Re: New viral fever hits Maldives
Chikungunya & Dengue: ONE INSECT, DOUBLE THREAT
09 January 2007
It begins with a bite. Maybe on your arm or neck, nothing too painful. Then you swat it... and forget about it. Just a second of slight discomfort. You probably won?t even notice it until after a few seconds. But it?s those little things you have to watch out for?
Ahmed Adam had just come back to Male from his native island after spending his annual holidays there. It had been a fun trip and he had enjoyed himself thoroughly. So, to get ready for work the next day he had gone to sleep early. Sometime during the night he woke up, feeling a little feverish. He had a slight headache too. Blaming it on exhaustion he went back to sleep. The next morning he had to ask a family member to call his office to tell them that he was sick and wouldn?t be able to go to work. Next day, his joints began to ache. It was so bad that he could not even get up from bed. Thankfully, by the next day the fever had gone down a little and he was able to go see a doctor with the help of his brother, as his joints were still aching so bad that he could hardly stand or walk. The doctor?s diagnosis: Chikungunya.
Chikungunya fever is a viral disease transmitted to humans by the bite of infected mosquitoes. Chikungunya virus is a member of the genus Alphavirus, in the family Togaviridae. Chikungunya 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 since that time. When the first cases of chikungunya were reported in nearby countries like Sri Lanka and India, the Department of Public Health (DPH) in Maldives issued warnings about it and cautioned travelers to take care.
When reports of an anomalous fever spreading throughout Maldives first emerged in November, the DPH issued another warning about pretty much said that they had no idea what the new disease was. By the first week of December rumours had begun that the new viral fever was in fact Chikungunya, and the number of people who had come down with it was increasing rapidly. The DPH then sent some blood samples abroad, collected from throughout the country, to test whether they were dealing with Chikungunya. Prior to that Maldives had been seeing increasing numbers of people contacting Dengue fever and there had even been some fatalities from the disease. During the third week of December a four year old died in Faafu atoll Feeali, and although there was no way to confirm it, due to lack the necessary equipment in the island, the Health Center believed that the child had died of Dengue fever. But the symptoms that were being seen were different from Dengue and the DPH needed to find out for sure what they were exactly dealing with. On 25th of December, the DPH finally revealed that the results had confirmed that the anomalous fever was indeed Chikungunya.
When first he had heard about Chikungunya, Ahmed had laughed out at how ridiculous the name sounded.
?It was such a funny sounding name,? he said. ?And of course, we heard about it on the radio and TV but, I never thought I would ever contact that disease. I didn?t even meet anyone who had even had the disease all throughout the trip. I don?t know where I could have contacted it but I do know how. Mosquitoes were everywhere. I was bitten more times than I can remember.?
The rainy season that had begun near the end of last year had proved to be a two edged sword. Although it had brought much needed rains, it had also provided the mosquitoes with the necessary breeding grounds. With the rise in the mosquito population, it was only a matter of time before the diseases started spreading. Most islands in the Maldives have started awareness programs and other activities to combat mosquitoes, but the DPH has also expressed worries that not enough people were still taking it seriously and that they had not been getting enough support to from the public to combat the serious threat.
?While I was in my island, most of the people who had gone there for the holidays thought of it as a big joke,? said Ahmed. ?They were making fun of the name and even referred to it as ?chicken biriyani?. Although I heard the reports that a lot of people were suffering from the sickness I never met any of them. Some people asked us to join them to go looking for mosquito breeding places but we were too busy having fun. It could be that the people weren?t so eager to go hunting mosquitoes because they were there for the Eid holidays.?
Chikungunya and Dengeu fever virus are carried by a kind of mosquito called the Aedes aegypti mosquito, but recent research has shown that the virus has mutated into a form that enables it to be transmitted by Aedes albopictus (Tiger mosquito) also. The name of the disease, Chikungunya, is not related in any way to chickens. In fact the name is derived from the Makonde word meaning ?that which bends up?, in reference to the stooped posture developed as a result of the arthritic symptoms of the disease. The disease is generally not fatal although there is no specific treatment for it. Vaccine trials were carried out in 2000, but funding for the project was discontinued and there is no vaccine currently available.
The DPH has recently revealed that more than 3500 people in last December alone for diseases that are transmitted by mosquitoes. 17 percent of those affected had been diagnosed with Chikungunya. According to Wikipedia, the free internet encyclopedia, the symptoms of Chikungunya include fever which can reach 39?C, (102.2?F) a petechial or maculopapular rash usually involving the limbs and trunk, and arthralgia or arthritis affecting multiple joints which can be debilitating. The symptoms could also include headache, conjunctival infection, and slight photophobia. The fever typically lasts for two days and abruptly comes down. However, other symptoms, namely joint pain, intense headache, insomnia and an extreme degree of prostration last for a variable period, usually for about 5 to 7 days.
Although in Male, many preventative measures have been taken to combat and bring down the mosquito population and destroying mosquito breeding grounds, the two local hospitals have under pressure for some time now. Many have complained that the government was not doing enough to combat the double threat that has arrived in the form of the tiny flying insect. Recently the DPH announced that the tests that had done on the blood samples taken throughout the country have also brought to light another more serious problem: some of the blood samples had shown evidence of being infected with both Dengue and Chikungunya virus. Those who have been diagnosed with Chikungunya are usually given a painkiller (usually Paracetamol, but sometimes medicines much stronger have also been prescribed) for relief from the aching joints, however the DPH has urged victims not to use a painkiller other than Paracetamol as there was a chance that they might be infected with both the viruses, in which case it was dangerous and even life-threatening to use stronger painkillers.
It?s clear that if we don?t all get together to fight this threat, things are going to get worse. As the only effective method of combating the menace is to kill the disease carriers, mosquitoes, and prevent them from breeding, everyone should make an effort to make an effort to do that. Just buying an anti-mosquito mat or repellent from the nearest shop and keeping in the room isn?t enough. It?s social problem and we can only succeed if we get together.
http://www.eveningweekly.com.mv/?op=details&id=3550
