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It?s raining monsoon ailments!

Jeremy

Well-known member
http://www.cybernoon.com/DisplayArticle.asp?section=fromthepress&subsection=inbombay&xfile=July2006_inbombay_standard10381

Monsoon season is a time when we are more susceptible to diseases. Several medical authorities think so, too. Along with the romance of a wet breeze, the rains wash in several diseases. In addition to the usual illnesses, chikungunya, a viral infection, has surfaced to catch the attention of doctors.

Dr. Jehangir Sorabjee recommends:
?The specific facilities required to test for chikungunya are not available in any commercial laboratory in Mumbai,? informed Dr. Jehangir Sorabjee. The symptoms of chikungunya are high fever, body aches and rashes. During the monsoon, people face attacks from three different quarters: unclean water, mosquitoes and flooding.

?The intake of contaminated water leads to typhoid, cholera, hepatitis and gastroentitis. Every home must have clean water supply. One must be careful when eating out and go only to those places where the quality of food is dependable. Uncooked fruits and salads, at least outside, should be avoided, as should anything partially cooked. Water consumed should be boiled.?

?This is the mosquito breeding season and so it is very necessary to prevent water from pooling up in places. Besides the constant use of sprays, nets, coils and repellents there is not much one can do to avoid bites.?

?Leptospirosis is caused when rat urine, present in waters flooding the streets seeps in through broken skin. Vomiting, jaundice, body ache and sometimes even kidney failure are the results. Those who live in flood-prone areas should best avoid stepping out in such a situation.?

?There is no cure other than antibiotics, and sometimes even that does not help. We have had suspected cases of chikungunya but due to lack of facilities we have not been able to diagnose accurately. But I would like to point out that those patients got better.?

Dr. Suhash Phopale recommends:

Dr. Suhash Phopale says that the diseases most common in the monsoons are diarrhoea and dysentery.

?Incidents of malaria also increase, of course, but the incidents of chikungunya are most confounding. The disease is caused by a different family of mosquitoes altogether, and till now that breed was never found in India! It is serious in certain pockets of the state and I predict that it will become as common as malaria very soon.?

He said that the only course of prevention is to avoid mosquito bites. ?Water-borne diseases like typhoid, cholera, hepatitis, etc, are best prevented by boiling the water used for drinking and cooking. Aquaguard water is good but it has to be serviced more than usual if the purity is to be maintained.?

Dr. Porus Kapadia recommends:
Dr. Porus Kapadia, who runs an independent clinic at Byculla, feels that malaria rules when it comes to monsoon diseases.

?It is very difficult to prevent a mosquito bite,? he admits. ?The pattern of malarial symptoms has also changed. Initially, the symptoms were high fever and fits of shivering. Now this is accompanied even by loose motions and a mild stomach ache. Basically, whenever a fever is not accompanied by a cold or a cough, we temporarily treat it as malaria.?

?Chikungunya symptoms are similar to those of the flu, but it is a self-limiting disease. It lasts for about two-five days and leaves even without treatment. I have heard that there are pockets that are severely affected by the virus, but so far, there has been no test for the disease in Mumbai. Right now, it is not as threatening as malaria or dysentery, so nobody is paying too much attention to it. It is the duty of the government medical authorities to keep a check on new developments and to introduce new facilities to cope with them.?

?Early diagnosis in leptospirosis is very important. What sets it apart from other diseases is the reddening of the eyes within three-four days after infection. The disease can be contained.?

?Dengue is a dangerous illness. It?s most notable symptom is break-bone fever: joint aches, muscle aches accompanied by a high temperature, but the small percentage of people who contract dengue haemorrhage fever is at a higher risk. It causes one to bleed suddenly from anywhere, be it internal or external. It prevents the blood from clotting and the patient may bleed to death.?

?Early diagnosis and prompt treatment are the only solutions.?

The authorities have spoken. It?s time to arm yourself with galoshes, Baygon and a bottle of pure water
 
Re: It?s raining monsoon ailments!

Dr. Porus Kapadia recommends:
...
Chikungunya symptoms are similar to those of the flu, but it is a self-limiting disease. It lasts for about two-five days and leaves even without treatment.


Self-limiting?

Tell that to the 250,000 people in La Reunion that got infected in 3 months. Or you can tell that to the millions of people that have been infected in Andhra Pradesh, Mahastrata, Karnataka and Tamil Nadu over the past 7 months.

Word to the wise.

If you don't know the answer, ask someone that does.
 
Re: It?s raining monsoon ailments!

[FONT=Verdana, Arial, Helvetica, Sans Serif]Self-limiting.....I think not.[/FONT]
[FONT=Verdana, Arial, Helvetica, Sans Serif][/FONT]
[FONT=Verdana, Arial, Helvetica, Sans Serif]http://www.chennaionline.com/colnews/newsitem.asp?NEWSID=%7B6B28543E-BBF0-48C3-93EF-91E2C2B046CA%7D&CATEGORYNAME=HEAL[/FONT]
[FONT=Verdana, Arial, Helvetica, Sans Serif]New Delhi, July 26: Chikungunya, a debilitating non-fatal viral illness that shows the same symptoms as that of dengue fever, is prevalent in seven states, where over 97,000 suspected cases have been reported, the Lok Sabha was informed today. [/FONT]
[FONT=Verdana, Arial, Helvetica, Sans Serif]

The largest number of cases have been reported from Karnataka, Maharashtra and Andhra Pradesh, Health Minister Anbumani Ramadoss said. The other States affected are Tamil Nadu, Madhya Pradesh, Gujarat and Kerala.


The minister said the government was taking all steps to ensure that the disease did not spread to more states.


The government was monitoring the situation and assisting state governments to prevent its spread, he added.


Disputing the government figure, Yerrannaidu (TDP), who raised the matter, claimed that more than six lakh were suffering from the viral fever in Andhra Pradesh alone. He wanted a "health emergency" to be declared in the state.


Tejashwini Ramesh (Cong) said due to misinformation in rural areas, poultry industry in Karnataka had been hit in a big way as many people had stopped eating chicken believing that the disease emanates from this source (chicken).


Ramadoss said of the 10,611 samples sent from the affected States to laboratories in Pune and Delhi, 992 had proved positive. (Agencies)
[/FONT]
 
Re: It?s raining monsoon ailments!

http://www.dnaindia.com/report.asp?NewsID=1043750

Chikungunya scare dips chicken sales

Haima Deshpande
Tuesday, July 25, 2006 22:24 IST

PUNE: First it was bird flu that hit sales of chicken and eggs. Now it is the turn of the mosquito-spread chikungunya to further hit the dwindling sales figures. Reason? The misconception that chikungunya is a kind of avian flu.

So hard-hit is the poultry industry by this latest turn of events that the National Egg Co-ordination Committee (NECC) has stepped in with a band of top actors from the Marathi film industry to dispel the myth that chikungunya is an avian disease.

The name ?Chikungunya? comes from Swahili meaning ?stooped walk? reflecting the physique of the person suffering from the disease.

Clad in Maharashtra?s traditional navwari (nine-yard) sari, actors Jaishree Gadkar, Asha Kale, Nishigandha Wad, Varsha Usgaonkar, Madhu Kambekar, Usha Naik, Sarla Yevlekar, Alka Kubal, Priya Borde, Rekha Rao, Aishwarya Narkar and Madhu Velankar will launch NECC?s latest public awareness campaign.

Slotted for all television channels across the State, this song and dance Marathi campaign is designed to educate the viewers about chikungunya.

Maharashtra, Karnataka and Andhra Pradesh have been severely affected by this mosquito-spread illness which reared its head after 54 years in late 2005. Since then it has spread rapidly leading to widespread alarm.

So severe is the impact that the health ministers of the Southern States will meet at Bangalore on July 30 to find out ways to check the spread of the disease which threatens to assume epidemic proportions. Crippling arthralgia and frequent arthritis accompany the fever.

The other systematic symptoms of this Aedes Aegypti mosquito transmitted disease are clinically distinct.

Speaking to DNA, N B Kale of Venkateshwara Hatcheries who coordinated the campaign emphasized that such a campaign was needed to revive the sagging sales figures of chicken and eggs.
 
Re: It?s raining monsoon ailments!

So hard-hit is the poultry industry by this latest turn of events that the National Egg Co-ordination Committee (NECC) has stepped in with a band of top actors from the Marathi film industry to dispel the myth that chikungunya is an avian disease.

Slotted for all television channels across the State, this song and dance Marathi campaign is designed to educate the viewers about chikungunya.

Looks as though the situation is not getting any better in India. But hey, that one doctor said it was self-limiting so we shouldn't be worried. Should we?
So severe is the impact that the health ministers of the Southern States will meet at Bangalore on July 30 to find out ways to check the spread of the disease which threatens to assume epidemic proportions. Crippling arthralgia and frequent arthritis accompany the fever.

Rut Roh!

I do take issue with the wording they have chosen "threatens to assume epidemic proportions". The reason I take issue is because it was threatening to do that in January of this year, now it is way past epidemic proportions. It is so far past epidemic proportions that it is now into pandemic proportions.
 
Re: It?s raining monsoon ailments!

http://indiaenews.com/2006-07/16299-states-affected-chikungunya-says-government.htm
New Delhi - The government Wednesday admitted that four Indian states have been badly hit by Chikungunya, a devastating viral illness that resembles dengue fever, but it claimed there have been no causalities so far.

?The states affected with Chikungunya fever during the current year are Tamil Nadu, Karnataka, Andhra Pradesh, Maharashtra, Madhya Pradesh, Gujarat and Kerala,? Health and Family Welfare Minister Anbumani Ramadoss told the Lok Sabha.

?At least 121 districts in these seven states have been affected with total of 974,541 suspected cases,? the minister said replying to a calling attention motion moved by TDP member Yerran Naidu over the situation arising out of the spread of Chikungunya fever in various parts of the country, particularly in Andhra Pradesh.

Ramadoss said that Andhra Pradesh, Tamil Nadu, Maharashtra and Madhya Pradesh have been worst affected by the viral illness, which according to him, is not fatal.

?It is caused by Chikungunya virus. It is spread by the bite of female Aedes mosquitoes, primarily Aedes Aegypti. Humans are considered to be the major sources or reservoir of Chikungunya virus for mosquitoes,? the minister, himself a medical practitioner, said.

?There is no vaccine or specific medicine available against the infection. There is no specific cure too. The symptoms can be alleviated by taking pain relieving drugs like paracetamol, plenty of fluids and normal diet.?
Ramadoss assured that the government was ?actively monitoring the situation and assisting State governments to prevent its spread?.

?The affected states have been provided detailed guidelines for prevention and control of Chikungunya,? he said.

Naidu contested the minister?s statement and claimed that more than 600,000 were suffering from the viral fever in Andhra Pradesh itself. He wanted a ?health emergency? to be declared in the state.

Congress party MP Tejashwini Ramesh urged the central government to provide special assistance for the poultry farmers in Karnataka as misinformation about Chikungunya had affected them adversely.

?People in the rural areas believe the disease had something to do with chicken. So the poultry industry was hit by it,? Ramesh pointed out.
 
Re: It?s raining monsoon ailments!

For about 3 months now I have been saying that India has millions of Chikungunya cases.

Just in case you were wondering, it looks like the data is starting to come in which proves that I wasn't on drugs.

‘At least 121 districts in these seven states have been affected with total of 974,541 suspected cases,’


These are the governments numbers, which in India are always less than the actual numbers. Regardless, the governments current count puts us at around 1 million suspected cases. It should be remembered that MOST people that suffer from Chikungunya go to see private doctors and therefore would not be counted in the governments official tally.

You want proof that the governments official numbers are incorrect?


Here you go:
Naidu contested the minister’s statement and claimed that more than 600,000 were suffering from the viral fever in Andhra Pradesh itself. He wanted a ‘health emergency’ to be declared in the state.


So TDP member Yerran Naidu disputes the government numbers and says that more than 600,000 were suffering in just Andhra Pradesh. I should highlight that Naidu said "more than 600,000" so most likely his numbers are a little low because a lot of people either never sought medical attention or just weren't counted.

Finally I take issue with another statement the governement made.

but it claimed there have been no causalities so far.

This is a flat out lie. Sorry but that is what it is. There have been many causalities in India from Chikungunya. Chikungunya on average causes low mortality (less than 1% of those infected) and we at FluTrackers have posted many articles that show that Chikungunya can be fatal and has been fatal in some cases in India.
 
Re: It?s raining monsoon ailments!

Commonground said:
Thank you Jeremy for all of your hard work

Your Welcome!

It's just nice to know that after all this time I am not insane.:D
 
Re: It?s raining monsoon ailments!

My thanks also. I have been reading your posts on Chikungunya for a while now and am basically very confused as to what is going on.

- Chik has been a known entity for years but seems to have had its own Quinghai 'event' in or around Reunion and now seems much more virulent and/or easily transmitted. What change, if any, do you thing has occurred?

- The Indian authorities seem to be at a total loss. I have seen reports of 'there are no treatments' and 'we are ensuring treatments are being distributed', I also seem to remember someone referring to a vaccine at one point. Beyond analgesics for the joint pain is there anything?

- There seems to be a great deal of trouble with the diagnosis, particularly confusion with Dengue (and at the time the epidemic was rife on the East African coast they seemed to group them as one, at least from the treatment point of view). What (assuming there is a budget for such things) is the test for Chik?

I hesitate to ask this of you Jeremy - in the light of the time you are already putting in - but I would be very interested in your thoughts on the situation as a whole, whats happening and whats going to happen.

I thought information flow was bad for H5N1 but compared to Chik the situations is positively rosy.
 
Re: It?s raining monsoon ailments!

JJackson said:
My thanks also. I have been reading your posts on Chikungunya for a while now and am basically very confused as to what is going on.

- Chik has been a known entity for years but seems to have had its own Quinghai 'event' in or around Reunion and now seems much more virulent and/or easily transmitted. What change, if any, do you thing has occurred?

- The Indian authorities seem to be at a total loss. I have seen reports of 'there are no treatments' and 'we are ensuring treatments are being distributed', I also seem to remember someone referring to a vaccine at one point. Beyond analgesics for the joint pain is there anything?

- There seems to be a great deal of trouble with the diagnosis, particularly confusion with Dengue (and at the time the epidemic was rife on the East African coast they seemed to group them as one, at least from the treatment point of view). What (assuming there is a budget for such things) is the test for Chik?

I hesitate to ask this of you Jeremy - in the light of the time you are already putting in - but I would be very interested in your thoughts on the situation as a whole, whats happening and whats going to happen.

I thought information flow was bad for H5N1 but compared to Chik the situations is positively rosy.

What change, if any, do you thing has occurred?

Here are my thoughts on the changes.

Theory 1: Mosquito to Human Transmission

This theory basically says that Chikungunya is being transmitted via mosquitos. The French have claimed that the virus has mutated. However, they still claim that the virus is spread by tiger mosquito (Aedes albopictus).

Take the dengue outbreak that occured in Singapore in 2005.

Now take the dengue outbreak that occured in Cuba in 1977.

The outbreak on La Reunion do not seem to follow the Singapore outbreak of 2005, but might follow the Cuba outbreak of 1977. However the government of La Reunion fogged the bejesus out of the island and still it had no effect at slowing down the outbreak.

The virus being mosquito born might explain why the exported cases of Chikungunya from the South Indian Ocean and India have not developed into full blown outbreaks in Europe.

However, something just doesn't seem right. First off the spread of Chikungunya in La Reunion and India don't look like a mosquito outbreak should look according the Singapore outbreak. The spread of the disease looked much more like a human outbreak as it spread from town to town.

The high infection rate that we are seeing in La Reunion and India could be explained by saying that the population have no immunity to the new strain of Chikungunya so therefore everyone gets it, just like was seen in the Cuba outbreak of 1977.

But I am still left with doubts that mosquitos are soley responsible for these outbreaks.

Theory 2: Human to Human Transmission

There is some evidence that points to this virus being human to human, mostly the speed at which it spreads and the fact that the spreading of the virus seems to move from town to town and village to village failry consistently.

Furthermore there was another strain that occured on La Reunion in which mothers were infecting their newborn children. This strain proves that there is human to human transmission, but not in the form that would explain the huge explosion of cases.

However, we did not see huge explosions of cases in Europe due to exported cases (FYI: I thought we would and I was wrong on that), so that might mean that the virus isn't able to spread human to human or there was something inhibiting the virus from spreading. It could be temperature related as almost all of the cases of Chikungunya have been occuring between the Tropic of Cancer and the Tropic of Capricorn and the virus might not be adapted to colder less tropical climates.

I would be all for Human to Human transmission if we had seen cases explode due to importation. We did not so either it is not human to human or if it is human to human it needs a certain climate to replicate and spread.

That being said I do believe there have been changes, the French have confirmed some mutations, but like most viruses Chikungunya is continually mutating so most likely more mutations have occured and these new mutations might cause the virus to be human to human, if it is not already, or become more lethal.

Beyond analgesics for the joint pain is there anything?
The answer is maybe.

There was some work done on a Chikungunya vaccine at the University of Maryland. However, the new outbreak is a different strain of Chikungunya and I have no idea if the old vaccine will work against the new strains of Chikungunya.

To date, I believe the US military has the old vaccine but I doubt I have my doubts it would work or even be ready available should we need it.

Beyond that, there is really no cure for Chikungunya and all you can do is try to treat the symptoms by reducing the patients inflammation.

What (assuming there is a budget for such things) is the test for Chik?

There is a test for Chikungunya.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3022710&dopt=Abstract

A rapid, micro-scale focus reduction neutralization test for chikungunya virus was developed. In the test, cell monolayers are prepared in a 96-well tissue culture plate and the PAP (peroxidase-antiperoxidase) staining technique is used for detection of foci of chikungunya virus infected cells. This test is suitable for rapid diagnosis and epidemiological studies of the virus.

...thoughts on the situation as a whole, whats happening and whats going to happen.

I will answer this a little later as that will take some time to explain.

Hope this information I have provided is helpful on where my head on this virus and will give you my 'Chikungunya Outlook' by the end of the week.

-Jeremy
 
Re: It?s raining monsoon ailments!

Thanks Jeremy,
I also believe it is transmitted between people. The conclusion I've come to just from reading all the posts. Also I believe this:

"..... if it is human to human it needs a certain climate to replicate and spread."

Thanks again it is much appreciated.:)
 
Re: It?s raining monsoon ailments!

Jeremy thank you very much.

I had missed the mother/baby transmission, is it know how this is occuring i.e placental trnsmission pre-natal, through the milk or just very close contact?
 
Re: It?s raining monsoon ailments!

Good question JJackson, the baby/mother transmission went in one ear and out the other. Hmmmmmmmm
 
Re: It?s raining monsoon ailments!

http://www.hindu.com/2006/07/27/stories/2006072712030500.htm
Nearly six lakh in State affected by chikungunya

Special Correspondent
<TABLE width="100%" bgColor=#d0f0ff border=0><TBODY><TR><TD>Many Health Department employees on leave saying they have been infected </TD></TR></TBODY></TABLE>

<HR color=lightblue noShade>The Government has released nearly Rs. 5 crore for supply of medicines in the districts
There have been cases of people mistaking viral infections with similar symptoms for chikungunya
<HR color=lightblue noShade>

BANGALORE: Although the Government claims to have taken adequate steps to prevent the spread of chikungunya, there seems to be no respite from the disease for the people. Reports of outbreak of the disease continue to pour in from different places.
Minister for Health and Family Welfare R. Ashok told The Hindu on Wednesday that nearly six lakh people had been affected by the disease and it had spread to rural and urban areas. Many employees of the Health Department had gone on leave in the past few days saying they themselves had been infected. There had also been cases of people mistaking all viral infections with similar symptoms for chikungunya, he said.
After the conference of Health Ministers of the southern States to be held here on July 30, a delegation would proceed to New Delhi to urge the Centre to set up a research centre for communicable diseases in Bangalore. It had also been decided to seek financial assistance from the Centre to fight the disease. The Centre would be urged to allocate more funds for the health sector in the budget in the coming years, he said.
According to Health Department officials, about 5.83 lakh people are down with chikungunya in all the 27 districts. It was much more than the 2. 86 lakh people reported to have been affected a month ago. Over 4,148 samples had been collected from all the districts and over 200 of them had tested positive, they said.
Mr. Ashok said the Government had taken steps to contain the spread of the disease. It had released nearly Rs. 5 crore for supply of medicines in the districts affected by chikungunya, he said.
A Health Control Room would be set up soon in the Directorate of Health and Family Welfare Services for monitoring the spread of communicable diseases and to supervise availability of drugs in taluk and district hospitals. It would also help in reaching to hospitals those injured in road accidents, he said.
Under the 12th State Finance Commission, funds were granted to purchase 77 ambulances. Twenty-seven ambulances would be given to district hospitals in the first phase in a weekThe department had also decided to reconstitute health committees of district and taluk hospitals for utilising funds collected in the form of user charges. The district in-charge Minister would head the district hospital committee and the MLA concerned the taluk hospital committee.
 
Re: It?s raining monsoon ailments!

about 5.83 lakh people are down with chikungunya in all the 27 districts. It was much more than the 2. 86 lakh people reported to have been affected a month ago.

Looks like the there have been about 200,000 in the past month. So much for this outbreak being on the decline.

Just in case anyone was wondering that makes at least 600,000 cases in Andrha Pradesh according to TDP member Yerran Naidu and now Karnataka says they also have at least 600,000 cases.

My best guess is that there are at least 10-20 million cases of Chikungunya in India, but I wouldn't be suprised if there were 50 million by now.

You have to remember, that India has over 1 billion people so 10-20 million is only 1 -2 % of their total population.
 
Re: It?s raining monsoon ailments!

JJackson said:
Jeremy thank you very much.

I had missed the mother/baby transmission, is it know how this is occuring i.e placental trnsmission pre-natal, through the milk or just very close contact?

I cannot seem to find the reference to the mother/baby transmission. Once I do I will post it again.

However, I believe that it was either through breastfeeding or birth.
 
Re: It?s raining monsoon ailments!

http://www.chikungunya.net/evolution/PointChikRun20060209.pdf

Page 6:

Surveillance hospitali?re des transmissions m?re - enfant 17 cas de transmission m?re ? enfant ont ?t? rapport?s au 5 f?vrier. 8 nouveau-n?s ont pr?sent? une forme neurologique et 9 un syndrome algique pr?dominant. A noter ?galement que ce nombre n?est pas exhaustif, et que le dispositif sera renforc? la semaine prochaine par un recueil actif direct aupr?s des services concern?s.

Machine Translation:
Hospital monitoring of the transmissions mother - child 17 cases of transmission mother - child were brought back to February 5. 8 new-born babies presented a neurological form and 9 a syndrome algic prevailing. To also note that this number is not exhaustive, and that the device will be reinforced the next week by a direct active collection near the services concerned.
 
Re: It?s raining monsoon ailments!

http://www.hindu.com/2006/07/28/stories/2006072814520100.htm
Indian Mission in Oman not inactive: Govt.

New Delhi, July 28 (PTI): Maintaining that India has cordial relations with Oman, the Government on Thursday told the Rajya Sabha that deportation of its nationals overstaying in that country was not directed against Indians.

"It is the sovereign right of a country to find out illegal persons living there and it is not directed against Indians and Keralites," Minister of State for External Affairs, E Ahamad, said during Zero Hour.

Responding to a query raised by CPI(M) member, A Vijayaraghavan, on the plight of Indians in Oman, Ahamad said about 900 Indians who had been rounded up had been released on production of documents, while others have been deported.

Denying the charge that the Indian Mission was inactive, the Minister said the Embassy had worked very hard and the Government was doing everything possible.

Earlier, raising the issue, Vijayaraghavan said 15,000 Indians were overstaying in Oman as their labour card and visa had not been renewed, and added they were living in inhuman conditions in jail.

CPI(M) member, Brinda Karat, drew the attention of the Government to the on-going relay hunger strike by 1,000 anganwadi workers and demanded that their jobs should be regularised.

AIADMK member, C Perumal, said 50 lakh people have been affected by the dreaded Chikungunya in Tamil Nadu and pointed out that the disease was spreading because no effective measures have been taken by the State Government to contain the epidemic.
N P Durga (TDP) urged the Government to declare health emergency in Andhra Pradesh.
 
Re: It?s raining monsoon ailments!

AIADMK member, C Perumal, said 50 lakh people have been affected by the dreaded Chikungunya in Tamil Nadu and pointed out that the disease was spreading because no effective measures have been taken by the State Government to contain the epidemic.


I hope this is a typo, because if it is not than C Perumal just said that Tamil Nadu has about 5 million chikungunya cases.

In case you were wondering, Tamil Nadu has a population of 61.5 million. If the 50 lakh number is correct than 8% of Tamil Nadu is infected.

While I think it most likely is a error I would not be suprised by the 8%.
 
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