The two vector borne diseases Chikungunya and Dengue are reigning supreme with their bludgeon and blunderbuss across the landscape of Bangladesh. The two viral genres have more similarities than differences compounding a clinical picture challenging to the poor masses and to the unarmed physicians.
Both the predators prey using female Aedes aegypti and Aedes albopictus mosquitoes that predominantly take on flights at the first and last light. The incubation period, sign-symptoms, clinical presentations, treatment modalities and laboratory interpretations are more or less the same.
The incubation period for Chikungunya ranges from 3-7 days. Dengue holds an incubation period between 3-14 days. Though Dengue has been coined by a superlative “Break bone disease”, but the pain and ache of Chikungunya may be even more. There is a good deal of overlapping in clinical presentation in the duel between Chikungunya and Dengue. Some cases of Dengue remain asymptomatic so are a few Chikungunya carrier but cases of Chikungunya do not usually result in severe complication relating it to a benign condition than Dengue.
The most salient features in both the conditions are predominantly fever, headache, arthralgia, myalgia, nausea, vomiting and rash but Chikungunya is characterised per se by a shorter course of fever, conjunctivitis, arthritis, arthralgia, myalgia or rash.
The term Chikungunya is derived from Kimakonde language, meaning stooping which the victims possess due to arthralgia. Chikungunya is suspected by a sudden onset of high fever (104-1050F) frequently associated with other common signs symptoms like headache, myalgia, arthralgia, vomiting, fatigue and rash. The pain is indeed debilitating.
Dengue may differentiate itself from Chikungunya having a more insidious and a relatively prolonged course of fever, retro-orbital pain, abdominal pain and bloody vomiting. The prevailing epidemiology should throw a light.
The laboratory tests to confirm a diagnosis should be made by serology and virology. Though the costly and sophisticated tests like reverse transcriptase-polymerase chain reaction (RT-PCR), ELISA may confirm; IgM, IgG respective antibodies, could be diagnostic and confirmatory but are not available in most of our settings. A simple Complete Blood Count should not be ignored. In Dengue this ordinary blood test may reveal leukopaenia, neutropaenia or thrombocyto-paenia where as in Chikungunya, lymphocytosis is classical.
Other than Dengue Haemorrhagic Fever and Dengue Shock Syndrome, treatment is directed to relieve symptoms for both Dengue and Chikungunya. Plenty of fluids, analgesic like Paracetamol, bed rest are the hallmark of the treatment. Aspirin, Ibuprofen should be avoided. United States Centre for Disease Control and Prevention advocates the best way to prevent diseases that are spread by mosquitoes is by using insect repellent.