NCR is in the grip of Chikungunya New Delhi September 15, 2016: Chikungunya fever is a non-fatal debilitating viral illness, spreads by the bite of infected female Aedes aegypti / albipecto mosquito. Symptoms develop 3-7 days bite by an infected mosquito. Classical triad is skin rash, joint pains and high fever. Most patients will recover within 1-2 week. Cold compression may easy pain. “There is no vaccine to prevent or drugs to treat. One must take plenty of rest and drink fluids to prevent dehydration. Aspirin or NSAIDS should not be taken until dengue is ruled out. Both ailments may present with similar symptoms”, said Padma Shri Awardee Dr KK Aggarwal – President Elect IMA and President Heart Care Foundation of India. In 20%, joint involvement may persist for weeks and in 10% cases; they tend to persist for months. In 10 %, swelling disappears; pain subsides, but will reappear with every other febrile illness for many months. Each time the same joints get swollen, with mild effusion and symptoms persist for a week or two after subsidence of the fever. 92% have symmetric polyarthralgias, 67% arthritis, 75% skin rash. 89% have very good clinical response to NSAIDS. 27% require low-dose steroids & 5% methotrexate therapy. Non-weight bearing exercises may be suggested (slowly touching the occiput (back of the head) with the palm, slow ankle exercises, pulley assisted exercises, milder forms of yoga). Standard treatment is Paracetamol one gram up to four times a day for up to four weeks. At four weeks if pain persists four weeks course of oral steroids can be given. At eight weeks if pain persist specific disease modifying drugs like hydroxychloroquibe may need to be added. Chikungunya can unmask psoriasis arthritis of rheumatoid gathia arthritis in some cases. It can cause in some cases neuro and ocular manifestations (encephalitis, mono neuritis, optic neuritis).