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[CHENNAI] Joint pain in patients with chikungunya, a mosquito-borne viral disease that is on the rise in parts of Asia and Africa, is different from that linked to rheumatoid arthritis, Indian scientists report.
Scientists at the regional centre of Indian Council of Medical Research (ICMR) at Port Blair say that the insights have “implications in case management.”  
“Patients with the more common ‘rheumatoid’ arthritis, that results from an immunity problem in which the body produces antibodies against itself, are usually prescribed steroids that are not needed for chikungunya-related joint pains,” Palluru Vijayachari, ICMR regional centre director, told SciDev.Net.
Also, unlike rheumatoid arthritis that can affect the lungs, heart and skin, chikungunya-related arthritis is restricted to bones, muscles and joints. There is yet no cure for the disease and treatment is focused on symptom relief.
“The study was conducted because not much information exists about the pathological changes and evolution of symptoms in acute and chronic chikungunya disease,” Vijayachari explained. This information would help clinicians provide better care to chikungunya patients, Vijayachari said.
These are preliminary findings from a three-year study initiated in 2008 on 203 patients. ICMR scientists are further studying disease progression and immune responses, which can lead to development of new and/or modified methods of treatment, Vijayachari added.
According to the World Health Organization, a major outbreak of chikungunya occurred recently in the Indian Ocean islands in February 2005, followed by another in 2006, and in 2007 when several other countries in South-East Asia were also affected. A localised outbreak was reported from north-eastern Italy in 2007.
Chikungunya’s symptoms are often confused with dengue, another disease spread by the same mosquito Aedes aegyptii. These include an abrupt onset of fever with joint pain. Other common symptoms are muscle pain, headache, nausea, fatigue and rash. The joint pain is often debilitating, but usually ends within a few days or weeks, but in some cases joint pain may persist for several months, or even years.

The findings were published in the Transactions of the Royal Society of Tropical Medicine and Hygiene online in February. 

Link to original abstract in Transactions of the Royal Society of Tropical Medicine and Hygiene

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