WHO on Chikungunya in India - 10/17/2006

[Jeremy]

http://www.who.int/csr/don/2006_10_17/en/index.html

Chikungunya in India
17 October 2006
From February 2006 to 10 October 2006, the WHO Regional Office for South-East Asia has reported 151 districts in 8 states/provinces of India affected by chikungunya fever (see below). The affected states are Andhra Pradesh, Andaman & Nicobar Islands, Tamil Nadu, Karnataka, Maharashtra, Gujarat, Madhya Pradesh, Kerala and Delhi. More than 1.25 million suspected cases have been reported from the country, which 752,245 were from Karnataka and 258,998 from Maharashtra provinces. In some areas reported attack rates have reached 45%.

A team from the Ministry of Health and Family Welfare, health officials from Kerala and staff from the WHO India Office and Regional Office for South-East Asia investigated the outbreak in Kerala. They carried out clinical and epidemiological examinations of suspected cases in hospitals and at home, and collected clinical samples. An entomological survey revealed high densities of Aedes albopictus in the affected areas as well as in areas not affected by the disease.

For personal protection, individuals should take measures to protect themselves against the bites of the mosquitoes which transmit the virus (including Aedes aegypti), which are active during the daytime. Elimination of breeding sites can contribute to the reduction of mosquito densities. As a result, a key recommendation from the investigation team is for urgent vector control measures coupled with an intensive awareness campaign in the community. Health care staff at all levels, government officials and nongovernmental organizations are called upon to assist in this information and health education campaign. The Communication-for-Behavioural Impact methodology has been successful in mobilizing affected populations for vector control activities.

For more information:
- Chikungunya Information Sheet from the WHO Regional Office for South-East Asia

- Communication-for-Behavioural Impact method: WHO Mediterranean Centre for Vulnerability Reduction

- WHO Pesticides Evaluation Scheme

 

[Jeremy]

Re: WHO on Chikungunya in India - 10/17/2006

<TABLE class=MsoNormalTable style="MARGIN-LEFT: 0.05in; WIDTH: 99%; BORDER-COLLAPSE: collapse" cellSpacing=0 cellPadding=0 width="99%" border=0><TBODY><TR><TD style="PADDING-RIGHT: 1.45pt; PADDING-LEFT: 1.45pt; BACKGROUND: white; PADDING-BOTTOM: 0in; WIDTH: 100%; PADDING-TOP: 0in" vAlign=top width="100%">http://www.searo.who.int/en/Section10/Section2246.htm

Chikungunya Fever, a re-emerging Disease in Asia

</TD></TR><TR style="HEIGHT: 15pt"><TD style="PADDING-RIGHT: 1.45pt; PADDING-LEFT: 1.45pt; PADDING-BOTTOM: 0in; WIDTH: 100%; PADDING-TOP: 0in; HEIGHT: 15pt" vAlign=top width="100%">Chikungunya fever, is a viral illness that is spread by the bite of infected mosquitoes. The disease resembles dengue fever, and is characterized by severe, sometimes persistent, joint pain (arthritis), as well as fever and rash. It is rarely life-threatening. Nevertheless widespread occurrence of diseases causes substantial morbidity and economic loss
Epidemiology
Epidemics of fever, rash and arthritis, resembling Chikungunya fever have been recorded as early as 1824 in <?XML:NAMESPACE PREFIX = ST1 /><ST1:COUNTRY-REGION w:st="on"><ST1LACE>India</ST1LACE></ST1:COUNTRY-REGION> and elsewhere. However, the virus was first isolated between 1952-1953 from both man and mosquitoes during an epidemic of fever that was considered clinically indistinguishable from dengue, in the <ST1:COUNTRY-REGION><ST1LACE w:st="on">Tanzania</ST1LACE></ST1:COUNTRY-REGION>.
Chikungunya fever displays interesting epidemiological profiles: major epidemics appear and disappear cyclically, usually with an inter-epidemic period of 7-8 years and sometimes as long as 20 years. After a long period of absence, outbreaks of CHIK fevers have appeared in <ST1:COUNTRY-REGION w:st="on"><ST1LACE>Indonesia</ST1LACE></ST1:COUNTRY-REGION> in 1999.
Chikungunya in <ST1LACE w:st="on">Asia</ST1LACE> (1960-1982)
Between 1960 and 1982, outbreaks of Chikungunya fever were reported from Africa and <ST1LACE>Asia</ST1LACE>. In Asia, virus strains have been isolated in <ST1:CITY>Bangkok</ST1:CITY> in 1960s; various parts of <ST1:COUNTRY-REGION w:st="on">India</ST1:COUNTRY-REGION> including <ST1:CITY>Vellore</ST1:CITY>, <ST1:CITY>Calcutta</ST1:CITY> and Maharastha in 1964; in <ST1:COUNTRY-REGION w:st="on">Sri Lanka</ST1:COUNTRY-REGION> in 1969; <ST1:COUNTRY-REGION>Vietnam</ST1:COUNTRY-REGION> in 1975; <ST1:COUNTRY-REGION>Myanmar</ST1:COUNTRY-REGION> in 1975 and <ST1:COUNTRY-REGION><ST1LACE>Indonesia</ST1LACE></ST1:COUNTRY-REGION> in 1982.
Recent occurrences of chikungunya fever
After an interval of more than 20 years, chikungunya fever has been reported from several countries including <ST1:COUNTRY-REGION>India</ST1:COUNTRY-REGION>, and various Indian Ocean islands including <ST1:COUNTRY-REGION>Comoros</ST1:COUNTRY-REGION>, <ST1:COUNTRY-REGION>Mauritius</ST1:COUNTRY-REGION>, Reunion and <ST1:COUNTRY-REGION w:st="on"><ST1LACE>Seychelles</ST1LACE></ST1:COUNTRY-REGION>.
Chikungunya fever in India
Till 10 October 2006, 151 districts of eight states/provinces of <ST1:COUNTRY-REGION><ST1LACE>India</ST1LACE></ST1:COUNTRY-REGION> have been affected by chikungunya fever. The affected states are Andhra Pradesh, Andaman & Nicobar Islands, Tamil Nadu, Karnataka, Maharashtra, Gujarat, Madhya Pradesh, Kerala and <ST1:CITY><ST1LACE>Delhi</ST1LACE></ST1:CITY>.
More than 1.25 million cases have been reported from the country with 752,245 cases from Karnataka and 258,998 from <ST1LACE>Maharashtra</ST1LACE> provinces. In some areas attack rates have reached up to 45%.
Chikungunya and dengue fevers
The clinical manifestations of chikungunya fever have to be distinguished from dengue fever. Co-occurrence of both fevers has been recently observed in Maharashtra state of <ST1:COUNTRY-REGION><ST1LACE w:st="on">India</ST1LACE></ST1:COUNTRY-REGION> thus highlighting the importance of strong clinical suspicion and efficient laboratory support.
Treatment, prevention and control
Treatment
Chikungunya fever is not a life threatening infection. Symptomatic treatment for mitigating pain and fever using anti-inflammatory drugs along with rest usually suffices. While recovery from chikungunya is the expected outcome, convalescence can be prolonged (up to a year or more), and persistent joint pain may require analgesic (pain medication) and long-term anti-inflammatory therapy.
Prevention and control
No vaccine is available against this virus infection. Prevention is entirely dependent upon taking steps to avoid mosquito bites and elimination of mosquito breeding sites.
To avoid mosquito bites:

</SPAN>Wear full sleeve clothes and long dresses to cover the limbs;

</SPAN>Use mosquito coils, repellents and electric vapour mats during the daytime;

</SPAN>Use mosquito nets ? to protect babies, old people and others, who may rest during the day. The effectiveness of such nets can be improved by treating them with permethrin (pyrethroid insecticide). Curtains (cloth or bamboo) can also be treated with insecticide and hung at windows or doorways, to repel or kill mosquitoes.

</SPAN>Mosquitoes become infected when they bite people who are sick with chikungunya. Mosquito nets and mosquito nets and mosquito coils will effectively prevent mosquitoes from biting sick people.
To prevent mosquito breeding
The Aedes mosquitoes that transmit chikungunya breed in a wide variety of manmade containers which are common around human dwellings. These containers collect rainwater, and include discarded tires, flowerpots, old oil drums, animal water troughs, water storage vessels, and plastic food containers. These breeding sites can be eliminated by

</SPAN>Draining water from coolers, tanks, barrels, drums and buckets, etc.;

</SPAN>Emptying coolers when not in use;

</SPAN>Removing from the house all objects, e.g. plant saucers, etc. which have water collected in them

</SPAN>Cooperating with the public health authorities in anti-mosquito measures.
Role of public health authorities

</SPAN>National programme for prevention and control of vector borne diseases should be strengthened and efficiently implemented with multisectoral coordination

</SPAN>Legislations for elimination of domestic/peridomestic mosquitogenic sites should be effectively enforced

</SPAN>Communities must be made aware of the disease and their active cooperation in prevention and control measures elicited
</TD></TR></TBODY></TABLE>

 

[Jeremy]

Re: WHO on Chikungunya in India - 10/17/2006

Sometimes there is no other word than lie to describe what someone is saying.

The Tourism Minister Kodiyeri Balakrishnan sounds like the Minister of Propaganda.

The WHO report says exactly the opposite of what he claims it says.

http://www.medindia.net/news/view_news_main.asp?x=15143
17 Oct 2006
Kerala Tourism Will not be Affected by Chikungunya: Minister <TABLE align=left><TBODY><TR><TD>

</TD></TR></TBODY></TABLE>
A large number of cases of suspected chikungunya fever in Kerala will not affect the state's booming tourism sector, Tourism Minister Kodiyeri Balakrishnan said Tuesday.

"As the World Health Organisation (WHO) has come out with a report saying that the fever widespread here is not chikungunya, things have cheered up. There have been no reports of cancellation by tourists who have already booked to travel to Kerala," Balakrishnan told reporters here.

The fever, which has claimed more than 130 lives in this season, had hit tourist hotspots like Alappuzha, Kumarakom, Kollam and Kovalam.

The fresh tourist season is all set to commence later this month and the industry is gearing up for it.

"We have given directions to strengthen tourism clubs in colleges and schools to ensure that Kerala is kept clean and this season we expect better participation from these clubs which would add colour to the tourism season," added the minister.

Kerala Tourism director B. Suman said there was a plan to build three dhows that would showcase for tourists how the 16th century spice trade with the Middle East used to be conducted.

"Each dhow will cost Rs.10 million. We have sought the central government's financial assistance. Once we get the green signal, work would begin for it," said Suman.

Meanwhile, the fifth India International Boat Show would begin at Kochi Oct 20.

"The show would also have 16 boats that are coming from Greece as part of the Vasco da Gama Yacht rally and en route to the finishing point in Portugal," said Suman.

Source-IANS
SRM

Medindia on Chikungunya-Overview
Chikungunya is a relatively a rare viral fever that is caused by the bite of a common mosquito. It causes high fever with sometimes joint pain and rashes on the body. It is important to exclude other conditions like Dengue before diagnosing it.

 

[Jeremy]

Re: WHO on Chikungunya in India - 10/17/2006

Based on all the tracking that I have done I would say that there have been at least 15-25 million cases of Chikungunya in India since October of 2005.

The underreporting is rampant and most people who get infected do not go to public hospitals. Most of those infected either go to private hospitals or don't go to the hospital at all because there is no cure for Chikungunya.

The official WHO numbers are at least 6 months old.

But hey, what do I know.