Chikunguniya : Preventive Measures

Hardeep Sembi

Close on the heels of reports on Dengue fever, the country now faces a resurgence of Chikungunya, with a number of cases being reported in the state of Kerala. Do read on........

Chikungunya [chick'-en-GUN-yah], also called chikungunya virus disease or chikungunya fever, is a viral illness that is spread by the bite of infected mosquitoes. The disease resembles dengue fever, and is characterized by severe, sometimes persistent, joint pain (arthritis), as well as fever and rash.

· Chikungunya occurs in Africa, India, and Southeast Asia. It is primarily found in urban areas.
· There is no specific treatment for chikungunya.
· Prevention centers on avoiding mosquito bites in areas where chikungunya virus may be present, and by eliminating mosquito breeding sites.

How is chikungunya spread?

Chikungunya is spread by the bite of an Aedes mosquito, primarily Aedes aegypti . Humans are thought to be the major source, or reservoir, of chikungunya virus for mosquitoes. Therefore, the mosquito usually transmits the disease by biting an infected person and then biting someone else. An infected person cannot spread the infection directly to other persons ( i.e., it is not a contagious disease). Aedes aegypti mosquitoes bite during the day. The Aedes mosquitoes that transmit chikungunya breed in a wide variety of manmade containers which are common around human dwellings. These containers collect rainwater, and include discarded tires, flowerpots, old oil drums, animal water troughs, water storage vessels, and plastic food containers.

What are the symptoms of chikungunya?

Chikungunya usually starts suddenly with fever, chills, headache, nausea, vomiting, joint pain, and rash. In Swahili, "chikungunya" means "that which contorts or bends up." This refers to the contorted (or stooped) posture of patients who are afflicted with the severe joint pain (arthritis) which is the most common feature of the disease. Frequently, the infection causes no symptoms, especially in children. While recovery from chikungunya is the expected outcome, convalescence can be prolonged (up to a year or more), and persistent joint pain may require analgesic (pain medication) and long-term anti-inflammatory therapy. Infection appears to confer lasting immunity.

How soon after exposure do symptoms appear?

The time between the bite of a mosquito carrying chikungunya virus and the start of symptoms ranges from 1 to 12 days.

How is chikungunya diagnosed?

Chikungunya is diagnosed by blood tests. Since the clinical appearance of both chikungunya and dengue are similar, laboratory confirmation is important, especially in areas where dengue is present.

What is the treatment for chikungunya?

There is no specific treatment for chikungunya. Supportive therapy that helps ease symptoms, such as administration of nonsteroidal anti-inflammatory drugs, and getting plenty of rest, may be beneficial. Infected persons should be isolated from mosquitoes in as much as possible in order to avoid transmission of infection to other people.

How can chikungunya be prevented?

Prevention of the disease centers on avoiding mosquito bites when traveling to areas where chikungunya occurs. Eliminating mosquito breeding sites is another key prevention measure. To prevent mosquito bites, do the following:

· When indoors, stay in air-conditioned or well screened areas. Use bed nets if sleeping in areas that are not screened or air-conditioned.

· When outdoors during times that mosquitoes are biting, wear long-sleeved shirts and long pants. Use mosquito repellents on skin and clothing.

· Use insect repellents.

· Use sparingly on children, and don't apply to their hands, which they often place in their mouths.

· Apply lightly and evenly to exposed skin; do not use underneath clothing. Avoid contact with eyes, lips, and broken or irritated skin.

· To apply to your face, first dispense a small amount of repellent onto your hands and then carefully spread a thin layer.

· Wash off when exposure to mosquitoes ceases.

· When using repellent and a sunscreen, apply the sunscreen first. After 30 minutes to an hour, apply the repellent. This allows the sunscreen time to penetrate and bind to the skin, and will not interfere with the efficacy of the repellent.

· For your clothing, use an insect repellent spray to help prevent bites through the fabric. Use a product that contains permethrin. Permethrin should only be used on clothing, never on skin.

· When using any insect repellent, always FOLLOW LABEL

DIRECTIONS.

· Do not inhale aerosol formulations.