Title: Chikungunya and case management
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2Cycle of Infection
3Chikungunya Infection ???????????
- ?.?. 2501 ????????????? ??????????????????????(40
,000/2,000,000) 2 - ?.?. 2519 ?????????????????
- ?.?. 2531 ??????????????? ????????????
- ?.?. 2534 ??????????????(96)
- ?.?. 2536 ?????????? ???????????????
- ?.?. 2538 ???????????????????? (576)
?????????? ???????(331)
482 ??,, Median age 54 ?? (range8-81), lt 15 yr
old 2
5CHIK 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.
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7Lancet Infect Dis 2007731927
8 ?????????????????
- ???????????????
- ??????
- ??????? ?????????????????? ? ???? ????????
??????????????? ???????????????????????????? 7
??? - ???????????????? (incubation period) 2-3 ???(
range of 1-12 days.)
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- ?????????????? 39.1 c ????????????? 39 c ???
50 ?????????? 40 c ????? 17 - ???????????????????????????????????????????????
- (Chik 15 VS Den 5 )
10???????????????
- polyarthralgia ??????? arthritis ???????????????
???? ?????? ???? ?????????? ????
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????????.
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day 1 2 3 4 5 6 7
40 39 38 37 36
rash
Joint Large small
11 ?.?. 2551
?? ????? ???. ????????
12CHIKUNGUNYA FEVER JOINT SWELLING
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14???????????? CHIKUNGUNYA FEVER
?????? ??.????? ???????????????? ??????????????
??????????????????
15?????????????????
- dengue fever
- dual infection of Chikungunya and Dengue
- Rubella
16Summary of Dengue Fever Symptomatology (Dengue
type I)
0
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???) ??????? 2 ???????? ????????? ??????????????,
???????? - 11 ??????? 2538
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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)
19Treatment
- 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
????????????????????????
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- ??????????????????????????????
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? ?????????????????????????? 5 ???
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