Chickengunya

Abstract

Dear Sir,

There is a recent outbreak of the disease chickengunya in Pakistan. A lot of cases have been reported out of which majorly are from Karachi. The increase in temperature and deplorable sanitary conditions of Pakistan further adds fuel to the fire by providing excellent breeding grounds for the arthropod vectors.¹ Thus I am writing to your esteemed journal to inform the readers about the disease and its possible ways of prevention.

Sindh Health Department released a report which stated that a total 4,329 chikungunya suspected cases surfaced in the province, out of which 3, 462 were from Karachi while rest of the cases surfaced in Tharparkar/Mithi, Sanghar and Umerkot.² Out of total 3,462 in Karachi, 1740 cases were reported in District Malir, 156 in District Central, 180 in District South, 1210 in District West, 165 in District East and 11 in District Korangi.³

"Chikungunya" word comes from the Makonde language which means to walk bent over. During an outbreak in Tanzania in 1952, disease was first described. Chikungunya is an RNA virus and a member of the Togaviridae family. It is transmitted by a bite from an infected female mosquito Aedesmosquitoes (Aedes aegypti and Aedes albopictus) and the symptoms appear after a few days. Symptoms include fever (sometimes as high as 104 °F),joint pain ,headache ,muscle pain ,rash, swelling around the joints. Other symptoms include fatigue  , nausea aphthae , erosions and cheilitis atypical manif neurological, cardiovascular, skin, ocular, renal and other manifestations. ⁴

Only a blood test can definitively diagnose chikungunya as symptoms are not always easy to tell apart from other conditions.

Currently, there is no vaccine or antiviral treatment. There are no specific drugs to treat chikungunya; doctors simply recommend rest and plenty of fluid Medication focuses on relieving the symptoms rather than the causes. ⁵Seeing as the major mode of chikungunya transmission is by mosquito bite, the best methods of prevention involve minimizing contact with mosquitos. Steps that can be taken to prevent chikungunya include:

• Using insect repellent containing DEET (N, N-Diethyl-meta-toluamide) or picaridin on skin and clothing.
• Wearing clothing that covers the whole body.
• Staying indoors as much as possible, especially during early morning and late afternoon.
• Avoiding traveling to areas experiencing outbreaks.
• Using products containing oil of lemon eucalyptus or PMD (p-Menthane-3, 8-diol) can be effective.
• Using air-conditioning - this deters mosquitos from entering rooms.
• Sleeping under a mosquito net.
• Using mosquito coils and insecticide vaporizers.

Although chikungunya is very rarely fatal, the symptoms are distressing and can be long-lived. Avoiding mosquitos is the key of prevention. The outbreak is closely tied up with the warm climate and wretched sanitary state of the city Educating the public on vector control measures such as spraying insecticides, an urgent need to rid the city of stagnant water bodies and other preventive measures should be emphasized.