- Other symptoms, usually rarer, are: headache, vomiting, sore throat and nausea.
Step 3. Know how to differentiate chikungunya from fever
The symptoms of both diseases have several aspects in common; even the geographic location of infections is virtually the same. Sometimes there is a “dilemma” about the diagnosis, leaving healthcare professionals facing a clinical challenge in determining the disease. However, joint pain is much more closely linked to chikungunya, making the diagnosis clearer in most cases.
Dengue has myalgias more frequently, with joints being more rarely affected
Step 4. Go to the doctor
Diagnosis is based on the signs and symptoms of the condition; usually, to confirm a diagnosis of chikungunya, the doctor will order a blood test. It will detect the presence of antibodies to the disease in the blood, indicating that the patient has been exposed to the virus.
- Blood will be drawn from the patient's vein and stored in a sterile container for examination in the laboratory.
- There are several laboratory tests available to confirm the condition. The most used is RT-PCR (reverse transcriptase followed by polymerase chain reaction), which looks for the virus. The viral load left by the disease is large and easily detected. It is usually this viral load that causes patients to experience great discomfort.
Step 5. Know how long the infection can last
The acute infection will be active for a few days to two weeks; in this period, the infected person will probably be extremely tired, with a high fever and a lot of pain in the joints and muscles, almost unable to walk.
After this stage, there is the subacute phase, which can last from a few months to several years. 63% of patients still suffer from joint pain and swelling about a year after the initial infection. In the long term, there may be a form of seropositive arthritis or rheumatism with the HLA B27 antibody. This disease is similar to post-infectious arthritis known as Reiter's Syndrome.,
Step 6. Be aware that this disease is not fatal, but there is no treatment
Even with severe symptoms, it is a condition that rarely causes death; death usually occurs in the elderly. However, there is no treatment other than methods to reduce discomfort, similar to other viral illnesses. Tests have been carried out with certain medications to try a more effective treatment, without much positive results.
Method 2 of 4: Relieving Muscle Pain During the Acute Stages of Disease
Step 1. Rest as much as you can
Since there is no cure for chikungunya, it is necessary to do everything possible to increase the body's ability to regenerate. One of the best ways is to rest whenever you can. Sleep when there is no other task to do and don't try too hard during the day.
- Use blankets and pillows to make the patient very comfortable.
- Make a schedule to rest for two weeks or more.
Step 2. The patient must be well hydrated
Muscle tissue is made up of 75% water. When your body's hydration level is low, your muscles are more susceptible to stiffness, cramps, and other discomforts. Chikungunya causes a high fever, significantly contributing to dehydration and consequently an increased risk of cramps.
- Drink lots of water and other fluids to keep your body hydrated.
- If there is nausea, the person should drink frequently, either water, sports drinks or electrolyte drinks. Make your own electrolyte drink by mixing 6 cups of water, 1 cup of sugar and 2 teaspoons of salt.
- Always pay attention to your hydration levels. Patients with this disease are more likely to become dehydrated, and will likely need help eating and drinking, due to lethargy, weakness, and inability to care for themselves. Diarrhea and vomiting are not very present in chikungunya and are rarely the main causes of dehydration.
- The person will need intravenous fluids to rehydrate.
Step 3. Take medicine to reduce fever
Antipyretics, medications known to lower fever, may be helpful in treating chikungunya as they also relieve joint pain. Acetaminophen, acetaminophen, ibuprofen and naproxen are the best options to fight these symptoms.
It is important to read and follow the manufacturer's instructions for use. Do not administer a dosage greater than what is written on the package insert of any over-the-counter medicine
Step 4. Try using a warm compress
Placing a warm compress on painful joints and areas can provide temporary relief from discomfort in such areas. Try using electric compresses, leaving them for 20 minutes on the joint in each application. Do not leave it on for longer than this period, as the skin may be burned. Apply it again only after an hour.
- An alternative is to use a hot water bottle if you don't have a compress. Fill a plastic bottle with hot water and wrap it in a cloth or paper towel.
- Another option is to switch between a cold and hot compress. Ice can help numb joints, reducing pain, while heat often increases blood circulation and improves muscle discomfort. The ice pack should be wrapped with a paper towel and never left for more than 20 minutes on the skin.
Step 5. Discuss with a doctor about narcotic pain relievers to treat pain
When muscle discomfort is severe, you may want to ask your doctor if you can use narcotic pain relievers such as Durogesic, Codaten, Tylex, among others. Such medications are derived from morphine and opium and are combined with pain-reducing drugs. Although the side effects are intense, most cases of chikungunya debilitate patients so much that these drugs can be used to reduce discomfort.
- Only the physician should prescribe the proper dosage and administration period of the drug.
- These medications should not be taken with Tylenol and other types of acetaminophen.
Method 3 of 4: Using Supplements and Herbs
Step 1. Increase your vitamin C intake
Improve your body's ability to fight muscle pain by consuming 1,000 mg of vitamin C twice a day. This will help to strengthen the immune system; although it is difficult to obtain this amount only through food, fresh fruits and vegetables are always the best options. Supplements are also viable alternatives. The richest food sources in vitamin C are:
- Oranges: 69 mg of vitamin C per serving.
- Pepper: Each serving has 107 mg of vitamin C.
- Red peppers: 190 mg of vitamin C per serving.
Step 2. Take vitamin D to help treat chronic pain
Low levels of vitamin D have been linked to chronic pain. In addition, this nutrient can help reduce muscle fatigue and recovery time.
Consume 200 IU (two capsules) of vitamin D3 per day. Despite being obtained through the sun, it will not be possible to stay outdoors during rest, requiring the consumption of supplements
Step 3. Drink green tea
Muscle pain can be caused – in part – by inflammation. Green tea is known to be a natural anti-inflammatory that can help treat muscle pain. In addition, this drink regulates the functioning of the body's natural killer cells, responsible for combating infectious agents. Therefore, green tea will not only treat the disease, it will improve the patient's immunity.
Drink at least one cup a day
Step 4. Consume ginseng extract
According to experts, the ginseng extract can facilitate the body's immune response, in addition to alleviating the exhaustion and muscle pain experienced in diseases that drain the patient's energy, such as chikungunya.
There is no medical consensus regarding the dose. Follow the instructions on the product insert
Step 5. Try consuming aged garlic
Supplements of something aged may help reduce discomfort and muscle pain, due to the chemical allicin, contained in garlic. Aged garlic also contributes to the regulation of the body's natural killer cells. Consume aged garlic supplements to help fight infection.
Method 4 of 4: Avoiding chikungunya
Step 1. Use mosquito nets
When living in or traveling to a place with chikungunya outbreaks, some precautions need to be taken to minimize the risk of infections. The place where you sleep should be protected with a mosquito net, an insecticide screen to keep mosquitoes away.
When sleeping with any part of the body against the mosquito net, the individual will still be susceptible to being bitten through the screen
Step 2. Use an insect repellent spray
Use products with DEET, picaridin or IR3535 to protect against stings; if you want, also try repellents with citriodora eucalyptus oil or para-menthane-diol. Reapply spray according to manufacturer's instructions.
- The repellent should contain enough insecticide to kill mosquitoes.
- When using sunscreen together with insect repellent, apply the sunscreen first and then the spray.
Step 3. Wear long-sleeved clothing and pants
Cover your body to prevent mosquitoes from reaching your skin by wearing pants and long-sleeved shirts.
Step 4. Do not leave water containers uncovered
Any discovered body of water – cisterns, buckets and the like – are suitable places for the development of the Aedes Aegypti larva. Cover them, especially if there are four or more containers within 10 m of your house.
Step 5. Be very careful when living in places with outbreaks
In Brazil, the Northeast and North regions are the ones that register the most cases of chikungunya, which is spread through the bite of a mosquito infected by the virus, the vector of the Aedes species, which has already caused several outbreaks in other parts of the world, such as in local around the Indian Ocean. This "explosion" of cases of the disease will continue to be a risk until the fight against this public health problem is better controlled.
- Consume foods that are easy to tolerate. Soups and broths are good options to keep the energy level high; if it is possible to eat solid foods, they are also good alternatives. In fighting fever and infection, the body will expend a lot of calories with the accelerated functioning of the metabolism, making it all the more important to eat nutritious food during recovery.
- The patient must always have someone to help, especially in the early stages of the disease. Pain and discomfort can be great for walking, making it difficult to move, especially without assistance. The person should avoid walking if not necessary, as the weakness is great and the risk of a fall is greater.