title: Pharmacologic management of pain in patients with Chikungunya: a guideline.
abstract: From the arrival of Chikungunya virus in the Americas in 2013 until March 2016, approximately two million cases of the disease have been reported. In Brazil, the virus was identified in 2014 and thousands of people have been affected. The disease has high attack rates, infecting 50% of a population within a few months. Approximately 50% of infected people develop chronic symptoms lasting for months or years. Joint involvement is the main clinical manifestation of Chikungunya. It is characterized by swelling and intense pain that is poorly responsive to analgesics, both in the acute and chronic phase of the disease. This significantly compromises quality of life and may have immeasurable psychosocial and economic repercussions, constituting therefore, a serious public health problem requiring a targeted approach. Physicians are often not familiar with how to approach the management of pain, frequently prescribing limited analgesics, such as dipyrone, in sub-therapeutic doses. In addition, there are few published studies or guidelines on the approach to the treatment of pain in patients with Chikungunya. Some groups of specialists from different fields have thus developed a protocol for the pharmacologic treatment of Chikungunya-associated acute and chronic joint pain; this will be presented in this review.
authors.affiliation: Departamento de Medicina Clínica, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
authors.forename: Carlos Alexandre Antunes de
authors.initials: CA
authors.lastname: Brito
authors.affiliation: Instituto de Tratamento da Dor, Real Hospital Português de Beneficência em Pernambuco, Recife, Pernambuco, Brazil.
authors.forename: Ana Karla Arraes von
authors.initials: AK
authors.lastname: Sohsten
authors.affiliation: Departamento de Medicina Clínica, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
authors.forename: Clezio Cordeiro de Sá
authors.initials: CC
authors.lastname: Leitão
authors.affiliation: Departamento de Pediatria, Universidade de Pernambuco, Recife, Pernambuco, Brazil.
authors.forename: Rita de Cássia Coelho Moraes de
authors.initials: RC
authors.lastname: Brito
authors.affiliation: Departamento de Reumatologia, Hospital Agamenom Magalhães, Recife, Pernambuco, Brazil.
authors.forename: Lilian David De Azevedo
authors.initials: LD
authors.lastname: Valadares
authors.affiliation: Departamento de Reumatologia, Hospital Getúlio Vargas, Recife, Pernambuco, Brazil.
authors.forename: Caroline Araújo Magnata da
authors.initials: CA
authors.lastname: Fonte
authors.affiliation: Departamento de Pediatria, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Pernambuco, Brazil.
authors.forename: Zelina Barbosa de
authors.initials: ZB
authors.lastname: Mesquita
authors.affiliation: Departamento de Infectologia, Universidade Federal de Mato Grosso do Sul, Campo grande, Mato Groso do Sul, Brazil.|Fundação Oswaldo Cruz, Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil.
authors.forename: Rivaldo Venâncio
authors.initials: RV
authors.lastname: Cunha
authors.affiliation: Departamento de Infectologia, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
authors.forename: Kleber
authors.initials: K
authors.lastname: Luz
authors.affiliation: Escola Superior de Ética e Bioética, Conselho Regional de Medicina de Pernambuco, Recife, Pernambuco, Brazil.
authors.forename: Helena Maria Carneiro
authors.initials: HM
authors.lastname: Leão
authors.affiliation: Curso de Graduação em Medicina, Universidade de Pernambuco, Recife, Pernambuco, Brazil.
authors.forename: Cecília Moraes de
authors.initials: CM
authors.lastname: Brito
authors.affiliation: Programa Nacional de Controle da Dengue, Ministério da Saúde, Brasília, Brazil.
authors.forename: Lívia Carla Vinhal
authors.initials: LC
authors.lastname: Frutuoso
mesh_terms: D000208:Acute Disease; D000700:Analgesics / Q000008:administration & dosage*; D018771:Arthralgia / Q000188:drug therapy* / Q000821:virology; D065632:Chikungunya Fever / Q000150:complications / Q000188:drug therapy*; D002908:Chronic Disease; D002985:Clinical Protocols; D006801:Humans; D010147:Pain Measurement; D017410:Practice Guidelines as Topic
chemical_list: D000700:Analgesics