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Original article
peer-reviewed

Clinical Spectrum of Chikungunya in Pakistan



Abstract

Background

Chikungunya fever is a pandemic disease caused by an arthropod-borne chikungunya virus (CHIKV). The virus spreads through mosquitoes. This mosquito induced viral illness is clinically suspected on symptoms from fever and severe polyarthralgia. The recent outbreak of chikungunya was reported in November 2016 in the metropolitan city Karachi, Pakistan. We emphasis on the awareness of the etiology and vector control to prevent serious consequences.

Method

A total number of 1275 patients were included in this cross-sectional study. These patients were enrolled based on clinical findings described by Centers for Disease Control and Prevention (CDC). Our exclusion criteria were patients with missing data or having co-infection with dengue or malaria. The patients were tested for chikungunya antibodies, malaria, and dengue. The patients were followed for three months.

Results

Out of 1275 consenting patients from the emergency department, 564 tested positive for chikungunya antibodies and out of these 564 patients 365 had co-infection of dengue and malaria. So based on exclusion criteria, 199 patients had isolated chikungunya infection and were studied for the frequency of clinical symptoms. The most common finding was joint pain and fever on presentation and joint pain was the only chronic finding which persisted.

Conclusion

Our study demonstrated the frequency of clinical findings in chikungunya infection. It also signifies the importance of testing for antibodies because it helped in excluding patients with false positive clinical findings and differentiating co-infection with malaria and dengue. It also gauged patient's view about the cause of this disease. 



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Original article
peer-reviewed

Clinical Spectrum of Chikungunya in Pakistan


Author Information

Syeda Naqvi Corresponding Author

Jinnah Postgraduate Medical Centre, Jinnah Sindh Medical University (SMC)

Shehroz Bashir

Medicine Unit 7, Jinnah Sindh Medical University (SMC)

Chintan Rupareliya

Department of Neurology, University of Missouri, Columbia, Missouri

Abdullah Shams

Internal Medicine, CMH Lahore Medical and Dental College

Pirthvi Raj Giyanwani

Civil Hospital Karachi, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Zeeshan Ali

Jinnah Postgraduate Medical Centre, Jinnah Sindh Medical University (SMC)

Faiza Qamar

Jinnah Postgraduate Medical Centre, Jinnah Sindh Medical University (SMC)

Vijesh Kumar

Jinnah Postgraduate Medical Centre, Jinnah Sindh Medical University (SMC)

Vikash Talib

Accident & Emergency, Jinnah Sindh Medical University (SMC)


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Animal subjects: This study did not involve animal subjects or tissue. Conflicts of interest: The authors have declared that no conflicts of interest exist.


Original article
peer-reviewed

Clinical Spectrum of Chikungunya in Pakistan


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Original article
peer-reviewed

Clinical Spectrum of Chikungunya in Pakistan

  • Author Information
    Syeda Naqvi Corresponding Author

    Jinnah Postgraduate Medical Centre, Jinnah Sindh Medical University (SMC)

    Shehroz Bashir

    Medicine Unit 7, Jinnah Sindh Medical University (SMC)

    Chintan Rupareliya

    Department of Neurology, University of Missouri, Columbia, Missouri

    Abdullah Shams

    Internal Medicine, CMH Lahore Medical and Dental College

    Pirthvi Raj Giyanwani

    Civil Hospital Karachi, Dow University of Health Sciences (DUHS), Karachi, Pakistan

    Zeeshan Ali

    Jinnah Postgraduate Medical Centre, Jinnah Sindh Medical University (SMC)

    Faiza Qamar

    Jinnah Postgraduate Medical Centre, Jinnah Sindh Medical University (SMC)

    Vijesh Kumar

    Jinnah Postgraduate Medical Centre, Jinnah Sindh Medical University (SMC)

    Vikash Talib

    Accident & Emergency, Jinnah Sindh Medical University (SMC)


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Animal subjects: This study did not involve animal subjects or tissue. Conflicts of interest: The authors have declared that no conflicts of interest exist.

    Acknowledgements


    Article Information

    Published: July 06, 2017

    DOI

    10.7759/cureus.1430

    Cite this article as:

    Naqvi S, Bashir S, Rupareliya C, et al. (July 06, 2017) Clinical Spectrum of Chikungunya in Pakistan. Cureus 9(7): e1430. doi:10.7759/cureus.1430

    Publication history

    Received by Cureus: June 15, 2017
    Peer review began: June 22, 2017
    Peer review concluded: June 26, 2017
    Published: July 06, 2017

    Copyright

    © Copyright 2017
    Naqvi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Background

Chikungunya fever is a pandemic disease caused by an arthropod-borne chikungunya virus (CHIKV). The virus spreads through mosquitoes. This mosquito induced viral illness is clinically suspected on symptoms from fever and severe polyarthralgia. The recent outbreak of chikungunya was reported in November 2016 in the metropolitan city Karachi, Pakistan. We emphasis on the awareness of the etiology and vector control to prevent serious consequences.

Method

A total number of 1275 patients were included in this cross-sectional study. These patients were enrolled based on clinical findings described by Centers for Disease Control and Prevention (CDC). Our exclusion criteria were patients with missing data or having co-infection with dengue or malaria. The patients were tested for chikungunya antibodies, malaria, and dengue. The patients were followed for three months.

Results

Out of 1275 consenting patients from the emergency department, 564 tested positive for chikungunya antibodies and out of these 564 patients 365 had co-infection of dengue and malaria. So based on exclusion criteria, 199 patients had isolated chikungunya infection and were studied for the frequency of clinical symptoms. The most common finding was joint pain and fever on presentation and joint pain was the only chronic finding which persisted.

Conclusion

Our study demonstrated the frequency of clinical findings in chikungunya infection. It also signifies the importance of testing for antibodies because it helped in excluding patients with false positive clinical findings and differentiating co-infection with malaria and dengue. It also gauged patient's view about the cause of this disease. 



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Create a free account to continue reading this article.

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Syeda Naqvi, M.D.

Jinnah Postgraduate Medical Centre, Jinnah Sindh Medical University (SMC)

For correspondence:
syedafati240@gmail.com

Shehroz Bashir

Medicine Unit 7, Jinnah Sindh Medical University (SMC)

Chintan Rupareliya

Department of Neurology, University of Missouri, Columbia, Missouri

Abdullah Shams, M.D.

Internal Medicine, CMH Lahore Medical and Dental College

Pirthvi Raj Giyanwani, M.D.

Civil Hospital Karachi, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Zeeshan Ali

Jinnah Postgraduate Medical Centre, Jinnah Sindh Medical University (SMC)

Faiza Qamar

Jinnah Postgraduate Medical Centre, Jinnah Sindh Medical University (SMC)

Vijesh Kumar

Jinnah Postgraduate Medical Centre, Jinnah Sindh Medical University (SMC)

Vikash Talib

Accident & Emergency, Jinnah Sindh Medical University (SMC)

Syeda Naqvi, M.D.

Jinnah Postgraduate Medical Centre, Jinnah Sindh Medical University (SMC)

For correspondence:
syedafati240@gmail.com

Shehroz Bashir

Medicine Unit 7, Jinnah Sindh Medical University (SMC)

Chintan Rupareliya

Department of Neurology, University of Missouri, Columbia, Missouri

Abdullah Shams, M.D.

Internal Medicine, CMH Lahore Medical and Dental College

Pirthvi Raj Giyanwani, M.D.

Civil Hospital Karachi, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Zeeshan Ali

Jinnah Postgraduate Medical Centre, Jinnah Sindh Medical University (SMC)

Faiza Qamar

Jinnah Postgraduate Medical Centre, Jinnah Sindh Medical University (SMC)

Vijesh Kumar

Jinnah Postgraduate Medical Centre, Jinnah Sindh Medical University (SMC)

Vikash Talib

Accident & Emergency, Jinnah Sindh Medical University (SMC)