Chikungunya? Help!

“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” William Osler

By Alex P. Vidal

If indeed it is true that there was a suspected outbreak of Chikungunya disease in five Iloilo towns, then there is reason for us to press the panic button.

By all means, we need help! No more beating around the bush.

Help should come from the Department of Health (DOH) and the World Health Organization (WHO) which originally coined the viral disease (genus Alphavirus) transmitted to humans by infected mosquitoes--including Aedes aegypti and Aedes albopictus.

The almost 300 suspected cases of chikungunya were all detected in the five Iloilo towns, according to Iloilo Provincial Health Office (PHO) assistant head, Dr. Ma. Socorro Colmenares-Quiñon, who monitored several patients in the towns of Guimbal, Oton, Carles, Tigbauan and Igbaras.

She said the patients manifested symptoms of chikungunya.

“Most of them were reported to have headache and joint pains which are the symptoms of chikungunya. It was followed by two days of fever and rashes,” Quiñon said as quoted by reporter Louine Hope Conserva.

FATAL

How deadly is chikungunya? Is it as fatal as the, Ebola, SARS and HIV?

The WHO explained that the name chikungunya originates from a verb in the Kimakonde language, meaning “to become contorted”. This refers to the “stooped” appearance of those suffering with joint pain.

Symptoms reportedly appear between four and seven days after the patient has been bitten by the infected mosquito and these include: High fever (40°C/ 104°F), joint pain (lower back, ankle, knees, wrists or phalanges), joint swelling, rash, headache, muscle pain, nausea, and fatigue.

Chikungunya is rarely fatal, confirmed the WHO. Symptoms are generally self-limiting and last for two to three days.

The virus remains in the human system for five to seven days and mosquitoes feeding on an infected person during this period can also become infected, according to the WHO.

Chikungunya shares some clinical signs with dengue and can be misdiagnosed in areas where dengue is common, it adds.

Chikungunya can reportedly be detected using serological tests. Recovery from an infection will confer life-long immunity.

Chikungunya has been identified in nearly 40 countries. Countries having documented, endemic, or epidemic chikungunya are:

Asia: Human chikungunya virus infection has been documented in Cambodia, East Timor, India, Indonesia, Laos, Malaysia, Maldives, Myanmar, Pakistan, Philippines, Réunion, Seychelles, Singapore, Taiwan, Thailand and Vietnam.

Africa: Chikungunya occurs in Benin, Burundi, Cameroon, Central African Republic, Comoros, Congo (DRC), Equatorial Guinea, Guinea, Kenya, Madagascar, Malawi, Mauritius, Mayotte, Nigeria, Senegal, South Africa, Sudan, Tanzania, Uganda and Zimbabwe.

Europe and the Americas: Aside from minor incidence rates caused by imported cases from travelers, Italy is the only European country which has had an outbreak. The Americas have not had any major outbreaks so far.

IDENTIFIED

The WHO confirmed that chikungunya was first identified in Tanzania in the early 1952 and has caused periodic outbreaks in Asia and Africa since the 1960s.

Outbreaks are reportedly often separated by periods of more than 10 years. Between 2001 and 2011, a number of countries reported on chikungunya outbreaks.

2005-2006: More than 272 000 people were infected during an outbreak of Chikungunya in the Indian Ocean islands of Réunion and Mauritius where Ae. albopictus was the presumed vector.

2006: Outbreak in India, more than 1 500 000 cases of chikungunya were reported with Ae. aegypti implicated as the vector.

2007: Migration of infected people introduced the infection in a coastal village in Italy. This outbreak (197 cases) confirmed that mosquito-borne outbreaks by Ae. albopictus are plausible in Europe.

AREAS

The WHO said in areas where the vector of chikungunya is Ae. aegypti and Ae. albopictus, vector prevention and control can be combined with dengue control efforts.

Conserva quoted Quiñon as saying, “Most of them were reported to have headache and joint pains which are the symptoms of chikungunya. It was followed by two days of fever and rashes.”

Carles reportedly recorded 102 cases, Oton has 20 cases, Tigbauan with 43 and Ibaras with 118.

Conserva reported further that Quiñon has advised residents in affected areas to practice the 4S Kontra Dengue (Search and Destroy, Seek early consultation, Self-protective measures and Say no to indiscriminate fogging) to combat chikungunya or submit themselves to isolation if they believe they contracted German measles.

A collective effort is needed to fight the disease. Let’s always make it a top priority to clean our surroundings. After all, an ounce of prevention is better than a pound of cure.