Chikungunya Virus Infection in Pregnancy

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Dr. Sabiha Anjum (Obstetrician and Gynaecologist )
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Chikungunya Virus Infection in Pregnancy

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Joy, excitement and challenges surround every pregnancy. The mother-to-be is entrusted with the task of keeping good health and taking necessary precautions to safeguard herself as well as the child she is carrying. The mother, during this period, is vulnerable to diseases and infections due to a lowered immunity and must take extra care to ensure protection from infection and diseases. Chikungunya is one such disease which can be easily contracted.

What Is Chikungunya?

Chikungunya is a vector-borne infection which is caused by the Chikungunya virus. It is spread by the female tiger mosquito that breeds in stagnant water and spreads the virus. These are the same mosquitoes which spread dengue, and they can be recognised by the white stripes on their legs.

When Are You at Risk of Getting Affected by Chikungunya?

Chikungunya can spread during any season. It is similar to malaria regarding how it spreads. Monsoon is the time when the highest number of cases of Chikungunya is reported, as warm, humid weather and stagnant water is the perfect environment for tiger mosquitoes to breed.

The tiger mosquitoes are known to be most active early in the morning and in the late afternoon, and they typically bite only during the day time.

Causes of Chikungunya?

How does Chikungunya spread?

If you’ve been intrigued by this question, here is what you need to know:

Chikungunya is transmitted by mosquitoes but can also be transmitted by infected humans. Usually, the disease is spread by a mosquito called Aedes aegypti or Aedes albopictus, more commonly known as the tiger mosquito.

Causes of Chikungunya?

Chikungunya can be categorised into two phases – acute and chronic.

Acute Chikungunya refers to the incidence of infection, followed by a viral phase (during which the virus is present in the body, lasting about a week), followed by the convalescent phase (during which virus cannot be found in blood tests, and the body begins to recover). The signs and symptoms of the disease last only a short while, and the person’s health recovers almost completely.

Chronic Chikungunya, on the other hand, has been reported as the continuation of the signs and symptoms of the infection for more than a month after the virus has been cleared out of the body. In fact, cases have been reported of patients continuing to exhibit symptoms such as muscle pain, joint pain, for as long as three years after the infection. The exact cause for these prolonged symptoms is yet to be determined.

Signs & Symptoms of Chikungunya in Pregnant Women

It is important to understand how Chikungunya spreads, but what is more important to comprehend is the first signs and symptoms of Chikungunya in pregnant women.

Signs & Symptoms of Chikungunya in Pregnant Women

Early detection of the infection is necessary to cure it without allowing it to have a significant impact on the mother or the child. The symptoms of the Chikungunya infection show up between 3-7 days after the mosquito has bitten.

Here are some of the signs and symptoms that indicate the presence of this infection in pregnant women:

1. Joint and Muscle Pains

Once infected by the virus, the host body will experience severe pain in the joints and muscles. The ankle, elbow joints and wrists, in particular, hurt a lot, especially in the morning. The pain might persist for a week or also for more than a month, and at times there might also be swelling around the joints.

2. Fever

The infected body will also suffer from high and recurring fever which can sometimes go as high as 104 degrees Celsius.

3. Chills

Like in malaria, even a Chikungunya infection will give you chills, and you will feel abnormally cold even if the weather is not very cold.

4. Rash

One might also experience the Chikungunya rash during pregnancy on any part of the body, and this will be characterised by raised, spotted lesions and joint pains with swelling.

5. Headaches

Severe headaches also accompany Chikungunya infection and can be very painful to endure.

6. Pain in the Lower Back Region

Along with a headache, the lower back may also ache.

7. Nausea and Vomiting

The feeling of having an upset stomach with the sensation of throwing up, followed by vomiting is also a symptom of being infected by the Chikungunya virus.

8. Fatigue

The feeling of tiredness and being low on strength is also one of the symptoms of the Chikungunya infection as the fever, headache, rash and other associated infection tend to sap the energy out of your body.

While most of the symptoms of Chikungunya are very general, one might tend to take these signs lightly as it might be usual to develop symptoms such as fatigue, tiredness, chills and fever during pregnancy. This may lead to the pregnant woman not taking appropriate precautions leading to further complications. In case any of these signs persist for more than a few days, it is best to consult a doctor without any delay to ensure the safety of both the mother and the child.

Treatment of Chikungunya

In case you are diagnosed with Chikungunya, it is essential to take effective treatment straight away so that it does not impact your health or your child’s during pregnancy. Currently, there are no known cases of transmission of the infection from a pregnant mother to her foetus.

NOTE: Before understanding the cure for Chikungunya, it is important to differentiate it from other similar infections such as dengue and malaria. This can be done by getting your blood tests taken to separate the microorganism causing the disease.

Here are some treatments that can help cure Chikungunya:

1. Rest

There is no specific treatment to cure a viral infection immediately and hence the best way to fight a virus is by ensuring ample rest so that the body gets time to recover. Ensure that the environment around you is not too hot or damp.

2. Medicines for Pain and Fever

The joint/muscle pains and fever which accompany Chikungunya can be addressed with necessary medication such as paracetamol, and anti-inflammatory drugs which will help the pain and fever subside.

3. Apply Cream/Oil to Reduce Skin Rashes and Irritation

Applying various herbal or medicated oils and cream can help reduce the rashes and help get rid of scaling dryness of the skin. There are different medicated creams available depending upon the kind of skin problem faced by you. Use these only after taking your doctor’s approval.

4. Exercise

Light exercise at home or under the supervision of a physiotherapist can help you get relief from joint and muscle pain and reduce stiffness. However, it is advised to keep the exercise light and only to the extent that it does not tire you out, and to perform these exercises only after the active infection is over.

Home Remedies for Chikungunya:

Following are some of the home remedies to cure Chikungunya:

  • Cold compression to reduce joint pains and swelling
  • Epsom salt soaks to bring relief from pain
  • Use of ginger as it boosts immunity and provides relief from pain and fever
  • Consumption of garlic as this helps in improving circulation and reduction of joint pain due to its anti-inflammatory properties
  • A glass of milk with turmeric will assist in increasing the immunity of the body and heal any sore spots or swollen joints at a faster pace

Chikungunya Diet During pregnancy:

It is advised to have plenty of fluids such as coconut water, soups, fruit juices, ORS etc. and avoid any junk, fat-filled or spicy food if you have Chikungunya during pregnancy. Foods which are rich in vitamin C and E, and leafy vegetables should form a part of your diet if you are infected with the virus.

Ensure that you follow a diet rich in vitamins because they are important in countering any diseases that are caused by mosquitoes.

Precautions

Precautionary methods can be adopted to prevent contracting this disease. Here are a few simple tips on how to prevent Chikungunya:

  • Ensure that there is no water stagnation in your vicinity, especially during monsoons.
  • Restrict garbage build-up and ensure proper disposal of all waste material.
  • Cover all water tanks and reservoirs around you so that mosquitoes do not get in.
  • Wear light-coloured, protective clothing as dark colours attract mosquitoes.
  • Use mesh or netting on the windows and doors to prevent the entry of mosquitoes.
  • Use of mosquito repellent can help in safeguarding from mosquito bites.
  • Mosquitoes cannot survive in cold temperatures, and hence it is advised to stay indoors. in an air-conditioned room if possible.
  • Maintain a clean and tidy environment as this will not allow mosquitoes to breed.

Following these simple steps can go a long way to ensure Chikungunya prevention and control and keeping you and your child safe.

FAQs

1. What are the side-effects of Chikungunya?

Death due to Chikungunya infection has not been reported till date. However, it might have a long-lasting effect on the general health of your body wherein joint pains and scars from rashes might take some time to heal completely.

2. What are the after-effects of Chikungunya?

After the infection has been cured, there will be after-effects such as joint pains, muscle pain, occasional fever, tiredness, etc. that may persist for a long time.

3. If I had Chikungunya virus, can I get it again?

If you have contracted Chikungunya once, then you are not likely to get it again as your body will develop resistance to the virus. As of now, there have been no known cases of re-occurrence of Chikungunya in a person who was already infected.

4. What is the incubation period of Chikungunya?

The incubation period for Chikungunya in most cases is between 3-7 days which is characterised by a sudden shoot up in the body temperature. The overall period of Chikungunya infections can range from 1-12 days.

5. What is the recovery time for Chikungunya?

Subject to proper care and medication, the infection itself might start easing out within 10 days of first signs of occurrence. However, the repercussions of the infection such as weakness, joint aches, muscle pains etc. might last for weeks or months also.

6. If I have Chikungunya, will it harm the foetus?

Chikungunya is not transmitted to the baby by the mother in the usual course of pregnancy. However, if the mother has contracted Chikungunya just before she goes into labour, then there is a possibility of transmitting the virus to the baby. In case the newborn baby is infected with the virus, it requires immediate attention, and the baby might also be kept in isolation for further treatment.

Any illness during pregnancy affects the mother, and indirectly the child, and Chikungunya is not different. However, one must remember that it is not a fatal disease, and proper precautions and care can ensure a complete recovery.

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