The onset of the monsoons in India brings both good and bad tidings. Good tidings include welcome relief from the scorching summer heat, bonus to farmers, gardeners etc.  The monsoons bring life but just as easily bring death in the form of the innocuous winged killer, the mosquito. As angry thunderheads break out, hordes of mosquitoes threaten India with sometimes fatal malaria, dengue, filariasis or elephantiasis and other diseases.

Today the mosquito can breed anywhere from a rice field to a cupful of water i.e. basically anywhere where there is dirty or even clean but stagnant water accumulation.

Among the three common mosquito transmitted diseases dengue and malaria can be fatal if not treated on time but chikungunya can leave behind more after effects like the severe body and joint pain. The disease was first identified during an outbreak in southern Tanzania in 1952.  It has nothing to do with consumption of chicken as some people believe but is purely a mosquito transmitted viral disease like malaria and dengue.  The word chikungunya is derived from the Kimakonde language which means ‘’contorted’ ’describing the typical stooped appearance of sufferers  due to the severe joint pain[arthralgia].  The disease mostly occurs in Africa, Asia and the Indian subcontinent but a severe outbreak in 2015 affected many American countries.

The disease is transmitted to humans by the bite of chikugunya virus infected female mosquito. The 2 mosquito species involved are the ‘’aedes aegypti’’ and ‘’aedes albopictus’’. These are commonly called ‘’tiger mosquito’’due to their striped appearance.  They also cause dengue. Very important to note that these mosquitoes bite during the daytime with peak activity in early morning and late afternoon.  Commonly bite outdoors though ‘’aedes aegypti’’ can also bite indoors.  So please take precautions against mosquito bites during daytime too as people commonly associate mosquito bites with night.

Symptoms.  These usually occur within 4 to 8 days of mosquito bite and include

1] Abrupt onset of fever

2] Very severe joint pain making the patient to adopt a bent back or stooped appearance to try to get relief from the agony. This is one characteristic symptom which can help in differentiating chikungunya from malaria or dengue.

3] Headache and muscular pain

4] Fatigue

5] Nausea

6] Skin rash

Most patients usually recover fully, very rarely there may be eye, heart or nerve complications. But the joint pain can persist for months or even years. Hence though malaria and dengue can be fatal unlike chikungunya they do not leave after effects like this relatively less ‘’talked about mosquito disease’ so, please do not underestimate chikungunya, in general take adequate anti mosquito measures.

Diagnosis

This is from a blood sample and based on developing antibodies to the chikungunya virus in the blood. However antibodies to this virus develop only 10—14 days after infection and hence blood diagnosis of this disease can be done late only unlike malaria and dengue. Sometimes a minimum of 3 blood samples taken days apart may be required for a positive result. It is better that the doctor use his clinical acumen to diagnose the disease after first testing for malaria and dengue. If malaria and dengue tests turn out negative and if fever and joint pain are predominant then the physician can start treatment for chikungunya.  The symptoms for all 3 are quite similar only joint pain is more pronounced in chikungunya.

Treatment

Treatment of chikungunya is nonspecific and mainly symptomatic e.g. antipyretics or anti fever medication for fever, analgesics or pain killers for the muscle and joint pain, drinking plenty of fluids for hydration etc. As of now there is no commercial vaccine available for chikungunya.

Prevention

Remember!!!

–Mosquitoes need water to breed

–No water, no mosquitoes!!!

–A small water collection can breed thousands of mosquitoes

Some simple precautions to avoid mosquitoe breeding

—Seal overhead tanks with mosquito proof lids, cover overflow pipe with nylon gauze

—Introduce mosquito larvae eating fish in wells and fountains .These are available free of cost at selected government medical centres. In Margao at the Urban Health Centre near Hospicio.

–Allow proper drainage of collected water especially during rains. Give proper gradient and clear blockages.

–Observe a ‘’dry day’’ once a week. If you need to keep water collected in a container, empty and dry it once a week and fill it with fresh water.

–Change water in vases, pots etc. at least once a week.

–Get rid of bottles, tins tyres, barrels, coconut shells etc. or keep them inverted to drain water. They are the most potent sources of mosquito breeding.

–Use mosquito bed nets, window screens, etc. to avoid mosquitoes from reaching you.

–Keep your surroundings clean. Easier said than done. Just walk around Aquem and see all the dirt, garbage and waste matter selfishly thrown about by uncaring residents.

–Immediately consult a doctor for any fever, body-ache, headache etc. It might not be the simple common cold you assume.

–Create awareness in the community on how to prevent mosquito breeding.

Dr. Edgar Menezes