Chikungunya fever in children: A Descriptive Study
Abstract
In the Indian sub-continent, first isolation of the chikungunya virus was done in Kolkata during 1963. During 2006 reports of large scale outbreaks in several parts of India have confirmed the re-emergence of this virus in the country. Since the incidence of this disease is increasing. So a retrospective analysis of laboratory confirmed chikungunya patients admitted to pediatric ward was done to study biochemical profile of chikungunya fever in children. Total 51 children were laboratory confirmed for chickungunya, 36 of them had isolated chikungunya infection. Male/female ratio of isolated chikungunya was 2.6:1. Fever was invariably present, associated constitutional symptoms consisted of skin rash, vomiting, diarrhea, pain abdomen, cough, corrhyza, myalgia and bleeding manifestations. The most characteristic feature of the infections in infants was skin manifestations in form of symmetrical superficial vesiculobullous lesions & maculopapular erythematous rash. Nine patients (25%) had neurological manifestations. Joint pain was present in only three patients but none had arthritis. Most common hematological abnormality revealed thrombocytopenia in 39% cases. There was mild to moderate elevation of liver enzymes in 13 patients (36%). Average length of hospital stay was 5.1 days. Thirty four patients recovered completely & two left against medical advise. It is concluded from this study that skin manifestations and neurological manifestations are common in younger age group apart from other constitutional symptoms. Arthralgia and chronic polyarthritis is rare in this age group as found in adults.
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Introduction
Chikungunya was first isolated by R.W. Ross in 1952 in the Newala district of Tanzania.1 It causes a dengue-like illness, characterized by fever, rash, painful myalgia and arthralgia and sometimes arthritis. In the Indian sub-continent, first isolation of the virus was done in Kolkata in 1963.2,3 In 2016, a big upsurge/epidemic of chikungunya affecting the capital city of Delhi and other states was observed.3
The chikungunya virus is an envelope, positive stranded RNA alphavirus belonging to the Togaviridae family and transmitted by Aedes mosquito bites (mainly Ae. aegypti and Ae. albopictus). 4 The mosquito, well adapted to life in urban settings, breeds in clean puddles of stagnant water and collections of water in artificial containers. The mosquito is highly susceptible to the virus, prefers to live close to people, seeks a blood meal during day time and bites several people in a short period for one meal.5
Most descriptions of chikungunya fever are based on data obtained during epidemics mostly in adults.
Conclusion
It was concluded from this present study that Clinical manifestations of chikungunya fever are different in children as compared to adults. Chronic sequelae of joint involvement are rare in this age group whereas skin manifestations are common. Prognosis and outcome in children is good. An entirely different spectrum of disease is seen in infants with chikungunya as compared to older children who need to be carefully observed.