Melissa Szydlowski teaches at the Las Palmas Christian School in San Pedro de Macoris, Dominican Republic. Over three weeks ago she became ill with chikungunya. She answered a number of questions by e-mail for the Examiner on June 29 about her illness and recovery.
Szydlowski has not recovered. As a number of studies have noted, chikungunya pain and other symptoms can recur after the patients recovers from the illness. In her case, she says that she had about ten days of relief before pain returned to her feet, knees and wrists. Her hands and feet have become swollen.
The pain in her hands and fingers is worse now than during the illness. She has been using 800 mg. doses of ibuprofen to relieve her pain and that has helped somewhat. Ms. Szydlowski states that she has two friends who have also experienced the “regression.”
Her illness began about June 14. She woke that morning with severe pain on the bottom of her feet. It was so bad “that I almost had to crawl to the bathroom.” By the afternoon she was exhausted and had lost all appetite. By evening she was running a fever.
Szydlowski went to work that Monday, in pain and exhausted. She stayed home on Tuesday but forced herself to go in to school on Wednesday since it was the last day of classes. She said that “the exhaustion was the worst part.”
For the first three days of her chikungunya infection, she experienced “pain in my feet and aching in various body parts (hands, knees, neck), exhaustion, fever (on and off), and lack of appetite.”
I would compare the aches in my ankles and wrists to that of having sprained them— painful to move, unable to do some basic tasks (opening a sealed bottle of Coke is sometimes painful). Because it was so much pain, I felt like it was going to be impossible to recover quickly. You know, when you sprain something, it takes weeks. But the severe pain only lasted a few days.
After the pain began to subside, the itching began. Szydlowski did not notice an obvious rash, as many other patients have reported, but the itching was intense. That lasted for about three days as the pain subsided. She got her appetite back gradually. The illness lasted about ten days and then she began to feel 100 percent again.
In a June 28 tweet, Szydlowski posted to her Twitter account that her symptoms had returned. With the end of classes at the Las Palmas Christian School, she is returning to the United States for the summer. The Institut Pasteur describes the long-term effects of chikungunya this way:
The clinical symptoms of chikungunya usually disappear relatively quickly – patients tend to recover from the fever and rashes associated with the disease within a few days, but joint problems can persist for several weeks. Infection by the chikungunya virus does not seem to have been the direct cause of the small number of fatalities recorded during epidemics.
Joint pain can persist in subacute or chronic form for several months or even years, particularly in older patients. In a retrospective South African study, 10% of patients were still affected 3 to 5 years after acute infection by the chikungunya virus.
Ms. Szydlowski is a native of the Detroit, MI area. She is a 1999 graduate of Maranatha Baptist University in Watertown, WI. Prior to teaching in the Dominican Republic, she taught fourth grade at a Christian school in Maryland. She has just completed her first year of teaching in San Pedro de Macoris. The school is sponsored by DR Vision, a project of Daystar Baptist Missions.