Chikungunya Symptoms and Prevention -Dr. M R Sa’ad

Chikungunya is a peculiar name and it was unfamiliar to general people. Due to spreading fast in the capital city Dhaka with sporadic rains, there is no way to turn down the issue ‘Chikungunya’. Recently, the Ministry of Health and Family Welfare has detected 23 areas across the capital city Dhaka where the residents are at a greater risk of being infected with Chikungunya. Health experts say, people showing symptoms of the Chikungunya are attending at hospital in every day.
The word Chikungunya is a Makonde term which is the language spoken by the Makonde, an ethnic group in South-East Tanzania and northern Mozambique. The term is derived from the Makonde root verb ‘kungunyala’ meaning to dry up, become contorted. It has another meaning, ‘something that bends up’. The disease was first described by Morlon Robinson and W.H.R. Lumsden in 1955 following an outbreak in 1952 on the Mokonde plateau. A large outbreak occurred in the Democratic Republic of the Congo in 1999-2000. Since its discovery, recent outbreaks have spread the disease over a wider range across Africa, South Asia and South-East Asia.
According to World Health Organization (WHO), Chikungunya fever is a mosquito borne viral disease transmitted to humans by infected mosquitoes causing fever and severe joint pain. It’s an RNA virus. Chikungunya virus (CHIKV) is a member of the genus Alphavirus, in the family Togaviridae. The virus is transmitted from human to human by the bites of infected female mosquitoes named predominantly Aedesaegypti and Aedesalbopictus. The Chikungunya virus is transmitted to human body when a bite from an infected mosquito penetrates the skin and inculcates the virus into the body. These mosquitoes usually breed in open containers, buckets, coconut husks, bamboo stumps, flowering pots, tanks, disposable objects etc. Due to lack of cleanliness of these things with stagnant water in and around the houses, Chikungunya spreads fast.
In Bangladesh, the outbreak of Chikungunya was first detected in Rajshahi and Chapainawabgonj in 2008 and several cases were found in Pabna and Dohar upazila of Dhaka district in 2011. Chikungunya shares some similar clinical signs with Dengue fever. So it can easily be misdiagnosed. It’s not a fatal disease and don’t have any risk of death. But it can cause acute, sub-acute or chronic disease.

Symptoms
After the bite of an infected mosquito, onset of illness occurs usually between 4 and 8 days but can range from 2 to 12 days. Though both Chikungunya and Dengue show common features like fever and pain, in case of Chikungunya, pain is so severe that individual can hardly move his/her limbs. Some signs and symptoms of Chikungunya are following:
Sudden onset of fever (39-40’c or 102-104’f). Fever can vary from low to high grade
Small pimple like rash on body
Severe pain in joints. Pain may persist for several months or even years
Muscle pain, headache, backache
Nausea, vomiting
Diarrhea, pain behind eyes
Mental confusion is common in children but not in adult
Orbital, neurological, cardiac and gastrointestinal complains may contribute in occasional cases. People with hypertension, diabetes, pregnancy, elderly, pneumonia, tuberculosis, co-infection with dengue, COPD are at greater risk.
As Chikungunya and Dengue are transmitted by the same mosquitoes and share some resembling features so it’s quite tough to differentiate Chikungunya and Dengue based on clinical symptoms & signs only. A complete blood test can be done. Other serological or laboratory tests should be done based on the advice of registered Doctors.

Treatment
There is no specific treatment for Chikungunya. And there is no commercial antiviral or vaccine for Chikungunya. Supportive treatment is recommended and basically treatments focus on relieving the symptoms.
The following steps may be followed
Complete bed rest
Drink plenty of pure drinking water or fluid to prevent dehydration
Cold compression by Icepack or wet towel may help in alleviating joint pain and fever
Paracetamol is the drug of choice for relieving pain and fever
But self-medication should be avoided. Every medication should be advised and prescribed by registered doctors
Patient with multifactorial disease may need hospitalization or if associated conditions worsen like decreasing of urine output, bleeding manifestations
Among of all measures, proper consciousness and awareness required for prevention of Chikungunya. As the habitats of responsible vectors of Chikungunya breed in natural and artificial stagnant water filled containers, so cleaning and reducing the number of habitats that facilitate breeding of the mosquitoes is the foremost function. Before or during outbreaks, insecticides should be sprayed around the houses to destruct the habitats of the mosquitoes and kill the immature larva. City corporation authority can take mosquito elimination program for quick footstep. Responsible mosquitoes can bite throughout daytime. So people of mosquito prone areas and infected personal should take rest under bed-net even in day time. Using of mosquito coil, spray, insect repellent can reduce indoor biting. Not letting water stagnate.
Chikungunya is a non-fatal disease and it’s curable.  Health experts advised not to panic over Chikungunya. Proper knowledge and consciousness can minimize the spread of Chikungunya. But this is not the government’s job only rather people from all walks of life should step forward to raise awareness against Chikungunya.