TOPICS: Chikungunya threat

Chikungunya is an emerging viral disease and a public health problem in South Asia, including Nepal, in recent years. In Nepal vector borne diseases like dengue and chikungunya are very common and easily transmitted by the bite of infected mosquitoes widely found in Nepal, including Kathmandu valley.

Most people do not know about chikungunya because of common symptoms like fever and severe joint pain, including muscle pain, headache, nausea, fatigue and rash.The disease shares some clinical signs with dengue and zika, so even health professionals misdiagnose them in areas where they are common.

The joint pain is often very debilitating and usually lasts for a few days or may be prolonged for weeks. Most patients recover fully, but in some cases joint pain may persist for several months or even years. Serious complications are not common, but in elderly people it may lead to death. In many cases the infection may go unrecognized or misdiagnosed.

The virus is transmitted from human to human by the bites of infected female mosquitoes, Aedesagypti. These mosquitoes can be found biting throughout the day though their peak activity is early morning and late afternoon. Onset symptoms appear usually after four to eight days of mosquito bites. Serological tests are done for diagnosis based on the symptoms.

Chikungunya virus was first confirmed in Kolkota in 1963-64 during a fever outbreak in India, but it had not been detected since 1973. It was again detected in 2005 after an interval of 32 years. The disease may be brought to Nepal by migrant workers and others from India and in Tarai region chikungunya is more prevalent.

For chikungunya, as in dengue, there is no specific antiviral drug available. Treatment is done for relieving symptoms, including joint pain, using anti-pyretic and painkillers. Patients need to drink lots of fluid and get plenty of rest. There is no commercial vaccine available.

Protective clothing using insect repellents and other measures to prevent mosquito bites are important to avoid this disease. Public health measures like not letting water collect around residences where mosquitoes breed are crucial. The best way of prevention is to protect oneself from mosquito bites.

The government should increase awareness and be prepared to prevent outbreaks by a mosquito control program.

Nepal is an MSc in Microbiology from TU