Chikungunya - Sri Lanka

[Gert van der Hoek]

Re: CHIKUNGUNYA - SRI LANKA

Re: CHIKUNGUNYA - SRI LANKA

Featured Article: Chikungunya in the Jaffna peninsula

Tuesday, 19 December 2006

The human suffering is intensifying in the Jaffna peninsula. It was with the closure of the A9 highway by the Sri Lankan government that the human tragedy initially started in the Jaffna peninsula.

Thereafter there was scarcity for food provisions and other essential commodities leading to a price hike. The people could not afford to purchase that with their bear minimum income or with no income at all.

Then there is scarcity for the medicines in the peninsula and the people are unable to by them even by paying exorbitant prices. The hospitals are labouring hard to continue their medical treatment in the midst of non availability of medicines.

It is in the midst of such a human tragedy that there are reports that the people of the peninsula are seriously affected by Chikungunya. The elderly people who already suffer from diabetes or blood pressure are affected by this disease. There are reports that certain students sitting GCE O/L exams are also affected by the chikungunya.

Mobile medical clinics should be set up in the peninsula immediately to save the people from Chikungunya. Although the government proclaims to the world that it si taking measures to leave the people from the suffering, it doesn?t appear that there is any improvement in the peninsula.

Therefore, the government must act and act expeditiously.

http://www.sibernews.com/news/featured-article/-200612197228/

 

[Gert van der Hoek]

Re: CHIKUNGUNYA - SRI LANKA

Re: CHIKUNGUNYA - SRI LANKA

Sri Lanka ? ICRC Bulletin No. 08

20 Dec 2006 16:28:31 GMT

Source: International Committee of the Red Cross (ICRC) - Switzerland

Reuters and AlertNet are not responsible for the content of this article or for any external internet sites.

General situation
In the past three weeks, renewed fighting between the government security forces (SLSF) and the Liberation Tigers of Tamil Eelam (LTTE) ? there have been constant military operations and artillery exchanges in the Vakarai area of Batticaloa district and in the Kellar-Seruvilla area of Trincomalee district ? has resulted in further casualties among civilians and in thousands of newly displaced families.

Of the 35,000 displaced civilians trapped for the past three months by heavy fighting in Vakarai, about 15,000 have managed to flee the area and reach the government-controlled area in the southern part of the district.

The displaced are presently being housed at 36 different sites and assisted by several humanitarian organizations as well as the Government of Sri Lanka.

In the meantime, another 4,000 civilians have fled the fighting in the eastern part of Trincomalee district and reached the town of Kantale, where they are sheltering around the local schools and temples.

A 35-truck convoy, organized by the Sri Lankan Department of Essential Services in cooperation with the ICRC and the United Nations, reached Vakarai on 29 November with 250 tonnes of food, water and other items such as tents, hygiene kits and medicines for distribution to thousands of displaced people.

On 11 December, the ICRC, working in cooperation with the Italian Red Cross, evacuated 30 injured civilians by boat from Vakarai to Valachenai hospital, a better-equipped facility in the government-controlled area.

It has brought several injured civilians from Kellar town to Kantale Base Hospital, provided displaced families in Kantale with tents and hygiene kits and built water distribution points and sanitary facilities.

It has also provided assistance to thousands of displaced people in Batticaloa district, distributing tents and shelter construction material in several sites.


Health
The ICRC continued to lend a hand to the health authorities in the North and East.

In the past three weeks 27 seriously ill people, accompanied by their caretakers and doctors, have been flown from Jaffna Teaching Hospital to Colombo on board ICRC flights.

Samples have been transported from Jaffna to Colombo for tests, and essential medical supplies, including medicines, vaccines and dressing materials, brought from Colombo to the teaching hospital and health services in Jaffna.

In an effort to help the health authorities respond to the massive outbreak of chikungunya, the ICRC has donated more than 1,000 kg of urgently needed medicines in Jaffna.

The donation included 500,000 tablets of paracetamol and other painkillers.

Through the Sri Lanka Red Cross Society (SLRCS), the ICRC has lent support for the 10-day "Chikungunya and Dengue Control Days" campaign run by the health authorities in Kilinochchi.

It has helped SLRCS volunteers in Batticaloa, Trincomalee and Jaffna conduct activities to promote health and prevent diseases, in particular chikungunya and dengue.

It has also donated dressing and injection materials to Kantale Base Hospital, and continues to provide support to SLRCS mobile health teams in Batticaloa and Jaffna.

Water and habitat
Over the past few weeks, the ICRC has assisted more than 500 families who fled the fighting in Vakarai and sought shelter in the government-controlled area of Batticaloa district.

It has provided displaced civilians at sites in Alankulam and Kiram with more than 350 tents and distributed construction material to build more than 300 shelters.

It has built more than 40 latrines and sanitary facilities at the same sites, as well as several water distribution points.

It is distributing more than 20 cubic metres of drinking water every day at each site.

Economic security
In Kantale town, the ICRC has provided basic assistance in the past three weeks to more than 1,200 displaced people currently accommodated in six different sites near local schools and temples.

The assistance included 720 hygiene kits, 300 tarpaulins and 600 jerry cans.

In Batticaloa district, the ICRC, working with SLRCS volunteers, has distributed essential household items (sheets, mats, buckets, mosquito nets, pots and so on) to more than 80 families in Urugamam, Changaladi district, and provided 200 families in Alankulam and Urugamam with mats, jerry cans, hygiene kits and other essential household items.

It has distributed 718 hygiene kits to displaced families sheltering in the Vakarai area, and 114 hygiene kits to about 400 civilians on Mandaithivu Island, in Jaffna.

In addition, it has provided the health authorities with 16 tonnes of milk powder for all children in Jaffna aged between 1 and 5.

In the Vanni, it has distributed kitchen sets, tarpaulins and mosquito nets to vulnerable people in Thirunagar and Thondamanagar, and 80 hygiene parcels in Mullaitivu district.

Mosquito nets have been distributed for displaced babies in Kandavalai.

In Kilinochchi district, 137 displaced families in Pesalai town have received 140 hygiene kits, 140 jerry cans, 140 mosquito nets, 30 rakes and several bottles of disinfectant.

http://www.alertnet.org/thenews/fromthefield/220224/380bbeefcbffaa79b62f84c8ac3f5052.htm

 

[Gert van der Hoek]

Re: CHIKUNGUNYA - SRI LANKA

Re: CHIKUNGUNYA - SRI LANKA

President declares war on mosquitoes

President Mahinda Rajapaksa is to appoint a special Presidential Task Force to combat the mosquito menace in Colombo and in other parts of the country which had created serious problems during the past few months.

The President had noted with deep concern the amount of mosquito coils burnt during the night and the toxic fumes emanating from them that are inhaled by the people.

The President had instructed Minster Nimal Siripala De Silva to immediately combat the mosquito scourge after he found that 125 personnel of the Presidential Security Unit had fallen ill from either Chikungunya or Dengue.

http://www.nation.lk/2006/12/31/news5.htm

 

[Gert van der Hoek]

Re: CHIKUNGUNYA - SRI LANKA

Re: CHIKUNGUNYA - SRI LANKA

Chikungunya outbreak in Tsunami refugee camp

Tears from the East

By N. Dilshath Banu

A crowded narrow corridor, sandwiched between rows of shelters, each separated by tin and wood partitions -- this is where the daily life of about 50 people unfolds. The adults try to focus on somehow keeping the home fires burning while the children unaware of their problems play ?hide and seek? in this small space.

The daily difficulties are brought home to me as I watch A.M. Arusiya, a 48-year-old mother of three, rush out her dwelling, on hearing the voice of a fish vendor. But with no money to make her purchase, within a few minutes, she?s back empty handed.?I couldn?t pay the fishmonger the last five times, and this time he scolded me and walked away refusing to sell any fish without getting his money. If the tsunami had never occurred?? she mutters, walking into her hut.

It is two years since the tsunami hit this village on the East Coast with terrifying force and for Arusiya, there is every reason for being bitter at her plight. Living in a refugee camp in Periyanilavanai, a village in Kalmunai, the worst affected Division of the Amapara District, life has been desperately hard. During the initial stages when a wave of sympathy saw relief pouring in to the country, the East Coast commanded attention, as it was the worst affected region. However, it didn?t take long for clashing opinions on tsunami recovery and rebuilding in the north and the east to emerge, a serious impediment to the rehabilitation process.

Apart from the political differences, lack of coordination among the International and local non-governmental organisations, coupled with lack of land availability, escalating prices of building materials and labour cost have in turn hindered the co-financing system, a programme to rebuild houses for tsunami victims.

And so, two years on, many tsunami victims of the East Coast are waiting in their ?temporary shelters? hoping that someday they could move to their own houses. Some of the fortunate people who were able to get a portion of their money were able to see thecolumns of the houses being built, but the only progress the majority have seen is the foundation of their houses being laid.

?We were in a cramped camp for a long time, and we protested that we needed permanent houses. After many protests, this is what we got,? said Arusiya, pointing to the temporary shelter. ?My husband used to be a fisherman, but after we lost our two-year-old child, he never wants to go to sea again. We borrow money from other vendors. All of us in this camp do. But now the vendors don?t like lending to us because we cannot pay back soon enough.?

Seated on a narrow veranda, 60-year-old Adambava Bebi , is busily wrapping beedi leaves. ?I was able to somehow get the raw material from India and started this business to earn some money for myself without bothering the children who were also affected by the tsunami.

For every 1000 beedi sticks, Adambava Bebi earns Rs. 120 and if she?s lucky, more than Rs 200. Most of the time, she spends the money on buying things for her grandchildren?s schooling. They also live with her in the same shelter.

Her story is a familiar one. ?I was living with my extended family about 65 metres from the sea. It took 10 years of hard labour for my son to build a better house for the whole family. The tsunami took 35 people from my family. We also didn?t recover anything that was washed away from the house. Today, I don?t have money even to buy a mosquito net,? she says sadly.

A recent outbreak of chikungunya flu had affected many in the camp and only one organisation had responded to their plea for mosquito nets.

Forty km north of Kalmunai, Payaskaran Premila, 32, a pregnant mother moves out of a common toilet with her two-year-old daughter and walks barefoot along the sandy road to her hamlet in the far corner of remote Thiraimadu, a tsunami resettlement village in Batticaloa District, where 367 families and 1067 people have been settled.Though the Thiraimadu resettlement scheme is established in a spacious area, each small shelter houses three families with nearly 12 people or more. Inside the shelter, the stench of wet clothes assails us. There are piles of clothes, books and kitchen utensils stacked on top of each other, leaving hardly any space to sleep. The tin walls and roofs are corroded.

?These days with the heavy rains the water floods in. We have to dry our clothes and other items very often. It?s difficult to do so with so many people living in one shelter. But our house is still under construction and because of the high prices of bricks, sand and other building material and the labour cost the progress has been slow. Sometimes, we work along with the labourers to ensure that the work is being done. But the government is not releasing the money if the initial stages are not completed and NGOs are not willing to pay more than they pledged,? said Premila.

Premila and many others in the Thiraimadu resettlement village as well as tsunami victims in the Eastern Province, are undergoing the same problem- their houses are being built for nearly two years, yet the construction has not reached the roof level. There are others who lived within the buffer zone prior to the tsunami who have not even been allocated land to build their homes.

?After the tsunami, we got many relief items, even from the South. Everyone seemed eager to help rebuild our country. Everyone was concerned about our suffering till last year. This year, our suffering seems to be invisible to them,? sighed Premila.

Far away from Premila?s hut, a lorry carrying men, women and children, who appeared to be traumatized catches the eyes of some tsunami refugees.?These people are Vakarai refugees,? said these tsunami victims in unison.

The plight of the tsunami victims in the East appears to have been overshadowed by the distress faced by the fleeing refugees from Vakarai and the tense security situation there.

http://www.sundaytimes.lk/061231/Plus/000_pls.html

 

[Gert van der Hoek]

Re: CHIKUNGUNYA - SRI LANKA

Re: CHIKUNGUNYA - SRI LANKA

A nation felled by chikungunya

By Kumudini Hettiarachchi

Nimal was perfectly normal, getting about his work, both official and domestic. One night, as he was driving back home, shivers and rigors wracked his body.

Back at home, teeth chattering, he was hardly able to climb into bed, for his bones felt as if he had been put on the rack and each and every limb pulled and strained.

Nimal was another, like the hundreds and thousands across Sri Lanka, who have been felled by chikungunya.

?Chikungunya cases are being reported from almost all districts,? confirmed Deputy Epidemiologist Dr. Paba Palihawadana, however, explaining that it was very difficult to give the exact numbers because the Epidemiology Unit gets only the official figures under the ?notified categories?.

Even at state hospitals, chikungunya would fall under the ?viral fever? category and many people are also seeking treatment from private doctors and hospitals, she said. ?We have sent a special investigation form to state hospitals to try and collate statistics.?

With regard to how chikungunya has affected not only households but also whole streets and communities, she says only a tiny mosquito-bite is needed to spread the disease.

?Sri Lanka had had an outbreak in 1965 and by now we have lost our immunity. So it?s like a virgin population that is falling victim. The other factor is that many people are travelling abroad even to places like Madagascar for gem mining, and so it is easy to pick up the infection,? she says.

It first hit Mannar and then there was an outbreak in Kalmunai. When the Epid Unit checked, it was found that a bus plies between Mannar and Kalmunai, so obviously not only would it have carried passengers but also a few mosquitoes, she says.

Stressing that in the early stages it is very difficult to differentiate between chikungunya and dengue, Dr. Palihawadana said the Epid Unit became alert when in October 2006, a doctor reported ?unusual? fever cases, people who took a long time to recover and also came repeatedly for treatment. The symptoms included fever, a red rash and joint pains and aches.

The Epid Unit immediately instructed its Regional Epidemiologists to collect blood samples for testing and as reports came negative for dengue, rubella and measles, the suspicion fell on chikungunya.

Incidentally, chikungunya comes from Makonde, the language of the ethnic group Makonde in southeastern Tanzania and northern Mozambique and refers to ?that which bends up?, the crippling nature of the illness.

With chikungunya being identified as the likely cause, samples were sent out for verification, as Sri Lanka did not have the facilities for testing. ?Now, however, we have testing facilities at state institutions like the Medical Research Institute and Ragama Hospital and private places like Genetech,? she says, explaining that most doctors go by clinical examination yet.

The most common complaint being joint pains, Dr. Palihawadana says they could last from a few days to a few weeks or rarely even a year. ?The joint pains are very bad as soon as you wake up. That?s why most people double up in pain. In adults the pains are severe and the limbs that are used more often get affected the worst,? she says citing the example of a bartender who keeps opening bottles whose finger-joints ached the most.

Some of the other symptoms may include headache, photophobia (aversion to light), fatigue, nausea and vomiting, The Sunday Times understands.

Explaining that there is no vaccine or specific treatment for chikungunya, Dr. Palihawadana advises patients to rest, take lots of fluids and paracetamol six-hourly to relieve fever and joint-pain.

If the fever persists, see a doctor because more dangerous dengue masquerades as chikungunya, she warns.

http://www.sundaytimes.lk/070114/Plus/011_pls.html

 

[Gert van der Hoek]

Re: CHIKUNGUNYA - SRI LANKA

Re: CHIKUNGUNYA - SRI LANKA

More entomologists to fight epidemics

Nadira GUNATILLEKE

COLOMBO: Health Care and Nutrition Ministry will recruit 300 entomologists this year under the direction of Minister Nimal Siripala de Silva to meet the rising demand, Ministry sources said.

There are only 65 entomologists in the country. The Sri Lanka Entomologists? Association was set up in 1917 but after 90 years still Sri Lanka has only 65 entomologists.

Minister de Silva has taken this decision considering the high demand for entomologists with the increasing density of mosquitos and related diseases such as Dengue and Chikungunya as a result of the Global warming, posing a direct impact on tropical countries, the sources added.

Sri Lanka has successfully controlled Malaria and Filaria but new mosquito related diseases such as Dengue and Chickungunya have emerged. Doctors do not consult entomologists as they think it is a dishonour for them.

But the Health Ministry will take steps to decentralise powers within the ministry and deliver a better public service, the sources said.

Mosquitos can be successfully controlled using pest controlling methods but most of those have a negative impact on environmental friendly insects such as bees and butterflies. Decreasing harvest is a result of lack of bees and butterflies.

Countries such as Australia are now facing the negative impacts of global warming like the increasing number of dry zones but such countries are taking action to control it by planting a large number of trees. But Sri Lanka has not commenced such programmes yet.

The Government will made arrangements soon to coordinate all ministries and implement similar programmes to reduce global warming.

http://www.dailynews.lk/2007/03/17/news30.asp

 

[Gert van der Hoek]

Re: CHIKUNGUNYA - SRI LANKA

Re: CHIKUNGUNYA - SRI LANKA

Mosquito menace may bring on deadly diseases

By Nadia Fazlulhaq

With the inter-monsoon rains beginning, the mosquito menace may increase and therefore immediate action would have to be taken to control the threat of dengue and chikungunya before they affect the people, health officials said.

?Waste disposal is the foremost in the urban areas of the Central Province, especially in Kandy and Matale. There are no large land plots to dump the garbage. We encourage residents in these areas to dump the garbage in a pit, in their own gardens? said Central Province Provincial Director of Health Shanthi Samarasinghe.

Mrs. Samarasinghe said that in rural areas in the Central Province water in wells is at a low level.

?There are times water could be drawn only once in three days, so people tend to build water tanks. There is nothing wrong in building these water tanks, but people must be advised to clean the walls of the tanks and cover the tanks with a fitting lid?, she said.

In Nuwara Eliya, the mosquito menace is at a low level due to the cool climate there. Ratnapura Medical Officer Dr. Hilanthi Seneviratne said areas like the Ratnapura town, Eheliyagoda, Balangoda and Kuruwita are prone to mosquito breeding.

?Garbage disposal is the major problem in the urban areas of the Sabaragamuwa province. We fume all the areas where mosquito breeding takes place as a temporary solution. We also take samples from suspected areas for further testing?, she said.

Southern Province Health Ministry Secretary Buddhapriya Nigamuni said common awareness programmes were being held in the province encouraging proper waste disposal systems. The aim of the health officials was that every household use its own backyard to dispose of garbage appropriately.

?For the past two months mosquito breeding decreased due to the warm weather but when the rainy season begins, there is a high risk of dengue and chikungunya spreading. People are worried at the rise of chikungunya. We have not received any reports on chikungunya but with the increase of dengue there is a higher risk of chikungunya too?, said Colombo Municipal Council Chief Medical Officer Dr. Pradeep Kariyawasam.

According to Dr. Kariyawasam the spread of chikungunya and dengue was great in houses with large gardens and ponds where there is a bigger risk of mosquitoes breeding while areas where houses were built very closely with no gardens are less prone to mosquito breeding.

The CMC is hoping to have a house-to-house campaign in several high risk areas on March 31. Around 1000 volunteers would be visiting these areas, advising on prevention methods and taking action against house owners who create an environment for mosquito breeding.

?We will continue awareness campaigns after March, by which time the monsoon would be on and many people will be taking basic prevention methods? he said.

According to Dr. Kariyawasam, Kollupitiya, Bambalapitiya, Wellawatte, Pamankada, Havelock Town, Kirulapone, Thimbirigasyaya, Narahenpita, Borella, Kuppiyawatte, Cinnamon Gardens and Kotahena are the areas found to be high risk areas in Colombo City.
Several private sector blue-chip companies will be funding awareness programmes and campaigns organized by the CMC.

The second week of May will be the National Dengue Week and the CMC is hoping to get not only schools, but also Government departments and private sector offices to keep their environment clean.

?Competitions for students, housing complexes residents and public servants will be held while the star system for houses will be introduced once again in Colombo? said Dr. Kariyawasam.

http://www.sundaytimes.lk/070318/News/116news.html

 

[Gert van der Hoek]

Re: CHIKUNGUNYA - SRI LANKA

Re: CHIKUNGUNYA - SRI LANKA

Anti Dengue, Chikungunya campaign ahead of monsoon

Shirley Wijesinghe

COLOMBO: The Public Health Department of the CMC is to enlist the participation of schoolchildren ,the private sector and NGOs to inspect premises, in its Dengue and Chikungunya Prevention Campaign and issue notices on such premises that do not confirm to guidelines from March 31.

The campaign was specially organised with the expected South-West monsoon rains during the next few months which could cause a resurgence of Dengue and Chikungunya cases in Colombo.

CMC Public Health Department Chief Medical Officer Dr. Pradeep Kariyawasam has appealed to those who are interested in joining the campaign voluntarily to contact his department on Tel.2691922.

The adopted strategy this year is to request schools, Government and Private sector organisations to clean up their premises, get rid of the containers and breeding places and also inspect the neighbouring lands up to a distance of 200 yards with the help of the Public Health Department of the CMC thus creating a buffer zone without mosquitoes around the institutional premises.

http://www.dailynews.lk/2007/03/19/news22.asp

 

[Gert van der Hoek]

Re: CHIKUNGUNYA - SRI LANKA

Re: CHIKUNGUNYA - SRI LANKA

Workshop on Microbiology

COLOMBO: The Health Ministry and the Medical Research Institute in association with four leading French health institutions - Pasteur Institute, French Institute of Public Health Surveillance (INVS), Pitie Salpetriere Hospital and World Health Organisation will hold two-week workshop from March 19 to 30 on the "Improvement of the Microbiology, Diagnosis and the Surveillance Tools in Sri Lanka at the Medical Research Institute.

This is yet another opportunity where France and Sri Lanka cooperate for mutual benefit and enhance the relations between the two countries. Global issues including virus transmitted by mosquitoes (i.e.: Chikungunya, dengue fever) and other transmitted diseases (i.e.: seasonal flu, avian flu and leptospirosis) for which France is actively involved in the research process will be addressed during the programme.

Expertise on biological diagnosis and surveillance will be shared between the French and Sri Lankan experts in the field.

On the direction of the former Health Minister in France Douste-Blazy, the INVS and the Pasteur Institute jointly conducted a mission to evaluate the health status of Sri Lanka in December 2005. Subsequent to this, ten eminent French scientists affiliated to the leading diagnostic health institutions have liaised with the Health Ministry in Sri Lanka and the Medical Research Institute to fulfill this venture.

The practice sessions will be conducted using sophisticated equipment which will then be donated to the relevant Sri Lankan Institutions. This cooperation will continue with exchange of experts from both countries, through participation in international conferences and training programmes.

http://www.dailynews.lk/2007/03/20/news27.asp

 

[Gert van der Hoek]

Re: CHIKUNGUNYA - SRI LANKA

Re: CHIKUNGUNYA - SRI LANKA

French scientists to Exchange expertise with Sri Lanka

Nadira Gunatilleke

Colombo: The sixty-year-old relationship between Sri Lanka and France will be strengthened and researchers of both countries will be benefited from the Sri Lanka-France collaboration in improving microbiological diagnosis and surveillance tools, French Ambassador Michel Lummaux said.

He was addressing the inauguration of `Improvement of the Microbiological Diagnosis and Surveillance tools' to be held at Medical Research Institute (MRI), Colombo from March 19 to 30.

He said that this collaboration is the first step of a cooperation that is going to last for a long time. "Nations cannot think rationally any more. Like any other things viruses travel very quickly all over the world and it should be addressed globally", he added.

Healthcare and Nutrition Minister Nimal Siripala de Silva said Prof. Tissa Vitharana gives a dynamic leadership for the Mahinda Chinthanaya. He pointed out that France and Sri Lanka have numerous connections and similarities. Minister commended the significant support extended towards Sri Lanka by the French Government during Tsunami disaster.

Sri Lankan people are intelligent and talented. What is lacking is proper training. Sri Lanka will be immensely benefited by this programme. The Minister also pointed out that the MRI is dominated by ladies and they deliver a commendable service by not doing private practice like other doctors.

The results of research and findings should contribute to the wellbeing of the common man. Only then there will be less Chikungunya and dengue fever. These services should not be limited to the elite of Colombo. The monopoly of the MLTs will be over by next few years, he said.

Science and Technology Minister Prof.Tissa Vitharana said that the potentials of the MRI will be developed with the assistance of French Government.

The responsibility of the MRI is facing and controlling epidemics successfully, he added.

It is expected to exchange knowledge, experience and data between Sri Lankan and French scientists. Lecture and workshops will take place at the MRI for local researchers and scientists.

French Government has provided all equipment required for the training. Acting Director, MRI, Dr. Lulu Rachid, Healthcare and Nutrition Ministry Secretary Dr. Athula Kahandaliyanage and the Head of the Department of Virology, Dr. Geethani Wickremesingha also spoke. WHO Representative Dr. S. Puri and Coordinator Dr. Fredrik Gay and several others were also present.

http://www.dailynews.lk/2007/03/21/news22.asp

 

[Gert van der Hoek]

Re: CHIKUNGUNYA - SRI LANKA

Re: CHIKUNGUNYA - SRI LANKA

CMC breeding mosquitoes while targeting residents

The Colombo Municipal Council (CMC) is to conduct a one-day house-to-house campaign on March 31 in several high risk areas in Colombo, deploying a large number of volunteers to brief residents on preventive methods and take action against those who create mosquito breeding environments.

But the Vihara Maha Devi Park a major landmark maintained by the CMC serves as a prime mosquito breeding ground, well enough to spread Dengue and Chikungunya to almost all the residents in Colombo. The bank of the pond within the park is lined with tyres, empty plastic bottles and shopping bags with the stagnant water already breeding mosquitoes. The drains which have not been cleared are blocked with shopping bags and lunch sheets while large refuse bins overflow with garbage.

Visitors to the park said the CMC health officials have either forgotten or ignored public places and focus only on private residencies.

The CMC should declare a day to clean public places or the mosquito menace would continue even if the residents kept their premises clean, they said.

http://www.sundaytimes.lk/070325/News/115.news.html

 

[drjagathv]

Re: CHIKUNGUNYA - SRI LANKA

Re: CHIKUNGUNYA - SRI LANKA

This is just a quick reply to keep the public informed about the present status of Chikungunya viral infection in the Kandy district in central Sr Lanka. Now the infection is found to be prevalent in most parts of the central province, except in the high altitudes where the mosquito density is less. Chikungunya infection is widespread in the urban areas. There are few cases of dengue fever as well despite severe drought which we experienced in the month of March. These conditions may spread among the local population as there was rain during the last couple of days signifying the beginning of rainy season. It is important to concentrate upon the arrangement of adequate preventive measures in order to prevent reemergence of infections in epidemic proportions with the beginning of the rainy season.
Dr. V. W. Jagath Vasanthathilaka.
Consultant Rheumatologist.
Teaching Hospital Kandy

 

[JJackson]

Re: Chikungunya - Sri Lanka

Thanks for the update.

Do you think the public are sufficiently aware of the dangers of wide spread re-emergence and will they be vigilant in checking for potential breeding sites? Are the authorities gearing up with an information or eradication program?

 

[Gert van der Hoek]

Re: Chikungunya - Sri Lanka

Sri Lanka warned of epidemic spread with monsoon

Monday, April 9, 2007, 5:47 GMT,

ColomboPage News Desk, Sri Lanka.

Apr 09, Colombo: Sri Lanka Ministry of Healthcare and Nutrition has warned the public of a possible outbreak of epidemics, especially dengue and chikungunya, with the south western monsoon raging with heavy thunder showers.

The Ministry says that 15,000 dengue cases were reported in 2005 April under similar weather conditions.

The Minister of Healthcare and Nutrition has instructed the officials to enhance the anti mosquito programmes and seek public support to stem an outbreak.

http://www.colombopage.com/archive_07/April954724SL.html

 

[Gert van der Hoek]

Re: Chikungunya - Sri Lanka

CMC's anti-dengue campaign a success

Shirley Wijesinghe

COLOMBO: "No to D & C" campaign fight Dengue and Chikungunya that could spread after the next monsoon rain was conducted successfully.

"More than 11,085 houses have been inspected by a team of volunteers. The CMC summoned notices for 356 house owners who did not followed our instructions given for mosquito breeding preventing measures.

Health Inspectors of the CMC will visit these places after one week to ensure the said measures is taken" CMC Public Health Department Chief Medical Officer Dr. Pradeep Kariyawasam said.

Based on the findings of PHIs the CMC hopes to file action under the Act on Mosquito Prevention against those who fail to show progress on keeping instructions given after one week prior to the notice.

"The campaign will cease temporarily during the Sinhala and Tamil festive season and it will be reactivated after the festive season" Dr. Kariyawasam told Daily News yesterday.

The campaign would cover 50 per cent of the city land area to ensure zero mosquito breeding sites.

http://www.dailynews.lk/2007/04/10/news23.asp

 

[Gert van der Hoek]

Re: Chikungunya - Sri Lanka

Sri Lanka Ministry of Health to be tough on mosquito breeding

Monday, April 23, 2007, 14:42 GMT, ColomboPage News Desk, Sri Lanka.

Apr 23, Colombo: The Sri Lanka Ministry of Health is planning to implement a new anti-mosquito bill soon with the hope of eradicating the mosquito menace that causes thousands of cases of dengue, malaria, encephalitis, filaria and chikungunya each year.

The bill, which is now in the committee stage in Parliament, will allow legal action against any individual or institution that is responsible for facilitating mosquito breeding.

Careless house and other property owners as well as heads of local and national government institutions would face litigation under the new laws.

http://www.colombopage.com/archive_07/April23144231SL.html

 

[Gert van der Hoek]

Re: Chikungunya - Sri Lanka

Sustaining dengue and chikungunya prevention programmes in 2007

Role of the citizens, NGO, government and private sectors:

Dr. Pradeep KARIYAWASAM

A MAJOR CHALLENGE: Dengue Fever (DF) and Dengue Hemorrhagic Fever (DHF) are acute febrile diseases, found in the tropics, with a geographical spread similar to malaria.

Caused by one of four closely related virus serotypes of the genus Flavivirus, family Flaviviridae, each serotype is sufficiently different that there is no cross-protection and epidemics caused by multiple serotypes (hyperendemicity) can occur.

Dengue is transmitted to humans by the mosquito Aedes aegypti (rarely Aedes albopictus). The term ?dengue? is a Spanish attempt at the Swahili phrase ?ki denga pepo?, meaning ?cramp-like seizure caused by an evil spirit?.

A global pandemic began in Southeast Asia in the 1950s and by 1975 DHF had become a leading cause of death among children in many countries in that region.

Epidemic dengue has become more common since the 1980s - by the late 1990s, dengue was the most important mosquito-borne disease affecting humans after malaria, there being around 40 million cases of dengue fever and several hundred thousand cases of dengue hemorrhagic fever each year.

A clinical dengue fever-like illness has been known to be endemic in Sri Lanka from the beginning of the century, and it was serologically confirmed in 1962.

Following an outbreak of chikungunya in 1965, there was an islandwide epidemic of dengue associated with DEN type 1 and 2, with 51 cases of DHF and 15 deaths, from 1965 to 1968.

Although most of the towns throughout the country were affected during this outbreak, the greatest impact was felt in the western coastal belt. Colombo, the capital, recorded the highest number of cases and the first two cases of DHF was also occurred at this time.

In Colombo, cases of dengue fever have demonstrated a biphasic pattern over the past with two separate peaks, the first occurring around June - August and the second around November - December, following the monsoon rains.

It is clearly evident that Dengue fever is associated with the rainfall and shows an increase following the monsoon rains.

Chikungunya

Chikungunya fever is a viral disease transmitted to humans by the bite of infected mosquitoes, usually Aedes Aegyptii or Aedes Albopictus but many other mosquitoes may be involved with suspected mutation of the virus.

Chikungunya virus (CHIKV) is a member of the genus Alphavirus, in the family Togaviridae.

CHIKV was first isolated from the blood of a febrile patient in Tanzania in 1953, and has since been identified repeatedly in west, central and southern Africa and many areas of Asia, and has been cited as the cause of numerous human epidemics in those areas.

Epidemics of illnesses resembling chikungunya have first been recorded from India as early as 1824. However after isolation of the virus (CHIKV) in 1953 the disease has been reported from a wide geographic region from West Africa to Philippines in Asia.

It has been reported from Sri Lanka in 1969. Most recent outbreaks have been reported from India (Kerala and Tamilnadu) and various Indian Ocean islands including Comoros, Mauritius, Reunion and Seychelles.

The term ?chikungunya? comes from Makonde, the language of the ethnic group Makonde in the South Eastern part of Tanzania and Northern Mozambique. This word refers to the meaning ?that which bends up? with regard to the crippling nature of the illness.

CHIKV infection can cause an acute debilitating illness, most often characterised by fever, severe joint pain and rash.

It is characterised by a rapid transition from a state of good health to the illness. Temperature rises abruptly as high as 40 degree C (typically in children) and is often accompanied with shaking chills.

After a few days fever may subside and rise again resulting in a saddle back fever curve. Arthralgia or joint pain is Polyarticular and symmetrical involving knees, elbows, ankles, and small joint sites of previous injuries. Pain is most intense on waking up in the morning.

Chikungunya patients typically avoid movements as much as possible. Joints may swell without significant fluid accumulation. These symptoms may last from 1 week to several months and are accompanied by myalgia or muscle pain.

Rash characteristically appears on the first day of illness, but onset may be delayed. It usually arises as a flush over the face and neck, which evolves to a maculopapular or macular form with pruritis.

It later spread to the trunk, limbs, palms and soles in that order of frequency. Petechial skin lesions can also be seen.

Other symptoms may include headache, photophobia, fatigue, nausea and vomiting. Hemorrhagic phenomena are relatively uncommon.

The prolonged joint pain associated with CHIKV is not typical of dengue. Co-circulation of dengue fever in many areas may mean that chikungunya fever cases are sometimes clinically misdiagnosed as dengue infections, therefore the incidence of chikungunya fever could be much higher than what has been previously reported.

Sri Lanka experienced an epidemic of Chikungunya in 2006, spreading from Mannar and the Eastern Province to the other parts of the country.

Due to the availability of a non-immune population the disease spread to epidemic proportions in the latter part of 2006 involving even citizens of Colombo.

In all the islands or towns where chikungunya spread between 50 to 80 percent of the local population were affected.

Hence, as the economic centre of the country the magnitude of the problem is critical for the Sri Lankan economy?s survival as Colombo would come to a standstill in case of a large outbreak!

Therefore, for the control and prevention of these two diseases that devastated Colombo in 2006, the Public Health Department of the Colombo Municipal Council has initiated a control programme termed ?No to D and C campaign? which has activities spread throughout the year.

The ?No to D and C campaign? was initiated by the Public Health Department of the Colombo Municipal Council as a joint Public Private partnership towards a better tomorrow. Several leading governmental and non-governmental institutions have teamed up with us in this endeavour.

The strategies undertaken by the Colombo Municipal Council, Public Health Department in controlling and preventing these two diseases are as follows:

* Strengthen the existing surveillance system - We had initiated this surveillance system where our staff visited the hospitals in the Colombo area on a daily basis and collected the information on the reported dengue cases.

* Geographic mapping to identify the high-risk areas - Case information was mapped geographically, including information from past years to identify the potential high-risk areas.

* Rapid vector control (prevention of clustering) - on receiving the case information, a team comprising of a Public Health Inspector, A field Assistant and members of the vector control unit would visit that place and conduct mosquito control activities in an area of 250 metre radius from the housing unit. Rapid action of this nature has prevented clustering of cases during this year to a considerable level when comparing to the previous years.

* Routine integrated vector control programmes

* ?No to D and C campaign? - Special House to House inspection programme - March 31, 2007

* 1,000 volunteers, 12500 houses inspected in high risked areas - Dengue and chikungunya - walk

* 1,000 volunteers and school children

* Around the Municipal Council - School based dengue control programme

* School awareness programme

* Setting up of dengue control teams within the schools

* Buffer zone creation around the schools - 250 metre radius

* Activities for a sustainable behavioral change in the students

* School recycling programme - Government institution based control programme

* Awareness programme

* Shramadana campaigns

* Routine inspections and monitoring

* Prosecutions - Housing scheme based control programme

* Awareness campaign

* Recycling programme

* Shramadana campaigns

* Chemical control

* Prosecutions - Transitional settlement based control programne

* Awareness campaign

* Shramadana campaigns

* Routine inspections

* Empowering the community for mosquito control

* Chemical control

* Mapping of Bare Lands and Construction sites and routine inspection and mosquito control work in and around them

* Strengthen the prosecutions - From May 1, 2007, the charge levied for harbouring and breeding mosquitoes will be Rs. 25,000.

* Supervision, monitoring and evaluations

It is now evident that dengue cannot be controlled without the fullest cooperation of the general public.

In Colombo, we have come to identify that approximately 95 per cent of the cases are within 250 metres from a bare land, 90 per cent of the cases are within 250 metres from a construction site, 85 per cent within 250 metres from a governmental or private institution, 65 per cent within 250 metres from a school and 60 per cent within 250 metres from a garbage collection depot or a disposal site.

These are the approximate findings of the environmental research conducted by the Public Health Department of the Colombo Municipality.

It is also evident that although the people keep their immediate surroundings clean, bare lands, construction sites, governmental and private institutions and schools with all sorts of breeding sites favourable for mosquito breeding are within a distance of 250 metres from their dwellings.

Having a multitude of such high-risk environments, which are known dengue-breeding sites clearly indicate hot spots for outbreaks.

The Public Health Department of the CMC has done well compared to other areas to keep the number of patients to a minimum, even though our staff strength is at an all time low. Just seven years ago Colombo accounted for about 15-30 per cent of the dengue patients found in the country.

Last year our share was less than 7 per cent and although the country had a 110 per cent increase Colombo with its sustained efforts reduced the increase to 9 per cent in the city. This year by mid April the country had 1,574 patients; Colombo District 446, with 74 in the city.

Therefore, it is up to the public of the Colombo city area to help us to sustain these low levels and keep the city of Colombo free of dengue breeding sites by eliminating them.

It is important to remember that dengue mosquito has a maximum flying range of 250 metres (average 50-150 metres), and although you keep your surrounding free of breeding, if your environment is not clean you are at risk of contacting Dengue fever.

Apart from the schools, other governmental institutions, private sector conglomerates should use this strategy to safeguard the health of their workers by sustaining such a programme in the future.

The message from the Public Health Department is to keep your house and garden free of mosquito breeding and keep your surrounding environment, at least around a radius of 250 metres, free of breeding with the help of your neighbours to prevent a dengue epidemic taking place in Colombo this year and in the future.

Remember, breeding dengue mosquitoes is a punishable offence. Don?t practise it and don?t let others practise it. It is your responsibility to safeguard your own and fellow citizens? health.

The writer is the Chief Medical Officer of Health, Colombo.

http://www.dailynews.lk/2007/04/28/fea01.asp

 

[drjagathv]

Re: Chikungunya - Sri Lanka

This short note is to update the situation of Chikungunya fever prevalent in the region in and around the city of Kandy in Sri Lanka. There was a drop in number of patients encountered by the clinicians in Kandy during the months of March and April 2007; however, the number of patients seeking treatment for Chikungunya fever and joint pains are in the increase during the months of June and July with the beginning of the rainy season in the central hills of Sri Lanka. It is important to pay due attention towards the preventive measures by the residents living in and around Kandy with the reemergence of Chikungunya fever along with the beginning of rainy season in the hill capital.
Dr .V. W. J. K. Vasanthathilaka.
Consultant Rheumatologist, Teaching Hospital Kandy.

 

[drjagathv]

Re: Chikungunya - Sri Lanka

Thanks for the update.

Do you think the public are sufficiently aware of the dangers of wide spread re-emergence and will they be vigilant in checking for potential breeding sites? Are the authorities gearing up with an information or eradication program?

Public is now aware of the dangers of Chikungunya fever, unlike in the year 2006 this infection was wide spread and the public was not aware of the illness. They are currently aware of the dangers as this fever which can occasionally be life threatening in debilitated individuals, and also in patients who are already having other long standing illnesses. They are aware of the disabling joint pains and the chronic nature of this illness; often the public take adequate precautions nowadays, as they are aware of the short term and long-term consequences of these infections.
Dr .V. W. J. K. Vasanthathilaka.
Consultant Rheumatologist, Teaching Hospital Kandy.

 

[drjagathv]

Re: Chikungunya - Sri Lanka

- Sri Lanka
There is an increased prevalence of in Sri Lanka after heavy and continuous rain in most parts of the Island. there was flooding in the north central and eastern provinces. We also read news items that was reported in Australia. Many Australian and New Zealand residents travel to sri Lanka during the holidays and visit their relatives therefore it is obvious that there is a global distribution of this type of fever as some do not have obvious symptoms, they suffer with a mild fever for couple of days without any complications.
Dr V W J Vasanthathilaka