The Outbreak of Chikungunya

Chikungunya is a viral disease caused by the chikungunya virus. The virus is transmitted from human to human by the bites of infected female mosquitoes. Most commonly, the mosquitoes involved are Aedes aegypti and Aedes albopictus, two species which can also transmit other mosquito-borne viruses, including dengue. These mosquitoes can be found biting throughout the day; although, the bitings peak early in the morning and during late afternoon.

The disease was first detected in 1952 in Africa following an outbreak on the Makonde Plateau. According to the initial 1955 report, the term ‘Chikungunya’ is derived from the Makonde root verb kungunyala which means to dry up or become contorted. Chikungunya virus is believed to be originated in Central and East Africa, where the virus was discovered in a sylvatic cycle between forest-dwelling mosquitoes and nonhuman primates. Since its discovery in Africa, in 1952, Chikungunya virus outbreaks have occurred occasionally, but recent outbreaks have spread the disease to other parts of the world. Numerous chikungunya re-emergences have been documented in Africa, Asia (specifically India) and Europe, with irregular intervals of 2?20 years between outbreaks. Currently, chikungunya virus has been identified in nearly 100 countries across the globe.

Chikungunya disease does not often result in death, but the symptoms can be severe and disabling. The disease typically begins with sudden high fever that lasts for a week or two. The fever is usually above 39 °C (102 °F) and sometimes reaching 40 °C (104 °F) and may be lasting several days, breaking, and then returning. Following the fever, joint pain occurs. It generally lasts for weeks but is some cases it might last for years. The most affected joints are arms and legs, in addition, the affect here is symmetrical. Pain most commonly occurs in minor joints, such as the wrists, ankles, and joints of the hands and feet as well as some of the larger joints, typically the shoulders, elbows and knees. Another characteristic symptom of chikungunya is rash. It occurs in 40-50% of cases, generally occurring two to five times a day along with the other symptoms. Digestive symptoms, including abdominal pain, nausea, vomiting or diarrhea, may also occur. In more than half of cases, normal activity is limited by significant fatigue and pain.

The disease shares some clinical signs with dengue, and can be misdiagnosed in areas where dengue is common. However, chikungunya is very different from dengue. It can circulate with the help of monkeys, birds and cattle, but dengue spreads only through mosquitoes. While for dengue the symptoms subside in about 15 days, Chikungunya symptoms can prolong for 3-6 months. While Chikungunya?s main symptoms are high fever and excruciating joint pain, dengue manifests with high fever, drop in platelet count and rash.

There is no specific cure for Chikungunya, and there is no vaccine to-date to prevent it so majority of the treatment is focused on relieving the symptoms. An infected person needs to provide complete rest to his body, drink a lot of fluids, and also take medication like ibuprofen, naproxen, or acetaminophen to reduce the fever and the affect of pain until the symptoms fade. Lately, immunotherapy proved to be very effective and beneficial for the treatment of Chikungunya. Studies in animals using passive immunotherapy have been very informative, and clinical studies using the same have progressed efficiently. Passive immunotherapy involves administration of anti-CHIKV (another name for chikungunya virus) to those exposed to a high risk of Chikungunya infection.

Thenold proverb “Prevention is better than cure” applies very well in this case. It is always better to go by the principles of prevention, and save ourselves from the deadly repercussions the of Chikungunya. Being indifferent or negligent to our health may definitely cause illness which may end to the costly cure and perhaps, sometimes impossible to get normal health. The best way to avoid CHIKV infection is to prevent mosquito bites. As such, following precautions are important – (i) Use mosquito repellent on exposed skin; (ii) Wear long sleeves shirts and pants; (iii) Have secure screens on windows and doors to keep mosquitoes out; (iv) Get rid of mosquito breeding sites by emptying standing water from flower pots, buckets and barrels; (v) Change the water in pet dishes and replace the water in bird baths weekly; (vi) Drill holes in tire swings so water drains out because stagnant water causes mosquitoes to breed. Additionally, a person with chikungunya fever should limit their exposure to mosquito bites in order to avoid further spreading the infection. The person should stay indoors or under a mosquito net.

Chikungunya virus is a serious global threat for both the sheer number of individuals it infects, as well as the intensity and duration of the suffering it causes in each patient. It is rapidly expanding across the globe and will continue to infect millions each year. Scientists and health officials are all working together to limit the suffering it brings. People around the globe should be vigilant about controlling the mosquito population near their homes. While the scientists are at work to prevent and cure the disease, it is also our individual responsibility to minimize the cases of Chikungunya in our communities by spreading awareness and following basic precautions.

– Contributed by Riddhi, a Student of Bachelor  of Commerce (Hons)

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