DENGUE and Zika are inevitably becoming permanent residents in our country’s microbial inhabitants. So far, reported Zika cases had already reached six. As it turned out lately, they are keeping unwelcome company with chikungunya, which, by its name alone, appears of African origin much like Zika.
Moreover, all three viral diseases share the same insect carrier species, Aedes aegypti, which is becoming a formidable population in our community considering occasional outbreaks of dengue around the country.
So, how do we distinguish chikungunya from dengue? To answer this question, we will be indebted to a broad Mexican study of Joel Navarrete-Espinosa and five other colleagues published last March in the Journal of Medical Microbiology.
There are clear similarities between dengue and chikungunya in clinical manifestations. First, both cause fever all the time. Second, they develop algesia (painful conditions), such as headaches, myalgia (muscular pain), moderate arthralgias (joint pains) and ocular (eye) pain.
Third, vascular liquid leak are also observed, including related signs such as petequiae and tourniquet test positive. However, these signs are most frequently observed in hemorrhagic dengue fever (HDF) in addition to hemorrhage and gingival bleeding.
Moreover, like dengue, chikungunya already has four known viral strains or serotypes. It is still unreported which strain caused the recent outbreak in Cavite.
However, there are exclusive symptoms associated with chikungunya. First, it develops exclusive inflammatory symptoms, such as arthritis and conjunctivitis, and incapacitating (severe) polyarthralgias (multiple-joint pains). Thus, these symptoms are diagnostic of this viral infection. Second, edema formation may be observed; although HDF occasionally also develops edema.
Chikungunya, however, rarely, if ever, shows a positive tourniquet test.
With regard to platelet count, the study showed that both chikungunya and dengue can reach as low as 100,000. However, chikungunya platelet count generally starts going up on the seventh day without going back down again, while dengue trend may fluctuate through the 10th day. HDF, however, can reach as low as almost zero platelet count (without platelet transfusion) and stay low toward the 10th day.
I guess this is one case of being forewarned as being forearmed. Health education is key to effective and safe self-care.