Contracting Chikungunya: Our Rash Decision

Chikungunya, how do I even begin to describe you?  I’m speechless as I consider this strange, arthropod-borne, African illness that had me down for 10 days.  Have you ever even heard of it before?  I hadn’t until this past January, when I saw a poster about it in the hospital here in Dominica. Locally, people are calling it “The Chik”, and every other person you meet has had it. In fact, it’s recently been declared an epidemic in the Caribbean. Personally, I think The Chik is a sneaky, little bastardo, and it’s worth it to go geeky for a few minutes and check out what the medical literature is saying. (Note: no plagiarism here! I’ve gotten this info by looking up “Chikungunya Fever” on UpToDate.)

Chikungunya was first identified in the 1950’s during an outbreak in Tanzania, and it’s here that The Chik got it’s strange name. It’s from a local language of Tanzania, and it denotes “stooped walk” or “that which bends up”. (I’ll soon describe how well Nic and I fit those descriptions.) During the 50’s there were many outbreaks throughout Africa, and it spread to Southeast Asia.  Oddly, at some point The Chik decided to take a break, and it was rarely seen for about 30 years. Then, it inexplicably made a huge comeback in 2004. Just compare it to William Shatner’s career (whose comeback I find totally awesome.)

In recent years it’s been causing outbreaks all over Asia.  It was thought to be a tropical disease until an outbreak occurred in northeast Italy in 2007. (No one is safe!) This stealthy virus made its way to our neck of the woods very recently; the FIRST time “local transmission” of Chikungunya was ever reported anywhere in the Americas was only this past December in St. Martin.  Now, just 5 months later, it’s all over the Caribbean.

Where, oh where, will The Chik strike next? Well, that’s up to two components: an outbreak can only occur in an area where one of two particular mosquitos dwell, and it must be during the time of year that those mosquitos are thriving (summer). The Aedes aegypti mosquito is the most common culprit. This nasty blood-sucker also carries dengue fever and yellow fever.  The other mosquito doesn’t transmit disease as often, but it’s got a cool name, so it’s worth mentioning. Aedes albopictus is also known as the Asian tiger mosquito.  This fella has been found to carry diseases with names as awesome as it’s own: Japanese encephalitis and eastern equine encephalitis virus. Both mosquitos have white spots and are a bit smaller than the mosquitos we Minnesotans are used to seeing. There is a standing order to kill on sight. Pictures included for identification. (Floridians, this info might be most helpful to you . . . )

Aedes aegypti. Take a close look–this one is in the process of feeding. Disgusting.

Asian Tiger Mosquito

Okay, time to conclude the science lesson and take a look at what this awful illness is like. For me, it started on a Friday night; I found myself really irritable. Yes, yes, irritability isn’t really out of the norm for my “passionate” self, but this was more like skin-crawling irritability. Sitting, standing, laying on the couch–every position was uncomfortable. Plus, as a med student, the weekends are all about getting extra work done, but I simply couldn’t focus and was just too tired to study. By Sunday afternoon I was sure I must be fighting something. I was expecting a few sniffles and sneezes to come my way . . . but, oh, The Chik far exceeded these expectations.

When I awoke Monday morning, I had 2 really random pains: my left thumb joint and my right jaw joint, or the TMJ. No big deal. I suspected it might be Chikungunya, but I wasn’t panicking, because I had no idea how bad I’d be feeling by the next day. When I got home from work that afternoon Nic greeted me in his nervous, hypochondriac voice, “Honey, I’ve got a rash all over my stomach.”  Yes, he most certainly did–a blotchy red rash covered every inch of his stomach, chest, and back.

When I took a look at my own skin, I found little pink bumps all over my thighs and stomach. I’ve never had such a widespread rash, and it completely creeped me out. There was no turning back, The Chik had taken hold.

Tuesday morning I had to call in sick.

Tuesday afternoon we had to ask our amazing neighbor to take care of our kids for the evening.

Tuesday night was a sleepless night that consisted of switching positions every two minutes because the current position was painful, shivering and covering up with a blanket, throwing off the blanket and sitting in front of a fan because you’re sweating, and thinking, “My God, My God, I’ve never felt this way before.”

By Wednesday morning we looked like this:

Those red eyes are no joke, folks. I hadn’t just woken up and I wasn’t crying when I took this picture; that’s how they looked for 2 days.

Click HERE to see how we spent the next 3 days.

So, how did this illness completely lay us out for 4? The main symptoms of Chikungunya are fever and “polyarthralgia”, which means multiple joint pains. The joints that are most commonly affected are the ankles, wrists, and all the many joints in the hand. Our hands were stiff, swollen, and so weak and painful that we couldn’t open or grip things. Nic couldn’t get the microwave door open and he struggled to pop pills through their foil backing. Also, his feet hurt more than mine, and he described it as every muscle and ligament being sprained. And, unfortunately, the virus isn’t all that partial to just the wrists and ankles. Our backs and necks were stiff and sore; my neck was so painful that I couldn’t lean my head to the side in either direction. Oh yes, and all the muscles of our arms and legs ached as well. When we’d force ourselves off the couch to get a drink or use the restroom, we’d limp our way there, like so:

But, alas, that still wasn’t the extent of what this insane virus did to us! If you’ve ever had a previous joint injury, it gets a hot, firey anger from the virus and starts to hurt again. I’m one of the many people who is bothered by the oh-so-annoying TMJ (jaw joint). The right side of my jaw was so painful that it hurt to even eat spaghetti. And you know that motion where you rub your lips together to blend in chapstick or lipstick? Yeah, I couldn’t complete that minor feat. Chikungunya can also cause mouth sores, which both of us had. Eating was not it’s usual enjoyable experience during this illness. And let’s not forget the rash–we also had that freaky rash. Still, the worst part of the illness for both of us was that we FELT drastically and horribly ill. We were drained of all energy, and there’s no better way to say it than we felt completely awful. I didn’t even have the stamina to read. When we weren’t sleeping, there was no other way to pass the hours than to keep watching things on Netflix. Those long, uncomfortable days led us to watch things like this ridiculous movie. Colossal waste of time, but Johnny Depp does have a surprisingly nice voice in this extremely quirky musical.

By Friday we were beginning to recover and the rash was clearing up. Saturday brought continued improvement. When we awoke on Sunday morning, however, we both had a new and different rash that was the most maddeningly, intensely itchy thing we have ever experienced. It was getting ridiculous–was this stupid virus ever going to leave us?!

And, well, I think the jury is still out on that. A week later, my appetite isn’t back to normal, our hands still ache, and several of our lymph nodes are still swollen. So, if you’ve got a Caribbean excursion planned anytime soon, you had better pack some mosquito repellent . . . and mosquito nets . . . and citronella candles . . . and those little fans that emit repellent . . . and a gas mask . . . and a biohazard suit . . . and never go outside. Other than that, enjoy your vacation.