Chikungunya…that which bends up

Chikungunya is a mosquito borne viral disease. Around 3500 cases of Chikungunya have been reported from Ratnapura, Kalmunai, Polonnaruwa and Monaragala districts during the recent epidemic (December 2008/January 2009).

The infective agent is Chikungunya Virus (CHIKV), which belongs toalpha-virus under Toga viridae family. It is an "Arbovirus"(Ar-arthropod,bo-borne).It was first isolated form the blood of a febrile patient in Tanzania in 1953 and was first reported from Sri Lanka in 1969. Cyclical appearance of epidemics and becoming silent sometimes for decades is a characteristic of this infection. The first epidemic of Chikungunya was reported from Colombo and Kalutara in 2006.

This viral infection is spread by mosquitoes Aedis aegypti and Aedis albopictus, the same vectors of Dengue Fever. Aedis aegypti is the principal vector of Chikungunya. This is a household container breeder and aggressive day time biter. Aedis albopictus in Asia, and other varieties of mosquitoes in Africa also contribute to the spread of this epidemic. Mosquitoes get infected when they feed on a blood meal of an infected person. Similarly, when the infected mosquito bites another human being, the virus may be transmitted. The incubation period or time from infection to illness is 2 to12 days, however, it is usually 3 to 7 days.

One should suspect Chikungunya if the following symptoms are there:

• High Fever.
• Joint pains: many joints are often affected.
• Rash.
• Nausea, vomiting and headache.

It should be noted that the differentiation of Dengue fever and Cikungunya at initial stages can be difficult. Unlike dengue fever, Chikungunya does not kill people, except the very old and those with preexisting morbidities. However, this illness can make a patient suffer sometimes for months, due to handicapping joint pains.

There is no specific treatment for Chikungunya. You should drink a lot of fluids and take pain killers for pain. If the symptoms are severe after a considerable duration of time, a specialist may decide on starting long-term anti inflammatory therapy.

Chikungunya can be prevented through the following strategies:

• Risk communication to the public with the use of mass media and community members.
• Control of mosquito breeding sites.
• Preventing mosquito human contact.
• Strengthening the epidemiological surveillance.
• Fogging at selected locations with Malathion, kills adult mosquito population, of limited value.

Chikungunya, as Dengue fever, is a result of unsustainable development. Unplanned town development and poor solid waste management systems have provided ample breeding grounds for the mosquitoes. Chikungunya epidemics should be an eye opener to all Sri Lankans to initiative a positive trend towards a Safer Sri Lanka.