Mumbai doctors see a spurt in chikungunya cases
City doctors are seeing a spurt in cases of chikungunya – a viral infection spread by an infected Aedes Aegypti mosquito, with people coming to the medical clinics with acute joint pain and other symptoms such as fever and rashes.
“We have seen 20 confirmed cases of the infection in the past fortnight,” said Dr Shalini Suralkar, a consultant physician with Powai’s LH Hiranandani Hospital. “The patients are in the age group of 30-50. None of them required hospitalisation,” said Suralkar, citing a case of a 45-year-old woman who came in with a history of fever, rashes and joint pain. While her fever and rashes subsided, the pain in her foot, ankles and hands persisted. The patient has to be eventually put on a course of steroids.
Chikungunya is caused by the chikungunya virus (CHIKV). In addition to excruciating joint pain, fever and rashes, the infection also causes joint swelling, headache, nausea and fatigue. Its pain-related symptoms are similar to rheumatoid arthritis.
According to Suralkar, chikungunya arthritis can last up to three to six months. In such cases, patients are put on steroids and their doses are tapered gradually. If patients don’t get relief, they are prescribed immunomodulatory treatment in the form of hydroxychloroquine. “In chikungunya, patients generally do not require hospitalisation and mortality is very rare. But it can be a very morbid condition in which patients are unable to do their daily activities and are in extreme pain,” said Suralkar, adding that in mild cases, patients generally respond to anti-inflammatory medication, and sometimes with a short course of steroids.
The clinical signs of chikungunya are similar to dengue, thus there is a chance of misdiagnosis if timely testing is not done. Doctors said patients are seeking medical help within one of two days of symptoms because of the fear of Covid-19, and this has helped in the early diagnosis of other diseases. “There is no direct treatment for chikungunya and all interventions are mostly for symptom relief,” said physician Dr Gautam Bhansali, who has been seeing two to three confirmed cases every day since the past two weeks. “It is a viral disease that leads to reduced platelet count and causes severe dehydration. We advise patients to increase their fluid intake if they are not hospitalised, and some other medications are given for fever and pain relief,” he said.
Consultant internist Dr Samrat Shah from Bhatia Hospital has also been seeing two to three confirmed cases every day. “Only one or two patients in a week have required hospitalisation due to severe joint pain and high-grade fever,” said Shah, adding the treatment includes intravenous fluids, antipyretics, anti-inflammatory and disease-modifying antirheumatic drugs.