Chikungunya patients back in care as symptoms linger

Pune: It was a troubling year for Maharashtra in terms of Chikungunya infections with the virus sickening as many as 5,757 people, more than three times the number last year.

Doctors in the city said this week that those who had the infection during the monsoon are now feeling certain after-effects in the winter, such as acute joint pains, body ache and in a few instances, neurological problems.

Joint pain and aches are commonly known side effects of chikungunya infection. The problem was also attributed to dip in temperatures by doctors.

"We are getting a lot of patients post chikungunya and dengue who are complaining of joint pain. In our experience, they make up nearly 20-25% of the OPD cases we've had this winter," said Dr Pankaj Sharma, consultant orthopedic surgeon at Apollo Clinic.

Dr Sharma added: "The main reason for increase in joint pains is inflammation of joints during a viral illnesses. This affects all age groups. People with pre-existent joint problems suffer worse pain. Most common joints involved are the small joints of the feet and hands. Winter usually brings up such aches as the cold heightens perception of pain and joint stiffness. It eases once the weather turns warmer."

Dr Danish H Memon, HoD of Internal Medicine at Noble Hospitals said their OPD has been receiving chikungunya patients coming for follow-ups, with some complaining of acute joint pains exacerbated by the cold. "Those who were diagnosed with chikungunya are still coming in for a follow-up as it takes about one to two months for the pain to subside. Some may need three to four months. In most of these patients, we start treatment for rheumatoid arthritis along with calcium and vitamin D supplements. Patients have also complained of tiredness and fatigue," he said.

Dr Santosh Sontakke, consultant neurologist from Ruby Hall Clinic's 'Headache Clinic' said that some patients who had severe chikungunya in July and August reported a tingling, numbness, shooting pain and other sensory disturbances that have lingered.

He said: "This year's chikungunya virus strain seems to have a more prolonged course and wider multisystem effects, particularly on neurological functions. Most patients needed long-term management for their symptoms with immunomodulators or other supportive treatments to improve quality of life."

Other doctors noted that younger patients too have experienced such symptoms. "Also, additional medication for patients can be tapered off after three months. Now though medication goes on for 2-3 years due to acute pain," said Dr Shweta Khopde-Vidhate, consultant rheumatologist with the DPU Super Specialty Hospital.

"These patients can be classified as post-viral arthralgia (chikungunya arthritis). Few of them, especially the active working-age group patients, come with neurological manifestations, which deserve meticulous examination and continuous treatment with timely follow-ups," she said.