Page 140 - Journal of Special Operations Medicine - Winter 2014

Diagnosis Disclaimer
Diagnostic testing is based on the time frame of the ill- The views expressed in this publication are those of the
ness and should be considered in patients who develop author and do not reflect the official policy or position
acute fever and arthralgia. In the first 8 days of the ill- of the Department of the Army, Department of Defense,
ness, RT-PCR and IgM testing is recommended. Sero- or the US Government.
conversion of IgM to IgG is seen in positive cases in
convalescent samples drawn 10 to 14 days following the
acute sample. Virus isolation is performed in a Biosafety Disclosure
Level (BSL) 3 lab. Additional information regarding test- The author has nothing to disclose.
ing in the United States can be found at http://www.cdc.
gov/chikungunya/. Testing is also performed at multiple
other locations worldwide as noted on the Pan Ameri- Bibliography
can Health Organization website at www.paho.org. http://www.cdc.gov/chikungunya/hc/index.html.
http://www.paho.org/hq/index.php?option=com_topics&vie
w=article&id=343&Itemid=40931.
Treatment and Vaccination Morens DM, Fauci AS. Chikungunya at the door: déjà vu all
There is currently no vaccination for chikungunya, nor over again? N Engl J Med. 2014;371:885–887.
are there any specific therapies for those infected. Treat- Staples JE, Fischer MF. Chikungunya virus in the Americas:
what a vectorborne pathogen can do. N Engl J Med. 2014;
ment is symptomatic in nature, with rest, judicious fluids, 371:887–889.
and pain control with nonsteroidal anti-inflammatory
drugs being key.

Importance in a Deployed Setting COL Burnett is currently the Area-Support Group-Kuwait
Command Surgeon and is board certified in pediatrics and
Chikungunya should be strongly considered in any pa- pediatric infectious diseases. He has served overseas in Ko-
tient who develops an acute fever with symmetric poly- rea, Germany, Kosovo, Iraq, Afghanistan, Kuwait, and as the
arthralgias. Viremic patients can further infect feeding JSOTF-P Surgeon in the Philippines. He is a graduate of the
mosquitoes for up to a week, spreading the disease to University of Wisconsin-Madison and the Medical College of
others in the immediate area. With no available vaccine, Wisconsin.
prevention is key by using a DEET-based repellent and
permethrin-treated uniforms (Figure 2).

Figure 2 Centers for Disease Control and Prevention map of
chikungunya cases.

Countries and territories where chikungunya cases
have been reported* (as of October 14, 2014)

Notes: *Does not include countries or territories where only
imported cases have been documented. This map is updated
weekly if there are new countries or territories that report
local chikungunya virus transmission.
Source: http://www.cdc.gov/chikungunya/geo/index.html

130 Journal of Special Operations Medicine Volume 14, Edition 4/Winter 2014