MUMBAI: Chikungunya

[Jeremy]

http://timesofindia.indiatimes.com/articleshow/1833360.cms

MUMBAI: The entire state, barring Ratnagiri and Sindhudurg in the coastal Konkan region, is down with chikungunya, the state government has admitted.

State public health Secretary Vijay Satbir Singh confirmed that a record number of 2225 cases of high fever were reported on Saturday and more than 1.15 lakh cases of chikungunya had been registered since 1 April this year.

Singh, himself a doctor by profession, said he had undertaken an extensive tour to bring about awareness immediately after a few cases were reported from parts of Marathwada.

Singh said he found people storing water for a long time, sometimes for more than a fortnight, during his state-wide visit. So the state government has now asked them to observe a "dry day" at least once every week.

"Dry day", Singh explained, was the day when all water containers would be emptied to be filled again the next day. "Stored water is the place where mosquitoes breed. This breeding happens faster if water is stored for a longer time," Singh added, explaining why the state government had hit on a plan for "dry days" to counter chikungunya.

The state government has also decided to rope in all the southern states in its fight to halt the spread of the disease that is marked by high fever and joint aches.

A joint action plan was being prepared to tackle the disease that is marked by high fever and severe joint pain, the state public health secretary said on Monday.

"We are drafting an integrated action plan for the purpose. We have already approached the Centre for the technical support for the purpose," Singh said.

"According to the reports we have, cases have been reported from the entire state barring Ratnagiri and Sindhudurg," he added. But the public health secretary made it clear there was no cause of panic as the disease was neither infectious nor fatal.

"One has to bear the disease for at least four or five days," Singh said. The largest number of cases, till date, has been reported from Nanded, where chikungunya has had 21195 people down.

Next comes Jalgaon, which has seen 12696 cases so far. Next come Beed with 10894 cases, Yeotmal with 7013 cases and Nagpur with 6136 cases till date.

Singh said chief minister Vilasrao Deshmukh would be personally reviewing the situation at a high-level meeting at Latur on Tuesday.

That will be followed by a day-long workshop on chikungunya of senior officials of the public health and medical education departments at Aurangabad on August 4.

 

[Jeremy]

Re: MUMBAI: Chikungunya

But the public health secretary made it clear there was no cause of panic as the disease was neither infectious nor fatal.


​

First he says that Chikungunya is not infectious.

Excuse me? Pardon Moi?

Tell that to the millions of people that have been infected over the past 7 months in India.

Second he says that Chikungunya is not fatal.

Ummmm, WRONG!

Chikungunya is fatal, but only fatal in less than 1% of all cases.

 

[Commonground]

Re: MUMBAI: Chikungunya

unbelievable! Thanks Jeremy.

 

[Jeremy]

Re: MUMBAI: Chikungunya

This is the best story on Chikungunya I have seen come out of India, and considering I have read them all that is saying a lot.

Great job Dr Sandeep Rai.

http://www.hindustantimes.com/news/181_1758984,0050.htm
Beware: chikungunya is coming...

Dr Sandeep Rai

Mumbai, August 2, 2006

Chikungunya fever is a rare form of viral disease characterised by fever, joint pains and spread by mosquitoes. Since late 2005, chikungunya fever has been causing extensive outbreaks is several islands in South-West Indian ocean including Reunion Islands, Seychelles, Mauritius, Mayetta and Madagascar.

In India it was first reported in December 2005 in Andhra Pradesh, where it started as an urban phenomenon and has since then spread to more than 1,400 villages in southern India.

Other regions in grip of this unprecedented epidemic are certain regions of Karnataka, Tamil Nadu, Maharashtra, Orissa and Madhya Pradesh. Unofficial figures point to lakh of cases having been reported in last six months from affected figures.

More than 19 districts of Maharashtra including Pune, Nasik and Ahmdnagar are affected and recently virus has been tested positive in few patients from Khodala village in Thane and few suspected cases (virus report awaited) have been reported from suburbs of Mumbai.

Unlike public perception this disease has nothing to do with poultry, instead it is a viral fever spread by day time biting mosquitoes of genus Aedes i.e. Aedes Aegypti, Aedes Albopicticus (Tiger mosquito). Interestingly both of these types of mosquitoes also spread the dreaded dengue fever. The infected Aedes mosquito can carry both the viruses at same time and infect a person. It is perfectly possible for a person to have chikungunya and dengue fever together at the same time.

With the possibility of dengue raising its head once again in rainy season this combination of a dual epidemic can prove to be catastrophic.

Chikungunya fever is characterised by high fever (101F-104F), headache, vomiting, malaise, severe joint pains including wrist, knees and ankles. The swollen and painful joints are painful to touch and are characteristic of this disease.

They can last from a few days to few months. After 2-3 days of onset of fever a rash may be noticed over trunk and the limbs. The disease is self limiting and rarely fatal and unlike dengue fever the bleeding manifestation are not common in this disease.

The complications although rare are seen mostly in affected children which include menigoencephalitus and pneumonia.

The rather difficult to pronounce "chikungunya" name came from "Swahili" a language spoken in East Africa which literally means "that which bends up" referring to the stooped posture the patient develops because of severe joint pains in this disease; the virus is also known by other names like as "buggy creek" virus and "Chikv".

The disease was first described in 1953, following an outbreak of this fever on border between Tanganyika and Mozambique. In India the first epidemic of this disease was recorded in Kolkata in 1963 and last outbreak of infection occurred in India in 1971. No active surveillance of this disease was done after that and it was assumed that the virus had "disappeared" from the subcontinent.

It was soon a forgotten disease and hence it is not surprising that most present-day health-care providers have not even heard of this disease. The re-emergence of this epidemic in late 2005 in Andhra Pradesh took both the government and doctors off guard and found health administration totally lacking in controlling the situation.

The re-emergence of this long-dormant infection has been a subject of lot of research and discussion in the medical community. A study on virus isolated from Reunion Islands outbreak was studied at Pasteur Institute in Paris and found that the present virus has mutated (changed) itself to a more aggressive from than its predecessor which had cause earlier outbreaks, same authorities however believe that the absence of infection in India for more than 35 years led to no immunity for this virus and could be reason for rapid spread of infection, while others blame it on exponential increase in population of mosquitoes especially of genus, Aedes, in recent times.

There is no preventive treatment for this disease and presently no vaccine is available. Once the patient develops this disease then symptomatic treatment including bed rest, plenty of fluids, vitamins and analgesics for joint pains are needed but should be given in consultation with a doctor as the symptoms of this disease resemble dengue fever. It is necessary to exclude it by blood tests as dengue fever can be associated with complications of bleeding and severely low blood pressure (shock) which can be life threatening.

A double infection with both chikungunya and dengue can occur together which can also be detected with blood tests. There are very few laboratories at present equipped to detect chikungunya virus. Serological test like ELISA detect antibodies against the virus in the blood and are available in select few laboratory only.

IgM capture ELISA test is necessary to distinguish it from dengue. An expensive but more reliable PCR test is available at few bigger laboratories which can detect the virus promptly and in large per cent of cases.

Mumbai because of its very high density of population, large slum dwellings and in this season of heavy rains is very vulnerable to outbreak of this epidemic. In view of very recent reports in of few suspected cases from Goregoan and Vakola in Mumbai, there is an urgent need on part of government to go on a war footing drive against mosquitoes especially to conduct large-scale foggings.

The author is an Associate Professor of Internal Medicine and Unit Head in the Post Graduate Department of Medicine at MGM Medical College and Hospitals, Navi Mumbai. He can be contacted at sahaja<A href="mailto:sahaja_center@vsnl.net">_center@vsnl.net.