KARACHI: Though rarely fatal, chikungunya is a debilitating disease with serious socioeconomic consequences at the individual and community levels; it causes sharp reduction in the quality of life in patients with low immunity and nutrition levels and can exacerbate poverty.

This was stated by Dr Bushra Jamil, a professor and head of the adult infectious diseases section of the Aga Khan University Hospital (AKUH) during a seminar held on Friday at the Dr Panjwani Centre for Molecular Medicine and Drug Research at Karachi University.

Titled ‘The recent outbreak of Chikungunya in Pakistan’, the event aimed at creating awareness of the mosquito-borne illness which, according to some estimates, has affected more than 700 people in three areas of Karachi; Malir, Lyari and Orangi.

“The disease has been in Pakistan for a long time, though it only recently received media and government attention. It is not localised to Karachi either as people generally believe as we have recently identified a few cases from the interior of Sindh under our ongoing research project,” she explained.

Citing information from the website of US-based Centres for Disease Control and Prevention, she said it had mentioned Pakistan as a country which saw more than a dozen cases of chikungunya in October 2006. No reference for the data had been given, though.

The disease, she said, was first described during an outbreak in southern Tanzania in 1952. The name ‘chikungunya’ was derived from a word in the Kimakonde (Tanzanian) language, meaning ‘to become contorted’, and described the stooped appearance of sufferers with joint pain.

Tracing some major outbreaks of the disease, she said the largest documented outbreak of chikungunya occurred in 2005-06 in the Indian Ocean islands of Réunion and Mauritius.

The disease, she said, had been identified in over 60 countries in Asia, Africa, Europe and the Americas. The cases of chikungunya fever (between 1952-2006) had been reported from many countries including Australia, Burma, Cambodia, India, Indonesia, Malaysia, the Philippines, Taiwan, Thailand, Timor, Vietnam, Congo, South Africa, Nigeria, Zimbabwe and Uganda.

Citing a 1970 study under which eight viruses were examined in 372 serum samples taken from rodents, domestic animals and humans in Pakistan, she said it detected the West Nile, Zika, Japanese encephalitis, chikungunya, Uganda and Royal Farm viruses, though largely in low prevalence.

“At least six of these eight viruses cause fevers in humans. This study showed that these viruses exist in our environment and it’s only when they cause an outbreak that they come in the limelight,” she said.

The most important feature of chikungunya, she pointed out, was its impact on the quality of life, which reduced sharply not only during active illness, but also for several months after clinical recovery in patients with low immunity and nutrition levels.

“Although it is largely believed that complications of chikungunya are not serious, illness in individuals from poor backgrounds can have serious consequences, such as reduced productivity at the individual and community levels. Their vulnerability to other infections increases.

“Attention to the links between poverty, illness and human development are key in future research related to chikungunya infection,” she said.

Talking about the symptoms of chikungunya that included high-grade fever, headache, rash and serious joint pains, she said that they were generally self-limiting but could take a long time for recovery in patients with low immunity levels and those already suffering from some disease.

“Since there is no vaccination or specific antiviral drug treatment for the illness, it is important that measures are taken to prevent the infection. The foremost is to eradicate mosquito breeding sites and adopt measures to prevent mosquito bite in day and night time,” she said.

“The risk of a person transmitting the virus to a biting mosquito or through blood is highest when the patient is viremic during the first week of illness.

“Blood-borne transmission is possible; cases have been documented among laboratory personnel handling infected blood and a healthcare worker drawing blood from an infected patient,” she said.

Published in Dawn February 4th, 2017