Chronic chikungunya spurt sparks concern in city & Mumbai

Pune: A growing number of chikungunya patients in the city and Mumbai are not recovering as expected and progressing into a chronic phase, known as chronic chikungunya disease or chronic chikungunya arthritis, according to rheumatologists."The earlier data suggested that only 5-7% of chikungunya cases turned chronic. In this outbreak, about 20-30% of patients are being referred by general practitioners and family doctors because their symptoms are persisting beyond six weeks despite routine treatment," said Dr Pravin Patil, a leading rheumatologist in the city.The current outbreak is proving to be more severe and affecting more patients with chronic joint pains than previous ones."Chikungunya is no longer just a once-in-30-years epidemic. It is coming back more often, like dengue. We are seeing patients with severe chikungunya-related arthritis, who had the infection years ago. Certainly, we will see more such patients in the coming years. We need more follow-up data on these patients to determine the exact prognosis of chronic chikungunya arthritis," Dr Patil added.In the current chikungunya outbreak scenario, fever and rash followed by joint pain should be considered chikungunya, even if the test results are negative. If the pain persists beyond four to six weeks, patients should consult a rheumatologist for an accurate diagnosis and proper treatment, experts said."Ideally, any joint pain or swelling that lasts more than four to six weeks after the acute illness should prompt a referral to a rheumatologist. Rheumatologists are well-trained in assessing disease activity and they can offer many treatment options for patients with chronic chikungunya arthritis," said Dr Sanjay Patil, the secretary of the Hospital Board of India (HBI), Indian Medical Association (IMA), Maharashtra chapter.Jehangir Hospital's rheumatologist Dr Nachiket Kulkarni said, "We aim to intervene early to prevent long-term damage. Chronic chikungunya arthritis has a different immunological signature. Early identification can help us manage it more effectively."Some literature defines chronic chikungunya disease or arthritis as symptoms lasting beyond three months. "But in practice, we tend to consider it chronic if symptoms persist beyond six weeks. Rheumatological intervention should be considered around this time to prevent further damage," said Mumbai's rheumatologist Dr Nilesh Nolkha.Attached with the Nair Hospital, Dr Nolakha underlined a steep spike in chronic cases. "Almost 20-30% of affected patients are entering a chronic phase in Mumbai too," he added.As the acute phase of chikungunya is now more severe than it used to be, people are experiencing residual effects, such as neurological and liver issues. "Early diagnosis and intervention are essential to prevent joint damage and manage other potential complications," said Sancheti Hospital's rheumatologist Dr Nilesh Patil.
Stay updated with the latest news on Times of India. Don't miss daily games like Crossword, Sudoku, and Mini Crossword.