Holidaying woman loses sight after contracting chikungunya in Grenada

By Pedro Forte
A sixty-nine (69) year old woman who was vacationing in Grenada lost her sight after contracting chikungunya disease. The vector-borne illness raged through the Caribbean last year and was declared a regional crisis by the Caribbean Public Health Agency (CARPHA) and already 250 cases of dengue have already been reported in Belize.
According to reports, the lady was bitten while in Grenada in July last year and developed flu-like symptoms, fever, rash and joint pain and was subsequently seen by her doctor who prescribed steroids for muscle weakness in her face.
Upon her return to the UK, she started to have problems with the vision in her right eye despite the fact that most of the unpleasant symptoms of chikungunya had cleared up.
Meanwhile Dr Abhijit Mohite, who treated the woman and co-authored the report on her case says that vision problems are likely being under-reported by those who have contracted chikungunya disease according to a report in Live Science.
“Her main symptom was that she felt she could not see the lower half of her vision in the right eye. This had come about only a day before she came to see us, and about three weeks after she returned from Grenada,” said Mohite.
Initially she had 20/20 vision and could see with normal acuity and appeared fine but her right optic nerve started to swell while doctors raced to diagnose and cure her illness. Within days her vision had deteriorated to 20/80 and a blood test confirmed chikungunya while ruling out any other cause including tumour, infection or inflammation on a nerve or optic pathway. According to Mohite, inflammation was a normal reaction to the onset of chikungunya and she was prescribed steroids after awaiting results for six days.
“One of the main risks of high-dose steroids is that they can exacerbate an infection, if she had another infection somewhere else in the body. This is why we had to await all the other tests before we could start steroids, and this took six days,” he said.
Half of the patient’s nerve cells had died during this wait and the steroids were able to decrease the inflammation but irreparable damage was already done. The vision loss is permanent.
“The steroids, unfortunately, were not started soon enough in our patient,” Mohite said. The vision loss was permanent.
This is the first known case of a woman in the United Kingdom developing this problem. However, other doctors around the world have noted eye problems in those infected with the disease.
“It’s underreported because people don’t even do the studies to figure out if it’s chikungunya or another infection. My personal opinion is that it’s really not an uncommon event to get some level of eye involvement,” said Dr Aileen Marty, director of the Florida International University Health Travel Medicine Program and Vaccine Clinic. Dr Marty was not part of the report.
Chikungunya is transmitted by two species of mosquito — Aedes aegypti and Aedes albopictus — mosquitoes that are recognizable by their black and white legs.
The report was published online July 28 in the journal BMJ Case Reports.

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