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8/19/2019 Bahan Kuliah Pakar 3

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CHIKUNGUNYACHIKUNGUNYA

Sigit WidyatmokoSigit Widyatmoko

Fakultas KedokteranFakultas KedokteranUniversitas MuhammadiyahUniversitas Muhammadiyah

SurakartaSurakarta


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IntrodutionIntrodutionChikungunya virus is o! A!rian originChikungunya virus is o! A!rian origin

and is maintained among non humanand is maintained among non human

"rimates on that ontinent #y Aedes"rimates on that ontinent #y Aedes

mos$uitoes o! the su#genusmos$uitoes o! the su#genus

Stegomyia%Stegomyia%&eadily transmitted among human in&eadily transmitted among human in

ur#an areas #y A aegy"tiur#an areas #y A aegy"ti

Also #een introdued into Asia 'here itAlso #een introdued into Asia 'here it"oses a "rominent health "ro#lem"oses a "rominent health "ro#lem

(ndemi in rural A!ria and intermittent(ndemi in rural A!ria and intermittent

e"idemis in ur#an o! A!ria and Asiae"idemis in ur#an o! A!ria and Asia


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Common in H)A*+,- "atientsCommon in H)A*+,- "atients

An investigational live attenuatedAn investigational live attenuatedvaine has #een develo"ed #utvaine has #een develo"ed #ut

re$uires !urther testingre$uires !urther testing


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Signs and Sym"tomsSigns and Sym"toms

Full #lo'n disease is most ommonFull #lo'n disease is most ommonamong adults. in 'hom the linialamong adults. in 'hom the linial"iture may #e dramati"iture may #e dramati

/he a#ru"t onset !olo's an inu#ation /he a#ru"t onset !olo's an inu#ation

"eriod o! , to 0 days"eriod o! , to 0 daysFever and severe arthralgia areFever and severe arthralgia are

aom"anied #y hills andaom"anied #y hills and

onstitutional sym"toms suh asonstitutional sym"toms suh asheadahe. "hoto"ho#ia. on1untivalheadahe. "hoto"ho#ia. on1untivalin1etion. anore2ia. nausea. andin1etion. anore2ia. nausea. anda#dominal "ain%a#dominal "ain%


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Migratory "olyarthritis mainly a3etsMigratory "olyarthritis mainly a3ets

the small 1oints o! the hands. 'rists.the small 1oints o! the hands. 'rists.ankles. and !eet. 'ith lesserankles. and !eet. 'ith lesser

involvement o! the larger 1ointsinvolvement o! the larger 1oints

&ash may a""ear at the outset or&ash may a""ear at the outset or

several days into the illnessseveral days into the illness

/he rash is most intense on the trunk /he rash is most intense on the trunk

and lim#sand lim#s

4etehiae are oasionally seen and4etehiae are oasionally seen and

e"ista2is is not unommone"ista2is is not unommon


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/he virus is not a regular ause o! the /he virus is not a regular ause o! theHF syndrome. even in hildrenHF syndrome. even in hildren

A !e' "atients develo" leuko"eniaA !e' "atients develo" leuko"enia(levated levels o! AS/ 5as"artate(levated levels o! AS/ 5as"artate

amino trans!erase6 and C&4 5C*amino trans!erase6 and C&4 5C*

reative "rotein6 have #een desri#ed.reative "rotein6 have #een desri#ed.as have mildly dereased "lateletas have mildly dereased "lateletountsounts

&eovery may re$uire 'eeks%&eovery may re$uire 'eeks%Some older "atients ontinue to su3erSome older "atients ontinue to su3er

!rom sti3ness. 1oint "aint. and!rom sti3ness. 1oint "aint. andreurrent e3usion !or several yearsreurrent e3usion !or several years


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A related virus. 7nyong*nyong. ausedA related virus. 7nyong*nyong. auseda ma1or e"idemi o! arthritis and rasha ma1or e"idemi o! arthritis and rashinvolving at least , million "eo"le as itinvolving at least , million "eo"le as itmoved aross eastern and entralmoved aross eastern and entral

A!ria in the 89:;s%A!ria in the 89:;s%A!ter its mysterious emergene theA!ter its mysterious emergene the

virus virtually disa""eared. leaving onlyvirus virtually disa""eared. leaving onlyoasional evidene o! its "ersisteneoasional evidene o! its "ersistenein kenya until a transient resurgene o!in kenya until a transient resurgene o!e"idemi ativity in 899-e"idemi ativity in 899-


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