A Comprehensive Report on Managerial Epidemiology of Chikungunya Virus

This report provides a comprehensive overview of the Chikungunya virus, beginning with its origins in Africa and tracing its global spread. It details the virus's pathophysiology, including its symptoms such as fever and joint pain, and its transmission via infected mosquito bites. The report covers diagnostic methods, treatment options, and the evolution of the virus, including the emergence of different lineages and outbreaks in various regions like Asia, Europe, and the Americas. Furthermore, it examines the epidemiology of the virus, citing statistics from different countries and the Centers for Disease Control (CDC) updates. The report also discusses the prognosis, complications, and economic impacts of the virus, concluding with recommendations for control measures such as mosquito control and travel advisories.

Running head: MANAGERIAL EPIDEMIOLOGY 1
MANAGERIAL EPIDEMIOLOGY
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Institutional Affiliation

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Introduction
The incident of this disease was first recorded in the African continent after an outbreak on
the plateau of Makonde in the year 1952 (Musso & Gubler 2015). Tanzania and Mozambique
are bordered my Makonde plateau. The word chikungunya comes from a Makonde verb that
means ‘’something that is bending up’’ in reference to bend down posture because of the
inflammation of joints causing pain which a symptom of this disease infection. This means
‘’the illness of the bent walker'' in Swahili.
This disease is believed to have originated from East or Central Africa. It has been
circulating in a sylvatic circle in transit from nonhuman primates and misquotes dwelling in
the forest. The virus exhibits random behaviour or lack of a specific pattern in occurrence
with the absence of large human outbreaks. However, the virus can circulate in between naïve
human hosts and mosquitoes in African urban centers and as well as throughout Asia in a
similar circle as the dengue viruses. There has been an occasional occurrence of Chikungunya
virus outbreak since its discovery in Africa in the year 1952. The disease has been spread to
the rest of the world due to its recent outbreaks (Weaver & Forrester 2015). Europe and
Asia(India) are among the places where numerous chikungunya re-emergence have been
documented. The virus was listed as a National Institute of Allergy and Infectious Diseases in
the year 2008 in The United States of America. Currently, more than forty countries across
the world have been reported to be affected by the disease.
Pathophysiology
Signs and symptoms of the virus
 Sudden fever accompanied by pain in the joints. The joint pain can last for a number
of days or sometimes extend foe some weeks and it is often very debilitating.

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 Nausea, headache, fatigue, rash and muscle pain.
Transmission
Transmission of this disease can occur from one person to another through female
mosquitoes bites which are infected. The two mosquito species commonly involved are
Aedes albopictus and e. aegypti. These two mosquito species can bite during the day, though
they mostly bite during morning hours and late in the evening. They can also bite outdoors,
but Ae. aegypti can also readily bite indoors (Heymsfield & Wadden 2017).
After being bitten by an infected mosquito, someone usually gets sick foe around seven
days but can range from two to twelve days.
Diagnosis
The virus can be diagnosed using several methods. Enzyme-linked immunosorbent assays
is a serological test that can be used to confirm the presence of IgG and IgM anti-
chikungunya antibodies (Mardekian & Roberts 2015).
During the first few days, the virus may be isolated from the blood.
Reverse transcriptase-polymerase chain reaction methods can also be used.
Treatment
The following are home remedies and medical treatments for reliving chikungunya virus:
rest, medicines and fluids that may reduce pain and fever (Kuo et al 2016).
Evolution of chikungunya virus

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Chikungunya polygenetic analyses have identified three main lineages namely, Asian,
East Central South African and West African lineage (Tsetsarkin, Chen & Weaver 2016).
There was re-emergence of East Central South African lineage the Indian Ocean and Africa
in the year 2004 and it later evolved into a novel Indian Ocean Lineage (IOL). There has been
increased transmission by Ae. albopictus due to adaptive mutations resulting in great
outbreaks in South East Asia, India, and Italy. In December 2013 the first exotic incidents of
the chikungunya virus were reported in the Western hemisphere. There were thirty thousand
reported and confirmed laboratory cases in Latin America and the Caribbean following the
rapid epidemic expansion. Re-emergence of East Central South African lineage and Asian
lineage has resulted in an epidemic of the virus in America.
Mexico reported the first autochthonous case of the virus in the Southern border state of
Chiapas in October 2014. One month later more cases were reported in the Mexican Institute
of Social Security and nine other states (Weaver & Lecuit 2015).
With evolution, several cases of outbreaks and infections have been reported recently.
Over two hundred and seventy thousand people were infected by Ae. albopictus in Mauritius
and Indian Ocean islands of Reunion in the year 2005-2006.
In the year 2006, there were reported cases of the virus outbreak in India caused by Ae.
Aegypti. One million five hundred thousand people were infected in that year.
A coastal village was also reported to have been affected in the year 2007. This was as a
result of the migration of people and one hundred and seven cases were confirmed (Burt et al
2017).
Epidemiology

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Several records classified chikungunya in a variety of ways: 165 described outbreaks, 31
reported imported incidents, 12 reported sporadic cases, 23 described epidemics, and 18
reported disease clusters. These records reveal that the virus has expanded steadily East and
South Asia over the last seventy years. Ever since the virus was reported in Asia prior to
1960, different countries have reported the circulation of the virus in the following
percentages, Malaysia 6.8%, Thailand 9%, Philippines 28%, Bangkok 11% and India 46%
(Thrusfield 2018).
Centers for Disease Control Update
In 2015 the virus was nationally notifiable in the United States. Several cases were
reported to local health departments and the Centre for Disease Control. ArboNet has
received a total of 156 cases of chikungunya virus in since the year 2017. Those infected
were believed to have contracted the virus when they traveled to areas which were affected.
There have no cases of transmission which has occurred locally.
The CDC has advised American citizens traveling to areas which are reported serious
cases of chikungunya virus to ensure they protect themselves properly from mosquito bites
and also share their travel plans with their health care providers. The CDC also revealed that
people who might have difficulties avoiding mosquito bites, women in late pregnancy and
long term travelers are at elevated risk of contracting chikungunya virus. CDC has made
available travel-related advisories about chikungunya at http://1.usa.gov/1k8gJeq and
everyone is encouraged to access the website.
Prognosis
Complications commonly seen include the following:

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 Neurological imbalance.
 Eye illnesses.
 When kidneys get affected it results in acute renal disease.
 Bullous lesions which are severe.
 Neurological infections like myelitis, cranial nerve impulses, and
meningoencephalitis.
 Liver damage leading to jaundice.
The virus has had negative impacts on the American economy as the government is now
forced to invest more money in the health sector to facilitate research and effective control of
the virus. This money could have been invested in other sectors to ensure an increase in the
country's GDP.
People suffering from this virus have also died. The death of productive citizens means the
country is losing a lot in the economic sector (Papaemmanuil et al 2016).
Conclusion
Chikungunya virus is a disease which needs to be controlled as it can be spread in a large
region within a very short period of time. The mosquitoes responsible for transmitting the
virus should be controlled through getting rid of bushes around our homes and spraying of
appropriate insecticides.
Travel advisories should also be made available to everybody so that regions most affected
by the virus can be avoided.

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References
Burt, F. J., Chen, W., Miner, J. J., Lenschow, D. J., Merits, A., Schnettler, E., ... & Zaid, A.
(2017). Chikungunya virus: an update on the biology and pathogenesis of this emerging
pathogen. The Lancet Infectious Diseases, 17(4), e107-e117.
Heymsfield, S. B., & Wadden, T. A. (2017). Mechanisms, pathophysiology, and management
of obesity. New England Journal of Medicine, 376(3), 254-266.
Kuo, S. C., Wang, Y. M., Ho, Y. J., Chang, T. Y., Lai, Z. Z., Tsui, P. Y., ... & Lin, C. C.
(2016). Suramin treatment reduces chikungunya pathogenesis in mice. Antiviral
research, 134, 89-96.
Mardekian, S. K., & Roberts, A. L. (2015). Diagnostic options and challenges for dengue and
chikungunya viruses. BioMed research international, 2015.
Musso, D., & Gubler, D. J. (2015). Zika virus: following the path of dengue and
chikungunya?. The Lancet, 386(9990), 243-244.
Papaemmanuil, E., Gerstung, M., Bullinger, L., Gaidzik, V. I., Paschka, P., Roberts, N. D., ...
& Gundem, G. (2016). Genomic classification and prognosis in acute myeloid
leukemia. New England Journal of Medicine, 374(23), 2209-2221.
Thrusfield, M. (2018). Veterinary epidemiology. John Wiley & Sons.

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Tsetsarkin, K. A., Chen, R., & Weaver, S. C. (2016). Interspecies transmission and
chikungunya virus emergence. Current opinion in virology, 16, 143-150.
Weaver, S. C., & Forrester, N. L. (2015). Chikungunya: Evolutionary history and recent
epidemic spread. Antiviral research, 120, 32-39.
Weaver, S. C., & Lecuit, M. (2015). Chikungunya virus and the global spread of a mosquito-
borne disease. New England Journal of Medicine, 372(13), 1231-1239.