What you need to know about chikungunya
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Nearly 80 cases of chikungunya, the mosquito-borne viral disease, have already been reported this year in the Capital; there are no reports yet of the disease surfacing in other parts of the country. In the last two years, India has seen massive outbreaks, with the numbers running into thousands. According to the National Vector Borne Disease Control Programme website, the total number of chikungunya cases in India in 2016 was 58,136, with Karnataka topping the list at 13,506 cases, followed by Delhi at 12,221 and Haryana at 5,336.
“It occurs during the summers and peaks during the months of July-September, especially after the rain,” says Ashish Khattar, consultant, internal medicine, at the Venkateshwar Hospital in Dwarka, Delhi. Usually then, it is a pre-monsoon and monsoon disease; this year, however, it seems to have arrived much earlier.
It tends to be more prevalent in north India but last year Karnataka reported the highest number of chikungunya cases. Ambanna Gowda, consultant, internal medicine, at the Fortis Hospital in Bengaluru, says more than 10,000 suspected cases and 1,000 confirmed cases were registered last year, possibly due to lowering immunity and higher susceptibility to the virus. “Incidentally, in and around Bengaluru, chikungunya cases are seen throughout the year, unlike in other cities,” he says.
“It shares similar clinical signs with dengue and the symptoms usually begin within three-seven days of a mosquito bite,” says Dr Gowda. “It starts with the abrupt onset of high-grade continuous fever, which lasts for two-three days, along with severe, debilitating joint pain and joint swelling. Some other accompanying symptoms are body ache, nausea, fatigue, rashes, headache and retro orbital pain (occurring behind the orbit of the eye),” he adds. Dr Khattar warns that while the fever may subside, the joint pains may last from days to weeks, sometimes even months. A blood test is the only sure way of identifying chikungunya. Common laboratory tests for chikungunya include RT-PCR (reverse transcription polymerase chain reaction) and serological tests.
There is no vaccine or medicine for the disease. Treatment is focused on relieving the symptoms. “The current treatment modalities include relieving the symptoms, including the joint pain, using antipyretics and optimal analgesics. Symptomatic treatment gives relief to the patient,” says Rajesh Budhiraja, consultant (internal medicine) at the Asian Institute of Medical Sciences, Faridabad. Fluid intake and complete bed rest are the most important, suggests Dr Gowda. According to Dr Budhiraja, it is important to distinguish between chikungunya and dengue. In dengue, the symptoms subside in about 15 days; in the case of chikungunya, the symptoms can last for three-six months. While chikungunya’s main symptoms are high fever and excruciating joint pain, dengue comes with high fever, a drop in platelet count, and rash.
Prevention is the way to go
The Delhi government started its awareness programmes with print advertisements and radio ads in March and recruited volunteers from within the community to stop mosquito breeding. This vector disease crisis is man-made, caused primarily by large-scale construction activity and poor upkeep of overhead tanks, so we need to take precautions at the personal level too.
Elderly people and those with diabetes, heart disease, low immunity, and people who stay close to mosquito-breeding sites garbage dumping areas, standing water, and construction sites are more susceptible.
Obviously, you should try to avoid being bitten. “Wear clothes that cover you fully and using mosquito repellents, even mosquito nets if need be, always helps,” suggests Dr Gowda. “Do not go outside at dusk and at dawn, when mosquito activity is high. Also, use a repellent when you do go outside,” says Dr Budhiraja.
Of course, hygiene is important: Prevent water stagnation so mosquitoes do not breed and regularly change water in air coolers. Ensure there is no water standing around your house, such as in potted plants. This, again, can be a breeding ground for mosquitoes.