Chikungunya presence still unconfirmed
 

by Shanika Sriyananda

The deadly dengue virus is 'silently' raising its ugly head again taking some human lives along the way.

But to people it is not the dengue fever but the chikungunya fever that seems to send a chill down one's spine. With close upon 2,000 cases reported across the country, the panic stricken public think that each and every case is chikungunya fever (CF).

The fear has doubled as chikungunya spreads across the Indian sub-continent including our closest neighbour India.

Are they really victims of CF?

"All these cases are not CF and still we are in the process of identifying the cases", Consultant Epidemiologist Dr. Prabha Palihawadena of the Epidemiology Unit (EU) stressed adding that the public should not panic as there was no concrete evidence that CF is in Sri Lanka, yet.

It is difficult to draw a separation line between CF and dengue symptoms, the most common factor being that both viruses are transmitted by 'Aedes aegypti' mosquitoes.

According to WHO Regional Office for South-East Asia, over 1.25 million suspected cases of CF have been reported from eight Indian states.

CF is not transmitted from person to person and the viruses are transmitted to humans only through Aedes aegypti mosquitoes, which are also responsible for spreading dengue.

But Dr. Palihawadena advises the public to clean their environments by sweeping mosquito breeding places and said that the need of the hour was to promote public participatory programs.

"Media also have a responsibility of educating the public on their responsibility rather than reporting the number of victims of CF", she emphasised.

"If the symptoms of a patient are similar to those of the dengue, but the blood tests for the virus shows negative, then doctors should look into the possibility of the patient having contracted CF.

Sometimes the patient may not even have a temperature, only a patchy red rash on the body, hands, legs with joint pains, mainly in the wrists, knees, ankles or small joints", Dr. Palihawadana pointed out.

Consultant Epidemiologist of the EU Dr. Ananda Amarasinghe said that the best advice to the public was to seek medical advice as soon as they suspect that they have been infected with a viral fever. "Do not delay. Things will turn for the worse. Refraining from self medication is the other most important message that should go to the public", he said.

According to Dr. Amarasinghe, the EU is yet to receive the total number of viral fever cases that have been reported throughout the country. He said that viral cases were on the increase and cannot give a total assurance that the cases were CF.

However, the Medical Research Institute (MRI) has sent several samples to Thailand and to India for laboratory investigations to confirm CF. "The MRI is equipped with the facilities to check other viruses caused by mosquito bites but not the CF", he said.

According to Dr. Amarasinghe, CF is a mild form of disease compared to dengue, and the ultimate end result is if the disease reaches the worst situation, the patient will get arthritis. "It is rarely life-threatening. The victims will recover soon and CF is not a killer form of virus as dengue", he stressed.

He said that the virus will remain in the body from 2 to 12 days. Acute CF will last from a few days to a couple of weeks.

Dr. Amarasinghe also said that a person, if infected with CF or with dengue should stay indoors to limit exposure to mosquito bites to avoid further spreading of the infection. "Whether the fever is viral fever, dengue or CF, the best thing is to have a rest after consulting a doctor", he stressed.

No vaccine is available for this virus infection. Prevention is entirely dependent upon taking steps to avoid mosquito bites and elimination of mosquito breeding sites.

The EU consultants warned the public if they do not take action to clean their own environs, which may be deadly hot spots that breeds 'Aedes aegypti' mosquitoes, the spreading of dengue and CF will be speedy. According to WHO, elimination of breeding sites can contribute to the reduction of mosquito densities.

As a result, a key recommendation from the investigation team is for urgent vector control measures coupled with an intensive awareness campaign in the community.

[email protected]

****

What is Chikungunya fever?

Relatively a rare form of viral fever 'Chikungunya' is caused by an alphavirus that is spread by mosquito bites from the Aedes aegypti mosquito species. But a recent research by a Paris based Pasteur Institute claims that the virus has suffered a mutation that enables it to be transmitted by Aedes albopictus (Tiger mosquito).

Chikungunya was first discovered in Tanzania, Africa in 1952. An outbreak of Chikungunya was also discovered in Port Klang in Malaysia in 1999, affecting 27 people .

According to research this was the cause of the actual plague in the South Asian countries. The name is derived from the Makonde word meaning "that which bends up" in reference to the stooped posture developed as a result of the arthritic symptoms of the disease.

The disease was first described following an outbreak on the Makonde Plateau, along the border between Tanganyka and Mozambique, in 1952. Between 1960 and 1982, outbreaks of Chikungunya were reported from Africa and Asia. In Asia, virus strains have been isolated in Bangkok in the1960s; various parts of India including Vellore, Calcutta and Maharashtra in 1964; in Sri Lanka in 1969; Vietnam in 1975; Myanmar in 1975 and Indonesia in 1982.

Source : Wikipedia

****

Treatment

Since there is no proper vaccine available to treat CF the best prevention method that the health experts recommend is, beware of deadly mosquito bites. To avoid mosquito bites one has to simply follow these suggestions:

* Use mosquito coils, repellents or electric vapour mats during daytime;

* Wear full sleeved clothes and long dresses to cover limbs;

* Use mosquito nets for a baby or an elderly person who needs rest during day time and while sleeping at night.

To prevent mosquito breeding:

The deadly Aedes mosquitoes that transmit chikungunya and dengue, breed, especially in clean stagnant water, especially in containers where rainwater gets stagnated. They also breed in discarded tyres, flowerpots and plastic food containers.

Blocked gutters or drainage systems, tyres placed on roofs to keep the roofing intact, bird-baths, coconut shells, yoghurt or any other similar plastic containers, vases and ponds without fish could be its breeding areas. These breeding sites can be eliminated by:

* Draining out water from coolers, tanks, barrels, drums, buckets.

Emptying coolers when not in use.

How parents can deal with...

A hot-tempered child

Behaviours associated with a hot-tempered person are raised voice, rudeness and even physical and verbal aggression.

Reasons

1. Child is unable to handle his frustrations and anger constructively.

2. Child has learned from parents or peers to react to anger in a hot tempered manner.

3. Behaviour is the means chosen by the child to get what he wants or to seek revenge, to gain power or attention.

4. Behaviour is triggered by situations that attack the child's self-esteem.

5. Child has low self-esteem and low threshold for tolerance and frustration.

How to prevent

1. Model appropriate ways of expressing your anger and frustration for example, "I get very upset when I see your toys scattered all around your room."

2. Help your child to express his anger, for example, "You seem to be very upset. Are you angry about not being able to go swimming with Sally?"

3. Help your child to encounter rising agitation by deep breathing or muscle relaxation exercises.

4. Help your child handle his anger by getting him to role-play the appropriate response to anger-provoking feelings.

5. Help your child develop a positive self-image through his interest and activities.

6. Be willing to negotiate and work out solutions to disagreement or conflict.

What to do

1. Use reflective listening skills to acknowledge and respect your child's feelings of anger, for example "You seem to be very upset that your brother tore your drawing book."

2. Handle your child's anger in a calm and friendly manner.

3. Praise your child when he is able to handle his frustrations and anger constructively, for example "You were really patient while waiting your turn in line."

4. Provide physical outlets or other acceptable alternatives to enable your child to express his negative feelings like striking a punching bag.

5. Train child to talk himself out of his anger. Help him to say quietly to himself calming thoughts or thoughts of self-control like "Well! Names can't hurt me so I'll just ignore them."

6. After your child has cooled down, discuss with him on how both of you felt during the episode and alternative ways to solve such problems in the future.

What not to do

1. Scream/shout at child and raise tone of voice.

2. Judge, criticize, lecture and make sarcastic remarks.

3. Confront child as this will cause child to adopt defensive behaviour.

4. Punish child frequently as it makes child more rebellious.

Source: Handling Common Problems of Children.