What are the other Names for this Condition? (Also known as/Synonyms)

• Togaviridae Infection
• Togavirus Infections

What is Togaviridae Disease? (Definition/Background Information)

• Togaviridae Disease is a rare infection caused by viruses belonging to the family Togaviridae
• There are two major genera of Togaviridae, namely Alphaviruses and Rubaviruses
  • Alphaviruses may either be the encephalitic (such as Eastern equine encephalitis virus, Western equine encephalitis virus, and Everglades virus) or arthritic type (such as Chikungunya virus, Ross river virus, and Sindbis virus). These viruses are spread by bites of infected mosquitos
  • Rubiviruses (such as Rubella virus)
• Togaviridae Disease may leads to signs and symptoms such as headache, fever, chills, muscle pain, arthritis, and weakness in affected individuals
• Generally, affected individuals recover within 2 weeks. However, some Alphaviruses, such as Eastern Equine encephalitis virus, can lead to severe sickness and death

Who gets Togaviridae Disease? (Age and Sex Distribution)

• Togaviridae Disease is a rare viral disease, which affects individuals worldwide
• Both males and females may be affected
• Infection by the alphavirus types of Togavirus is transmitted by infected mosquitos

What are the Risk Factors for Togaviridae Disease? (Predisposing Factors)

The following are some risk factors for developing Togaviridae Disease:

• Indulging in outdoor activities in areas infested with mosquitos
• Not taking precautions against mosquito bites
• Not having been immunized against Rubella virus infection

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Togaviridae Disease? (Etiology)

Togaviridae Disease is caused by viruses belonging to the Togaviridae family

• There are two major genera of Togaviridae, namely Alphaviruses and Rubaviruses
  • Alphaviruses may either be the encephalitic (such as Eastern equine encephalitis virus, Western equine encephalitis virus, and Everglades virus) or arthritic type (such as Chikungunya virus, Ross river virus, and Sindbis virus). These viruses are spread by bites of infected mosquitos
  • Rubiviruses (such as Rubella virus)
• Infected mosquitos transmit the viruses belonging to the Alphavirus genus. Additionally, kangaroos and wild rodents may carry and transmit this type of virus as well
• In contrast, Rubivirus infection is airborne and can be contracted when an individual, who is not immunized against the virus, comes in direct contact with infected respiratory secretions (such as mucus or droplets from a sneeze)
• A pregnant woman infected with this virus can transmit the virus to her unborn child (trans-placental infection)

What are the Signs and Symptoms of Togaviridae Disease?

The signs and symptoms of Togaviridae Disease depend on the specific genus and virus causing the infection.

The signs and symptoms of encephalitic Alphavirus infection may include:

• High fever
• Headache
• Stiff neck
• Muscle pain
• Weakness

The signs and symptoms of arthritic Alphavirus infection may include:

• Rashes
• Fever
• Chills
• Pain in joints, which can be severe

The signs and symptoms of Rubivirus infection may include:

• Mild fever
• Headache
• Stuffy or running nose
• Inflamed red eyes
• Enlarged and painful lymph nodes:
  • At the base of the skull
  • At the back of the neck
  • Behind the ears
• Pink-colored rashes that appear in the face/neck and then spread throughout the body, lasting about 3 days
• Aching joints in young adult women

How is Togaviridae Disease Diagnosed?

Togaviridae Disease is diagnosed on the basis of the following information:

• Complete physical examination
• Thorough medical history evaluation
• Assessment of signs and symptoms
• Laboratory tests
• Imaging studies
• Biopsy studies, if necessary

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Togaviridae Disease?

The complications of Togaviridae Disease may include:

• Persistence of signs and symptoms for a prolonged time
• Encephalitis
• Sequelae from Eastern equine encephalitis virus (Alphavirus) infection
  • Impaired intellect
  • Seizures
  • Paralysis
• Stooped posture due to severe pain in arthritic Alphavirus infection
• Miscarriage or congenital defects, if pregnant women are infected with Rubivirus

Complications may occur with or without treatment, and in some cases, due to treatment also.

How is Togaviridae Disease Treated?

There is no cure for Togaviridae Disease, and treatment is usually given to manage the signs and symptoms and any complication that develops. It may be necessary to take the following measures:

• Drink lots of fluid 
• Rest and allow the body to recover
• Use medication, such as acetaminophen and ibuprofen, to reduce fever and pain

How can Togaviridae Disease be Prevented?

Togaviridae Disease due to Alphaviruses may be prevented by:

• Sleeping under mosquito nets (insecticide-treated mosquito nets); it is highly-recommended in endemic areas
• Use of mosquito repellent creams: It is also advisable to cover one’s skin by wearing clothes, such as full-length pants, full-sleeved shirts, etc.
• Maintaining good sanitary conditions, to prevent mosquitoes from breeding. When possible, eliminate all potential mosquito habitats that contain standing water, where mosquitoes breed and lay their eggs, such as water contained in temporary pools, old tires, discarded vessels, birdbaths, pots, rainwater puddles, etc.
• Using sprays containing permethrin can be used on clothes; sprays containing DEET can be used on skin
• Getting educated – Individuals who travel from a non-endemic region to endemic region(s) have to ensure that they are aware of the risk factors and basic preventive methods

Togaviridae Disease due to Rubiviruses may be prevented by:

• Getting vaccinated
• Avoiding close contact with infected individuals, especially contact with their respiratory secretions

What is the Prognosis of Togaviridae Disease? (Outcomes/Resolutions)

• The prognosis of Togaviridae Disease is dependent upon the severity of the signs and symptoms and associated complications, if any
• Approximately, 30-50% of those infected with Eastern equine encephalitis virus (Alphavirus) reportedly are unable to recover and succumb to the infection. Even after a severe infection, some individuals may have lingering effects of infection that may lead to intellectual impairment and paralysis
• An infected pregnant woman can transmit the virus to her unborn child, which may result in a miscarriage or congenital abnormalities in the child (after birth)
• Individuals with mild conditions have better prognosis than those with severe symptoms and complications
• Typically, the prognosis may be assessed on a case-by-case basis

Additional and Relevant Useful Information for Togaviridae Disease:

The following DoveMed website link is a useful resource for additional information:

http://www.dovemed.com/diseases-conditions/rare-disorders/