Oral Manifestations of Chikungunya - A Study

Gururaj N.*, Sivapathasundharam B.**, Raviprakash***
Periodicity:July - September'2013

Abstract

Chikungunya is one of the arboviral infections that were first described in Tanzania and Uganda in 1953. It belongs to the family Togaviridae and is transmitted by the bite of mosquitoes, mainly the Aedes aegypti and other Aedes mosquitoes. The clinical features of Chikungunya (CHK) include fever, headache, nausea, vomiting, myalgia, rash, and arthralgias. Hemorrhagic manifestations, though not common, occur in a few cases and consist of bleeding gums, epistaxis, haematemesis, and, very rarely, blood in the stool. The diagnosis is made with evocative symptoms in a patient living in or returning from an area where there is a known outbreak of Chikungunya fever, and laboratory confirmation is made by PCR or serology. As bleeding manifestations like gingival bleeding are common in viral hemorrhagic fevers, our aim in this study is to observe bleeding and other oral manifestations in patients suffering from Chikungunya. 125 patients complaining of fever and joint pain were screened, and 54 patients among them were diagnosed as Chikungunya patients and selected for our study based on the case definition given by the National Institute of Communicable Diseases, New Delhi (NICD), during the outbreak in Karnataka and Tamil Nadu. Gingival bleeding was recorded in 32 patients with preexisting gingivitis and periodontitis. In 12 patients, oozing from the socket was recorded three days after extraction from the extracted site, and palatal erythema was observed in 10 patients during the acute phase of illness. Lab investigations were carried out for all patients, and 20 of them showed increased bleeding time than normal. It was concluded that patients suffering from Chikungunya showed a tendency of bleeding in the oral cavity and should be differentiated from other viral hemorrhagic fevers and systemic diseases. Dental surgeons should be cautious in these patients before they proceed with any minor oral surgical procedure.

Keywords

Chikungunya Fever, Oral Health, Bleeding Gums , Chikungunya Patients, Oral Complications, Chikungunya Virus, Gingivitis, Periodontitis.

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