The provincial health department decided on Saturday to investigate cases of high-grade fever and acute joint pain being reported at a Malir health facility after its medical superintendent communicated to officials that some of these cases were of ‘chikungunya’, a viral disease caused by infected mosquitoes.

The hospital in question is located in Khokhorapar No. 2.

Speaking to Dawn, progamme manager of dengue prevention and control, Dr Masood Solangi said that the medical superintendent of Al Mustafa Welfare Society hospital had informed him that his hospital had received some ‘chikungunya’ cases.

“I inquired him over this since the hospital doesn’t have the facility to diagnose chikungunya,” he explained, adding that symptoms of high-grade fever and acute joint pain might have led doctors to believe that patients had contracted ‘chikungunya’.

“However, we will investigate these cases on Monday with the help of experts arriving from Islamabad. The disease shares some clinical signs with dengue, for instance high-grade fever, body aches and rash, and can be misdiagnosed."

The disease, Dr Solangi pointed out, was rarely fatal and no other health facility in the city had reported a similar complaint with the surveillance centre.

"If cases were found positive, they will be the first cases of chikungunya in the country," he added.

According to him, the city immediately needs vector control strategies, especially fumigation and waste disposal measures, to prevent outbreak of diseases like malaria, typhoid and dengue.

“A decade ago, no dengue case was ever reported in winters but now we have. This shows that the virus has successfully adapted itself to the filthy conditions prevailing in the city. The theory that the dengue vector (a female mosquito) breeds only in clean water is no longer true since we have found its larvae in dirty water, too.”

The city, he said, hadn't seen a single fumigation drive this year.

Upon contact, staff at the Al Mustafa hospital said that hundreds of patients with complaints of high-grade fever and body aches had reported at the facility since last month.

“We don’t know what exactly they have since we can’t afford to test each and every case in the laboratory. Most patients are advised general medicines to alleviate pain and fever,” a doctor said on condition of anonymity.

Some patients were found to have dengue, others typhoid or malaria when their diagnosis was made, he added.

Currently, the facility to diagnose ‘chikungunya’ in the city only exists at the Aga Khan University Hospital (AKUH), health department sources say.

What is chikungunya

According to the World Health Organisation's (WHO) website, chikungunya is a viral disease transmitted to humans by infected mosquitoes. It causes fever and severe joint pain.

Other symptoms include muscle pain, headache, nausea, fatigue and rash.

Joint pain is often debilitating and can vary in duration. There is no cure for the disease. Treatment is focused on relieving the symptoms. The proximity of mosquito breeding sites to human habitation is a significant risk factor for chikungunya.

The disease occurs in Africa, Asia and the Indian subcontinent. In recent decades mosquito vectors of chikungunya have spread to Europe and the Americas. In 2007, disease transmission was reported for the first time in a localised outbreak in north-eastern Italy, the website added.

Outbreaks have since been recorded in France and Croatia.

Most patients recover fully in two to three weeks, but in some cases joint pain may persist for several months, or even years.

Occasional cases of eye, neurological and heart complications have been reported, as well as gastrointestinal complaints, the website says.

According to it, serious complications are not common, but in older people, the disease can contribute to the cause of death.

Often symptoms in infected individuals are mild and the infection may go unrecognised, or be misdiagnosed in areas where dengue occurs.

The name 'chikungunya' derives from a word in the Kimakonde language, meaning “to become contorted”, and describes the stooped appearance of sufferers with joint pain.

Key facts

• Transmitted to humans by infected mosquitoes.
• Causes fever and severe joint pain. Other symptoms include muscle pain, headache, nausea, fatigue and rash.
• Joint pain is often debilitating and can vary in duration.
• Shares some clinical signs with dengue, and can be misdiagnosed as dengue in areas where dengue is common.
• There is no cure for the disease. Treatment relieves symptoms.
• The proximity of mosquito breeding sites to human habitation is a significant risk factor for chikungunya.
• Disease occurs in Africa, Asia and the Indian subcontinent.