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ChikV: not just a nasty three-day fever

Tuesday, November 18, 2014

So what happened next? It’s 40 days since the first symptoms of ChikV appeared and I’ve been OK for the last two days. OK? OK, but just. Not good but OK. It’s been a trial, a hard six weeks.  

Here are some excerpts from my diary.

Day 7: Woke quite well. Stiff but not a sick stiff, more of a post-exercise stiffness, high waist, back-of-thighs-aching sort of thing. Head clear, very slight dizziness, rash faded 90 per cent with some itching. Will office today…Not bad, took two ibuprofen, saw a couple of kids quite comfortably then came home and immediately collapsed on the bed.  

Rash on and off itching a lot tonight. Generalised stiffness when getting up.

Day 9: Woke up achy all over and itching quite a bit. Not a bad day but very tired after office, came home and slept couple hours and have little energy. Rash on and off but quite itchy. Head congested, occasionally light-headed, dizzy and nauseous. 

Day 12: Good night's sleep but still urinating a lot at night. Good energy level for once although head still feels congested and lightish. Stretched a couple times during morning walk around house with Madame, my pothong Boxer-Doberman, and actually sweated a bit and felt good. Itch still there. Better day. 

Saw kiddies fairly well. Came home and did not have to sleep. Have not taken ibuprofen for past 48 hours and this morning took only two paracetamol before office. 

Itching still in evening. Pigmented rash persists but not itchy.

14th day: Sunday. Best day so far! Woke at 4.45, usual stiffness and nasal stuffiness, bit headachy, walked savannah and felt pretty good. Went out to see baby at 10 and did return achy and not feeling well, so slept an hour or so and woke up the best I have felt so far. Did take two paracetamol at 9 am but it is now 3.16 and feeling good, no headache, loose, rested. Itchy rash gone, pigmented remains.

21st day: Entire week have been having on-and-off feelings of immense weariness, lower-back ache, lightheadiness, nasal congestion and a desire to do nothing but lie down.Stomach rumbling, bit tender. Times when I feel really good and think, Aha! Over! Lasts minutes, occasionally hours, then relapses. Movement seems to help. 

 Still sleeping one to two hours per afternoon, after office and keep waking up with mild headache.  

But the worst thing is the apathy! No enthusiasm for anything.

4th Tuesday, four weeks after got chikungunya, woke this morning unable to straighten up because of pain in right lower back and right heel. Movement and stretching has helped the back pain but the heel still hurts nine hours later. Stomach is also a bit queasy depending on the food I eat, eg bread, dairy or curry seem to make me feel nauseated. 

 However for the first time since that Tuesday four weeks ago I feel quite energetic and ready to work and came home at 3pm and do not feel to sleep. Definitely improved compared to a week ago. Or even 48 hours.

In 1983, Dr SW Brighton published a three-year follow-up of just over 100 documented cases of chikungunya in the South African Medical Journal. His findings were alarming. About 90 of the cases had recovered completely. Of those 90, however, some 35 had recovered within “a matter of weeks.” Another 40 or so “stated they had recovered slowly over a period of up to a year.” The remainder said the recovery period was two to three years!

These are the ones who “recovered”? More than half of the patients took at least a year for body pains to resolve! 

 Age seemed to be a factor in recovery. Most of those who recovered quickly were under the age of 17.  

What about the others who had not recovered? Four people continued having “occasional” stiffness of the joints of the wrist and knees. The youngest was 45 and the oldest 60. The stiffness appeared to be exacerbated by exercise. Another three had “constant” stiffness in similar joints, especially in the morning for the first hour or so. Their ages were 55, 60 and 65 years.

The last six people had persistent joint “pain.” They were living with pain three years after getting ChikV. All except one 16-year-old girl were over 50.

How are they now? I e-mailed the hospital in South Africa to see if the good doctor was still there but have not received a reply.

What seems to be clear is that ChikV is not a mere acute disease, a nasty three-day fever with muscle and joint aches and an itchy rash. It has the potential to become a chronic illness. The figures above suggest that around 60 per cent of people who get ChikV will continue to suffer from joint pains for at least several months and about ten per cent are in pain for years. 

If these figures stand up, and there are around 1,000,000 cases in the Caribbean today, how will that impact on our economies?

Nov 11: First day since October 7 that I have got up without pain and am walking around not bent over, not even a bit, just some residual very minor and healthy soreness in lower back from exercise (jog and walk Savannah 48 hours ago). 

Don't trust this ChikV though, let's see what tomorrow brings.

Nov 13: Third day that I am almost back to myself, energy good, minor pains in lower back and heels from time to time, ie waking up in morning, getting up from desk after long time sitting, getting out of car after sitting in traffic jam. 

Enthusiasm for life is back. 

 Is it over?


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