Chikungunya viral disease

Introduction to Chicoponia's viral diseases The Chikungunya viral disease is an acute infectious disease caused by the Chicongonia fever virus that is transmitted by mosquito bites. Clinically, it is characterized by fever, rash, hemorrhage, and severe joint pain. A small number of patients have persistent joint stiffness. basic knowledge Sickness ratio: 0.05% Susceptible people: no specific population Mode of transmission: spread by mosquito bites complication:

The cause of the viral disease in Chikungunia

(1) Causes of the disease

Chiconunya fever virus belongs to the group A virus of the togaviridae, which is spherical or slightly polygonal, with an average diameter of 42 nm, a core inside, and a diameter of 20-30 nm. It is a single-stranded RNA virus with only one serotype and its antigen. Sexually associated with O'nyony-nyony virus, Mayaro virus, and Semliki forest virus, there is a small difference in antigenicity between the isolates in Africa and Asia, and the mice, rats, hamsters, etc. are susceptible. The virus can be propagated in chicken embryo fibroblasts, Beijing duck kidney and monkey kidney cells, HeLa cells, and the virus replicates in the host cells.

(two) pathogenesis

After the virus invades the human body, it quickly enters the local lymph nodes and continues to multiply in it. After 3 to 4 days, it enters the blood circulation to form viremia. Then, the virus invades the liver, spleen, kidney, heart, bone marrow, lymph, etc. It disappears from the blood, but the lymph nodes, spleen, and bone marrow still exist.

The pathological damage of yellow fever is caused by the accumulation of viruses in different organs and tissues, and the main damaged organs are liver, kidney, heart, and other tissues and organs may have different degrees of degeneration.

Liver lesions are mainly in the lobules, hepatocytes turbid and swollen, the nucleus becomes large, showing multiple microscopic vacuolar fat changes, coagulative necrosis and eosinophilic degeneration, mild or lack of inflammation, no obvious tissue hyperplasia, severe liver Lesions can lead to deep jaundice, hemorrhage and hypoglycemia, etc., renal lesions vary in severity, from tubular epithelial edema to tubular necrosis, special staining shows glomerular basement membrane thickening, balloon gap and proximal renal tubule There are protein substances inside, the distal renal tubules are transparent and pigmented tube type, renal dysfunction and uremia are caused by blood volume reduction, renal tubular necrosis, etc., myocardium has extensive degeneration and fat infiltration, and severe cases may have stoves. Bleeding, lesions often involving the sinus node and His bundle, clinical symptoms such as slow heart rate, arrhythmia, heart failure, occasional edema and small hemorrhage in the brain, histological changes in cell degeneration, fat infiltration, necrosis There is no obvious inflammatory cell infiltration, and the lesions are scattered.

Chicoponia virus disease prevention

Anti-mosquito and anti-mosquito is the main preventive measure of this disease. It should be managed well for acute patients, anti-mosquito isolation, mosquito nets for susceptible people, anti-mosquito measures such as anti-mosquito oil, anti-mosquito including killing mosquitoes and removing mosquitoes. Awkward place.

Inactivated vaccine injection has a certain effect.

1. Control the source of infection

Try to treat on the spot to reduce the chance of transmission. Patients should be protected against mosquitoes during viremia. The isolation period is 5 days after the onset of the disease. Suspected and confirmed cases should be reported in a timely manner.

2, cut off the route of transmission

Anti-mosquito and anti-mosquito are also the main preventive measures for this disease.

3. Protect susceptible populations

There are currently no vaccines available. Mainly take personal anti-mosquito measures.

Chicoponia virus disease complications Complication

Severe patients can have blood and circulatory failure.

Symphony of viral diseases in Chikungunia Common symptoms Abdominal pain, gingival bleeding, diarrhea, nausea, congestion, papules, bleeding tendency

The incubation period is 3 to 12 days, and the laboratory infection is 22 to 80 hours.

Rapid onset, chills, fever, body temperature rises rapidly to 38 ~ 40.5 ° C, accompanied by very severe joints and spinal pain of the extremities, or even complete loss of mobility, but the joints are not red and swollen inflammation changes, and headache, nausea, vomiting , abdominal pain, diarrhea symptoms, fever 1 to 6 days, most patients with fever, 1 to 3 days after re-heating, 37.2 ~ 38.3 ° C, for several days, 2 to 5 days after the disease, more than half of patients have relatively slow pulse, conjunctiva Congestion, more than 80% of patients with facial, neck and upper chest flushing, and in the face, trunk, limbs and palms (plantar) see scattered in the maculopapular rash, also visible bleeding points, ecchymoses or purpura, while having nasal and Gingival hemorrhage, gastrointestinal bleeding, etc., superficial lymph node enlargement, infants often have serious illness, death due to circulatory failure, adult disease, mild condition, almost no death, natural course of 3 to 10 days, but The recovery period is longer. 90% of patients have been relieved by joint pain and stiffness after several weeks to more than 3 years. Only a few patients have persistent pain and stiffness, with or without swelling.

Examination of viral diseases in Chikunguni

The total number of white blood cells can be slightly reduced, lymphocytes are relatively increased, platelets can be slightly reduced, a few patients are positive for rheumatoid factor, serum transaminase is elevated and albumin is decreased.

Diagnosis and diagnosis of viral disease in Chikunguni

diagnosis

Clinical diagnosis

In the epidemic areas and the epidemic season or laboratory exposure to the virus, sudden fever, bimodal fever, rash and severe joint pain and bleeding tendency can be diagnosed.

2. Laboratory diagnosis

The serum of the patient was diluted 1000 times within 3 days of the onset of the disease, and the cells were inoculated into the brain of the mouse or the kidney of the hamster kidney or the African green monkey. The virus was isolated and the serum was taken for neutralization test and hemagglutination inhibition test. For diagnosis, rapid, simple and specific experimental diagnosis can be performed by monoclonal antibody HI method or IF method.

Differential diagnosis

It needs to be differentiated from dengue fever, yellow fever, West Nile fever and other viral hemorrhagic fever. The diagnosis depends on serological tests and virus isolation.

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