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Yet another reason to be wary of Mosquitoes

I read a newspaper article that said the Department of Health has declared an outbreak of chikungunya in Cavite. What is chikungunya? Is it a new disease or is it really just another form of dengue as some people say? —linaliy_ed@gmail.com

The Department of Health (DOH) has indeed declared an outbreak of chikungunya in Cavite province late last month after more than 400 cases of the disease were reported in the town of Indang and two cases each in the cities of General Trias and Dasmariñas.

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Chikungunya is a disease that shares some commonalities with, but is not simply another form, of dengue.  Like dengue, it is mosquito-borne. Also, it is transmitted by the same mosquitoes that spread dengue, Aedesaegypti and Aedesalbopictus. It is likewise caused by a virus, but a different one from that that causes dengue. Incidentally, the mosquitoes that transmit dengue and chikungunya are also the ones that transmit the Zika virus.

Signs, symptoms, and outcome of chikungunya

Chikungunya may be asymptomatic, but usually patients develop symptoms.The signs and symptoms of the disease, which appear three to seven days after being bitten by an infected mosquito, are similar to those of dengue: high fever (39oC to 40oC), joint pain and swelling, skin rash, headache, muscle pain, nausea, vomiting, and fatigue. Infrequently, inflammation of the eyes also occurs.

In chikungunya, the joint pains are often severe and incapacitating. In fact, the name of the disease was derived from a word in the African Kimakonde language that means “to become contorted,” which describes the stooped appearance brought about by the joint pain that accompany the disease. The joint pain, which occurs in practically all symptomatic cases, typically involves more than one joint, usually in both arms and legs.

Chikungunya is more benign than dengue in that it does not cause bleeding, is rarely fatal, and serious complications seldom occur. Those over the age of 65, babies, and those with underlying chronic medical problems are most likely to have severe complications. Most patients recover fully, but in a few cases, joint pain may persist for several months, or even years.

Chikungunya in the Philippines

Chikungunya is not a new disease. It was first described during an outbreak in Southern Tanzania in 1952. Currently, it is endemic in Africa, Asia, and the Indian subcontinent, but thousands of cases have also been reported in the Caribbean islands, Latin American countries, and some South American countries. A few cases have also been recorded in Mexico, USA and France.

In the Philippines, the first documented case of chikungunya was reported in the 1960s. Outbreaks of the disease occurred in Davao and Cagayan de Oro following the devastation brought about by typhoon Sendong in 2011. In 2014, the DOH recorded 23 places in the country with Chikungunya cases that number in the thousands, but no deaths have been reported.

Treatment and prevention of chikungunya

There is no specific antiviral drug treatment and no vaccine for Chikungunya. Treatment is directed primarily at relieving the symptoms using antipyretics, pain relievers, and fluids.

The disease can be prevented by the same control measures against mosquitoes that are recommended to prevent dengue.

Eliminate all possible breeding places of mosquitoes in your neighborhood: fill potholes; cover water containers and septic tanks; do not allow empty cans, soft drink bottles, spare tires, etc. to accumulate water; ensure that drains and gutters are not clogged and that water flows freely in sewage lines; cut tall grass; dispose garbage properly and regularly.

Screen your house. Alternately use mosquito nets, mosquito repellants, mosquito coils (“katol”), and mats, and stick mosquito patches on outing clothing.

Email inquiries on health matters to: medical_notes@yahoo.com