Chikungunya An entangled and rampant disease

Chikungunya, which takes its name from the Makonde language's graphic description of the patient's state (bent over and unable to walk upright), is a mosquito-borne viral illness. It is spread by the bite of the Aedes mosquito, which also spreads dengue fever. There have been recent breakouts of Chikungunya virus (CHIKV) associated with severe illness. It causes an illness with symptoms similar to dengue fever and hence it is often confused with dengue, producing abject conditions for the patient.

Mosquitoes become infected with chikungunya virus when they feed on an infected person. Infected mosquitoes can then spread the virus to other humans when they bite them. Monkeys, and possibly other wild animals, may also serve as reservoirs of the virus. Aedes aegypti, a household container breeder and aggressive daytime biter which is attracted to humans, is the primary vector of chikungunya virus to humans.
Epidemics of fever, rash and arthritis, resembling Chikungunya fever have been recorded as early as 1824 in India and elsewhere. However, the virus was first isolated between 1952-1953 from both man and mosquitoes during an epidemic of fever that was considered clinically indistinguishable from dengue, in the Tanzania. Between 1960 and 1982, outbreaks of Chikungunya fever were reported from Africa and Asia.  In Asia, virus strains have been isolated in Bangkok in 1960s and various parts of India including Vellore, Calcutta and Maharastha in 1964.
Chikungunya virus infection can cause a debilitating illness, most often characterized by fever, headache, fatigue, nausea, vomiting, muscle pain, rash, and joint pain. “Silent” chikungunya virus infections (infections without illness) do occur; but how commonly this happens is not yet known. Chikungunya virus infection (whether clinically apparent or silent) is thought to confer life-long immunity. Acute chikungunya fever typically lasts a few days to a couple of weeks, but as compared to dengue, West Nile fever, and other viral fevers, some patients have prolonged fatigue lasting several weeks. Additionally, some patients have reported incapacitating joint pain, or arthritis which may last for weeks or months.
Recently Municipal Corporation of Delhi(MCD) has issued notices to 30 government offices, schools and colleges in the last one week for mosquito-breeding on their premises. According to senior MCD officials, cases of dengue and other mosquito-borne diseases like chikungunya and malaria are on the rise and action is being taken to ensure that people keep their premises clean and not allow stagnation of water. A total 155 cases of dengue have been reported from across the city this season, including four cases which came into spotlight as they are of Chikungunya.
The matter of concern is that there is no vaccine or specific antiviral treatment currently available for chikungunya fever. Treatment is symptomatic and can include rest, fluids, and medicines to relieve symptoms of fever and aching such as ibuprofen, naproxen, acetaminophen, or paracetamol. Aspirin should be avoided though. Infected persons should be protected from further mosquito exposure (staying indoors in areas with screens and/or under a mosquito net) during the first few days of the illness so they can not contribute to the transmission cycle.
Now, the obvious question that comes to any mind is, if we are not really prepared to combat such a situation then what are the authorities doing to curb the menace. Diseases do not hit us with ad-campaigns. At the maximum they may come with a trailer, before they turn into an epidemic. Whether we recognize this trailer or not is important. Apparently it seems that we missed it out in this case.
Change in government policies to promote public-private collaboration to deal with such crisis situations should be given serious thought. Setting up awareness camps, launching mobile clinics are a few exemplary initiatives to start with. We must take this as a lesson and carry on the good work. So that in future if such an unfortunate thing happens yet again we are well equipped to strike back.
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