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Chikungunya and case management

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Cycle of Infection Chikungunya Infection . . 2501 ... – PowerPoint PPT presentation

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Title: Chikungunya and case management


1
?????????????????????? ??? ?????????????????????
??????????????????
  • ???????????

2
Cycle of Infection
3
Chikungunya Infection ???????????
  • ?.?. 2501 ????????????? ??????????????????????(40
    ,000/2,000,000) 2
  • ?.?. 2519 ?????????????????
  • ?.?. 2531 ??????????????? ????????????
  • ?.?. 2534 ??????????????(96)
  • ?.?. 2536 ?????????? ???????????????
  • ?.?. 2538 ???????????????????? (576)
    ?????????? ???????(331)

4
82 ??,, Median age 54 ?? (range8-81), lt 15 yr
old 2
5
CHIK Fever
IP 2-3 days (1-12 days) Clinical Feature -
Fever, acute onset, high 2-4 days - Joint pain /
swelling - Skin rash(MP) /- itchy - headache
/ retro-orbital pain - myalgia - GI
symptoms/signs - Petechiae (/- tourniquet
test) LaboratoryCBC- normal - leukopenia,
norm.platelet Treatment Symptomatics.
6
???????????????????????????????????
??. ????? ???.????????
7
Lancet Infect Dis 2007731927
8
?????????????????
  • ???????????????
  • ??????
  • ??????? ?????????????????? ? ???? ????????
    ??????????????? ???????????????????????????? 7
    ???
  • ???????????????? (incubation period) 2-3 ???(
    range of 1-12 days.)

9
??????????????????????????????
  • ?????????????? 39.1 c ????????????? 39 c ???
    50 ?????????? 40 c ????? 17
  • ???????????????????????????????????????????????
  • (Chik 15 VS Den 5 )

10
???????????????
  • polyarthralgia ??????? arthritis ???????????????
    ???? ?????? ???? ?????????? ????
    ??????????????????? ???? ??????? ?????? ???????
    ????????.

11
??????????????????????????
day 1 2 3 4 5 6 7
40 39 38 37 36
rash
Joint Large small
11 ?.?. 2551
?? ????? ???. ????????
12
CHIKUNGUNYA FEVER JOINT SWELLING
?????? ??.????? ???????????????? ??????????????
??????????????????
13
?????? ??????
?????? ??.????? ????????????????
????????????????????????????????
14
???????????? CHIKUNGUNYA FEVER
?????? ??.????? ???????????????? ??????????????
??????????????????
15
?????????????????
  • dengue fever
  • dual infection of Chikungunya and Dengue
  • Rubella


16
Summary of Dengue Fever Symptomatology (Dengue
type I)
0
17
??????????????????????????????????????????? (62
???) ??????? 2 ???????? ????????? ??????????????,
???????? - 11 ??????? 2538
????? ???????????????? ??? ???
????? ???????????????? ??? ???
18
  • Chikungunya
  • Fever, acute onset,
  • high 2-4 days
  • - Joint pain / swelling
  • - Skin rash(MP) /- itchy
  • - headache / retro-orbital pain
  • - myalgia
  • - GI symptoms/signs
  • - Petechiae (/- tourniquet test)
  • LaboratoryCBC- normal - leukopenia, norm.platelet
  • Dengue fever
  • High fever 5 - 7 days, may be biphasic
  • Headache, retro - orbital pain, muscle,
  • bone and joint pain
  • Rash diffuse flushing, erythrematous
  • Leukopenia, occasionally thrombocytopenia
  • More severe in adults (than children)

19
Treatment
  • Chikungunya fever is not a life threatening
    infection.
  • Symptomatic treatment for mitigating pain and
    fever using anti-inflammatory drugs along with
    rest usually suffices.

20
????????????
  • ?????????????????? ????????????????????
    ??????????????
  • ???????????????? Supportive care
  • ????????????????????????? ? ?????????????????????


21
?????????????????????????(1)
  • ???????? non-steroidal anti-inflammatory drugs
    (NSAID) ???????????? ????????????????????????
    ????? ???????????
  • ?????????????? steroids ???????????????
    ?????????????????????????

22
????????????(???)
  • ??????????????????????????? (?????? 12)
    ??????????????????????????????? 6 ???????
  • ?????????????????????????????????????????????????
    ?????????? NSAID ??????????????????

23
????????????????????????? (2)
  • ?????????? ?????????????? ??????????????
    ????????????????????????? ????
  • ?????? chloroquin ????? 250 mg ??????? NSAID
    ?????????????????????????????? chloroquin
    ????????????????????????

24
??????????????????????
  • ??????????????????????????????
    ??????????????????????????????????????????????????
    ??? ??????????????????????????? ????????????????
    ???????????????????????????
  • ?????????????????????????????????????????????????
    ? ?????????????????????????? 5 ???
    ??????????????????????

25
??????
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