Chikungunya Fever - Information Sheet

Chikungunya=20 Fever

Chikungunya = Fever, a=20 re-emerging Disease in Asia

Chikungunya fever, is = a viral=20 illness that is spread by the bite of = infected=20 mosquitoes. The disease resembles dengue = fever,=20 and is characterized by severe, sometimes=20 persistent, joint pain (arthritis), as = well as=20 fever and rash. It is rarely = life-threatening.=20 Nevertheless widespread occurrence of = diseases=20 causes substantial morbidity and economic = loss

Epidemiology

Epidemics of fever, = rash and=20 arthritis, resembling Chikungunya fever = have been=20 recorded as early as 1824 in = India=20 and elsewhere. However, the virus was = first=20 isolated between 1952-1953 from both man = and=20 mosquitoes during an epidemic of fever = that was=20 considered clinically indistinguishable = from=20 dengue, in the = Tanzania.=20

Chikungunya fever = displays=20 interesting epidemiological profiles: = major=20 epidemics appear and disappear cyclically, = usually=20 with an inter-epidemic period of 7-8 years = and=20 sometimes as long as 20 years. After a = long period=20 of absence, outbreaks of CHIK fevers have = appeared=20 in Indonesia=20 in 1999.

Chikungunya in = Asia = (1960-1982)

Between 1960 and = 1982,=20 outbreaks of Chikungunya fever were = reported from=20 Africa and = Asia. In=20 Asia, virus strains have been isolated in=20 Bangkok in 1960s; = various=20 parts of India = including=20 Vellore,=20 Calcutta and = Maharastha in=20 1964; in Sri=20 Lanka in 1969;=20 = Vietnam=20 in 1975;=20 = Myanmar=20 in 1975 and=20 = Indonesia= =20 in 1982.

Recent occurrences = of=20 chikungunya fever

After an interval of = more than=20 20 years, chikungunya fever has been = reported from=20 several countries including=20 = India,=20 and various Indian Ocean islands including = = Comoros,=20 = Mauritius,=20 Reunion and Seychelles.=20

Chikungunya fever = in=20 India

Till 10 October 2006, = 151=20 districts of eight states/provinces of=20 = India=20 have been affected by chikungunya fever. = The=20 affected states are Andhra Pradesh, = Andaman &=20 Nicobar Islands, Tamil Nadu, Karnataka,=20 Maharashtra, Gujarat, Madhya Pradesh, = Kerala and=20 = Delhi.=20

More than 1.25 = million cases=20 have been reported from the country with = 752,245=20 cases from Karnataka and 258,998 from=20 Maharashtra = provinces. In=20 some areas attack rates have reached up to = 45%.=20

Chikungunya and = dengue=20 fevers

The clinical = manifestations of=20 chikungunya fever have to be distinguished = from=20 dengue fever. Co-occurrence of both fevers = has=20 been recently observed in Maharashtra = state of=20 India=20 thus highlighting the importance of strong = clinical suspicion and efficient = laboratory=20 support.

Labo= ratory=20 Diagnosis

The clinical = manifestations of=20 chikungunya fever resemble those of dengue = fever.=20 Laboratory diagnosis is critical to = establish the=20 cause of diagnosis and initiate specific = public=20 health response.

Treatment, = prevention and=20 control

Treatment

Chikungunya fever is = not a life=20 threatening infection. Symptomatic = treatment for=20 mitigating pain and fever using = anti-inflammatory=20 drugs along with rest usually suffices. = While=20 recovery from chikungunya is the expected = outcome,=20 convalescence can be prolonged (up to a = year or=20 more), and persistent joint pain may = require=20 analgesic (pain medication) and long-term=20 anti-inflammatory therapy.

Prevention and=20 control

No vaccine is = available against=20 this virus infection. Prevention is = entirely=20 dependent upon taking steps to avoid = mosquito=20 bites and elimination of mosquito breeding = sites.=20

To avoid mosquito = bites:

Wear=20 full sleeve clothes and long dresses to = cover the=20 limbs;

Use=20 mosquito coils, repellents and electric = vapour=20 mats during the daytime;

Use=20 mosquito nets =96 to protect babies, old = people and=20 others, who may rest during the day. The=20 effectiveness of such nets can be improved = by=20 treating them with permethrin (pyrethroid=20 insecticide). Curtains (cloth or bamboo) = can also=20 be treated with insecticide and hung at = windows or=20 doorways, to repel or kill mosquitoes.

Mosquitoes=20 become infected when they bite people who = are sick=20 with chikungunya. Mosquito nets and = mosquito nets=20 and mosquito coils will effectively = prevent=20 mosquitoes from biting sick people.

To prevent = mosquito=20 breeding

The Aedes mosquitoes = that=20 transmit chikungunya breed in a wide = variety of=20 manmade containers which are common around = human=20 dwellings. These containers collect = rainwater, and=20 include discarded tires, flowerpots, old = oil=20 drums, animal water troughs, water storage = vessels, and plastic food containers. = These=20 breeding sites can be eliminated by

=20 Draining water from = coolers,=20 tanks, barrels, drums and buckets, = etc.;

=20 Emptying coolers when = not in=20 use;

=20 Removing from the = house all=20 objects, e.g. plant saucers, etc. which = have water=20 collected in them

=20 Cooperating with the = public=20 health authorities in anti-mosquito = measures.

Role of public = health=20 authorities

National=20 programme for prevention and control of = vector=20 borne diseases should be strengthened and=20 efficiently implemented with multisectoral = coordination

Legislations=20 for elimination of domestic/peridomestic=20 mosquitogenic sites should be effectively=20 enforced

Communities=20 must be made aware of the disease and = their active=20 cooperation in prevention and control = measures=20 elicited