Chikungunya:

By Dr. Soo

Living in Malaysia, where mosquito-borne illnesses such as dengue, Zika, and Chikungunya are present, it is important to be informed about these infections. As parents, keeping our children safe and healthy is always our top priority. While most people have heard of dengue, chikungunya is less well known, yet it can cause significant discomfort and distress, especially in children and families. Understanding what chikungunya is, how it spreads, what symptoms to look out for, and what steps to take if your child becomes infected can make all the difference in ensuring the best care and prevention.

What Is Chikungunya?

Chikungunya is a viral disease transmitted by the bite of infected Aedes mosquitoes, mainly Aedes aegypti and Aedes albopictus. These are the same mosquitoes responsible for spreading dengue and Zika viruses. The name “chikungunya” originates from an African language, meaning “that which bends up,” referring to the bent-over posture that often results from the severe joint pain caused by the infection.

Chikungunya is not a new disease—it was first identified in Tanzania in the 1950s—but it has re-emerged in many countries, including Malaysia, due to changing environmental conditions, global travel, and urbanization that favors mosquito breeding.

How Is It Spread?

The chikungunya virus is spread through the bite of an infected Aedes mosquito. These mosquitoes are daytime biters, with peak activity during early morning and late afternoon. A single bite is enough to transmit the virus. Unlike some infections, chikungunya does not spread directly from person to person, but if a mosquito bites someone who has the virus and then bites another person, it can continue the cycle of transmission.

Symptoms of Chikungunya

The incubation period (the time between being bitten and the appearance of symptoms) is usually 2–7 days. Chikungunya often begins suddenly, and its symptoms can be mistaken for dengue, which is why medical assessment is so important.

Common symptoms include:

• High fever (often above 39°C)

• Severe joint pain (especially in wrists, ankles, fingers, and knees)

• Muscle pain and stiffness

• Headache

• Fatigue and weakness

• Skin rash (in some cases)

In children, symptoms may sometimes be milder, but fever and irritability are common. Parents should be alert because children cannot always explain joint pain, but you may notice reluctance to walk, play, or use their hands normally.

How Is It Different From Dengue?

This is one of the most common questions parents ask. Both dengue and chikungunya are mosquito-borne illnesses with overlapping symptoms like fever, rash, and body aches. However, there are some key differences:

• Joint Pain: Severe and persistent joint pain is more typical of chikungunya than dengue.

• Bleeding: Dengue may cause bleeding symptoms (nosebleeds, gum bleeding, easy bruising), which are not typical of chikungunya.

• Complications: Dengue has a risk of severe complications such as shock and organ failure, while chikungunya is rarely life-threatening but can cause long-lasting joint problems.

Because it is difficult to distinguish between the two based on symptoms alone, laboratory tests are sometimes needed for confirmation.

Is Chikungunya Dangerous for Children?

Most children who contract chikungunya recover fully, but the illness can still be very distressing. The fever, body aches, and joint pains may cause extreme discomfort, loss of appetite, dehydration, and missed school days.

While severe complications are uncommon, chikungunya can be more serious in newborns, infants, and children with underlying health issues. Rare complications may include neurological problems (such as seizures or encephalitis) and heart involvement, but these are unusual.

The main concern for parents is ensuring adequate hydration, comfort, and monitoring for any signs of worsening illness.

How Is Chikungunya Diagnosed?

Doctors usually suspect chikungunya based on clinical symptoms and local outbreak history. Blood tests can help rule out other conditions, such as dengue or malaria. Specific tests for chikungunya (PCR or antibody detection) may be recommended in some cases, but they are not always necessary for routine management.

Treatment and Care

There is no specific antiviral medicine to cure chikungunya. Treatment is focused on relieving symptoms and supporting the body’s recovery.

Care at home and in the clinic may include:

• Fever management: Giving paracetamol to reduce fever and relieve pain. (Aspirin and certain NSAIDs should be avoided unless dengue is ruled out, as they can increase bleeding risk.)

• Hydration: Ensure your child drinks plenty of fluids to prevent dehydration.

• Rest: Allowing the child to rest adequately, as the illness can cause fatigue.

• Comfort measures: Warm compresses or gentle massage may help with joint stiffness.

Most children recover within 1–2 weeks, though joint pains can sometimes linger for weeks or even months in older children or adults.

When Should Parents Seek Medical Help?

Parents should bring their child to see a doctor if they develop:

• Persistent high fever (especially above 39°C)

• Severe or unusual joint pain

• Vomiting or refusal to drink fluids

• Signs of dehydration (dry lips, no tears when crying, reduced urine output)

• Seizures, confusion, or extreme drowsiness

• Rash with bleeding spots or bruises

Even if symptoms seem mild, it is always wise to consult your pediatrician for proper evaluation and guidance.

Prevention: Protecting Your Child from Chikungunya

Since there is no vaccine or specific treatment, prevention is the best strategy against chikungunya. Parents play a key role in protecting their children.

Steps you can take:

1. Eliminate mosquito breeding sites

   • Clear stagnant water from flowerpots, containers, and drains.

   • Change water in vases and pet bowls regularly.

   • Ensure water storage containers are tightly covered.

2. Use mosquito protection

   • Apply child-safe mosquito repellents, especially during the day.

   • Dress children in light-colored clothing that covers arms and legs.

   • Use mosquito nets for babies and toddlers during naps and at night.

3. Keep the home environment safe

   • Install window screens.

   • Use mosquito coils or electric vaporizers if necessary.

   • Encourage community participation in cleaning campaigns.

Living Through and After Chikungunya

While chikungunya can be extremely uncomfortable, most children recover well with proper care and rest. Parents should be patient, as fatigue and irritability may linger for a while even after the fever resolves. School attendance can resume once the child is fever-free and feeling better.

Importantly, once a person has recovered from chikungunya, they are likely to develop lifelong immunity, meaning they should not get infected again.

Final Thoughts

As parents, knowledge is one of our best tools in keeping our children safe. Chikungunya may not always be as widely discussed as dengue, but it is a real concern in Malaysia. By understanding the symptoms, knowing when to seek medical care, and practicing diligent mosquito control, we can greatly reduce the risk to our children.

If your child develops a sudden high fever and joint pain, do not panic—but do seek medical advice promptly. With proper care and monitoring, most children recover fully from chikungunya. Let us work together, as families and communities, to protect our little ones from mosquito-borne diseases and help them grow up healthy and strong

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