What is the Sindbis fever?
Sindbis fever is a viral disease that causes flu-like symptoms. It eventually leads to joint inflammation and often to skin rashes and occasionally causes encephalitis (encephalitis).
In many cases, however, the Sindbis fever is inconspicuous. The virus could be detected outside of Africa in Europe (especially in Scandinavia), Asia and Australia both in humans and in mosquitoes. In Germany, a case of illness was first confirmed in 2009.
Sindbis fever is also referred to as "epidemic polyarthritis" because of joint inflammation. The Sindbis virus exists in six different forms, although they are quite similar. Subspecies of the Sindbis fever are called Ockelbo, Karelian and Pogosta fever. Ockelbo fever was first detected in Sweden in 1982 and also occurs in Finland and western Russia.
The Sindbis fever is caused by the virus of the same name, which lives mainly in host birds. The pathogens are transmitted by nocturnal mosquitoes of the species-rich genus Culex, of which 16 species are native to Central Europe and to which the widespread "common mosquito" (Culex pipiens) belongs. In contrast, an infection between humans is not possible.
Birds are the main hosts of the Sindbis virus. To Europe, the virus seems to have been introduced not only by infected travelers, but especially by migratory birds.
The Sindbis virus, which was discovered in the northern Egyptian village of Sindbis in 1952, is one of the 60 to 70 nanometer so-called alphaviruses, which are enveloped RNA viruses that multiply in the cytoplasm of a cell and, because of their transmission by mosquitoes, as well Arboviruses are called.
Symptoms, complaints & signs
The Sindbis fever manifests itself first through fever. Three to eleven days after infection, there is an increasing malaise, often accompanied by headache and joint pain and severe fatigue. In general, Sindbis fever is associated with severe fatigue. Affected persons are mentally and physically less efficient and require regular breaks.
Many patients also complain of eye pain, due to conjunctivitis, which makes the eyes more sensitive to light in the process. The joint pain is weak at the beginning but becomes stronger as the disease progresses. They occur mainly on the wrists, fingers and ankles.
As the viral disease progresses, a rash sets in. The lesions first appear on the thighs and then spread to the soles of the feet and palms. Rarely, the rash and oral mucosa are affected by the rash. The actual fever runs in spurts.
So the symptoms apparently go back after one week, only to reappear after three to five days. In the absence or improper treatment, the Sindbis fever can develop into a chronic disease in which joint pain and skin changes persist permanently.
Diagnosis & History
The incubation period (the period between infection and the onset of the first disease symptoms) is between three and eleven days for Sindbis fever.
First, Sindbis fever causes headaches. Later it comes to joint complaints, of which especially the finger, wrists and ankles are affected. The patients feel cut off and tired.
Finally, redness and blisters on the skin. In the first days of illness, these skin changes on the trunk and thighs and at a later stage of the disease also on palms and soles.
The fever develops in two batches (biphasic): After a first fever burst, a temperature decline can be detected before it comes to a further increase in temperature.
Some Sindbis diseases cause nausea and vomiting. More frequent are reddening of the throat, conjunctivitis (conjunctivitis) and photosensitivity (photophobia). However, chronic disease progression was observed, leading to years of joint pain. With a blood test antigens formed against the Sindbis virus can be detected.
In the course of the disease joint problems in the fingers, wrists and ankles may occur. Patients with arthritis or rheumatic complaints may experience aches and pains, and other serious complications. In severe cases, the joint symptoms develop into a chronic disease that causes discomfort for years after the disappearance of Sindbis fever.
Furthermore, it can come to a strong fever. In some cases, the body temperature rises to 41 ° C or higher and the sufferer suffers serious circulatory problems. The concomitant gastrointestinal symptoms may cause, among other things, deficiency symptoms and dehydration. Both, if left untreated, can cause serious health complications and lead to death in children, the elderly and the sick.
Other possible consequences of the Sindbis fever are conjunctivitis, temporary photosensitivity and protracted rashes. Treatment involves the risks of administered analgesics. Preparations such as ibuprofen and diclofenac can cause unwanted side effects such as stomach bleeding or body aches.
Severe gastrointestinal complaints, impaired blood formation and skin irritation can also not be ruled out. If the condition is not cured properly, chronic symptoms may appear. Occasionally there are long-lasting arthritis, pneumonia and recurring pain.
When should you go to the doctor?
The Sindbis fever should always be examined by a doctor. In the worst case, it can lead to the death of the affected person untreated, so that an early therapy always has a positive effect on the further course of the disease. Therefore, even at the first symptoms and symptoms of this disease, a doctor should be consulted. A doctor should be consulted if the person is suffering from a high fever. In addition to the fever, there is also severe pain in the bones or in the joints and most sufferers are affected by severe tiredness.
Especially in African areas, these symptoms may indicate Sindbis fever and should be examined by a doctor. Furthermore, it comes through the disease also to the inflammation of the conjunctiva, which must also be treated by a physician. Most patients show a severe rash on the skin, which also indicates Sindbis fever.
When Sindbis fever primarily a hospital or a GP can be visited. In general, the disease can be treated relatively well, with a complete treatment does not lead to a reduced life expectancy of the person concerned.
Treatment & Therapy
The human immune system is usually good at detecting Sindbis virus infection, so in many cases special therapy is not required. Usually the symptoms of disease develop after a few weeks without permanent damage by themselves.
With a treatment of patients suffering from Sindbis fever a relief of the complaints is desired. In particular, analgesics are administered which have an antipyretic effect. Best suited for this are non-steroidal (no cortisone containing) preparations such as ibuprofen and diclofenac. The anti-inflammatory anti-inflammatory drug ibuprofen, however, can cause side effects such as gastric bleeding, as the preparation inhibits the synthesis of, among other things responsible for the blood coagulation prostaglandins.
The active ingredient Diclofenac is an analgesic (analgesic) used in moderate pain and inflammation. As side effects, however, gastrointestinal complaints, impaired blood formation and sensitivities to sunlight may occur. A causal therapy, directed against the Sindbis virus, does not yet exist.
Since a vaccine against Sindbis fever is not available, prevention of the disease can only be done by a consistent mosquito repellent. These include a sufficiently dense and bright clothing, close mesh mosquito nets and insect repellent. Especially the ankles as well as the hands and neck-neck-facial area should be rubbed with mosquito repellent preparations.
In areas where the disease is more prevalent, the elimination of possible mosquito breeding sites near houses is an important prophylactic measure for the prevention of Sindbis fever.
First and foremost, Sindbis fever should be diagnosed and treated early to avoid complications or other symptoms. The measures and the possibilities of a direct follow-up are clearly limited in Sindbis fever, so that a doctor should be contacted already at the first symptoms and signs of this disease.
There can be no self-healing, so always a treatment by a doctor is necessary. The person affected should be particularly well protected against mosquitoes and ideally avoid the risky area and not stay in this. Similarly, long clothing should be worn, with sprays and creams against mosquitoes are very helpful.
As a rule, the Sindbis fever can be cured relatively well by taking medication. The person concerned should first of all pay attention to a correct dosage and also to a regular intake of the medication in order to permanently alleviate the symptoms. Even after successful treatment, regular checks and examinations must be carried out. As a rule, Sindbis fever does not reduce the life expectancy of a person if it is diagnosed and treated in good time.
You can do that yourself
When staying in an African area, care should be taken to ensure adequate protection against infectious diseases or insects before starting the journey. If possible, insect repellents or home remedies should be used to protect against bites or stings. Wearing protective garments is recommended. Wide and long clothing provides the body with sufficient security.
Since the Sindbis fever can lead to numerous complications or a life-threatening condition in a difficult disease course, a doctor should be consulted already at the first health impairment after an insect bite. Medication is needed to relieve the symptoms. In particular, people with pre-existing conditions or a weakened immune system need medical help as quickly as possible.
To reduce the fever, cold wraps and envelopes can help. In addition, care must be taken that a sufficient amount of liquid is consumed. The body must be protected from dehydration. The organism should also be given sufficient vitamins and nutrients, although there is an inability to eat. Only then can the immune system be further supported in the fight against the pathogens. Sleep hygiene is also to be optimized. The oxygen supply is important and the bed linen should be regularly ventilated and changed.